• 제목/요약/키워드: chronic low back pain

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Influence on Autonomic Function Before, During, and After Transcutaneous Electrical Nerve Stimulation in Senile Patients with Chronic Low Back Pain

  • Lee Mun-Hwan
    • The Journal of Korean Physical Therapy
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    • 제14권3호
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    • pp.174-202
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    • 2002
  • Twenty five patients, 14 males and 11 females with an average age of 75years with chronic Low Back Pain were tested before, during, and after 10minutes transcutaneous electrical nerve stimulation. It is important to consider the effect of TENS on the autonomic function because the pain pathway and the ANS pathway are somehow correlated to each other. There is still controversy among researchers who have reported the effect of TENS on autonomic function. So the purpose of this study is to measure the effect of TENS on the ANS and to see the relation of the pain control mechanism and the change in the ANS. The results were as follows : 1) Systolic blood pressure between before and during the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 2) Systolic blood pressure between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 3) Systolic blood pressure between before and after 10 minutes experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 4) Diastolic blood pressure between before and during experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 5) Diastolic blood pressure between during and after 10 minutes experiment was significantly decreased(P<.05). 6) Diastolic blood pressure between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 7) Heart rate between before and during the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 8) Heart rate between during and after 10 minutes the experiment was significantly decreased(P<.05). 9) Heart rate between before and after 10 minutes the experiment was significantly decreased(P<.05). 10) Skin temperature between before and during the experiment was significantly increased(P<.05). 11) Skin temperature between during and after 10 minutes the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 12) Skin temperature between before and after 10 minutes the experiment was significantly increased(P>.05). 13) Respiratory rate between before and during the experiment was apt to be a little increased, but statistically there was no significant change(Pgt;.05). 14) Respiratory rate between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(Pgt;.05). 15) Respiratory rate between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05).

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허리부위 불안정성자 라이프케어를 위한 특징적과거력 조사의 유용성에 관한 연구 (A Study on the Usefulness of Characteristic Past History Investigation for Life Care in People with Lumbar Instability)

  • 기철;허명;송성민
    • 한국엔터테인먼트산업학회논문지
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    • 제13권8호
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    • pp.583-593
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    • 2019
  • 본 연구는 만성허리통증자의 특징적과거력의 존재수와 주관적 불안정성 통증 양상 및 이학적 불안정성 검사 간의 상관성을 조사하였다. 40명의 만성허리통증자들에게 4가지 특징적과거력의 존재 유무를 조사 한 후, 존재 수에 따라 5개 그룹으로 분류 하였다[그룹 1 (0) : n = 8, 그룹 2 (1) : n = 8, 그룹 3 (2) : n = 8, 그룹 4 (3) : n = 8, 그룹 5 (4) : n = 8]. 불안정성과 관련한 주관적 통증 양상 16개 항목의 양성반응을 조사하고, 7개의 이학적 불안정성 검사를 수행하여 그 결과를 점수화 하였다. 특징적과거력의 존재 수에 따른 주관적 불안정성 통증 양상, 이학적 불안정성 검사 점수를 비교하고 상관 분석을 하였다. 그 결과, 그룹 간 비교에서 유의한 차이가 있었다(p<.05). 또한 특징적과거력의 존재 수와 주관적 불안정성 통증 양상(r = .819, p = .000), 이학적 불안정성 검사(r = .606, p = .000) 사이에는 높은 양의 상관성을 나타내었고, 주관적 불안정성 통증 양상과 이학적 불안정성 검사(r = .571, p = .000) 사이에도 양의 상관성을 나타냈다. 본 연구 결과에 따라 3개 이상의 특징적과거력의 존재는 만성허리통증자의 허리부위 불안정성 진단에 유용한 변수가 될 수 있다. 또한 특징적과거력 정보와 주관적 불안정성 통증 양상 및 이학적 불안정성 검사 결과의 조합은 불안정성 진단의 정확도를 높일 수 있다.

만성 요천추부 신경근병증 환자의 보행분석 (Gait Analysis of the Chronic Lumbosacral Radiculopathic Patients)

  • 최병옥;유재응;정석
    • 한국전문물리치료학회지
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    • 제11권3호
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    • pp.19-24
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    • 2004
  • The purposes of this study were to analyze gait patterns of patients with chronic lumboscaral radiculopathy and to investigate gait parameters which can reflect a functional deficit in relation to the level of lumbosacral radiculopathy. The study population consisted of 25 patients of chronic lumbosacral radiculopathy and 25 healthy control subjects. Conventional physical examinations and three-dimensional gait analyses were performed on all participants. The data were analyzed using an independent sample t-test. The results were as follows: (1) In the patients' group, cadence, walking velocity, stride length and double support time were less than in the control group (p<.05). (2) In the patients' group, maximum flexion of hip, maximum flexion of loading response, maximum flexion of swing phase on the knee and maximum plantar flexion of pre-swing were less than the control group (p<.05). Using three-dimensional gait analysis, we could identify specific gait parameters to reflect a functional deficit related to the level of lumbosacral radiculopathy.

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Effect of epidural polydeoxyribonucleotide in a rat model of lumbar foraminal stenosis

  • Lee, Ho-Jin;Ju, Jiyoun;Choi, Eunjoo;Nahm, Francis Sahngun;Choe, Ghee Young;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • 제34권4호
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    • pp.394-404
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    • 2021
  • Background: We aimed to investigate the effect of epidural polydeoxyribonucleotide (PDRN) on mechanical allodynia and motor dysfunction in a rat model of lumbar foraminal stenosis (LFS). Methods: This study was conducted in two stages, using male Sprague-Dawley rats. The rats were randomly divided into eight groups. In the first stage, the groups were as follows: vehicle (V), sham (S), and epidural PDRN at 5 (P5), 8 (P8), and 10 (P10) mg/kg; and in the second stage, they were as follows: intraperitoneal PDRN 8 mg/kg, epidural 3,7-dimethyl-1-propargilxanthine (DMPX) (0.1 mg/kg), and DMPX (0.1 mg/kg). The LFS model was established, except for the S group. After an epidural injection of the test solutions, von Frey and treadmill tests were conducted for 3 weeks. Subsequently, histopathologic examinations were conducted in the V, S, P5, and P10 groups. Results: A total of 65 rats were included. The P8 and P10 groups showed significant recovery from mechanical allodynia and motor dysfunction at all time points after drug administration compared to the V group. These effects were abolished by concomitant administration of DMPX. On histopathological examination, no epineurial inflammation or fibrosis was observed in the epidural PDRN groups. Conclusions: Epidural injection of PDRN significantly improves mechanical allodynia and motor dysfunction in a rat model of LFS, which is mediated by the spinal adenosine A2A receptor. The present data support the need for further research to determine the role of epidural PDRN in spinal stenosis treatment.

척추온열마사지기기의 1회 치료의 효과에 대한 객관적 증거: 선행 연구 (Objective Evidence for the Effectiveness of Single-session Treatment with a Spinal Thermal Massage Device: A Pilot Study)

  • 나영일;김시윤;백승민;이정후
    • 산업융합연구
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    • 제20권10호
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    • pp.209-218
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    • 2022
  • 마사지 치료는 1회 치료만으로 통증을 경감시키고 스트레스를 이완시킵니다. 그러나 아직까지 1회 마사지 치료의 효과에 대한 객관적인 데이터를 확인한 연구가 없었습니다. 그래서 본 연구에서는 마사지 치료와 동일한 효과가 있는 것으로 보고된 척추 마사지 기구로 1회 치료를 실시하여 통증 경감과 스트레스 이완의 효과의 증거를 확인하고자 하였습니다. 10년 전부터 시각적상사척도 4점의 요통이 있었던 45세 남자 환자 1인을 대상으로 척추 마사지 기구를 실시한 1차 실험과 침상안정을 실시한 2차 실험을 실시하였습니다. 시각적상사척도 측정과 실시간으로 심박 변이도를 측정하여 자율신경계를 확인하였고 총 5회 혈액검사를 실시하여 스트레스 관련 혈액검사(코르티솔, 에피네프린, 노르에피네프린)를 실시하였습니다. 침상안정을 취한 2차 실험에 비해 척추 마사지 기구로 1회 치료를 받은 1차 실험에서 유의미한 통증 감소효과를 보였습니다. 또한 1차 실험에서 자율신경계 활성도 및 부교감 신경계의 활성도가 증가되어 있었으며 혈중 에피네프린과 노르에피네프린이 감소되어 있었습니다. 이것은 기존의 마사지 치료 효과와 동일한 결과이며 1회 척추 마사지 기구를 통해 얻어지는 효과의 증거라 사료됩니다.

A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

  • Lee, Seung Eun;Park, Seung Won;Ha, Sam Yeol;Nam, Taek Kyun
    • Journal of Korean Neurosurgical Society
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    • 제55권6호
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    • pp.370-374
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    • 2014
  • To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

요실금 자각 증상이 있는 중년여성들의 통증 및 삶의 질 정도에 대한 조사 (A Survey of the Pain and Quality of Life of the Middle-Aged Women with the Subjective Symptom of Urinary Incontinence)

  • 김은영;김근조;하미숙
    • 한국산학기술학회논문지
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    • 제11권11호
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    • pp.4382-4394
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    • 2010
  • 본 조사는 요실금 자각 증상이 있는 중년여성을 대상으로 요실금의 주관적 정도와 통증이 그에 따른 삶의 질에 미치는 영향을 알아보고자 하였다. 2010년 2월부터 5월까지 병원을 외래로 방문한 만성 근골격계 여성 환자를 대상으로 요실금 자각 증상이 있는 114명에게 요실금 관련 삶의 질 도구로 설문조사를 실시하였다. 전체적인 삶의 질은 보통($61.36{\pm}13.2$점)이라고 느꼈으며, 요실금과 관련한 통증은 허리통증으로 나타났다. 통증정도는 VAS 4~7의 중간통증으로 나타났으며, 요실금으로 인해 삶의 질 요인 중 행위의 회피 제한과 심리사회적으로 영향을 받는 것으로 나타났다. 조사로 인해 중년여성의 요실금과 통증이 삶의 질에 실질적인 영향을 미침으로 나타나 실질적인 중재 개발에 기초를 제공할 수 있을 것이라 생각된다.

20대와 40대의 급성 및 만성요통환자의 척추주위 근육에 관한 횡단면의 비교 (Characteristic of Cross-sectional Area of Lumbar Paraspinal Muscle in Patients of Acute and Chronic LBP)

  • 김대훈;박진규;박윤진;정대인;김성수
    • 한국콘텐츠학회논문지
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    • 제11권6호
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    • pp.270-278
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    • 2011
  • 이 연구는 20대와 40대의 급성과 만성 요통환자를 대상으로 척추 주위근육의 단면도를 비교하는 것이다. 20대(남자-9, 여자-10)와 40대(남자-8, 여자9)의 대상자들은 MRI로 요추(4번 하부 종단판) 단면도의 척추주위근육(장요근, 다열근, 척추기립근)들의 크기를 PACS(free-handling technique of the picture archiving and communication system(PACS)을 이용하여 측정하였다. 연구 결과 20대 급성과 만성 요통 환자들의 척추 주위근들의 차이는 통계학적으로 유의성이 없게 나타났으나, 40대 급성과 만성 요통환자들의 척추 주위근들의 차이는 만성 요통환자들이 근 위축이 통계학적으로 유의성 있게 나타났다. 또한 20대와 40대의 만성요통환자 척추 주위근들의 차이도 40대 만성요통 환자들에게 유의성 있게 나타났다. 연구에서 20대 만성환자들의 근 위축은 나타나지 않았으나 40대 만성환자들은 다양한 이유로 근 위축이 나타났다. 따라서 40대의 만성 요통환자들은 조기의 다양한 요부 근력 운동 및 기능적 활동 등으로 허리 주위근육의 위축을 감소시키는 것이 필요하다.

Extra-spinal sciatica and sciatica mimics: a scoping review

  • Siddiq, Md Abu Bakar;Clegg, Danny;Hasan, Suzon Al;Rasker, Johannes J
    • The Korean Journal of Pain
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    • 제33권4호
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    • pp.305-317
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    • 2020
  • Not all sciatica-like manifestations are of lumbar spine origin. Some of them are caused at points along the extra-spinal course of the sciatic nerve, making diagnosis difficult for the treating physician and delaying adequate treatment. While evaluating a patient with sciatica, straightforward diagnostic conclusions are impossible without first excluding sciatica mimics. Examples of benign extra-spinal sciatica are: piriformis syndrome, walletosis, quadratus lumborum myofascial pain syndrome, cluneal nerve disorder, and osteitis condensans ilii. In some cases, extra-spinal sciatica may have a catastrophic course when the sciatic nerve is involved in cyclical sciatica, or the piriformis muscle in piriformis pyomyositis. In addition to cases of sciatica with clear spinal or extra-spinal origin, some cases can be a product of both origins; the same could be true for pseudo-sciatica or sciatica mimics, we simply don't know how prevalent extra-spinal sciatica is among total sciatica cases. As treatment regimens differ for spinal, extra-spinal sciatica, and sciatica-mimics, their precise diagnosis will help physicians to make a targeted treatment plan. As published works regarding extra-spinal sciatica and sciatica mimics include only a few case reports and case series, and systematic reviews addressing them are hardly feasible at this stage, a scoping review in the field can be an eye-opener for the scientific community to do larger-scale prospective research.

Spinal Subdural Hematoma Associated with Intracranial Subdural Hematoma

  • Kim, Myoung Soo;Sim, Sook Young
    • Journal of Korean Neurosurgical Society
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    • 제58권4호
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    • pp.397-400
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    • 2015
  • The simultaneous occurrence of an intracranial and a spinal subdural hematoma (SDH) is rare. We describe a case of cranial SDH with a simultaneous spinal SDH. An 82-year-old woman visited the emergency room because of drowsiness and not being able to walk 6 weeks after falling down. A neurological examination showed a drowsy mentality. Brain computed tomography showed bilateral chronic SDH with an acute component. The patient underwent an emergency burr-hole trephination and hematoma removal. She exhibited good recovery after the operation. On the fourth postoperative day, she complained of low-back pain radiating to both lower limbs, and subjective weakness of the lower limbs. Spine magnetic resonance imaging revealed a thoracolumbosacral SDH. A follow-up spinal magnetic resonance imaging study that was performed 16 days later showed a significant decrease in the size of the spinal SDH. We discuss the pathogenesis of this simultaneous occurrence of spinal and cranial SDH.