• Title/Summary/Keyword: spinal pain

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Restoration of the Broken Lumbopelvic-hip Neuromuscular Chain and Coordinated Synergistic Activation in Low Back Pain

  • Park, Haeun;Park, Chanhee;You, Joshua (Sung) Hyun
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.215-224
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    • 2022
  • Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

Ferroptosis inhibitor ferrostatin-1 attenuates morphine tolerance development in male rats by inhibiting dorsal root ganglion neuronal ferroptosis

  • Hasan Dirik;Ahmet Sevki Taskiran;Ziad Joha
    • The Korean Journal of Pain
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    • v.37 no.3
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    • pp.233-246
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    • 2024
  • Background: Ferrostatin-1 and liproxstatin-1, both ferroptosis inhibitors, protect cells. Liproxstatin-1 decreases morphine tolerance. Yet, ferrostatin-1's effect on morphine tolerance remains unexplored. This study aimed to evaluate the influence of ferrostatin-1 on the advancement of morphine tolerance and understand the underlying mechanisms in male rats. Methods: This experiment involved 36 adult male Wistar albino rats with an average weight ranging from 220 to 260 g. These rats were categorized into six groups: Control, single dose ferrostatin-1, single dose morphine, single dose ferrostatin-1 + morphine, morphine tolerance (twice daily for five days), and ferrostatin-1 + morphine tolerance (twice daily for five days). The antinociceptive action was evaluated using both the hot plate and tail-flick tests. After completing the analgesic tests, tissue samples were gathered from the dorsal root ganglia (DRG) for subsequent analysis. The levels of glutathione, glutathione peroxidase 4 (GPX4), and nuclear factor erythroid 2-related factor 2 (Nrf2), along with the measurements of total oxidant status (TOS) and total antioxidant status (TAS), were assessed in the tissues of the DRG. Results: After tolerance development, the administration of ferrostatin-1 resulted in a significant decrease in morphine tolerance (P < 0.001). Additionally, ferrostatin-1 treatment led to elevated levels of glutathione, GPX4, Nrf2, and TOS (P < 0.001), while simultaneously causing a decrease in TAS levels (P < 0.001). Conclusions: The study found that ferrostatin-1 can reduce morphine tolerance by suppressing ferroptosis and reducing oxidative stress in DRG neurons, suggesting it as a potential therapy for preventing morphine tolerance.

The Occurence Properties of the Complications in Spinal Cord Injury (척수손상환자의 합병증 발생특성)

  • Son Jung-Woo;Nam Chul-Hyun
    • The Journal of Korean Physical Therapy
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    • v.4 no.1
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    • pp.27-42
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    • 1992
  • The purpose of this study is to investigate the occurence properties of the complications in spinal cord injured patients. Clinical observation were for 116 cases in and out wards, were carried out during one year from july, 1990 to June, 1991 at 4 general hospitals in Taegu, Korea. The results of this study is summarized as follows : 1. Among the 116 cases, $67.7\%$ was male and $35.3\%$ was female. The largest groups were noted in $60.7\%$, of the forties by age, in $34.5\%$ of the middle school by educational career, in $27.6\%$ of the administer by professional division. 2. The number of complications in a patient in the largest group was two-type. The next groups were three-type, $23.3\%$ and five-type, $20.7\%$. Of each factors, the largest numbers of two-type recorded tuberculosis of spine$(71.4\%)$, thoracic cord injury$(63.4\%)$, incomplete paraplegia$(48.4\%)$, and inwards during 1-2 months $(47.4\%)$. 3. Total number of the complications were counted to 367 cases. The largest group of complications was pain, $24.8\%$. The next groups were pressure sores, $19.9\%$. spasticity, $12.5\%$, and urinary tract infection, $9.3\%$. 4. The number of the 4 major complications(pain, pressure sores, joint contracture, spasticity) was counted to 280 cases. The largest group of the major complications was pain, $32.5\%$. The next groups were pressure sores, $26.1\%$, joint contracture, $25.9\%$ and spasticity, $16.4\%$. Of each factors, the largest numbers of the pain recorded female$(40.5\%)$, thirties$(49.2\%)$, non-educate $(53.8\%)$, labor$(38.2\%)$, traffic accidents$(32.8\%)$, thoracic cord injury$(34.4\%)$, complete paraplegia$(58.1\%)$, and inwards during above 13 months$(37.5\%)$. 5. The largest group of the pain portion was shoulder. $49.4\%$. The non groups were lower extremity, $25.2\%$, hip, $11.0\%$, and all bodies, $4.3\%$. The largest numbers of the shoulder pain recorded thirties$(59.4\%)$, traffic accidents $(52.7\%)$, cervical cord injury$(67.2\%)$. complete quadriplegia$(81.8\%)$, and inwards during above 13 months$(100.0\%)$. 6. The largest group of the pressure sores sites was sacral portion, $83.6\%$. The next groups were hip, $6.8\%$, maleollus, $4.1\%$. The largest numbers of pressure sores formation in the sacral portion recorded below 19 and above $60(100.0\%)$, falling objects$(100.0\%)$, lumbar cord injury$(100.0\%)$, incomplete paraplegia$(100.0\%)$, and in wards during 3-4 months$(95.9\%)$. 7. The largest group of the joint contracture portion was lower extremity, $61.4\%$, follows was upper extremity, $38.6\%$. The largest numbers of the joint contrcture portions recorded thirties$(100.0\%)$, traffic accidents$(86.1\%)$, cervical cord injury$(80.4\%)$, complete quadriplegia$(86.7\%)$, and inwards during 3-4 months $(82.2\%)$ 8. The largest group of spasticity portion was lower extremity, $53.0\%$. The next groups were hip. 23.9, 23.9, ankle, $8.7\%$, and elbow, $4.3\%$. The largest numbers of the spasticity portions recorded above $60(100.0\%)$, falling $(100.0\%)$, cervical cord injury$(71.4\%)$, incomplete quadriplegia$(71.4\%)$, and inwards during 1-2 months $(100.0\%)$.

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R-type Calcium Channel Isoform in Rat Dorsal Root Ganglion Neurons

  • Fang, Zhi;Hwang, Jae-Hong;Kim, Joong-Soo;Jung, Sung-Jun;Oh, Seog-Bae
    • The Korean Journal of Physiology and Pharmacology
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    • v.14 no.1
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    • pp.45-49
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    • 2010
  • R-type $Ca_v2.3$ high voltage-activated $Ca^{2+}$ channels in peripheral sensory neurons contribute to pain transmission. Recently we have demonstrated that, among the six $Ca_v2.3$ isoforms ($Ca_v2.3a{\sim}Ca_v2.3e$), the $Ca_v2.3e$ isoform is primarily expressed in trigeminal ganglion (TG) nociceptive neurons. In the present study, we further investigated expression patterns of $Ca_v2.3$ isoforms in the dorsal root ganglion (DRG) neurons. As in TG neurons, whole tissue RT-PCR analyses revealed the presence of two isoforms, $Ca_v2.3a$ and $Ca_v2.3e$, in DRG neurons. Single-cell RT-PCR detected the expression of $Ca_v2.3e$ mRNA in 20% (n=14/70) of DRG neurons, relative to $Ca_v2.3a$ expression in 2.8% (n=2/70) of DRG neurons. $Ca_v2.3e$ mRNA was mainly detected in small-sized neurons (n=12/14), but in only a few medium-sized neurons (n=2/14) and not in large-sized neurons, indicating the prominence of $Ca_v2.3e$ in nociceptive DRG neurons. Moreover, $Ca_v2.3e$ was preferentially expressed in tyrosine-kinase A (trkA)-positive, isolectin B4 (IB4)-negative and transient receptor potential vanilloid 1 (TRPV1)-positive neurons. These results suggest that $Ca_v2.3e$ may be the main R-type $Ca^{2+}$ channel isoform in nociceptive DRG neurons and thereby a potential target for pain treatment, not only in the trigeminal system but also in the spinal system.

The Suppressive Action of Electroacupuncture on Cold Allodynia Development in the Rat Model of Neuropathic Pain (전침(電鍼)이 신경병증성(神經病症性) 냉이질통(冷異質痛) 발생(發生) 억제(抑制)에 미치는 영향(影響))

  • Park, Sang-Min;Lee, Yun-Ho;Kang, Sung-Keel
    • Journal of Acupuncture Research
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    • v.22 no.6
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    • pp.27-36
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    • 2005
  • Introduction : The aim of the study is to investigate the suppressive action of electroacupuncture on cold alloynia development in the rat model of neuopathic pain. Methods : To produce neuropathic pain, the right superior caudal trunk was resected $1{\sim}2\;mm$ between S1 and S2 spinal nerves. The rats were divided into control and four electroacupuncture groups: Two electroacupuncture groups were given 2 Hz or 100 Hz electroacupuncture for 20 minutes everyday after the sacral nerve injury. Other two electroacupuncture groups were given 2 Hz or 100 Hz electroacupuncture for 20 minutes just one session at one hour after the sacral nerve injury. The right point of Joksamni (ST36) was applied for electroacupuncture. The control group was induced neuropathic pain without electroacupuncture. The cold allodynia was assessed by immersing the tail in $4^{\circ}C$ water. The latency to an abrupt tail movement after rat tail immersion was measured with a cut-off time of 15 sec at 4th, 7th and 14th day after the sacral nerve injury. Results : The results were as follows; 1. At 4th experimental day, there were no significant differences between 2 Hz or 100 Hz electroacupuncture groups and the control group. 2. At 7th experimental day, everyday 2 Hz or 100 Hz electroacupuncture groups showed significant differences compared with the control group. But There were no significant differences between 2 Hz and 100 Hz electroacupuncture groups. 3. At 14th experimental day, everyday 2 Hz electroacupuncture group showed significant differences compared with the control group. But everyday 100 Hz electroacupuncture group showed no significant difference compared with the control group and everyday 2 Hz electroacupuncture group. 4. There were no significant differences between the control and 2 Hz or 100 Hz electroacupuncture groups which were done just one session at one hour after the surgery. 5. Everyday 2 Hz electroacupuncture group showed significant differences in the one session of the 100 Hz electroacupuncture group. Conclusion : Everyday 2 Hz electroacupuncture exerts a suppressive action on cold allodynia development in the rat model of neuropathic pain.

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Vertebral Distraction during Anterior Cervical Discectomy and Fusion Causes Postoperative Neck Pain

  • Ha, Seung Man;Kim, Jeong Hoon;Oh, Seung Hun;Song, Ji Hwan;Kim, Hyoung Ihl;Shin, Dong Ah
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.288-292
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    • 2013
  • Objective : Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. Methods : This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 $kgf{\cdot}cm$) and the low torque group (distraction force${\leq}6kgf{\cdot}cm$) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. Results : The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days ($y=0.99{\times}-1.1$, $r^2=0.82$; $y=0.77{\times}-0.63$, $r^2=0.73$, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively ($3.1{\pm}1.3$, $2.6{\pm}1.0$ compared with $6.0{\pm}0.6$, $4.9{\pm}0.8$, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. Conclusion : Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 $kgf{\cdot}cm$.

Effect of Frutus gardeniae herbal acupuncture on the rat model of ankle sprain pain (치자(梔子) 약침(藥鍼)이 백서(白鼠) 모델 족과 염좌(捻挫) 통증(痛症)에 미치는 영향(影響))

  • Koo, Sung-Tae;Cho, Myoung-Soo;Park, Sung-Sub;Kim, Young-Tae;Park, Kwi-Jong;Kim, Kyoung-Sik;Sohn, In-Cheul
    • Korean Journal of Acupuncture
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    • v.22 no.2
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    • pp.57-74
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    • 2005
  • Objective : Frutus gardeniae, seed of Gardenia jasminoides Ellis is one of the crude drugs used for the treatment of inflammatory condition in oriental medicine. Methodes : The present study aimed to examine the analgesic effect and anti-inflammatory effect of Frutus gardeniae extract (FGE) on a rat model of ankle sprain pain, and the relations between FGE-induced effect and endogenous nitric oxide (NO) and inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), and c-Fos protein expression in the spinal cord. As a chronic pain model, ankle sprain pain model was used to test the effect of FCE injection applied to acupuncture point. After the induction of ankle sprain, rats subsequently showed a reduced stepping force of the affected limb for at least the next 4 days. The reduced stepping force of the limb was presumably due to a painful knee. FGE dissolved in normal saline was injected several acupoints. Results : After the treatment, behavioral tests measuring stepping force were periodically conducted during the next 8 hours. FGE produced significant improvement of stepping force of the hindlimb affected by the ankle sprain lasting at least 4 hours. FGE produced the improvement of stepping force of the affected hindlimb in a dose-dependent manner. In addition, FGE injection showed inhibitory effect on the paw edema induced by ankle sprain. Both NO production and iNOS, COX-2 protein expression increased by ankle sprain were suppressed by FGE. FGE on combination with electroacupuncture (EA) produced more powerful and longer lasting improvement of stepping force of the hindlimb affected by the ankle sprain than either FGE or EA did. The present study suggest that FGE produces a potent analgesic effect on the ankle sprain pain model of the rat and that FGE-induced analgesia modulate endogenous NO through the suppression of iNOS/COX-2 protein expression.

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A Case of Hinman Syndrome Complicated by Chronic Renal Failure (만성 신부전을 초래한 Hinman 증후군 1례)

  • Lee Gyeong-Hoon;Lee Eun-Sil;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.90-94
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    • 1998
  • Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

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Lumbo-pelvic stabilization approach for lower back dysfunction (요통의 요골반부 안정화(lumbo-pelvic stabilization) 접근법)

  • Kim, Suhn-Yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.4 no.1
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    • pp.7-20
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    • 1998
  • Activity of the trunk muscles is essential for maintaining stability of the lumbar spine because of the unstable structure of that portion of the spine. The central nervous system deals with stabilization of the spine by contraction of the abdominal and multifidus muscles in anticipations of reactive forces produced by limb movement. Recent evidence indicates that the lumbar multifidus muscle and transversus abdominis muscle may be involved in controlling spinal stability. Stabilization training in neutral spine is an integrated approach of education in proper posture and body mechanics along with exercise to improve strength, flexibility, muscular and cardiovascular endurance, and coordination of movement.

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Effect of Amniotic Membrane to Reduce Postlaminectomy Epidural Adhesion on a Rat Model

  • Choi, Hyu-Jin;Kim, Kyoung-Beom;Kwon, Young-Min
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.323-328
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    • 2011
  • Objective : Epidural fibrosis and adhesion are the main reasons for post-laminectomy sustained pain and functional disability. In this study, the authors investigate the effect of irradiated freeze-dried human amniotic membrane on reducing epidural adhesion after laminectomy on a rat model. Methods : A total of 20 rats were divided into two groups. The group A did not receive human amniotic membrane implantation after laminectomy and group B underwent human amniotic membrane implantation after laminectomy. Gross and microscopic findings were evaluated and compared at postoperative 1, 3 and 8 weeks. Results : The amount of scar tissue and tenacity were reduced grossly in group of rats with human amniotic membrane implantation (group B). On a microscopic evaluation, there were less inflammatory cell infiltration and fibroblast proliferation in group B. Conclusion : This experimental study shows that implantation of irradiated freeze-dried human amniotic membrane reduce epidural fibrosis and adhesion after spinal laminectomy in a rat model.