• 제목/요약/키워드: lower back pain

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The Correlation between Caudal Epidurogram and Low Back Pain

  • Jo, Dae-Hyun;Jang, Sul
    • The Korean Journal of Pain
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    • 제25권1호
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    • pp.22-27
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    • 2012
  • Background: The common causes of lower back pain with or without leg pain includes disk disease and spinal stenosis. A definitive diagnosis is usually made by means of magnetic resonance imaging (MRI), but treatment is often difficult because the MRI findings are not consistent with the symptoms of the patient in many cases. The objective of this study was to observe the correlation between the patterns of epidurography performed in patients having lower back pain with or without leg pain and the position or severity of the pain as subjectively described by the patients. Methods: The subjects of this study were 69 outpatients with lower back pain with or without leg pain who visited our clinic and complained of predominant pain on one side. We performed caudal epidural block using an image intensifier. A mixture of the therapeutic drug and the contrast agent (10 ml) was injected to observe the contrast flow pattern. The patients who complained of predominant pain on one side were divided into the left side group and the right side group. A judgment of inconsistency was made if the contrast agent flowed to the side of the pain, while a judgment of consistency was made if the contrast agent flowed to the opposite side of the pain. The degree of the drug distribution was evaluated by counting the number of cells to which the contrast agent's flowed for evaluating the correlation between the contrasted cell and the severity of pain (one group ${\leq}$ VAS 7, the other group ${\geq}$ VAS 8) the degree of the contrast agent's contrast was evaluated by dividing and counting an image into 15 cells (the left, right, and middle sections at each level of L4, L5, S1, S2, and S3). Results: Thirty out of the 69 patients who had laterality in pain, that is, those who complained of predominant pain on one side, showed that the laterality of the pain and the contrast agent flow was consistent, while 39 patients showed that the laterality was inconsistent (P: 0.137). The evaluation of the correlation between the pain and the contrast agent flow showed that the mean number of contrasted cells was $9.0{\pm}2.2$ for the 46 patients in the group with a VAS of 7 or lower and $6.5{\pm}2.0$ for the 23 patients in the group with a VAS of 8 or higher, indicating that the former group showed a significantly greater number of contrasted cells (P < 0.001). Conclusions: This study, conducted with patients having lower back pain with or without leg pain, showed that the contrast flow pattern of caudal epidurography had a significant correlation with the severity of the pain but not with the laterality of the pain.

척추수술 후 증후군 환자에서 관찰된 추간관절통에 대한 고주파신경절리술 (Raiofrequency Neurotomy for Lumbar Facet Joint Pain in the Patients with Failed Back Surgery Syndrome)

  • 이정훈;심재철
    • The Korean Journal of Pain
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    • 제18권2호
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    • pp.151-155
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    • 2005
  • Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

요통이 있는 병사의 통증, 우울, 군생활 적응에 관한 연구 (A Study of Pain, Depression, and Adjustment to Military Life of Soldiers with Low Back Pain)

  • 이지현;김종임
    • 근관절건강학회지
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    • 제17권2호
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    • pp.173-182
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    • 2010
  • Purpose: The purpose of this study was to examine levels of pain, depression, and adjustment to military life in soldier who experienced low back pain, in order to produce fundamental data for the development of health improvement programs to prevent and manage low back pain in soldiers with low back pain. Methods: Subjects of this study consisted of 317 soldiers who had low back pain. Study instruments were Visual analog scale (VAS), the Center for Epidemiological Studies-Depression Scale (CES-D), and adjustment to military life scale. Collected data were analyzed by the SPSS Win 14.0 program. Results: Mean score of pain was 4.16 points, depression was 8.58 points, and adjustment to military life was 69.15 points. The level of pain was negatively related to adjustment to military life (r=-.241, p<.001) and positively related to depression (r=.262, p<.001). There was a negative relationship between depression and adjustment to military life (r=-.442, p<.001). Conclusion: Soldiers who had low back pain experienced higher levels of pain and depression and lower level of adjustment to military life. Therefore, further study is needed to develop and examine a nursing intervention to manage low back pain for them.

등받이 유무에 따른 하지 운동프로그램이 허리통증이 있는 대학생들에게 미치는 영향 (Effects of Lower Limb Exercise Program on the Backrest Chair in College Students with Low Back Pain)

  • 김윤환;서태화
    • 한국엔터테인먼트산업학회논문지
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    • 제14권7호
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    • pp.469-476
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    • 2020
  • 본 연구는 등받이 유무에 따른 하지 운동프로그램이 허리통증이 있는 대학생에게 미치는 영향을 알아 보기 위해 균형능력, KODI, VAS 검사를 이용하였다. 광주광역시 소재 K대학교 학생 32명을 대상으로 4주간 탄력밴드를 이용한 하지 운동프로그램을 진행하였으며 등받이의 유무에 따른 집단 별 16명씩 무작위로 선정하여 진행하였다. 균형능력과 KODI 점수에서는 집단과 시간에 의한 상호작용이 없는 것으로 나타난 반면 VAS 점수에서는 집단과 시간에 의한 상호작용이 나타났다. 또한 두 집단 모두 중재 후에 균형능력, KODI, VAS 점수에서 유의하게 증가하였다. 따라서 등받이 유무와 상관없이 의자에 앉아서 시행하는 하지운동 프로그램이 오랜시간 앉아서 생활하며 허리통증이 있는 학생과 직장인에게 일상에서 쉽게 할 수 있는 운동 프로그램으로 적용하는 것이 필요할 것으로 생각된다.

경도 지적장애 자동차제조업 근로자의 근골격계 위험 요인 조사 -목과 허리 부위 중점으로- (Risk Factors of Musculoskeletal System in Automobile Manufacturing Workers with Mlid Intellectual Disabilities: Focus on Neck and Lower Back Regions)

  • 황영인;박두진
    • PNF and Movement
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    • 제22권1호
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    • pp.129-137
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    • 2024
  • Purpose: The aim of this study was to investigate and compare the risk factors focusing on the neck and lower back between general workers (GW) and mild intellectual disability workers (MIDW) in the automobile manufacturing industry. Methods: A total of 32 participants were required for this study design to achieve 80% power, 0.9 effect size, and an alpha level of 0.05. Each group consisted of 16 subjects, including GW and MIDW. Pain levels in the neck and lower back were measured for all participants using the visual analog scale (VAS). A dual digital inclinometer was used to measure the range of motion (ROM) in the neck and lower back three times, and the average was used for analysis. The independent t-test was used to compare between the wo groups. Cohen's d effect analysis was employed to determine the effect size. The significant level was set at 0.05. Results: In the MIDW, neck pain was significantly higher, and left cervical flexion was significantly decreased compared with the GW. There was no significant difference in lower back pain between the MIDW and GW. However, both lumbar flexion and extension, as well as lateral flexion, were significantly reduced in the MIDW compared with the GW. Conclusion: This study reveals that MIDW working in the automobile manufacturing industry have a greater risk of neck pain, limitation in left cervical flexion, and overall restriction in the ROM of the lower back compared with GW.

자궁적출술 후 하복부 및 요추부 통증을 호소하는 환자에 대한 한방 복합 치료 1례 (Case Report: The Complex Korean Medicine Treatment of Abdominal and Lower Back Pain after Laparoscopic Hysterectomy)

  • 이유진;권민진;김나영;임유라
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.197-206
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    • 2023
  • Objesctives: This study reports the effect of Korean medicine treatment on a patient with abdominal and lower back pain after a laparoscopic hysterectomy. Methods: The patient received Korean herbal medicine, pharmacopuncture treatment, and acupuncture treatment for six days. We measured the numeric rating scale (NRS), Oswestry Disability Index (ODI), Range of Motion (ROM), and Life-5 Dimensions scale (EQ-5D) to assess symptom changes. Results: After treatment, the patient showed decreased numeric rating scale (NRS) and Oswestry Disability Index (ODI), as well as augmented Range of Motion (ROM) and European Quality of Life 5 Dimensions scale (EQ-5D). Conclusion: The results indicate that Korean medicine treatment is effective management for patients with abdominal and lower back pain after a laparoscopic hysterectomy.

Repetitive Transcranial Magnetic Stimulation to Treat Depression and Insomnia with Chronic Low Back Pain

  • Park, Eun Jung;Lee, Se Jin;Koh, Do Yle;Han, Yoo Mi
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.285-289
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    • 2014
  • Transcranial magnetic stimulation (TMS) is a noninvasive and safe technique for motor cortex stimulation. TMS is used to treat neurological and psychiatric disorders, including mood and movement disorders. TMS can also treat several types of chronic neuropathic pain. The pain relief mechanism of cortical stimulation is caused by modifications in neuronal excitability. Depression is a common co-morbidity with chronic pain. Pain and depression should be treated concurrently to achieve a positive outcome. Insomnia also frequently occurs with chronic lower back pain. Several studies have proposed hypotheses for TMS pain management. Herein, we report two cases with positive results for the treatment of depression and insomnia with chronic low back pain by TMS.

만성 요통에 대한 매선요법을 병행한 한방치료의 효과에 대한 후향적 연구 (The Effects of Korean Medical Treatment Combined with Embedding Acupuncture on Patients with Chronic Lower Back Pain: a Retrospective Study)

  • 김선욱;신정철
    • Journal of Acupuncture Research
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    • 제33권2호
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    • pp.165-171
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    • 2016
  • Objectives : The purpose of this study was to investigate the clinical effects of Korean medical treatments combined with Embedding acupuncture on patients with chronic lower back pain. Methods : We reviewed the medical records of 40 patients with chronic lowerback pain hospitalized at Dongshin Korean Medicine Hospital from March, 2015 to February, 2016. They were divided into two groups: the embedding acupuncture group(20 patients) and the non-embedding acupuncture group(20 patients). To evaluate the efficacy of the treatments, the 40 patients were asked to complete a Numerical Rating scale (NRS) and the Oswestry Disability Index (ODI) four times during admission. Results : The mean NRS of the embedding acupuncture group decreased more significantly than the non-embedding acupuncture group at days three and ten of admission. The ODI change and ODI rate of change of the embedding acupuncture group were significantly greater than the non-embedding acupuncture at days three and ten of admission. Conclusion : Korean medical treatment combined with embedding acupuncture might be effective in reducing pain and improving the life quality of patients with chronic lower back pain. We hope that further studies will be done to produce more clinical data and ensure effective application of these results.

Narrative Review of Pathophysiology and Endoscopic Management of Basivertebral and Sinuvertebral Neuropathy for Chronic Back Pain

  • Hyeun Sung Kim;Pang Hung Wu;Il-Tae Jang
    • Journal of Korean Neurosurgical Society
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    • 제66권4호
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    • pp.344-355
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    • 2023
  • Chronic lower back pain is a leading cause of disability in musculoskeletal system. Degenerative disc disease is one of the main contributing factor of chronic back pain in the aging population in the world. It is postulated that sinuvertebral nerve and basivertebral nerve main mediator of the nociceptive response in degenerative disc disease as a result of neurotization of sinuvertebral and basivertebral nerve. A review in literature is done on the pathoanatomy, pathophysiology and pain generation pathway in degenerative disc disease and chronic back pain and management strategy is discussed in this review to aid understanding of sinuvertebral and basivertebral neuropathy treatment strategies.

진동자극 환경에서의 요부 안정화 운동이 만성요통환자의 균형능력 및 기능장애수준에 미치는 영향 (The Effects of Integrating Vibration Into Stabilization Exercise on Balance and Disability in Patients With Chronic Low Back Pain)

  • 손창환;문영;최종덕
    • 한국전문물리치료학회지
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    • 제26권1호
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    • pp.19-27
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    • 2019
  • Background: Compared to healthy people, patients with chronic lower back pain have reduced balance abilities which may cause proprioception problems, patients with chronic lower back pain avoid physical activities due to pain, and reduced activity levels lead to muscle weakening, which can further exacerbate pain. Recently, there have been many studies on the use of sensory stimulation; and among these studies, interventions that use vibrational stimulation have shown functional improvements in the patients. Objects: This study examined the effects of a stabilization exercise with vibration stimulation on the balance ability and disability in patients with chronic back pain. Methods: The subjects of the study were 30 persons who were randomly assigned to the experimental group and the control group, with 15 subjects in each. The subjects were evaluated before and after intervention via a balance ability test, the Korean Oswestry disability index (KODI) test, a pain test, and a proprioceptive sensory test. Both groups received general physical therapy. The experimental group performed the stabilization exercise with vibration stimulation, and the control group performed a general stabilization exercise, three times a week for six weeks. Results: After the intervention, both groups showed significant improvements in the balance ability test, the KODI test, the pain test, and the proprioceptive sensory test. The experimental group showed statistically significant, higher improvements than the control group in the balance ability test, the KODI test, and the proprioceptive sensory test. Conclusions: The stabilization exercise with vibration stimulation for patients with chronic back pain has been reported to provide greater functional improvements than the conventional intervention method. Therefore, the stabilization exercise in a vibration stimulation environment could be a useful intervention for patients with chronic back pain.