In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with ...In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.展开更多
We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was...We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was suffering from lower back pain when bending forward and she had severe pain from her right thumb to her wrist. These symptoms were not improved by massage and orthopedic treatment. On the other hand, once modifying the morphology of natural teeth, those symptoms improved dramatically. No side effects were observed, and the prognosis was good. Our observation suggested a close relationship between the oral situation and remote musculoskeletal conditions, and further multidisciplinary studies are needed to clarify the mechanisms.展开更多
The attrition of professional nurses is a sad reality. Work-related musculoskeletal lower back pain (WRMLBP) among nurses has been cited as a factor of increased sick leave and poor health. Occupational predisposing f...The attrition of professional nurses is a sad reality. Work-related musculoskeletal lower back pain (WRMLBP) among nurses has been cited as a factor of increased sick leave and poor health. Occupational predisposing factors of lower back pain are strenuous physical stresses of nursing, obesity and poor physical conditioning. Regular stretching and strengthening exercises dissipate lower back pain. This commentary’s objectives are to explain the association between obesity and lower back pain and the exercise mechanism that dissipates this pain, thereby concluding that nurses should consider regular exercise as a therapeutic option.展开更多
OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating t...OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating time length group(SL),moderate heating time length group(ML), and long heating time length group(LL) respectively received 15, 30, and 60 min of moxibustion therapy stimulating the acupoint Guanyuan(CV 4). The conventional acupuncture group(CA) received needle acupuncture treatment as a control group. The participants were treated continuously over a 2-week treatment period for a total of 10 sessions, with five sessions given per week. Participants were assessed weekly by blinded assessors, using the visual analogue scale(VAS) and Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores reduced in all four groups during treatment. There were significant differences in VAS scores(P < 0.01) and RMQ scores(P < 0.01) between before treatment and after 2 weeks of treatment in the LL group. After treatment, the LL group reported significantly lower VAS scores compared with the CA group, ML group,and SL group(P < 0.05).CONCLUSION: The long and moderate lengths of heat-stimulating time of 30 and 60 min may be more effective for relieving lower back pain than that of short stimulating time lengths.展开更多
Purpose: Muscle stretching is frequently prescribed in physical therapy to manage lower back and neck pain. However, there is no clear evidence regarding the differences in effectiveness of active and passive stretchi...Purpose: Muscle stretching is frequently prescribed in physical therapy to manage lower back and neck pain. However, there is no clear evidence regarding the differences in effectiveness of active and passive stretching. Therefore, we aimed to evaluate the relative effectiveness of a 12-week program of active and passive stretching on selected physical and mental stress variables of sedentary men with lower back and neck pain. Methods: A cohort of 28 sedentary men, 30 - 49 years old, were divided into two intervention groups: the passive stretching group (PSG, n = 15) and the active stretching group (ASG, n = 13). A trainer assisted with static passive stretching, while participants in the ASG were provided with an instructional video. The following outcomes were measured at the start and end of the first and twelfth week of the stretching program: physical measures (visual analogue scale score of lower back and neck pain;finger-to-floor distance, gravimetric assessment of pelvic tilt, muscle hardness of the biceps femoris, and straight-leg raising) and mental stress measures (α-amylase and cortisol levels in saliva samples). Results: Although both active and passive stretching produced acute changes in lower back and neck pain, only passive stretching yielded long-term improvement in pain, finger-to-floor distance, pelvic tilt, hardness of biceps femoris muscle and cortisol levels (p Conclusion: Passive stretching is superior to active stretching in reducing pain, increasing muscle extensibility and correcting posture among a group of sedentary men with lower back and neck pain.展开更多
慢性腰痛(chronic low back pain,CLBP)具有病程长、发病率高、复发率高、致残率高等特点,降低CLBP的复发是一个重要课题。影响CLBP复发的西医角度内外因素有年龄、性别、脊柱先天畸形、前庭功能、心理因素、遗传、职业、平素姿势及中...慢性腰痛(chronic low back pain,CLBP)具有病程长、发病率高、复发率高、致残率高等特点,降低CLBP的复发是一个重要课题。影响CLBP复发的西医角度内外因素有年龄、性别、脊柱先天畸形、前庭功能、心理因素、遗传、职业、平素姿势及中医角度的气血、体质、神。不仅要从结构上认识CLBP,还要从体质、气血、神等方面,在辨证体系指导下做综合调整,方能激活自身的自愈功能,实现降低CLBP的复发。展开更多
背景:目前运动疗法是非药物治疗腰痛的有效方法,运动疗法可通过骨骼和肌肉之间的机械-化学偶联维持腰椎的稳定,但目前尚无关于运动疗法通过机械-化学偶联缓解慢性非特异性下背痛之间研究进展及最佳治疗方案的明确阐述。目的:综述运动疗...背景:目前运动疗法是非药物治疗腰痛的有效方法,运动疗法可通过骨骼和肌肉之间的机械-化学偶联维持腰椎的稳定,但目前尚无关于运动疗法通过机械-化学偶联缓解慢性非特异性下背痛之间研究进展及最佳治疗方案的明确阐述。目的:综述运动疗法时椎旁肌通过机械-化学偶联影响腰椎稳定性进而缓解慢性非特异性下背痛的相关研究进展,以及目前运动疗法治疗慢性非特异性下背痛的最佳方案。方法:在万方数据库、中国知网、维普、Web of Science和PubMed数据库进行文献检索,以“慢性非特异性下背痛,腰椎稳定,椎旁肌,运动疗法”为中文检索词,以“chronic nonspecific low back pain,lumbar stabilization,paravertebral muscle,exercise therapy”为英文检索词,检索各数据库建库至2024年1月发表的相关文献,最终纳入93篇文献进行归纳总结。结果与结论:运动疗法可以通过适当的机械刺激作用于椎旁肌和骨骼并使其产生相应的变化。运动疗法主要通过机械-化学偶联方式来提高椎旁肌的质量,进而维持腰椎稳定,从而更好地缓解慢性非特异性下背痛,是慢性非特异性下背痛的重要干预措施。但是,对于运动疗法通过腰椎稳定来治疗慢性非特异性下背痛的确切有效方案尚无明确报道。个体化运动方案的制定对于慢性非特异性下背痛的治疗和预后尤为重要。同一个体的肌肉质量与骨骼质量是密切相关的,影像学评估椎旁肌的质量和体积对于疾病的发现和干预具有重要意义。展开更多
基金Supported by The National Research Foundation of Korea Grant funded by the Korea Government,No.00219725.
文摘In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.
文摘We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was suffering from lower back pain when bending forward and she had severe pain from her right thumb to her wrist. These symptoms were not improved by massage and orthopedic treatment. On the other hand, once modifying the morphology of natural teeth, those symptoms improved dramatically. No side effects were observed, and the prognosis was good. Our observation suggested a close relationship between the oral situation and remote musculoskeletal conditions, and further multidisciplinary studies are needed to clarify the mechanisms.
文摘The attrition of professional nurses is a sad reality. Work-related musculoskeletal lower back pain (WRMLBP) among nurses has been cited as a factor of increased sick leave and poor health. Occupational predisposing factors of lower back pain are strenuous physical stresses of nursing, obesity and poor physical conditioning. Regular stretching and strengthening exercises dissipate lower back pain. This commentary’s objectives are to explain the association between obesity and lower back pain and the exercise mechanism that dissipates this pain, thereby concluding that nurses should consider regular exercise as a therapeutic option.
基金Supported by the National Natural Science Foundation of China(Study the Mechanism Based On the P38mapk Signal Pathway Mediated by Cautery Moxibustion Therapy of Hui Medicine Treatment Idd,No.81360567 And Research on Mechanism of Koa Treated By Cautery Moxibustion of Hui Medicine Based on Wnt/β-catenin Signaling Pathway,No.81460757)Ningxia Natural Science Foundation(Evaluation of Different Moxibustion Doses for Low Back Pain,No.NZ11208)
文摘OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating time length group(SL),moderate heating time length group(ML), and long heating time length group(LL) respectively received 15, 30, and 60 min of moxibustion therapy stimulating the acupoint Guanyuan(CV 4). The conventional acupuncture group(CA) received needle acupuncture treatment as a control group. The participants were treated continuously over a 2-week treatment period for a total of 10 sessions, with five sessions given per week. Participants were assessed weekly by blinded assessors, using the visual analogue scale(VAS) and Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores reduced in all four groups during treatment. There were significant differences in VAS scores(P < 0.01) and RMQ scores(P < 0.01) between before treatment and after 2 weeks of treatment in the LL group. After treatment, the LL group reported significantly lower VAS scores compared with the CA group, ML group,and SL group(P < 0.05).CONCLUSION: The long and moderate lengths of heat-stimulating time of 30 and 60 min may be more effective for relieving lower back pain than that of short stimulating time lengths.
文摘Purpose: Muscle stretching is frequently prescribed in physical therapy to manage lower back and neck pain. However, there is no clear evidence regarding the differences in effectiveness of active and passive stretching. Therefore, we aimed to evaluate the relative effectiveness of a 12-week program of active and passive stretching on selected physical and mental stress variables of sedentary men with lower back and neck pain. Methods: A cohort of 28 sedentary men, 30 - 49 years old, were divided into two intervention groups: the passive stretching group (PSG, n = 15) and the active stretching group (ASG, n = 13). A trainer assisted with static passive stretching, while participants in the ASG were provided with an instructional video. The following outcomes were measured at the start and end of the first and twelfth week of the stretching program: physical measures (visual analogue scale score of lower back and neck pain;finger-to-floor distance, gravimetric assessment of pelvic tilt, muscle hardness of the biceps femoris, and straight-leg raising) and mental stress measures (α-amylase and cortisol levels in saliva samples). Results: Although both active and passive stretching produced acute changes in lower back and neck pain, only passive stretching yielded long-term improvement in pain, finger-to-floor distance, pelvic tilt, hardness of biceps femoris muscle and cortisol levels (p Conclusion: Passive stretching is superior to active stretching in reducing pain, increasing muscle extensibility and correcting posture among a group of sedentary men with lower back and neck pain.
文摘背景:腰椎小关节炎是引起下腰痛的一个主要原因,目前主要依靠MRI进行初步定性诊断,但仍有一定漏诊、误诊的概率发生,因此MR T2^(*)mapping成像技术有望成为定量检查腰椎小关节炎软骨损伤的重要检测手段。目的:探讨MR T2^(*)mapping成像技术在定量分析腰椎小关节炎软骨损伤退变中的应用价值。方法:收集南京医科大学第四附属医院2020年4月至2022年3月门诊或住院合并下腰痛共110例患者,设为病例组;同时招募无症状志愿者80例,设为对照组。对所有纳入对象L1-S1的小关节行3.0 T MR扫描,获取T2^(*)mapping横断位图像和T2WI图像,分别对所有小关节软骨进行Weishaupt分级及T2^(*)值测量,收集数据并行统计学分析。不同小关节Weishaupt分级之间小关节软骨T2^(*)值比较采用单因素方差分析。结果与结论:①经统计分析发现,病例组腰椎小关节软骨T2^(*)值(17.6±1.5)ms明显较对照组(21.4±1.3)ms降低,差异有显著性意义(P<0.05);②在病例组中,随着腰椎小关节Weishaupt分级增加,小关节软骨T2^(*)值也呈逐渐下降趋势,且这种差异有显著性意义(P<0.05);③提示T2^(*)mapping能够较好地显示腰椎小关节软骨损伤的早期病理变化,腰椎小关节软骨的T2^(*)值能够定量评估腰椎小关节的软骨损伤程度;T2^(*)mapping成像技术能为影像学诊断腰椎小关节炎软骨早期损伤提供很好的理论依据,具有重要的临床应用价值。
文摘慢性腰痛(chronic low back pain,CLBP)具有病程长、发病率高、复发率高、致残率高等特点,降低CLBP的复发是一个重要课题。影响CLBP复发的西医角度内外因素有年龄、性别、脊柱先天畸形、前庭功能、心理因素、遗传、职业、平素姿势及中医角度的气血、体质、神。不仅要从结构上认识CLBP,还要从体质、气血、神等方面,在辨证体系指导下做综合调整,方能激活自身的自愈功能,实现降低CLBP的复发。
文摘背景:目前运动疗法是非药物治疗腰痛的有效方法,运动疗法可通过骨骼和肌肉之间的机械-化学偶联维持腰椎的稳定,但目前尚无关于运动疗法通过机械-化学偶联缓解慢性非特异性下背痛之间研究进展及最佳治疗方案的明确阐述。目的:综述运动疗法时椎旁肌通过机械-化学偶联影响腰椎稳定性进而缓解慢性非特异性下背痛的相关研究进展,以及目前运动疗法治疗慢性非特异性下背痛的最佳方案。方法:在万方数据库、中国知网、维普、Web of Science和PubMed数据库进行文献检索,以“慢性非特异性下背痛,腰椎稳定,椎旁肌,运动疗法”为中文检索词,以“chronic nonspecific low back pain,lumbar stabilization,paravertebral muscle,exercise therapy”为英文检索词,检索各数据库建库至2024年1月发表的相关文献,最终纳入93篇文献进行归纳总结。结果与结论:运动疗法可以通过适当的机械刺激作用于椎旁肌和骨骼并使其产生相应的变化。运动疗法主要通过机械-化学偶联方式来提高椎旁肌的质量,进而维持腰椎稳定,从而更好地缓解慢性非特异性下背痛,是慢性非特异性下背痛的重要干预措施。但是,对于运动疗法通过腰椎稳定来治疗慢性非特异性下背痛的确切有效方案尚无明确报道。个体化运动方案的制定对于慢性非特异性下背痛的治疗和预后尤为重要。同一个体的肌肉质量与骨骼质量是密切相关的,影像学评估椎旁肌的质量和体积对于疾病的发现和干预具有重要意义。
