• Title, Summary, Keyword: Chronic low back pain

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Influence of the Application to Hyperbaric Oxygen Therapy and Physical Therapy on Chronic Low Back Pain in Elderly (고압산소와 물리치료의 복합 적용이 노인의 만성 요통 완화에 미치는 영향)

  • Yoon, Ju-Yeon;Jang, Mun-Geol;Hyun, Seung-Jun;Yoon, Bum-Chul
    • The Journal of Korean Physical Therapy
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    • v.23 no.4
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    • pp.23-28
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    • 2011
  • Purpose: To investigate the effects of hyperbaric oxygen therapy (HBOT) on chronic low back pain in elderly patients with impaired functioning in daily life. Methods: 35 subjects with chronic low back pain were randomly allocated into two groups, HBOT group and Placebo group. We applied TENS and mechanical massage to the lower back in both groups. Then 35% oxygen at 1.4 ATA was given to the HBOT group and atmospheric oxygen at 1 ATA to the placebo group. Results: Comparing the HBOT group with the placebo group after performing interventions six times in 2 weeks, a statistically significant difference in the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores was observed between the two groups. There was a statistically significant difference in VAS and ODI scores (56% and 34.97% respectively) between the HBOT group and the placebo group. A statistically significant difference was ascertained in the degree of variables VAS and ODI in the HBOT group. Conclusion: Application of HBOT in chronic low back pain could be beneficial for reducing pain and could help in functional recovery.

Alternation of Topical Heat and Cold for Chronic Low Back Pain : A Randomized Controlled Pilot Trial

  • Choi, Young Doo;Jo, Su Jeong;Jung, Chan Yung;Kim, Kap Sung;Lee, Seung Deok
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.77-87
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    • 2016
  • Objectives : This is a pilot study for a large randomized controlled trial to investigate the efficacy and safety of a newly developed contrast therapy device-- alternating topical heat and cold -- for patients with chronic low back pain. The main objective of this study is to confirm the feasibility of the study design. Methods : The design was a randomized, 2-arm, parallel-group, single-blind, placebo controlled trial. Patients in each group received real or sham contrast therapy in an acupuncture point 10 times over four weeks. The primary outcome measure was pain intensity on a 100-mm visual analogue scale (VAS). The secondary outcomes were back-related dysfunction based on the Oswestry Disability Index (ODI), the Roland-Morris disability questionnaire (RMDQ), and range of motion of lumbar spine based on the modified Schober test (mSchober test), Finger-to-Floor distance (FTF distance), and Finger-to-Thigh distraction (FTT distraction). Results : A total of 30 subjects with chronic low back pain were randomly assigned to a contrast therapy group (n=15) or a sham group (n=15). A repeated-measures analysis of variance showed statistically significant group time interaction for VAS, RMDQ, mSchober test and FTF distance (p<0.05). The treatment group showed significant improvement in pain intensity and functional disability as compared to the sham group. Conclusion : Contrast therapy may be an effective and safe treatment for chronic low back pain.

Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: No (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 부정적인 입장에서)

  • Bae, Jong-Seok
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.7-10
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    • 2010
  • Chronic low back pain (CLBP) is a distinct disease entity in that its clinical course and response to the treatment are quite different from acute low back pain (ALBP). CLBP is also closely related with systemic or preexisting psychosocial factors rather than focal or localized factors. Since there has been little consensus in practice regarding the proper management of CLBP, clinicians tend to approach and manage patients with CLBP in an empirical manner rather than an evidence-based one. In this article, I will review the difficulties of therapeutic choice in CLBP and provide superior aspects of medical treatment over invasive interventional treatments.

The Effectiveness of Endoscopic Radiofrequency Denervation of Medial Branch for Treatment of Chronic Low Back Pain

  • Jeong, Sun Yoon;Kim, Jin Sung;Choi, Won Suh;Hur, Jung Woo;Ryu, Kyoung Sik
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.338-343
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    • 2014
  • Objective : The aim of this study is to evaluate the clinical results of endoscopic radiofrequency ablation of medial branch in patients with chronic low back pain originating from facet joints. Methods : Between October 2010 and December 2013, 52 consecutive patients had suffering from chronic low back pain had undergone endoscopic radiofrequency denervation of medial branch of dorsal ramus. The clinical outcomes of these 52 patients were reviewed retrospectively. Preoperative and postoperative Visual Analogue Scale (VAS) and Korean version of Oswestry Disability Index (K-ODI), and patients' satisfaction with the procedure were assessed. Results : The pain scores on the VAS for back pain had improved significantly from a preoperative mean of 7.1 to a postoperative mean of 2 at the last follow-up (p<0.001). The clinical outcomes based on the K-ODI had also improved significantly from a preoperative mean of 26.5% to postoperative mean of 7.7% at the last follow-up (p<0.001). 80% of patients were satisfied with the procedure. There were no complications associated with the procedure. Conclusion : Our preliminary results demonstrate that endoscopic radiofrequency denervation of medial branch could be an effective alternative treatment modality for chronic back pain originating from facet joints that provides long-term pain relief.

Analysis of the Efficacy of Acupuncture for Chronic Low Back Pain Based on the Relationship Between Trunk Flexors and Extensors (요부 굴곡과 신전운동의 관점에서 분석한 만성요통의 침치료 효과)

  • Kim, Eu-Gene;Park, Won-Hyung;Cha, Yun-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.4
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    • pp.557-565
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    • 2012
  • The purpose of this study was to examine the effect of acupuncture on trunk flexors compared with trunk extensors in patients with chronic low back pain. The experimental group was treated with acupuncture on trunk flexors. The control group was treated with acupuncture on trunk extensors. Acupuncture treatment was performed 12 sessions over the course of 6 weeks. Volunteers who satisfied the requirements were enrolled in the study. Chronic low back pain was evaluated based on the VAS for bothersomeness, VAS for pain intensity at every treatment and 8, 12 and 24 weeks after starting the treatments, and ODI, SF-36 and BDI before and after treatments and 8, 12 and 24 weeks after starting the treatments. The VAS score for bothersomeness significantly decreased after treatment for up to 24 weeks after starting the treatments in both group (p<0.05). The VAS score for bothersomeness in the experimental group decreased more rapidly than that of the control group with statistical significance (p<0.05). The VAS score for pain intensity, ODI, SF-36 and BDI significantly improved after treatment for up to 24 weeks after starting the treatments in both group (p<0.05). The VAS score for pain intensity, ODI, SF-36 and BDI in the experimental group showed more rapid improvement than those of the control group. But, there were no statistical significances. Treating trunk flexors using acupuncture was more effective in decreasing the degree of bothersomeness caused by chronic low back pain than treating trunk extensors with acupuncture. There is a need to perform further studies.

Regression Analysis of the Relationship Among the Level of Pain and Dysfunction and Psychosocial Factors in Patients With Chronic Back Pain (회귀분석을 이용한 만성요통환자의 통증 및 기능장애수준과 심리사회학적 요인의 상관성 연구)

  • Choi, Im-soon;Jang, Hyun-jeong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.23 no.1
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    • pp.38-45
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    • 2016
  • Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

Effects of Manual Therapy and Theraputic Exercise on Chronic Pain and Body Function in Elder Women with Chronic Low Back Pain (도수치료와 치료적 운동이 만성 요통의 여성 노인의 만성 통증과 신체 기능에 미치는 영향)

  • Shim, Yong-hyun;Park, Jae-myoung;Yu, Seong-hun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.2
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    • pp.51-57
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    • 2017
  • Background: The purpose of this study is to examine the effects of manual therapy and therapeutic exercise on pain and body function in elder women with chronic low back pain. Methods: The patients with chronic low back pain were randomly divided 2 group. The experiment group (n=11) was taken manual therapy and therapeutic exercise program. The control group (n=10) was taken physical therapy program(hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Both groups intervention performed 3 session during 6 weeks. We measured the quadruple visual analogue scale, flexibility, static balance, leg strength subject of symptom before and after experiment. The significant test pared t-test according to applying the manual therapy and therapeutic exercise group and control group between group used independent t-test. Results: Pain assessment in the experimental group was significantly different between time and group. Flexibility test groups were not significantly different between time and group. The static balance was not significantly different for the time. Strength tests were also not significantly different for the time. Conclusions: According to the results, manual therapy and therapeutic exercise group it was found to be helpful in pain, flexibility, static balance, not strength in elderly patients with chronic low back pain.

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Relationship between Leg Length Discrepancy and Radiological Parameters of Lumbosacrum and Pelvis in Patients with Chronic Low Back Pain (만성 요통 환자의 하지 길이 부전과 요천추부 및 골반의 방사선학적 지표와의 관계)

  • Cho, Yu-Jeong;Chung, Seok-Hee;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.4
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    • pp.171-183
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    • 2010
  • Objectives : The biomechanical relationship of leg length discrepancy(LLD), Lumbar lordosis, pelvic variance and degenerative scoliosis is one of the most important parameters when treat musculoskeletal disorders, however the reports are still controversial. The purpose of this study was to compare the relationships between the parameters and bothersomeness in subject with chronic ow back pain. Methods : Sixty female and eight male adults with non specific low back pain over 3 months were recruited. LLD was measured by tape measure method. Lumbar lordosis, lumbosacral angle and related pelvic parameters were measured using simple radiologic films of lumbosacral view. Results : Lumbar lordosis was significantly correlated to the lumbosacral angle, pelvic incidence and difference of the both iliac widths. Pelvic incidence had significant correlation with difference of the both iliac widths. And difference of both iliac widths was related with LLD by radiologic film. There was also significant correlation between the LLD by radiologic film and tape measurement. Visual analogue scale(chronic low back pain) of normal lordosis group was greater than hyperlordosis group. Conclusions : There were close biomechanical relationships between lumbar, pelvis, and lower extremity. But in order to determine the effect of structure on the chronic low back pain, global balance of musculoskeletal structure seems to be worth further researching.

Effects of Sciatic Nerve Mobilization Technique on Perceived Pain and Knee Strength in Patient With Chronic Low Back Pain (좌골신경가동화기법이 만성 요통 환자의 통증과 슬관절 신전근력에 미치는 영향)

  • Cha, Hyon-Gyu;Oh, Duck-Won
    • Physical Therapy Korea
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    • v.17 no.3
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    • pp.31-39
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    • 2010
  • The purpose of this study was to determine the effect of sciatic nerve mobilization technique on perceived pain, straight leg raise test (SLR), and strength of knee extensor, location of symptoms (LOS) in patients with chronic low back pain. 22 patients with chronic low back pain were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 11 patients in each group. All patients received a routine physical therapy (hot pack and transcutaneous electrical nerve stimulation). The mobilization technique of the sciatic nerve was performed for 10 min in the case of the EG subjects. Outcome measurements included the level of the perceived pain, SLR, and strength of the knee extensor, LOS. The measurements were recorded 3 times: before the intervention, after the intervention, and at 1 hour of follow up. The two groups did not significantly differ with regard to the level of perceived pain, SLR, and strength of the knee extensor, LOS before the test (p>.05). In the case of the EG subjects, all the variables measured after the intervention significantly differed from those measured before the intervention (p<.05). However, in the case of the CG subjects, a significant difference was noted only with regard to the level of perceived pain (p<.05). The findings indicate that sciatic nerve mobilization technique exerts a positive effect on the control of subjective symptoms and knee strength in patients with chronic low back pain. Further studies are required to generalize the result of this study.

The Effect of Thoracic Joint Mobilization on Pain, Proprioception and Static Balance in Patients With Chronic Low Back Pain (흉추 관절가동술이 만성요통환자의 통증, 고유수용감각 및 균형수준에 미치는 효과)

  • Yang, Jin-mo;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.1-11
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    • 2015
  • The purpose of this study was to investigate the effect of lumbar stabilization training and additional thoracic mobilization on pain, proprioception and static balance in patients with chronic low back pain. The subjects of this study were 48 chronic low back pain patients who were randomly allocated to an experimental group 1 ($n_1=16$, lumbar stabilization and thoracic mobilization, thoracic hypomobility), experimental group 2 ($n_2=16$, lumbar stabilization and thoracic mobilization, thoracic normal mobility), and a control group ($n_3=16$, lumbar stabilization, thoracic hypomobility) after a thoracic mobility test. Both experimental groups underwent lumbar stabilization training and additional thoracic mobilization. The control group underwent only lumbar stabilization training. The intervention was performed 3 times per week, 30 minutes each time, for a total of 6 weeks. Thoraco-lumbar joint reposition error was measured using an electrogoniometer and static balance ability was measured using the Tetrax posture analysis system. Subjects' pain level was measured using a 100 mm visual analogue scale. Statistical analyses were performed using a one-way analysis of variance and a paired t-test. Post-hoc testing was carried out with a Bonferroni test. The pain level was significantly lower in both experimental groups compared to the control group. Both experimental groups showed significant reductions in joint reposition error angle (flexion, extension, and side bending) compared to the control group. The static balance level was significantly lower in both experimental groups than in the control group. In summary, lumbar stabilization exercises and additional thoracic mobilization significantly improved the pain level, proprioception, and static balance in patients with chronic low back pain.