• Title/Summary/Keyword: lower limb pain

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Painful legs and moving toes syndrome in a 16-year-old girl

  • Kim, Seung Soo;Hwang, Yong Seung;Kim, Young Chang
    • Clinical and Experimental Pediatrics
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    • v.59 no.9
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    • pp.381-383
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    • 2016
  • Painful legs and moving toes (PLMT) syndrome is characterized by spontaneous movements of the digits and pain in one or both lower extremities. Of the reported cases, a majority of the patients was female, and the mean age of onset was 58 years. Only one pediatric case has been reported so far. Herein, we report the first adolescent case of PLMT in Korea. A 16-year-old girl complained of tingling pain in the left leg and involuntary movement of the ipsilateral great toe one month after a second untethering surgery. Three years ago, she had undergone untethering surgery to correct lipomeningomyelocele at the S2 level of the conus medullaris. At that time, she was diagnosed with polyradiculopathy at the left L5 level with axonal involvement. We diagnosed her with PLMT syndrome and prescribed gabapentin. Her symptoms diminished within a day. Complete relief from involuntary movement of the toe was achieved within four months. PLMT is a rare syndrome but it should be considered in the differential diagnosis of children and adolescents with limb pain and spontaneous movement in their toes.

Change in Radiating Leg Pain After Traffic Accidents in Patients With and Without Herniated Intervertebral Disc

  • Youn, Deok-Won;Jeong, Hui-Gyeong;Kwon, Oh-Hoon;Choi, Ji-Hoon
    • Journal of Acupuncture Research
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    • v.34 no.4
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    • pp.185-189
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    • 2017
  • Background: The aim of this study was to assess the change in radiating leg pain after traffic accidents in patients with and without herniated intervertebral disc (HIVD) and improvement of radiating leg pain after traffic accidents. Methods: This was an retrospective study of 188 patients. Patients who had been admitted to the Hospital of Korean Medicine with the complaint of radiating leg pain after traffic accidents, and who had undergone lumbar spine magnetic resonance imaging to determine the presence or absence of HIVD were observed from April to June 2016. We analyzed sex, age, length of admission, direction (to a single leg or to both legs) and locations, (medial, anterior, lateral or posterior side of the lower limb) of radiating leg pain, presence or absence of HIVD, and number, grade and position of HIVD. The Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were used to evaluate the impact of radiating leg pain on patients. Results: Radiating leg pain NRS score decreased significantly in both the HIVD group (from $6.12{\pm}2.39$ to $4.31{\pm}1.87$, p < 0.001) and the no HIVD group (from $5.76{\pm}1.64$ to $3.85{\pm}1.41$, p < 0.001). ODI score also decreased significantly in both groups (HIVD, from $44.67{\pm}17.38$ to $26.83{\pm}13.18$; no HIVD, from $39.24{\pm}15.58$ to $19.69{\pm}12$.; both p < 0.001). Conclusion: There was no significant change in radiating leg pain after traffic accidents in patients with and without HIVD and improvement of radiating leg pain after traffic accidents.

The Effect of Peripheral Neurolysis in Diabetic Feet (말초 신경 감압술이 당뇨발에 미치는 효과)

  • Park, Bong-Ju;Kim, Ju-O;Yang, Gyoung-Ho;Choi, Soeng-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.52-57
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    • 2004
  • Purpose: We evaluated the effect of nerve decompression for restoration of plantar sweating and sensation in diabetic neuropathic feet, and we selected diabetic neuropathic patients with the possibility of overlying entrapmental neuropathy. Materials and Methods: From June 2002 to May 2003, we have investigated and follow-up examed 10 patients with diabetic neuropathic feet, with decreased sensation in their lower limb, who underwent peripheral nerve decompression. The surgical procedure was multiple neurolysis of the common peroneal nerve, posterior tibial nerve and its three branches of one limb. We compared the operated limb with the opposite, unoperated limb. We performed history taking, physical examination, sweat secretion test, touch sensory test using Semmes-Weinstein monofilaments and electrodiagnostic study, pre-operatively and post-operatively. Results: On 6 months after the operation, the post-operative tests showed that there were noticeable improvements to sensation, statistically (P<0.05), but there was no change in the sweat secretion test. According to the Cseuz criteria, 7 patients out of the 10 patients who received the multiple neurolysis showed excellent or good results. Conclusion: We observed that the peripheral nerve neurolysis could be benefit for improving sensation and alleviating pain of the diabetic neuropathic feet with nerve entrapmental symptoms, but there was no change in the sweat secretion on short-term follow-up. To identify whether the effect will be continued or not, additional follow-up will be required.

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Effect of Complex Korean Medical Treatment on Spinal Epidural Hematoma: A Case Report

  • Youn Young Choi;Young Kyung Kim;Eun Sol Won;Chae Hyun Park;Hwa Yeon Ryu;Jae Hui Kang;Hyun Lee
    • Journal of Acupuncture Research
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    • v.40 no.1
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    • pp.78-89
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    • 2023
  • This paper presents the clinical outcome of an 82-year-old female who experienced sudden back pain combined with lower limb paresthesia and weakness after epidural steroid injection. The magnetic resonance imaging of the thoracolumbar spine showed a spinal epidural hematoma (SEH) extending from T8 to L4. She was treated non-operatively in the traditional Korean medicine (TKM) hospital. The patient's progress was assessed using the Numerical Rating Scale (NRS), American Spinal Injury Association (ASIS), Spinal Cord Independence Measure version III (SCIM III), and self-reported symptoms. During the 22-day hospitalization period,the NRS score decreased from 7 to 2 points, the motor score on the ASIS scale increased from 65 to 95 points. The subjective sense of lower extremities was felt by 1 increased to 8. The SCIM III score increased from 32 to 69 points. These results suggest that TKM could effectively reduce pain and aid the rehabilitation of patients with SEH.

Allopregnanolone suppresses mechanical allodynia and internalization of neurokinin-1 receptors at the spinal dorsal horn in a rat postoperative pain model

  • Fujita, Masahide;Fukuda, Taeko;Sato, Yasuhiro;Takasusuki, Toshifumi;Tanaka, Makoto
    • The Korean Journal of Pain
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    • v.31 no.1
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    • pp.10-15
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    • 2018
  • Background: To identify a new strategy for postoperative pain management, we investigated the analgesic effects of allopregnanolone (Allo) in an incisional pain model, and also assessed its effects on the activities of the primary afferent fibers at the dorsal horn. Methods: In experiment 1, 45 rats were assigned to Control, Allo small-dose (0.16 mg/kg), and Allo large-dose (1.6 mg/kg) groups (n = 15 in each). The weight bearing and mechanical withdrawal thresholds of the hind limb were measured before and at 2, 24, 48, and 168 h after Brennan's surgery. In experiment 2, 16 rats were assigned to Control and Allo (0.16 mg/kg) groups (n = 8 in each). The degree of spontaneous pain was measured using the grimace scale after the surgery. Activities of the primary afferent fibers in the spinal cord (L6) were evaluated using immunohistochemical staining. Results: In experiment 1, the withdrawal threshold of the Allo small-dose group was significantly higher than that of the Control group at 2 h after surgery. Intergroup differences in weight bearing were not significant. In experiment 2, intergroup differences in the grimace scale scores were not significant. Substance P release in the Allo (0.16 mg/kg) group was significantly lower than that in the Control group. Conclusions: Systemic administration of Allo inhibited mechanical allodynia and activities of the primary afferent fibers at the dorsal horn in a rat postoperative pain model. Allo was proposed as a candidate for postoperative pain management.

Immediate effects of neuromuscular control exercise on neck pain, range of motion, and proprioception in persons with neck pain

  • Lee, Jae-Doo;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • v.9 no.1
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    • pp.1-9
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    • 2020
  • Objective: This study aimed to investigate the immediate effects of intervention using neuromuscular control, self-stretching (SS), and neck stabilization exercises (NSEs) on neck pain, range of motion (ROM), and proprioception of position sense in adults with neck discomfort. Design: Three-group pretest-posttest design. Methods: Forty-four adults who complained of neck pain participated in the experiment. They were randomly assigned to the following groups: neuromuscular control exercise (NMCE) group (n=15), SS group (n=14) and NSE group (n=15). The NMCE group did rolling with only upper limb pattern on both sides. The SS group performed neck stretching on each side, 3 sets of 30 seconds for each muscle. The NSE group had the pressure biofeedback applied with increases in pressure by 2 mmHg at a time from 20-30 mmHg while in the hook-lying position. All groups performed exercises for 10 minutes. Neck pain, ROM, and proprioception were measured to determine differences between the intervention methods. Results: Intra-group comparisons showed significant improvement after exercise in pain, ROM, and proprioception in the NMC group (p<0.05). In the comparison between groups, the NMC group had a significant decrease in pain compared to the other two groups (p<0.05). There was no difference in ROM between the groups but the NMC group showed significant improvement in left rotation compared to the stabilization exercise group (p<0.05). For proprioception, the NMC group had significantly lower error than the other two groups (p<0.05). Conclusions: NMCEs through upper extremity pattern rolling exercise is effective in improving neck pain, ROM, and proprioception.

A case study on Gak-gi-byung that is similar to beriberi Disease (각기병(脚氣病) 1례에 대한 증례보고)

  • Bae, Jung-Kyu;Ahn, Taek-Won
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.191-197
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    • 2007
  • Gak-gi-byung in Korean Medicine have many things in common with Beriberi disease, Guillain-Barre syndrome, Transverse myelitis and Cauda equina syndrome. Dong-Ui-Bo-Gam define Gak-gi-byung as syndrome that includes sudden lower limbs weakness, pain and edema. Gak-gi-byung start from the foregoing symptoms and could progress to general digestive, neurological or respiratory symptoms is found on many medical practitioners. In this case, we described a 60-years old man diagnosed as Gak-gi-byung in Korean Medicine. He complained Rt lower limb weakness, Rt Knee Clumsiness and limitation of his Rt knee & ankle motor. And his condition was improved through Korean Medical treatment such as acupuncture and herbal medicine like 'Chung-yul-sa-seup-tang' about 15 days.

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Clinical Analysis of Atherosclerotic Obstructive Disease in the Lower Extremity -Surgical Expierence in 25 Cases- (폐쇄성 하지 동맥경화증의 임상적 고찰 -25례의 수술 치험-)

  • 김창수
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.274-279
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    • 1995
  • To evaluate clinical pattern and operative outcome of atherosclerotic obstructive disease in the lower extremity, surgical experience in 25 patients between September 1987 and June 1994 was analyzed. There were 24 male patients and 1 female patient. The age of the patients ranged between 36 and 77 years[mean:60.9 years . Disabing intermittent claudication, rest pain, or ischemic gangrene[or ulceration was the operative indication. The patients were classified into three groups according to the level of obstruction: Aortoiliac level[11 cases/44% , femoropopliteal level[6 cases/24% , and whole level[8 cases/32% . Anatomic bypass with prosthetic graft was performed in all cases: aortobifemoral or aortofemoral bypass in 15 procedures, iliofemoral bypass in 5 procedures, femoropopliteal bypass in 13 procedures. The perioperative mortality rate was 12%. Two patients received postoperative major amputation. Twenty two patients were followed-up for 1 to 70 months[mean: 21 months . Late graft obstruction occurred in two patients. The cumulative patency rate at 3 years was 69.5%. The cumulative limb salvage rate at 3 years was 92.0%.

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Arterial Complication of Percutaneous Transluminal Angioplasty - A Report of Case - (경피 경관 혈관 성형술후 발생한 동맥내 합병증의 치험 1례)

  • 김상익
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1273-1277
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    • 1992
  • Percutaneous Transluminal Angioplasty[PTA] was introduced by Dotter and JudKins [1964], using coaxial catheters of increasing diameter. The remarkable advances in vascular catheter technology over the past several decades have permitted the development. But the application of the balloon catheters carries with it the risk of arterial injury, thrombosis, embolism, and loss of life or limb. A 53-year-old man was admitted to other hospital due to a intermittent claudication in his right leg for 10 years. and PTA was performed at that hospital. Thereafter he was transferred to our hospital because of coldness, pulselessness, rest pain, ischemic ulcer, and progressing gangrene at the anterior aspect of left lower leg. The left lower extremity was salvaged by left ilio-femoral bypass and later saphenous in situ femoro-popliteal bypass.

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The Effect of Low Back Pain and Pelvic Displacement on Foot Orthosis (발 보조기 착용이 요통환자의 골반 변위와 통증 변화에 미치는 영향)

  • Lee, Wan-Hee;Park, Dae-Sung
    • Journal of Korean Physical Therapy Science
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    • v.12 no.4
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    • pp.57-67
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    • 2005
  • The purpose of this study is to investigate the effect of low back pain(LBP) and pelvic displacement on foot orthosis. Before and after experiments were designed to compare the effect. 21 LBP patients who were the subjects diagnosed of applying foot orthosis for 3 weeks after, investigated about pelvic obliquity angle, displacement of ilium, lumbo-sacral angle by x-ray test which is one of pelvic displacement tests, visual analogue scale is used for LBP measurement. The result show the followings; First, Pelvic obliquity angle was significantly reduced after applying foot orthosis compared before using it(p<.05). Second, Displacement of ilium was significantly reduced after applying foot orthosis compared before using it(p<.05). Third, Lumbo-sacral angle was significantly reduced after applying foot orthosis compared before using it(p<.05). Fourth, LBP was significantly reduced after applying foot orthosis compared before using it(p<.05). This study tries to suggest new LBP treatment to reduce pelvic displacement by apply foot orthosis. In conclusion, foot orthosis reduces pelvic obliquity angle, displacement of ilium, lumbo-sacral angle and also decrease LBP. Further more, It needs of biomechanical study which can recognize relation between foot arch and pelvic displacement. This study will serve as a clinically useful data for diagnosis and treatment of LBP and biomechanical analysis of lower limb.

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