• Title/Summary/Keyword: Joint pain

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Facet joint disorders: from diagnosis to treatment

  • Yeong-Min Yoo;Kyung-Hoon Kim
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.3-12
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    • 2024
  • One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

Joint Pain in Patients with Osteoarthritis: Based on the 5th KNHNES (우리나라 골관절염 환자의 관절통증: 2012년 국민건강영양조사 자료를 이용하여)

  • Lee, Jinsook
    • Journal of muscle and joint health
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    • v.23 no.3
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    • pp.152-158
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    • 2016
  • Purpose:The purpose of this study was to examine the degree of joint pain, limitation of daily activities, and frequency of outpatient visits. Methods: This secondary analysis study used the data from the fifth Korean National Health and Nutrition Examination Survey (KNHNES). The data about general characteristics, prevalence and treatment of osteoarthritis, limitation of activities of daily living (ADL) and frequency of outpatient visits and hospitalization in 424 osteoarthritis patients over 50 years old were derived from the database. Data were analyzed with complex samples in SPSS ver. 20.0. Results: Among people with knee joint pain, 79.3% reported they had more than 4 out of 10 points of the degree of pain. Meanwhile, 97.3% of people with hip joint pain reported that they had more than 4 out of 10 points of the degree of pain. People reporting 10 out of 10 point of pain were 21.4% of those with knee joint pain and 25% of those with hip joint pain. The mean of the degree of knee joint pain was 6.35, and the mean of the degree of hip joint pain was 6.89 out of 10 points. About 50% of people with osteoarthritis visited an outpatient clinic within the last 2 weeks, and 27% had limitation of ADL. Conclusion: It is necessary to develop an integrated intervention program to improve quality of life in patients with osteoarthritis.

Studies on the Knee Joint Pain (무릎관절의 통증에 관한 연구)

  • Choe, Joon-Rieb;Lee, Hee-Jeon;Choe, Wook-Yoen;Han, Sang-Yoen
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.249-257
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    • 1992
  • It is general knowledge that knee joint pain can be attributed to trauma and degenerative change around the knee joint. However most patients who have suffered from pain or limited range of motion of the knee joint show no definite pathology on X-ray or laboratory examination. We examined 242 patients with knee joint pain and found compression or entrapment of the articular nerve fiber by the tissue around the knee joint resulted in pain in almost all cases. Conclusion: by relieving the compression of the articular nerve fiber with just physical therapy and LASER stimulation on the identified trigger points, in conjunction with NSAIDs, muscle relaxants, were found to be very effective in the treatment of knee joint pain.

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Pulsed Radiofrequency Application for the Treatment of Pain Secondary to Sacroiliac Joint Metastases

  • Yi, Yu Ri;Lee, Na Rea;Kwon, Young Suk;Jang, Ji Su;Lim, So Young
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.53-56
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    • 2016
  • Sacroiliac (SI) joint pain can result from degeneration, infection, malignancy, and trauma. Patients with metastatic bone pain who do not respond to conventional treatment may need more aggressive neuroinvasive approaches. Recently, pulsed radiofrequency (PRF) neuromodulation has emerged as a promising treatment alternative for refractory cases of SI joint pain. Nevertheless, there is no report on the treatment of pain arising from SI joint metastases with PRF. We are reporting about a 63-year-old woman suffering from buttock pain due to breast cancer metastases in the SI joint. We treated this patient with PRF neuromodulation of the L4-S3 primary dorsal rami and lateral branches using a rotating curved needle technique. The patient tolerated the procedures well, without any complications. She experienced about 70% reduction in pain, and pain relief was sustained for 10 months. This result suggests that PRF neuromodulation is a safe, effective treatment for pain from SI joint metastases.

Clinical Effectiveness of Ultrasound-guided Costotransverse Joint Injection in Thoracic Back Pain Patients

  • Yoon, Kyung Bong;Kim, Shin Hyung;Park, Sang Jun;Moon, Ji Ae;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.197-201
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    • 2016
  • Because of its anatomical location and function, the costotransverse (CTRV) joint can be a source of thoracic back pain. In this retrospective observational study, we evaluated the clinical effectiveness of the CTRV joint injection in thoracic back pain patients with suspected CTRV joint problems. We enrolled 20 thoracic back pain patients with localized tenderness that was provoked by the application of pressure on the affected CTRV joints. We injected it with 0.5 ml of a ropivacaine and triamcinolone mixture at each level. The mean pre-injection pain score decreased by 37.9% ($7.2{\pm}1.5$ to $4.5{\pm}1.7$, P < 0.001) two weeks after CTRV joint injection. In addition, 70% of patients reported an excellent or good level of satisfaction. We demonstrated that an ultrasound-guided injection of the CTRV joint reduced patients' pain scores and led to a high level of satisfaction at short-term follow-ups in patients with suspected CTRV joint problems.

Radiofrequency Facet Joint Denervation in the Treatment of Low Back Pain: Relationship with the Diagnostic Block (요부 후지낵측지 고주파 열응고술: 진단적 차단과의 연관성)

  • Shim, Jae-Chol;Seung, Ik-Sang
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.218-224
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    • 2001
  • Background: Response to diagnostic blocks does not consistently predict the outcome of interventional facet denervation. We investigated the relationship between pain relief by the percutaneous radiofrequency denervation of the lumbar zygapophysial joints with the result of facet joint diagnostic local anesthetic injection in patients with back pain originating from the lumbar zygapophysial joint. Methods: There were 35 patients enrolled, with ranging in age from 25 to 76 years ($52.6{\pm}12.7$ years, mean ${\pm}$ SD). We studied 7 men (20%) and 28 women (80%). All patients underwent double diagnostic block of $L_{3/4}$, $L_{4/5}$ and $L_5-S_1$ facet joint with 0.5% bupivacaine. The 35 patients fell into the following group. (1) Group A (n = 16): those who felt clear relief (pain free with Likert scale) from the double diagnostic block (2) Group B (n = 19): 11 patients who were always equivocal in their response to the double diagnostic block and 8 patients who were either pain free or equivocal in their response to the double diagnostic block. All 11 patients were done the facet joint denervation. The effect on the pain was evaluated with 4 point Likert scale 1, 6 and 12 weeks after the procedure. We evaluated the relationship between the pain response to diagnostic block and the pain relief with facet joint denervation. Results: Significant correlation was observed between the response to diagnostic block and pain relief with facet denervation (P < 0.05). We found no correlation between the categories of spinal operation and pain response to facet denervation (P value > 0.05). Conclusions: A satisfactory result of lumbar facet joint denervation can be obtained in many patients, especillay in patients whose pain were relieved by the diagnostic double facet joint block. It may be said that facet joint denervation for mechanical low back pain using radiofrequency thermocoagulation is a safe, easy, and repeatable technique.

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The Effect of Temporomandibular Joint Movement Restriction on Treatment of Sternocleidomastoid Muscle Pain (흉쇄유돌근의 통증치료가 측두하악관절의 운동제한에 미치는 효과)

  • Um, Ki-Mae;Bae, Young-Sook
    • The Journal of Korean Physical Therapy
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    • v.19 no.5
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    • pp.43-49
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    • 2007
  • Purpose: The purpose of this study was to the effects of temporomandibular joint movement restriction on treatment of SCM muscle pain. Methods: The Subjects(n=20) were males(n=7) and females(n=13) that had SCM muscle pain and movement restriction at one side oftemporomandibular joint. The massage and Taping performed on the SCM muscle during 4 weeks. The measured items of SCM pain were pressure-pain scale, DITI. The measured items of temporomandibular joint movement restriction were VAS, ROM, deviation. Results: SCM muscle of pressure-pain scale is lower in ipsilateral than counterlateral, But temperature is higher in ipsilateral than counterlateral. Pressure-pain scale was statistical significance (p<0.05). After studying, the pain and temperature of SCM muscle was decreased and statistical significance(p<0.05). After studying, VAS of Temporomandibular joint was decreased, ROM was increased, deviation was decreased. All of measured items of Before and after studying found a statistical significance(p<0.05). Conclusion: This study showed that SCM muscle pain related TM joint pain and movement restriction. The patient with TM joint movement restriction that may take effect on reducing SCM muscle pain.

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The Effect of Hand Moxibustion Therapy on Knee Joint Pain, Joint Range of Motion and Discomfort during ADL in Elderly People (수지뜸요법이 노인의 슬관절통증, 관절가동범위 및 일상생활활동 불편감에 미치는 영향)

  • Woo Soon-Nyeol;Yeo Hyun-Joo;Kim Kyung-Suk;Park Jeong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.244-253
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    • 2003
  • Purpose: This study was done for the purpose of testing the effects of hand moxibustion on pain in the knee joint, range of motion of the knee, and discomfort during ADL in elderly persons with knee joint pain. Method: Nonequivalent control group pre-post test research design was used. The participants were 35 elders who had knee joint pain. Sixteen were assigned to the experimental group and 19 to the control group. The instruments used for this study were the CRS (Graphic rating scale) for knee joint pain, goniometer for knee joint ROM, and modified ADL questionnaire developed by Lee. Analysis of data was done by percents, means and standard deviation, $x^2$-test, t-test, and ANCOVA using SPSS WIN 10.0. Result: The pain score for the right knee joint after hand moxibustion was significantly different between the experimental group and the control group after hand moxibustion (p=.035). The pain score for the left knee joint was not significantly different between the experimental group and the control group after hand moxibustion (p=.075). Right and left knee ROM scores were significantly different between the experimental group and the control group after hand moxibustion (Right p=.000, Left p=.034). Discomfort of ADL score was not significantly different between the experimental group and the control group after hand moxibustion (p=.053). Conclusion: In summary, knee joint pain in elders after hand moxibustion decreased and knee ROM in elders after hand moxibustion increased. So it would be useful for nurses to provide hand moxibustion as an alternative therapy to elders with knee joint pain in the community and thus reduce joint pain and increase knee ROM.

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Effect of Kinesiotaping and Joint Mobilization on The Metatarsophalangeal Joint Angle and Pain in Hallux Valgus Patients

  • Choi, Jung Hyun;Kim, Nyeon Jun;An, Ho Jung
    • Journal of International Academy of Physical Therapy Research
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    • v.8 no.2
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    • pp.1152-1157
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    • 2017
  • The aim of this study was to observe the effects of kinesiotaping and joint mobilization on the metatarsophalangeal joint angle and pain in hallux valgus patients Twenty-one female hallux valgus patients in their 20s were divided into two groups, a Kinesiotaping group (KT, n=10) and another group with the addition of joint mobilization (KTJM, n=11). After undergoing 6 weeks of intervention, the change in the metatarsophalangeal joint and pain were measured. Metatarsophalangeal joint angle was significantly increased both the KT and the KTMJ group after intervention. In the change of pain, both the KT and KTJM groups on an individual basis also experienced a significant decrease in pain, though comparison between the two groups failed to represent a significant difference. These findings suggest that Kinesiotatping and joint mobilization increased the joint angle and reduced pain.

The Effects of Hand Acupuncture Therapy on Pain, ROM, ADL and Depression among Elders with Low Back Pain and Knee Joint Pain (요통 및 슬관절통을 가진 노인에 대한 수지요법 적용의 효과)

  • Yang, Jin-Hyang
    • Journal of Korean Academy of Nursing
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    • v.39 no.1
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    • pp.10-20
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    • 2009
  • Purpose: The purpose of this study was to identify the effects of hand acupuncture therapy on pain, ROM, ADL, and depression among older people with low back pain and knee joint pain. Methods: The research was a quasi-experimental design using a non-equivalent control group pre-post test. The participants were 40 patients, 18 in the experimental group and 22 in the control group. A pretest and 2 posttest were conducted to measure the main variables. For the experimental group, hand acupuncture therapy, consisting of hand acupuncture and press-pellets based on corresponding points, was given. Results: There were statistically significant differences in pain, ROM in knee joint, and ADL in the experimental group but not in depression compared to the control group over two different times. Conclusion: The hand acupuncture therapy was effective for low back pain, knee joint pain, ROM in knee joint and ADL among the elders in this study. Therefore, the hand acupuncture therapy can be utilized in the field of geriatric nursing as a nursing intervention for older people with low back pain and knee joint pain.