• The Korean Journal of Pain
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• v.33 no.2
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• pp.121-130
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• 2020

Background: Transcutaneous electrical nerve stimulation (TENS), manual acupuncture (MA), and spinal cord stimulation (SCS) are used to treat a variety of pain conditions. These non-pharmacological treatments are often thought to work through similar mechanisms, and thus should have similar effects for different types of pain. However, it is unclear if each of these treatments work equally well on each type of pain condition. The purpose of this study was to compared the effects of TENS, MA, and SCS on neuropathic, inflammatory, and non-inflammatory pain models. Methods: TENS 60 Hz, 200 ㎲, 90% motor threshold (MT), SCS was applied at 60 Hz, an intensity of 90% MT, and a 0.25 ms pulse width. MA was performed by inserting a stainless-steel needle to a depth of about 4-5 mm at the Sanyinjiao (SP6) and Zusanli (ST36) acupoints on a spared nerve injury (SNI), knee joint inflammation (3% carrageenan), and non-inflammatory muscle pain (intramuscular pH 4.0 injections) in rats. Mechanical withdrawal thresholds of the paw, muscle, and/or joint were assessed before and after induction of the pain model, and daily before and after treatment. Results: The reduced withdrawal thresholds were significantly reversed by application of either TENS or SCS (P < 0.05). MA, on the other hand, increased the withdrawal threshold in animals with SNI and joint inflammation, but not chronic muscle pain. Conclusions: TENS and SCS produce similar effects in neuropathic, inflammatory and non-inflammatory muscle pain models while MA is only effective in inflammatory and neuropathic pain models.

• Korean Journal of Adult Nursing
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• v.20 no.2
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• pp.269-279
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• 2008

Purpose: The study was to examine the effect of lumbar stabilization exercise on back pain, physical fitness, sleep, and depression in middle-aged women who have chronic back pain. Methods: With one group pre-post test design, 18 subjects who have had more than 6 months of back pain were recruited by convenience sampling in D metropolitan area. Lumbar stabilization exercise was based on Tai Chi for back pain program developed by Lam(2003). This program was mainly focusing on strengthening lumbar stabilizing muscle for one hour per session, twice a week for 20 weeks. Degree of back pain, back pain disability, sleep, and depression were measured at three time points(pretest, 12 weeks, and 20 weeks) by a structured study questionnaire. Physical fitness variables including waist flexibility, mobility, and back muscle strength were measured three times at health promotion center located in the university hospital. Data were analyzed by frequency, descriptive statistics, and repeated measures of ANOVA. Results: Mean age of subjects was 52 years(SD = 6.4). Most of them(90%) had suffered from back pain more than one year and 67% was taking medicine to relieve their back pain. Results showed that back pain score and disability score were not significantly decreased after the exercise. On physical fitness variables, however, waist flexibility(F = 3.50, p = .04) and mobility(F = 3.31, p = .04) were improved after the exercise. Quality of sleep(F = 4.48, p = .03) was improved gradually and depression scores were also decreased(F = 3.12, p = .05) after the exercise. Conclusion: This lumbar stabilization exercise was not able to reduce chronic back pain, but could improve physical fitness and psycho-social variables for community dwelling women who have chronic back pain. Further study is needed to replicate this exercise with control group to confirm the positive effect.

• The Korean Journal of Pain
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• v.33 no.3
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• pp.226-233
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• 2020

Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.

• The Korean Journal of Pain
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• v.35 no.1
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• pp.106-113
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• 2022

Background: Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia. Methods: This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively. Results: A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month. Conclusions: Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.

• Journal of Korean Dental Science
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• v.1 no.1
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• pp.15-21
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• 2008

Purpose : This epidemiological research was conducted to investigate the relationship between the groups of TMD and the behavioral, psychological, and physical symptoms through RDC/TMD. Subjects and Methods : The subjects of this research were the 286 patients who had visited Seoul National University Bundang Hospital; their common chief complaint was temporomandibular discomfort. The mean age of the patients was 32.9 from 11 to 85, and the number of men and women was 67 and 219, respectively. The patients were examined through clinical and radiological methods and diagnosed by 1 investigator. They were divided into 3 groups: myogenous group (group 1), arthrogenous group (group 2), and combined group (group 3). The behavioral, psychological, and physical symptoms were evaluated through questionnaires on RDC/TMD. Specific items were selected to calculate the graded chronic pain (characteristic pain intensity, disability points), jaw disability, depression, and non-specific physical symptoms (pain items included/excluded) in the questionnaire. One-way ANOVA, Kruskal-Wallis test, and chi-square test were applied as statistical methods. Results : As a result of classifying temporomandibular disorder in this study, the patients were distributed as follows: 9.1% of group 1, 79.7% of group 2, and 11.2% of group 3. In the analysis of graded chronic pain (characteristic pain intensity, disability points), jaw disability, and non-specific physical symptoms (pain items included/excluded), group 3 had the highest score, and the difference was significant (p<0.001). Moreover, the depression score of group 3 was significantly higher than groups 1 and 2 (p<0.05). Note that that the second order of jaw disability score was group 2, on the other hand, those of the other groups were group 1. Conclusion : Myofascial pain could be assumed to be related closely to the behavioral, psychological, and physical symptoms except jaw disability compared to joint pain through RDC/TMD.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.2
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• pp.11-20
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• 2006

Low back pain is often experienced by many people who are in an activity flag. Their work and daily life are affected by low back pain. There are many causes of low back pain. Among those many causes, this study was focused on a relation between low back pain and the tightness of iliopsoas. The study was implemented by measuring the angles of the hip joints in subjects consisting of a 30 patients group, who had been selected from the outpatients at the Median Hospital, and a 30 people control group from the outpatients at the M Hospital and employee of M hospital. The patients group consists of the patients with low back pain who have intermittently or continuously experienced low back pain within the last 6 months. The group also had no symptom of spondylolysis or spondylolithesis and no muscular abnormality in terms of pathology without any experience of disc or spine fusion operation. The control group consisted out of persons who had never experienced lower back pain and had never been subjected to physical therapy due to lower back pain. The hip joint angles of the subjects of this study were measured by means of the modified Thomas test position. Data was analysed by independent sampling t-test using SPSS 11.0. The following results were obtained: 1. The measured angles of patient's both hip joints were significantly smaller than the control group's. 2. In the males group, The angles of patients' both hip joints were smaller than the controls'. In the females group, The angles of patients' both hip joints were smaller than the controls'. In conclusion, this study demonstrates that there is a significant difference in the tightness of the iliopsoas muscles when comparing the patient group with the control group. We should therefore pay more attention in releasing the muscle tightness of iliopsoas muscles when performing physical therapy with patients with lower back pain.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.69-80
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• 2015

PURPOSE: The purpose of the present study was to apply joint mobilization in a sitting position and in a prone position to patients with acute mechanical neck pain and compare the immediate treatment effects in these two positions. METHODS: After the baseline was assessed, 46 patients were randomly assigned to two groups: experimental group I ($n_1=23$) for joint mobilization in the sitting position and experimental group II ($n_2=23$) for joint mobilization in the prone position at the symptomatic cervical level. The patients in both groups received treatment by unilateral posterior-anterior gliding for 30 seconds per trial, 10 trials per session, for a total of 5 minutes, and two trials of 10 active extending motions with distraction per trial. RESULTS: In the Wilcoxon signed-rank test, all the pain and physical function variables were significantly improved after intervention in both groups (p<.05). In the Mann-Whitney U test, which compared the differences before and after the intervention between the two groups, experimental group I showed significant improvement over experimental group II in resting pain (p<.01), satisfaction with the treatment (p=.01), left rotation (p<.01) and CCFE (p<.01). In the analysis of covariance results, experimental group I showed significant improvement over experimental group II in the most painful motion pain (p<.01) and the most painful quadrant motion pain (p<.01). CONCLUSION: These outcomes suggest that joint mobilization should be applied in sitting positions for patients with acute mechanical neck pain that feel pain during sustained positions, extension or rotation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.33-44
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• 2017

Background: Lumbar stabilization exercise and gluteal muscle strengthening exercises are widely used to treat for lower back pain patient. The present study aimed to compare the effects of lumbar stabilization exercise and gluteal muscle strengthening exercises on chronic lower back pain with lumbar spine instability, with regard to pain intensity, disability, and psychosocial factors. Methods: Among 53 patients with chronic lower back pain, those with spine instability were selected using 5 examination tests. The selected 28 patients were randomly assigned to lumbar stabilization exercise group (LSE, n=15) and gluteal strengthening exercise group (GSE, n=13). Each group performed the corresponding exercise for 40 minutes, twice a week for 4 weeks. To analyze and compare the effects, pain intensity, the level of low back disability, and psychosocial factors were assessed before and after intervention. Results: There was significant difference in lower back pain intensity between the two groups before and after intervention. The change in low back disability was significant in the GSE group alone following intervention (p<.05), but no other significant difference was found between the groups. Among psychosocial factors, the changes in the fear-avoidance beliefs questionnaire (FABQ)-physical activity and FABQ-total were significant in the LSE group alone following intervention (p<.05). However, no significant difference were found in these factors between the two groups before and after intervention. Conclusions: LSE and GSE for lower back pain with lumbar spine instability showed no significant difference for pain intensity, physical disability, or psychosocial functioning.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.509-514
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• 2012

PURPOSE: This study aims to compare the effects of upper backbone joint mobilization and self-stretching exercise in the patients with chronic neck pain. METHODS: Thirty seven patients with chronic neck pain were divides into self stretching group(SSG, n=18) and mobilization group(MG, n=19). To assess the degree of neck pain, the visual analog scale (VAS) was utilized, and to measure the joint range of motion at the flexion-extension, it was compared and analyzed by using the cervical range of motion (CROM) device. RESULTS: The joint range of motion and visual analog scale of SSG and MG showed significant effects on both groups. In the comparison of groups, there was no significant difference, but it indicated effects on improving the pain and the range of joint motion in MG. CONCLUSION: According to the analysis, not only self-stretching exercise intervening for direct treatment but also upper backbone joint mobilization intervening for indirect treatment are effective to improve the pain and the range of motion.

• Physical Therapy Korea
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• v.15 no.3
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• pp.26-34
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• 2008

The purposes of this study were to assess and modify the original classification categories of the modified Oswestry Low Back Pain Disability Questionnaire (ODQ) and to determine the unidimensionality of the modified ODQ applying Rasch Analysis. The data were obtained from 108 work-related low back pain patients by physical therapists. Construct validity of the scale using the Rasch model required the structure of the rating scale to be modified from 6 response levels to 4 response levels. Eight items from the modified ODQ fit the Rasch model. The items, "pain intensity" and "social life" showed misfit statistics. In general, the order of item difficulty of the remaining 8 items showed a logical item difficulty hierarchy with the "changing degree of pain" item being the most difficult and the "walk" item being the easiest. The results showed that further study is needed to expand the construct of ODQ including additional higher-level items related to work activities. This study may be useful for establishing a standard method to assess the functionality of low back pain patients.