Chronic Lumbago Research Articles

Kinesiotherapy and non-steroidal anti-inflammatory drugs for nonspecific lumbago

A combined approach is recommended to treat chronic non-specific low back pain (lumbago), including pharmacological and non-pharmacological methods. Kinesiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs) have a high level of evidence in chronic lumbago. Kinesiotherapy includes posture and daily motor activity regimen training, a complex of therapeutic and breathing exercises, post-isometric relaxation, and other physical exercises. NSAIDs reduce pain, improve functional status, and increase patients' adherence to kinesiotherapy, relieving pain in the first days of treatment. A specific NSAID administration is usually individualized, considering the comorbidities and the risk of possible side effects. The use of meloxicam (Movalis) for back pain is discussed.

Therapeutic Uses of Earthworm – A Review

Based on review of literature on Unani Medicine and contemporary scientific investigations, the study demonstrates enormous potential of common Indian earthworm to combat many human ailments. The information on clinical, pharmacological and chemical studies carried out on earthworms between 1930 and 2009 in India and abroad has been reviewed in an effort to substantiate their medical efficacy. In this paper, the methods of collection and processing of earthworms, their pharmaceutical composition, preliminary pharmacological and clinical effects on (i) nervous system; (ii) blood circulatory system; (iii) cardiovascular system; (iv) respiratory system; (v) uterus smooth muscle function; and (vi) anticancer properties are reviewed. Therapeutic efficacy of earthworms has been shown for tracheitis and bronchial asthma, epilepsy, high blood pressure, schizophrenia, leg ulcers, mumps, eczema, urticaria and anaphylaxis diseases, burns and scald fractures, erysipelas, sequel of encephalitisB, chronic lumbago, skin crevices, blood deficiency apoplexy, acute injury of soft tissues, vertigo, hematemesis and hematuria, digestive ulcer, vesicle calculus and cancer. Taking lead from the present reports detailed scientific investigations are needed to discover new therapeutic agents of zoological origin which might be very specific to treat certain diseases and conditions, thus far, incurable in modern medicine.

Pain perception and thermographic analysis in patients with chronic lower back pain submitted to osteopathic treatment

Introduction: Lower back pain (LBP), one of the main causes of pain, employee absenteeism and disabilities, exhibits a multifactorial and degenerative etiology, with different characteristics. Objective: a) analyze the acute effect of osteopathic treatment on the temperature of three dermatomes of patients with chronic lumbago; and b) assess the subjective pain perception of patients before and after an osteopathic session. Materials and methods: Quasi-experimental cross-sectional study of 14 individuals treated at a physical therapy clinic in Brasilia, Brazil. Data collection included physical therapy, pain scale (VAS), thermographic and anthropometric assessment. Treatment consisted of a single osteopathic session. Results and conclusions: leg and foot temperature declined (∆% = 2.91 and 4.76%, respectively, p = 0005) in the innervations of 2 regions of interest (ROIs) of the L4 lower limb dermatome and pain levels decreased (∆% = 65.98 and 59.92%, p = 0.005) in the men and women, respectively. In addition, a strong correlation was observed between the maximum (r=0.742 and p-value = 0.002) and mean temperature variations of the lumbar region (r=0.733 and p-value = 0.003), according to the VAS. It was concluded that acute osteopathic treatment was efficient in varying the temperature at reference points of the dermatome analyzed and lowering pain perception, suggesting the effectiveness of the proposed treatment.

Radiofrequency facet joint denervation efficiency based on the severity of spondylarthrosis and in osteoporotic vertebral compression fractures. A retrospective study

ObjectivesRadiofrequency denervation of the facet joints is performed via a well-established method. Its primary, direct indication is a positive response to a nerve block injection (MBB). Our study aimed to find other, effective but indirect indication signs through the retrospective analysis of our patients treated earlier. Patients and methodsIn our institute between 1 January, 2008 and 31 December, 2017 facet joint denervation has been performed in more than 2000 cases, and we included 529 patients in our retrospective study. We had separate groups for vertebral compression fractures and for spondylarthrosis of different severity (Grade 1; 2–3; 4), thus we assessed the postoperative condition of these patients using Visual Analoge Scale (VAS). The efficacy of the intervention was examined in every groups separately according to symptoms and previous spine surgeries. ResultsIn view of our results, chronic lumbago and dorsalgia that are attributable to osteoporotic vertebral compression fracture are obvious indications if they do not respond to conservative therapy, as 76.8% of such patients remained asymptomatic for minimum 6 months (p = 0,000). Another indication is Grade 2 or 3 chronic spondylarthrosis without radicular involvement, since these groups reported a 51.4% success rate (asymptomatic for minimum 6 months) (p = 0,015). Long term pain relief is obviously impaired by the presence of radicular compression, as we were not able to decrease the pain of 97% of such patients. Our findings also suggest that the vast majority of those who have previously undergone spine surgery cannot benefit from the intervention. ConclusionBased on this study, facet joint denervation can serve as an effective therapy supplement in a properly selected group of patients who do not respond to oral NSAIDs, exercise and physiotherapy. By this procedure we found we can reach long term benefit in the groups of osteoporotic vertebral fracture patients and patients with moderate spondylarthrosis. According to our results and the literature datas the properly patient selection for the indication of the RF ablation can be as effective as the controversial diagnostic nerve block injections.

A development of an epiduroscopy training simulator based on spatial cognition learning

An epiduroscopy is an effective minimally invasive surgery (MIS) used for chronic lumbago and lumbar disc herniation. As such an endoscopy is hard to learn high-level surgical skills, efficient surgical training method or system is required. Therefore, this paper proposed an epiduroscopy training simulator based on spatial cognition learning. The proposed training simulator provided four scenarios for catheter manipulation training, and it provides quantitative training results based on various measured data (completion time, number of violation and surgical instrument trajectory).

Gait training assist system of a lower limb prosthetic visualizing muscle activation pattern using a color-depth sensor.

Some unilateral lower-limb amputees load the intact limb more than the prosthetic limb. This can cause chronic pains, fatigue, lumbago, and joint diseases, including knee osteoarthritis. To avoid and counteract these symptoms it is necessary to improve their asymmetric gait. Increasing the function of the hip abductor muscle is important to maintaining symmetrical weight distribution. Therefore, the purpose of this study is to develop a training assist system, which estimates and visualizes an abductor muscle by using a color-depth sensor. To estimate the muscle activation, first, the floor reaction force is calculated using a simple dynamic model. Then, the hip torque is calculated using joint angles. The floor reaction force and, the muscle length are calculated based on a human musculoskeletal model. Muscle activity is estimated by these parameters. Evaluation experiments of this proposed method were performed on healthy persons and unilateral trans femoral amputees, and the effectiveness of this proposed algorithm has been confirmed.

Effects of Pilates and Tai Chi on Pain and Dysfunction in Chronic Lumbago Patients

Effects of Pilates and Tai Chi on Pain and Dysfunction in Chronic Lumbago Patients

Contribution of Musculoskeletal Disorders to Chronic Lumbago in Parkinson’s Disease

Purpose: To clarify the impact of bone metabolism disorder on lumbago in Parkinson’s Disease (PD). Methods: Data was retrospectively analyzed from 52 patients with PD in our outpatient clinic for more than 1 year (mean age, 63 ± 4 years old; mean duration from onset, 6.3 ± 0.8 years). Patients’ characteristics, comorbid musculoskeletal disorders, serum bone metabolism biomarkers, and bone mineral density were examined. Results: Twenty-one PD patients (40.2%) had chronic lumbago. Severe comptocormia and scoliosis were the most common musculosketal disorders in this group (47.6%) affected by lumbago, followed by osteoporosis (14.3%), compression fracture (4.8%). There was no significant difference in the duration of PD, body mass index, frequency of falls, bone mineral density, tartrate-resistant acid phosphatase-5b, osteocalcin, and N-terminal telopeptide between PD patients with or without chronic lumbago. Multivaritae logistic regression analysis identified the independent predictors of chroni lumbago in PD patients as Hoen-Yahr stage (odds ration [OR] = 2.794, 95%CI 1.103 - 7.076), and elevated serum 1,25-OH2 vitamin D level ([OR] = 0.92, 95%CI 0.86 - 98). Conclusion: Bone metabolism disorders are found to be associated with chronic lumbago in PD patients.

Earthworm as a biopharmaceutical: from traditional to precise

As a traditional Chinese medicine (TCM), earthworm (Dilong) was applied in China for ages. Some active proteins and compounds in earthworm were characteristic composition as a pharmaceutical, including fibrinolytic enzymes, lumbrokinase, collagenase, superoxide dismutase, cholinesterase, catalases, glycosidases, metallothionein, calmodulin-binding protein, proteins with proliferation improving activity, lysenin, eiseniapore, antitumor protein, glycoprotein extract, gut mobility regulation peptide, antibacterial peptide, carbamidine, lumbritin, lumbrofobrim, terrestrolumbrolysin, purin, vitamin B, tyrosine, succinic acid, lauric acid, unsaturated fatty acid and so on. These earthworm components had more or less pharmacological and clinical functions on effects on the nervous system, blood system, the cardiovascular system, the respiratory system, uterus smooth muscle, and its anticancer function and sperm-killing function. Lumbricus metalchelatins (LMT) among these active components has detoxification function. LMT is one of the most common heavy metal detoxification, which are small cysteine-rich and non-ribosomal peptides that chelate soft metal and metalloid ions, such as cadmium, zinc and arsenic. LMT function of scavenging free radicals plays an important role in the process of the anti-aging, anti-oxidative stress and cell apoptosis, etc. No matter whole dry body or abstracted components, earthworm has been use to treat at least 19 human diseases in clinical, including treatments of tracheas, bronchial asthma, epilepsy, high blood pressure, schizophrenia, leg ulcers, mumps, eczema, urticaria and anaphylaxis diseases, chronic prostatitis, burns and scald, fractures, erysipelas, chronic lumbago, blood-deficiency apoplexy, acute injury of soft tissues, vertigo, hematemesis and hematuria, digestive ulcer, vesical calculus and cancer.

척추 질환으로 내원한 일본 직장인의 허리 통증 경험이 신체 부위 근골격계질환과의 관련성에 관한 연구

The study targeted Japanese employees who have visited hospital for spinal disorder. The study analyzed work environment and pain relief methods of work-related back pain patients, and the relationship between back pain and other body parts. The purpose of this study was to provide draw up measures for patients with back pain and to provide basic data for the sustainable prevention program. The study result of back pain, in other words, employees suffering from lumbago, had disparity between occupations; the highest number of patients were made up of 16-years or above long-serving employees, and below 5-years of short-serving employees. There were more patients complaining of chronic lumbago than acute lumbago, and patients recognized poor posture as the primary cause of lumbago. Furthermore, 99.5% of spinal disorder patients complain back pain, 23.2% use only alternative therapy, and 15.2% visit clinic and hospital with alternative therapy. Patients showed pain reduction and high satisfaction after using alternative therapy. The study targeted Japanese employees where complement therapy is more generalized than that of Korea, and thus there should be multilateral management programs provided in Korea as well.

Dexamethasone added to local lidocaine for infiltration along the spinal-epidural needle pathway decreases incidence and severity of backache after gynecological surgery.

BackgroundThe aim of this study was to evaluate the effect of dexamethasone added to local lidocaine infiltration on incidence and severity of backache after combined spinal-epidural anesthesia for gynecological surgery.Material/MethodsWe randomly allocated 160 patients to receive either local lidocaine infiltration along the pathway of the spinal-epidural needle (Group L) or local dexamethasone and lidocaine infiltration (Group DL). The incidence and scores for back pain were evaluated on the first, second, and third day (acute lumbago) and first, second, and sixth month (chronic lumbago) after surgery. Fentanyl consumption for management of back pain was recorded.ResultsThe incidence of acute, subacute, and chronic back pain was significantly lower in the DL group than the L group (P<0.05 for all comparisons). The VAS score for back pain on the first and second day and first and second month, were significantly lower in the DL group than the L group (P=0.0028, P=0.017; P<0.001, both), but there were no significant differences on the third day and sixth month. Fentanyl consumption in the first 3 postoperative days was significantly lower in the DL group than in the L group (P<0.001). The incidence of back pain during the first, second, and sixth month in patients who did not have preoperative lumbago were significantly lower in the DL group than in the L group (P<0.001, both).ConclusionsAddition of dexamethasone to local lidocaine infiltration effectively decreases the incidence and severity of back pain after combined spinal-epidural anesthesia implemented for gynecological surgery.

Treatment for low back pain, use of meloxicam

To manage patients with low back pain is an urgent problem of modern medicine. The paper considers the main causes of chronic nonspecific lumbago and the principles of its diagnosis and treatment in the context of evidence-based medicine. Medical treatment using analgesics (nonsteroidal anti-inflammatory drugs (NSAIDs), weak opioids), antidepressants, therapeutic exercises, and cognitive-behavioral therapy as components of a multidisciplinary treatment is noted to be highly effective. The efficacy and side effects of NSAIDs, the high efficiency and safety of using meloxicam in different dosage forms are outlined. The authors set forth their experience in treating 85 patients with chronic low back pain and an observation of a female patient who has concurrent chronic migraine and abuses analgesics.

Optimization of therapy in outpatients with chronic lumbago

Lumbago is one of the most common lower back pain syndromes in medical practice, which is benign in the vast majority of cases and caused by spinal osteochondrosis, injury, and muscle strain or spasm. The primary task of examining a patient with lumbago is to be certain that the pain is musculoskeletal and unassociated with a potentially dangerous spinal disease requiring emergency special therapy. Objective: to analyze the efficiency of treatment in outpatients with chronic lumbago. Patients and methods. One hundred and four patients followed up by us in the Smolensk Kinesitherapy Center were examined. A study group comprised 84 patients (34 men and 50 women; mean age 44.2±1.29 years) with dorsalgia (pain duration ≥3 months; mean 7.6±6.83 years);a control group included 20 persons (10 men and 10 women; mean age 31.9±1.88 years) without pain in the back. Neurological examination and magnetic resonance imaging revealed nonspecific lower back pain in 67 (79.8%) patients and radiculopathy in 17 (20.2%). Combination treatment including pharmacotherapy and kinesitherapy was proposed in all the patients. Results. 2.5–3 months after the initiation of therapy, pain regressed completely in 29 (34.5%) patients and was considerably alleviated in 27 (32.1%). Quality of life after therapy improved in the majority of patients. The patients in whom therapy was ineffective (n = 26; 31%) did not attend kinesitherapy classes and were cautious towards physical rehabilitation. Discussion . The findings indicated the high efficiency of a comprehensive approach to treating chronic lumbago, which is largely associated with rational psychotherapy, early patient activation, and adaptive behavior training.

Current principles in the management of patients with chronic nonspecific lumbago

To manage patients with low back pain is an urgent problem of modern medicine. The paper covers the main causes of chronic nonspecific lumbago and the principles of its diagnosis and treatment in the context of evidence-based medicine. A multidisciplinary treatment approach involving drug therapy with analgesics (nonsteroidal anti-inflammatory drugs), antidepressants, myorelaxants, therapeutic exercises, and cognitive-behavioral therapy is noted to be highly effective.

3주간의 복횡근 강화운동이 만성요통 환자의 요부근력과 통증완화에 미치는 영향

Purpose : The purpose of this study was to analyze the effects of transverse abdominal exercise on the change of chronic low back pain and lumbar muscle strength. Method : 18 chronic lumbago patients were transverse abdominal exercise for 3weeks. Result : 1. The strength of the lumbar extensor and flexor of the male subjects was increased significantly after abdominal exercise(p<0.05). 2. The strength of the lumbar extensor and flexor of the female subjects was increased significantly after abdominal exercise(p<0.05). 3. The study can confirm significant relationship between the lumbar muscle strength and lumbar pain before and after the exercise Conclusion : The study of could find the increase of the ability of the lumbar extensor and flexor of both male and female subjects suffering from chronic low back and pain using three-week transverse abdominal exercise. The study confirmed the general decrease of pain after the experiment.

Magnetic resonance imaging: a valuable method for diagnosing chronic lumbago caused by lumbar muscle strain and monitoring healing process

Background Magnetic resonance imaging (MRI) is the most sensitive technique for evaluating the healing process and should be performed before the patients return to their exercise routines. The aim of this research was to diagnose chronic lumbago associated with lumbar muscle strain and to monitor healing process by MRI. Methods Sixty-five symptomatic cases of chronic lumbago caused by lumbar muscle strain were collected from March 2009 to October 2011. MRI was used to examine, diagnose and monitor the healing process. The control group included 65 random cases of asymptomatic volunteers. MRI methods included routine sequences of GRE T1WI, TSE T2WI and special sequences of T2-STIR-FS, combined with DWI. We compared the MRI characteristics of symptomatic cases before and after healing and with asymptomatic controls. Results The important MRI characteristics of chronic lumbago with lumbar muscle strain included: (1) The low back muscle showed edema. (2) The low back intermuscular spaces showed edema and/or fluid. (3) The low back spaces beside the spinous process showed edema and/or fluid. (4) The low back vertebral articular process fossae or transverse process fossae showed fluid. Of these image characteristics, the intermuscular space edema provided the best diagnostic sensitivity, Se=83%, with YI=0.63, π=74%. The low back muscle edema provided the best diagnostic specificity, Sp=100%, with YI=0.66, π=83%. And the spaces edema beside the spinous process provided the best diangnostic accuracy, π=86%, with YI = 0.71, Se=80%, Sp=91%. The diagnosis accurate could be improved by combining multiple MRI characteristics. The diagnostic accuracy could achieve π=93%, with YI=0.86, Se=100% and Sp=86% when two characteristics were combined. After rehabilitation care, the edema disappeared on the repeated MRI. Conclusions MRI may well be a useful diagnostic method for lumbago with lumbar muscle strain. Combining routine sequences with T2-STIR-FS and DWI sequences could demonstrate the pathological changes of lumbar muscle strain and monitor the healing.

Chronic lumbago patient's physical fi ndings and relation to psychosocial factor

Chronic lumbago patient's physical fi ndings and relation to psychosocial factor

Effectiveness of intervention for low back pain in female caregivers in nursing homes: a pilot trial based on multicenter randomization

Although the importance of stretching exercise for pain-relieving and patient education is well documented for chronic lumbago patients, it is uncertain how effective on-the-job training (OJT) is for female caregivers in nursing homes. In the present pilot trial based on multicenter randomization, we evaluated the intervention effect of a lecture and stretching exercise on caregivers in nursing homes. Eighty-eight female caregivers (four nursing homes) volunteered to participate in this study, and they were separated into two groups randomly. For the intervention group, guidance by an orthopedist and an exercise instructor were provided as one OJT, and stretching exercises for only 6 min every day were recommended for low back pain prevention to the caregivers. Low back pain visual analogue scale (VAS), physical fitness, and mental and physical health were compared at baseline and immediately after the intervention. A total of 29 (33%) participants withdrew by 12 weeks. Regarding the reasons for withdrawal, 28 participants resigned, and one took a leave of absence due to exacerbation of lumbago. Adherence to the stretching exercises was 2.3 ± 1.3 (mean ± SD) times per week. No significant differences were seen for any outcome measurements. The high adherence group (≧3 times per week) did not show a change in the VAS, but the low adherence group (<3 times per week) and control group showed a tendency towards an increased score (p = 0.068). Even with the conduct of one OJT, and exercises of only 6 min every day, the adherence of caregivers was low, and there appeared to be few effects of the OJT.

The efficacy of paroxetine in chronic lumbago and lower limb pain: three case reports

The efficacy of paroxetine in chronic lumbago and lower limb pain: three case reports

Paravertebral glomangiomatosis

Glomangiomatosis is benign but may manifest as diffusely, locally infiltrating lesions and recur after simple excision. However, conservative treatment should be advocated. The authors report a recent case in which the lesion occurred in the paravertebral area. The patient was a 39-year-old Chinese man who complained of chronic lumbago for 20 years. The clinicopathological features, in conjunction with the immunostaining pattern and ultrastructural features, confirmed the diagnosis. Glomangiomatosis is an extremely rare soft-tissue lesion. To the best of authors' knowledge, only 10 cases have been reported in the English-language literature worldwide, and the current case is the first to represent a lesion arising from the paravertebral area. The authors review the English-language literature in glomangiomatosis.