The number of patients with low back pain has increased due to changes in living and working habits.It has become one of the most common diseases in Chinese and Thai clinics.Treatment with Thai traditional medicine ca...The number of patients with low back pain has increased due to changes in living and working habits.It has become one of the most common diseases in Chinese and Thai clinics.Treatment with Thai traditional medicine can effectively alleviate and manage low back pain.This paper aims to summarize the clinical efficacy and distinctive features of Thai traditional medicine(TTM)in managing low back pain.By reviewing recent literature on TTM treatments,including Thai massage,herbal hot massage,and Thai herbal medicine,the paper aims to lay a foundation for TTM treatment in the world and to promote the convergence and development of traditional Chinese and Thai traditional medicine treatment.Additionally,it advocates for the integration and advancement of both Chinese and Thai traditional medical practices,while also encouraging the dissemination of traditional medicine to other countries globally.展开更多
[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized c...[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized controlled trial design was employed in this study.Ninety patients with chronic low back pain were recruited and randomly assigned to either a control group(n=45),which received conventional rehabilitation,or an experimental group(n=45),which received conventional rehabilitation combined with core stability training.Both groups underwent treatment for 6 weeks.Assessments were conducted using the visual analogue scale(VAS),Oswestry disability index(ODI),and finger-to-floor test prior to treatment,6 weeks following treatment,and during the follow-up period,respectively.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups in terms of general information and various baseline measurements(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups demonstrated significant improvements in VAS scores,ODI scores,and lumbar anteflexion range of motion compared to baseline measurements(P<0.05).Notably,the magnitude of improvement in the experimental group exceeded that of the control group,with this inter-group difference reaching statistical significance(P<0.05).No serious adverse reactions were reported during the treatment process.[Conclusions]Core stability training combined with conventional rehabilitation can significantly enhance the alleviation of pain and functional impairments in patients suffering from chronic low back pain.This approach holds valuable implications for the optimization of rehabilitation treatment protocols.展开更多
Objectives:To explore the use of a traditional Chinese medicine(TCM)pattern scale as an outcome measure to evaluate the management of patients with chronic low back pain(CLBP).Methods:A total of 204 participants were ...Objectives:To explore the use of a traditional Chinese medicine(TCM)pattern scale as an outcome measure to evaluate the management of patients with chronic low back pain(CLBP).Methods:A total of 204 participants were recruited and randomly allocated into three CLBP treatment groups:Tuina only,physiotherapy only,and a combined physiotherapy+Tuina group.All participants were assessed for treatment outcomes using the TCM pattern scale as a substudy to a randomized controlled trial in which the Visual Analog Scale(VAS)was the primary outcome measure.TCM pattern scores were recorded by non-TCM research assistants who were trained to administer a TCM pattern questionnaire developed by the authors in collaboration with TCM experts.Results:Most participants(83%)were classified as having kidney deficiency pattern as the primary TCM pattern at baseline.All three intervention groups showed a significant decrease in overall TCM pattern score at month 2(M2)and month 5(M5).However,when the nimodipine method was applied,none of the three treatment arms showed a statistically significant change in the effective rate,even though the parent study reported a significant decrease in VAS scores in all treatment arms.Conclusion:This study found improvements in both the dominant TCM pattern score and the overall TCM pattern score for each group.These findings suggest that TCM pattern diagnosis,including entities recognized in International Classification of Diseases,11th Revision(ICD)-11,may be used as a quantitative outcome measure to reflect response to TCM-based intervention.The TCM pattern scale reported here may potentially be applied in other chronic pain studies involving TCM patterns.Further studies are warranted to validate this scale in other clinical conditions.展开更多
Aging is a pivotal risk factor for intervertebral disc degeneration(IVDD)and chronic low back pain(LBP).The restoration of aging nucleus pulposus cells(NPCs)to a youthful epigenetic state is crucial for IVDD treatment...Aging is a pivotal risk factor for intervertebral disc degeneration(IVDD)and chronic low back pain(LBP).The restoration of aging nucleus pulposus cells(NPCs)to a youthful epigenetic state is crucial for IVDD treatment,but remains a formidable challenge.Here,we proposed a strategy to partially reprogram and reinstate youthful epigenetics of senescent NPCs by delivering a plasmid carrier that expressed pluripotency-associated genes(Oct4,Klf4 and Sox2)in Cavin2-modified exosomes(OKS@M-Exo)for treatment of IVDD and alleviating LBP.The functional OKS@M-Exo efficaciously alleviated senescence markers(p16^(INK4a),p21^(CIP1)and p53),reduced DNA damage and H4K20me3 expression,as well as restored proliferation ability and metabolic balance in senescent NPCs,as validated through in vitro experiments.In a rat model of IVDD,OKS@M-Exo maintained intervertebral disc height,nucleus pulposus hydration and tissue structure,effectively ameliorated IVDD via decreasing the senescence markers.Additionally,OKS@MExo reduced nociceptive behavior and downregulated nociception markers,indicating its efficiency in alleviating LBP.The transcriptome sequencing analysis also demonstrated that OKS@M-Exo could decrease the expression of age-related pathways and restore cell proliferation.Collectively,reprogramming by the OKS@M-Exo to restore youthful epigenetics of senescent NPCs may hold promise as a therapeutic platform to treat IVDD.展开更多
Introduction: Common low-back pain is a frequent reason for consultation and a genuine public health problem. Preserving quality of life remains one of the main challenges. Objective: To evaluate the quality of life o...Introduction: Common low-back pain is a frequent reason for consultation and a genuine public health problem. Preserving quality of life remains one of the main challenges. Objective: To evaluate the quality of life of patients with low back pain seen in rheumatology consultations at Brazzaville University Hospital. Patients and Method: Cross-sectional, analytical study with control group, conducted at the Brazzaville University Hospital, from January 2 to September 30, 2023. Patients over 30 years of age, seen for documented common low-back pain, were included. Study variables were epidemiological, clinical and functional. The EIFEL and SF-36 scores were used to assess functional impact and quality of life, respectively. Results: We included 96 people divided into two groups: 48 patients with low back pain and 48 controls. The frequency of common low-back pain was 12.8%. The mean age of patients with low back pain was 59.14 ± 11.86 years. Women predominated (sex ratio 0.3). Degenerative disc disease was the main etiology. Common low-back pain had a moderate impact on functional abilities, with a mean EIFEL score of 11 +/− 5.51. Quality of life was impaired in patients with low back pain (overall SF-36 at 43.95%) compared with the control group, with a statistically significant difference (P Conclusion: Common low back pain affects patients’ overall quality of life, particularly in terms of physical pain and limitations due to physical condition.展开更多
Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading pr...Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.展开更多
Purpose: The purpose of this umbrella review was to synthesize the evidence from systematic reviews on the benefits and harms of exercise therapy and physical activity(PA) for the secondary prevention and management o...Purpose: The purpose of this umbrella review was to synthesize the evidence from systematic reviews on the benefits and harms of exercise therapy and physical activity(PA) for the secondary prevention and management of low back pain(LBP).Methods: An umbrella review was conducted to evaluate the effectiveness of exercise therapy and PA in the management and secondary prevention of LBP. A systematic search was performed in MEDLINE, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews,and Physiotherapy Evidence Database(PEDro), including reference lists of relevant reviews, covering studies published between January 1,2010 and May 20, 2024. Eligible studies were systematic reviews of randomized controlled trials and observational studies, with or without meta-analyses. The primary outcome for secondary prevention was LBP recurrence, while for management, primary outcomes included pain intensity and disability, with adverse events as secondary outcomes. Data were extracted across immediate, short-term, intermediate, and longterm follow-up periods. The Grading of Recommendations Assessment, Development, and Evaluation(GRADE) framework was used to assess the certainty of evidence, and the Assessment of Multiple Systematic Reviews tool(AMSTAR) tool was applied by 2 independent reviewers(JC, QL, and/or DXMW) to evaluate the quality of the included reviews. The study was prospectively registered on the Open Science Framework(OSF).Results: A total of 70 systematic reviews were included, 43 with meta-analyses, 7 with network meta-analyses, and 20 without meta-analyses.Six(out of 10) reviews with meta-analyses for secondary prevention indicated a small benefit from general exercises and leisure-time PA(low-to-moderate certainty). For LBP management, 35(out of 36) reviews reported that exercise therapies such as Pilates, motor control,mixed exercise, Tai Chi, water-based exercises, and yoga showed small beneficial effects on pain and disability compared to minimal intervention mainly in the short-term(low-to-moderate certainty). Seven network meta-analyses favored motor control and Pilates over other forms of exercise to reduce pain(low certainty). Adverse events were reported in less than 31% of the reviews, predominantly involving postexercise soreness and temporary increases in pain, mainly in yoga-related studies. Adverse events were considered minor, and no serious adverse events were reported.Conclusion: There is low-to-moderate certainty that exercise therapy and leisure-time PA are beneficial for improving pain and preventing the recurrence of LBP. However, evidence on the potential harms of these interventions is limited, and adverse events related to exercise and PA remain under-investigated.展开更多
Purpose:The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain(CNSLBP)following conservative interventions is related to correspondi...Purpose:The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain(CNSLBP)following conservative interventions is related to corresponding improvements in balance control.Methods:Randomized controlled trials were identified from 5 databases(MEDLINE,Cochrane Library,Embase,Web of Science,and PsycINFO).Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control.Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables.Results:Thirty one studies involving 1280 participants with CNSLBP were included.Moderate-quality evidence suggested that pain reduction was associated with and explained 34%-45%of decreases in body sway,as measured by center-of-pressure(CoP)area and CoP velocity with eyes open.However,no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions.Similarly,there was no significant association between pain reduction and CoP distance or radius.Low-quality evidence indicated that pain relief explained a 15%improvement in one-leg stance with eyes open but not in the eyes-closed condition.Additionally,very low-quality evidence suggested that pain relief explained a 44%decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open,mediolateral,or overall conditions.Furthermore,low-quality evidence indicated that reduced pain was associated with and accounted for 25%-43%of the improved composite and posteromedial scores of the star-excursion balance test,rather than the anterior and posterolateral scores.Conclusion:Depending on the type of balance assessment,pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP.Clinicians should pay close attention to the balance control in patients with CNSLBP,particularly among older adults.展开更多
Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-t...Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.展开更多
Objective This study aims to analyze the current state and emerging trends in research articles related to acupuncture treatment for low back pain(LBP).Methods The Web of Science core database was utilized to retrieve...Objective This study aims to analyze the current state and emerging trends in research articles related to acupuncture treatment for low back pain(LBP).Methods The Web of Science core database was utilized to retrieve relevant literature on acupuncture therapy for LBP from January 1,1997,to August 29,2023.Literature metrics analysis was conducted using Microsoft Excel,VOSviewer,SCImago Graphica,and Pajek.The analysis focused on annual publication volume,countries(regions),institutions,authors,journals,keywords,and references.Results A total of 1,434 papers on acupuncture treatment for LBP were identified,demonstrating a fluctuating growth trend over the past 25 years.Research in this field has been conducted in 57 countries,with the United States leading in terms of research output.Italy emerged as the country with the highest-quality publications,with an average citation frequency of 205.16 times.A total of 1,781 institutions contributed to research on acupuncture treatment for LBP,with Harvard University having the highest publication volume(cited 77 times).The number of authors contributing to this field reached 5,696,with In-Hyuk Ha having the highest publication count(31 papers)and Claudia-M.Witt is the most influential author(cited 2,699 times).Relevant research was published in 378 journals,with the Journal of Alternative and Complementary Medicine having the highest publication volume(77 papers),and Spine being the most influential journal(cited 3,420 times).A total of 3,854 keywords were identified,forming six main thematic clusters:care management,nerve stimulation,complementary medicine,pregnancy pain,rehabilitation research,and musculoskeletal pain.Twelve highly cited papers with citation frequencies≥85 times were recognized,predominantly consisting of randomized controlled trials.Conclusion Over the past 25 years,the number of articles published on acupuncture for LPB has shown a fluctuating trend of growth;the distribution of countries(regions)and institutions that publish articles is scattered,mainly based on inter-regional cooperation,and international cooperation is still insufficient;Journals in alternative and integrative medicine category provide references for scholars to submit manuscripts and learn about the frontiers;Acupuncture is effective and economical in the treatment of pain,and it has been widely used in the treatment of low back pain.However,the difference in efficacy between acupuncture and sham acupuncture or placebo acupuncture remains controversial.Therefore,in the future,it is necessary to consider the selection of appropriate efficacy evaluation methods in clinical trials that reflect the therapeutic advantages of acupuncture.展开更多
Chronic lower back pain(LBP)is the leading cause of disability worldwide.Due to its close relationship with intervertebral disc(IVD)degeneration(IVDD),research has historically focused more on understanding the mechan...Chronic lower back pain(LBP)is the leading cause of disability worldwide.Due to its close relationship with intervertebral disc(IVD)degeneration(IVDD),research has historically focused more on understanding the mechanism behind IVDD while clinical efforts prioritize pain management.More recently,there has been a shift toward understanding LBP as a distinct pathological entity.This review synthesizes current knowledge on discogenic LBP,combining known pathophysiology,molecular mechanisms,risk factors,diagnostic challenges,and available experimental models.IVDD is a complex,multifactorial process involving biochemical,mechanical,and inflammatory changes within the disc,leading to structural breakdown and potential discogenic pain.Key mechanisms include extracellular matrix degradation,upregulation of inflammatory mediators,immune cell infiltration,and aberrant nerve and vascular ingrowth.However,not all cases of IVDD result in LBP,highlighting the need for further investigation into the cellular,molecular,and biomechanical factors contributing to symptom development.Current diagnostic tools and experimental models for studying discogenic LBP remain limited,impeding the development of targeted treatments.Existing therapies primarily focus on symptom management rather than addressing underlying disease mechanisms.展开更多
Objective:The objective of this study is to explore the current situation of nurses’participant activation for self-management of low back pain,analyze its influencing factors,and provide a reference for improving th...Objective:The objective of this study is to explore the current situation of nurses’participant activation for self-management of low back pain,analyze its influencing factors,and provide a reference for improving the participant activation for self-management of low back pain.Materials and Methods:A cross-sectional study was conducted with 5,120 nurses recruited through convenience sampling from hospitals across 25 provinces and municipalities in China.Participants completed two standardized instruments:General Information Questionnaire which collected demographic characteristics and work-related factors,and the Participant Activation for Self-Management of Back Pain Questionnaire which measured activation levels across three dimensions(including self-management beliefs,self-management awareness,and knowledge related to low back pain).Results:The score of nurses’participant activation for low back pain self-management was 38.00(33.00,44.00).The results of multiple linear regression showed that nurses of different gender,age,and professional titles,whether they had administrative positions,and whether they had back pain in the past year were influencing factors of nurses’participant activation for low back pain management.Conclusion:The overall participant activation for self-management of low back pain is at a medium level.Their self-management awareness is strong,but their beliefs about management of low back pain are insufficient.Targeted intervention measures can be taken to improve their activation for management of back pain and reduce the incidence of occupational low back pain.展开更多
OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife...OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife)in the treatment of nonspecific low back pain(NLBP),providing evidence-based medical support for clinical treatment.METHODS:Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed,Web of Science,Chinese Biomedical Literature Database,Embase,and the Cochrane Library.Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool,and the data were analyzed using STATA 15.1.RESULTS:This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale(VAS),improvement in dysfunction using the oswestry disability index(ODI),and the effective rate.Blood-letting[surface under the cumulative ranking curve(SUCRA)=81.4]exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator,followed by cupping(SUCRA=70.4)and moxibustion(SUCRA=58.5).Scrapping therapy(SUCRA=77.7)had the most significant effect on improving NLBP-related functional impairment,followed by moxibustion(SUCRA=59.8),and then bloodletting(SUCRA=58.2).The effective rates of warm acupuncture(SUCRA=78.0),scrapping therapy(SUCRA=77.2)and blood-letting(SUCRA=58.6)were better than those of acupuncture(SUCRA=12.0),especially for cold and wet NLBP.These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.CONCLUSION:Blood-letting was the most effective treatment for relieving pain,and scrapping therapy was the most effective treatment for improving dysfunction.Warm acupuncture was the preferred treatment for cold and wet NLBP.However,further high-quality clinical studies are needed for validation.展开更多
BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Ther...BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen’s Device can relieve chronic low back pain,there have been no randomised controlled trials for these indications.AIM To evaluate the efficacy of Dr Allen’s Device in lumbar disc herniation(LDH)and non-specific low back pain(NSLBP).METHODS A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH(n=28)or NSLBP(n=27),out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group.The intervention was treatment with Dr Allen’s Device for 3 mo.Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire.RESULTS Thermobalancing therapy with Dr Allen’s Device showed a significant reduction in pain in the treatment group(P<0.001),with no recorded adverse effects.Both pain assessment scales showed a significant improvement in patients’perception of pain indicating improvement in HRQoL.CONCLUSION The out-of-hospital use of Thermobalancing therapy with Dr Allen’s Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects,improves the level of activity and HRQoL among patients with LDH and NSLBP.This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.展开更多
Objective To observe the therapeutic difference in treatment of Irishmen with discogenic low back pain （arthritis of cold-damp syndrome type） between heat-sensitive acupoint and acupuncture. Methods Eighty-two patie...Objective To observe the therapeutic difference in treatment of Irishmen with discogenic low back pain （arthritis of cold-damp syndrome type） between heat-sensitive acupoint and acupuncture. Methods Eighty-two patients were randomly assigned to the heat-sensitive group （43 cases） and the acupuncture group （39 cases）. Corresponding heat-sensitive points in the lumbosacral area were selected in the heat-sensitive group. Then moxibustion was performed at the heat-sensitive acupoint, thus conducting the moxibustion sensation. The treatment was ended when the sensation conduction was finished. If there appeared no moxibustion sensation, moxibustion at the corresponding painful point was lasted for 30 min. Needling was performed in the acupuncture group at corresponding Jiájǐ（夹 脊 EX-B 2）, Back-shu point, Wěizhōng （委中 BL 40）; matching points included Huántiào （环跳 GB 30）, Fēngshì（风市 GB 31）, Yánglíngquán （阳陵泉 GB 34）, Zhìbiān （秩边 BL 54）, etc. The waste was irradiated with TDP after needling, with the maintaining time of 30 min. The treatment was carried out twice weekly, four weeks as one therapeutic course. The therapeutic effect was statistically calculated after 8-week treatment. Results Nineteen cases were clinically cured, 20 improved, 4 failed, and the effective rate 90.7%（39/43） in the heat-sensitive group, while 9 clinically cured, 25 improved, 5 failed, and the effective rate 87.2%（34/39） in the acupuncture group. Signif icant difference was shown in the clinically cured case by 2 test （P0.05）. Conclusion Heat-sensitive acupoint was superior to traditional acupuncture in treatment Irishmen with discogenic low back pain.展开更多
As sciatica and low back pain are among the most common medical complaints, many studies have duplicated these conditions in animals. Chronic compression of the dorsal root ganglion （CCD） is one of these models. The...As sciatica and low back pain are among the most common medical complaints, many studies have duplicated these conditions in animals. Chronic compression of the dorsal root ganglion （CCD） is one of these models. The surgery is simple： after exposing the L4/L5 intervertebral foramina, stainless steel rods are implanted unilaterally, one rod for each vertebra, to chronically compress the lumbar dorsal root ganglion （DRG）. Then, CCD can be used to simulate the clinical conditions caused by stenosis, such as a laterally herniated disc or foraminal stenosis. As the intraforaminal implantation of a rod results in neuronal somal hyperexcitability and spontaneous action potentials associated with hyperalgesia, spontaneous pain, and mechanical allodynia, CCD provides an animal model that mimics radicular pain in humans. This review concerns the mechanisms of neuronal hyperexcitability, focusing on various patterns of spontaneous discharge including one possible pain signal for mechanical allodynia - evoked bursting. Also, new data regarding its significant property of maintaining peripheral input are also discussed. Investigations using this animal model will enhance our un-derstanding of the neural mechanisms for low back pain and sciatica. Furthermore, the peripheral location of the DRG fa-cilitates its use as a locus for controlling pain with minimal central effects, in the hope of ultimately uncovering analgesics that block neuropathic pain without influencing physiological pain.展开更多
Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspeci...Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.展开更多
Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled fro...Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.展开更多
OBJECTIVE:To observe the therapeutic effect of lumbar tender point deep tissue massage plus lumbar traction on chronic non-specific low back pain using change in pressure pain threshold,muscle hardness and pain intens...OBJECTIVE:To observe the therapeutic effect of lumbar tender point deep tissue massage plus lumbar traction on chronic non-specific low back pain using change in pressure pain threshold,muscle hardness and pain intensity as indices.METHODS:We randomly divided 64 patients into a treatment group(32 cases) and a control group(32 cases).Two drop-outs occurred in each group.Patients in the treatment group received tender point deep tissue massage plus lumbar traction and patients in the control group received lumbar traction,alone.We used a tissue hardness meter/algometer and visual analog scale(VAS) to assess the pressure pain threshold,muscle hardness and pain intensity.RESULTS:Following treatment,we obtained the following results in the treatment and control groups,respectively:the pressure pain threshold difference was 1.5±0.8 and 1.1±0.7;the muscle hardness difference was 4.2±1.6 and 3.5±1.3;and the VAS score difference was 1.9±0.9 and 1.4±0.8.Compared to the control group,the treatment group had higher pressure pain threshold(t=2.09,P<0.05),and lower muscle hardness(t=2.05,P<0.05) and pain intensity(t=2.46,P<0.05).CONCLUSION:Lumbar tender point deep tissue massage combined with lumbar traction produced better improvement in pressure pain threshold,muscle hardness and pain intensity in patients with chronic non-specific low back pain than with lumbar traction alone.展开更多
Based on extensive accumulated evidence and using the Grading of Recommendations Assessment, Development and Evaluation（GRADE） system, we have developed clinical practice guidelines for the use of acupuncture to tre...Based on extensive accumulated evidence and using the Grading of Recommendations Assessment, Development and Evaluation（GRADE） system, we have developed clinical practice guidelines for the use of acupuncture to treat low back pain（LBP）. In the guidelines, we considered the objective and scope of this guide, the diagnostic criteria and syndrome differentiation standards of traditional Chinese medicine and western medicine for LBP, the treatment principles of acupuncture, intervention opportunities for acupuncture, and recommendations for use of different acupuncture therapies for acute/subacute and chronic LBP.展开更多
基金the grants from the National Administration of Traditional Chinese Medicine Project for Enhancing Innovation Capabilities in Chinese Medicine(No.BJTH 2024-02F-0009)Shanghai Municipal Health Commission Seed Program for Research and Transformation of Medical New Technologies(No.2024ZZ1006)Shanghai Three-year Action Plan to Further Accelerate the Inheritance and Innovative Development of Traditional Chinese Medicine(No.2025-2027)(3-1-1).
文摘The number of patients with low back pain has increased due to changes in living and working habits.It has become one of the most common diseases in Chinese and Thai clinics.Treatment with Thai traditional medicine can effectively alleviate and manage low back pain.This paper aims to summarize the clinical efficacy and distinctive features of Thai traditional medicine(TTM)in managing low back pain.By reviewing recent literature on TTM treatments,including Thai massage,herbal hot massage,and Thai herbal medicine,the paper aims to lay a foundation for TTM treatment in the world and to promote the convergence and development of traditional Chinese and Thai traditional medicine treatment.Additionally,it advocates for the integration and advancement of both Chinese and Thai traditional medical practices,while also encouraging the dissemination of traditional medicine to other countries globally.
文摘[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized controlled trial design was employed in this study.Ninety patients with chronic low back pain were recruited and randomly assigned to either a control group(n=45),which received conventional rehabilitation,or an experimental group(n=45),which received conventional rehabilitation combined with core stability training.Both groups underwent treatment for 6 weeks.Assessments were conducted using the visual analogue scale(VAS),Oswestry disability index(ODI),and finger-to-floor test prior to treatment,6 weeks following treatment,and during the follow-up period,respectively.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups in terms of general information and various baseline measurements(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups demonstrated significant improvements in VAS scores,ODI scores,and lumbar anteflexion range of motion compared to baseline measurements(P<0.05).Notably,the magnitude of improvement in the experimental group exceeded that of the control group,with this inter-group difference reaching statistical significance(P<0.05).No serious adverse reactions were reported during the treatment process.[Conclusions]Core stability training combined with conventional rehabilitation can significantly enhance the alleviation of pain and functional impairments in patients suffering from chronic low back pain.This approach holds valuable implications for the optimization of rehabilitation treatment protocols.
基金financially supported by the HEAD foundation(IO number GRTHF0000101).
文摘Objectives:To explore the use of a traditional Chinese medicine(TCM)pattern scale as an outcome measure to evaluate the management of patients with chronic low back pain(CLBP).Methods:A total of 204 participants were recruited and randomly allocated into three CLBP treatment groups:Tuina only,physiotherapy only,and a combined physiotherapy+Tuina group.All participants were assessed for treatment outcomes using the TCM pattern scale as a substudy to a randomized controlled trial in which the Visual Analog Scale(VAS)was the primary outcome measure.TCM pattern scores were recorded by non-TCM research assistants who were trained to administer a TCM pattern questionnaire developed by the authors in collaboration with TCM experts.Results:Most participants(83%)were classified as having kidney deficiency pattern as the primary TCM pattern at baseline.All three intervention groups showed a significant decrease in overall TCM pattern score at month 2(M2)and month 5(M5).However,when the nimodipine method was applied,none of the three treatment arms showed a statistically significant change in the effective rate,even though the parent study reported a significant decrease in VAS scores in all treatment arms.Conclusion:This study found improvements in both the dominant TCM pattern score and the overall TCM pattern score for each group.These findings suggest that TCM pattern diagnosis,including entities recognized in International Classification of Diseases,11th Revision(ICD)-11,may be used as a quantitative outcome measure to reflect response to TCM-based intervention.The TCM pattern scale reported here may potentially be applied in other chronic pain studies involving TCM patterns.Further studies are warranted to validate this scale in other clinical conditions.
基金supported by the Ministry of Science and Technology of China(2020YFA0908900)National Natural Science Foundation of China(21935011 and 82072490)+1 种基金Shenzhen Science and Technology Innovation Commission(KQTD20200820113012029 and KJZD20230923114612025)Guangdong Provincial Key Laboratory of Advanced Biomaterials(2022B1212010003).
文摘Aging is a pivotal risk factor for intervertebral disc degeneration(IVDD)and chronic low back pain(LBP).The restoration of aging nucleus pulposus cells(NPCs)to a youthful epigenetic state is crucial for IVDD treatment,but remains a formidable challenge.Here,we proposed a strategy to partially reprogram and reinstate youthful epigenetics of senescent NPCs by delivering a plasmid carrier that expressed pluripotency-associated genes(Oct4,Klf4 and Sox2)in Cavin2-modified exosomes(OKS@M-Exo)for treatment of IVDD and alleviating LBP.The functional OKS@M-Exo efficaciously alleviated senescence markers(p16^(INK4a),p21^(CIP1)and p53),reduced DNA damage and H4K20me3 expression,as well as restored proliferation ability and metabolic balance in senescent NPCs,as validated through in vitro experiments.In a rat model of IVDD,OKS@M-Exo maintained intervertebral disc height,nucleus pulposus hydration and tissue structure,effectively ameliorated IVDD via decreasing the senescence markers.Additionally,OKS@MExo reduced nociceptive behavior and downregulated nociception markers,indicating its efficiency in alleviating LBP.The transcriptome sequencing analysis also demonstrated that OKS@M-Exo could decrease the expression of age-related pathways and restore cell proliferation.Collectively,reprogramming by the OKS@M-Exo to restore youthful epigenetics of senescent NPCs may hold promise as a therapeutic platform to treat IVDD.
文摘Introduction: Common low-back pain is a frequent reason for consultation and a genuine public health problem. Preserving quality of life remains one of the main challenges. Objective: To evaluate the quality of life of patients with low back pain seen in rheumatology consultations at Brazzaville University Hospital. Patients and Method: Cross-sectional, analytical study with control group, conducted at the Brazzaville University Hospital, from January 2 to September 30, 2023. Patients over 30 years of age, seen for documented common low-back pain, were included. Study variables were epidemiological, clinical and functional. The EIFEL and SF-36 scores were used to assess functional impact and quality of life, respectively. Results: We included 96 people divided into two groups: 48 patients with low back pain and 48 controls. The frequency of common low-back pain was 12.8%. The mean age of patients with low back pain was 59.14 ± 11.86 years. Women predominated (sex ratio 0.3). Degenerative disc disease was the main etiology. Common low-back pain had a moderate impact on functional abilities, with a mean EIFEL score of 11 +/− 5.51. Quality of life was impaired in patients with low back pain (overall SF-36 at 43.95%) compared with the control group, with a statistically significant difference (P Conclusion: Common low back pain affects patients’ overall quality of life, particularly in terms of physical pain and limitations due to physical condition.
文摘Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.
基金funded by the Medical Research Future Fund-MRFF 2019 (Rapid Applied Research TranslationRART award)funded by an Australian Government Research Training Program Scholarship-RTP+1 种基金funded by National Health and Medical Research Council of Australia Research Fellowshipsfunded by the National Health and Medical Research Council (NHMRC) Leadership Fellow level 2
文摘Purpose: The purpose of this umbrella review was to synthesize the evidence from systematic reviews on the benefits and harms of exercise therapy and physical activity(PA) for the secondary prevention and management of low back pain(LBP).Methods: An umbrella review was conducted to evaluate the effectiveness of exercise therapy and PA in the management and secondary prevention of LBP. A systematic search was performed in MEDLINE, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews,and Physiotherapy Evidence Database(PEDro), including reference lists of relevant reviews, covering studies published between January 1,2010 and May 20, 2024. Eligible studies were systematic reviews of randomized controlled trials and observational studies, with or without meta-analyses. The primary outcome for secondary prevention was LBP recurrence, while for management, primary outcomes included pain intensity and disability, with adverse events as secondary outcomes. Data were extracted across immediate, short-term, intermediate, and longterm follow-up periods. The Grading of Recommendations Assessment, Development, and Evaluation(GRADE) framework was used to assess the certainty of evidence, and the Assessment of Multiple Systematic Reviews tool(AMSTAR) tool was applied by 2 independent reviewers(JC, QL, and/or DXMW) to evaluate the quality of the included reviews. The study was prospectively registered on the Open Science Framework(OSF).Results: A total of 70 systematic reviews were included, 43 with meta-analyses, 7 with network meta-analyses, and 20 without meta-analyses.Six(out of 10) reviews with meta-analyses for secondary prevention indicated a small benefit from general exercises and leisure-time PA(low-to-moderate certainty). For LBP management, 35(out of 36) reviews reported that exercise therapies such as Pilates, motor control,mixed exercise, Tai Chi, water-based exercises, and yoga showed small beneficial effects on pain and disability compared to minimal intervention mainly in the short-term(low-to-moderate certainty). Seven network meta-analyses favored motor control and Pilates over other forms of exercise to reduce pain(low certainty). Adverse events were reported in less than 31% of the reviews, predominantly involving postexercise soreness and temporary increases in pain, mainly in yoga-related studies. Adverse events were considered minor, and no serious adverse events were reported.Conclusion: There is low-to-moderate certainty that exercise therapy and leisure-time PA are beneficial for improving pain and preventing the recurrence of LBP. However, evidence on the potential harms of these interventions is limited, and adverse events related to exercise and PA remain under-investigated.
基金supported by GP Batteries Industrial Safety Trust Fund(Funding number:R-ZDDR).
文摘Purpose:The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain(CNSLBP)following conservative interventions is related to corresponding improvements in balance control.Methods:Randomized controlled trials were identified from 5 databases(MEDLINE,Cochrane Library,Embase,Web of Science,and PsycINFO).Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control.Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables.Results:Thirty one studies involving 1280 participants with CNSLBP were included.Moderate-quality evidence suggested that pain reduction was associated with and explained 34%-45%of decreases in body sway,as measured by center-of-pressure(CoP)area and CoP velocity with eyes open.However,no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions.Similarly,there was no significant association between pain reduction and CoP distance or radius.Low-quality evidence indicated that pain relief explained a 15%improvement in one-leg stance with eyes open but not in the eyes-closed condition.Additionally,very low-quality evidence suggested that pain relief explained a 44%decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open,mediolateral,or overall conditions.Furthermore,low-quality evidence indicated that reduced pain was associated with and accounted for 25%-43%of the improved composite and posteromedial scores of the star-excursion balance test,rather than the anterior and posterolateral scores.Conclusion:Depending on the type of balance assessment,pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP.Clinicians should pay close attention to the balance control in patients with CNSLBP,particularly among older adults.
文摘Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences:CI2021B002.
文摘Objective This study aims to analyze the current state and emerging trends in research articles related to acupuncture treatment for low back pain(LBP).Methods The Web of Science core database was utilized to retrieve relevant literature on acupuncture therapy for LBP from January 1,1997,to August 29,2023.Literature metrics analysis was conducted using Microsoft Excel,VOSviewer,SCImago Graphica,and Pajek.The analysis focused on annual publication volume,countries(regions),institutions,authors,journals,keywords,and references.Results A total of 1,434 papers on acupuncture treatment for LBP were identified,demonstrating a fluctuating growth trend over the past 25 years.Research in this field has been conducted in 57 countries,with the United States leading in terms of research output.Italy emerged as the country with the highest-quality publications,with an average citation frequency of 205.16 times.A total of 1,781 institutions contributed to research on acupuncture treatment for LBP,with Harvard University having the highest publication volume(cited 77 times).The number of authors contributing to this field reached 5,696,with In-Hyuk Ha having the highest publication count(31 papers)and Claudia-M.Witt is the most influential author(cited 2,699 times).Relevant research was published in 378 journals,with the Journal of Alternative and Complementary Medicine having the highest publication volume(77 papers),and Spine being the most influential journal(cited 3,420 times).A total of 3,854 keywords were identified,forming six main thematic clusters:care management,nerve stimulation,complementary medicine,pregnancy pain,rehabilitation research,and musculoskeletal pain.Twelve highly cited papers with citation frequencies≥85 times were recognized,predominantly consisting of randomized controlled trials.Conclusion Over the past 25 years,the number of articles published on acupuncture for LPB has shown a fluctuating trend of growth;the distribution of countries(regions)and institutions that publish articles is scattered,mainly based on inter-regional cooperation,and international cooperation is still insufficient;Journals in alternative and integrative medicine category provide references for scholars to submit manuscripts and learn about the frontiers;Acupuncture is effective and economical in the treatment of pain,and it has been widely used in the treatment of low back pain.However,the difference in efficacy between acupuncture and sham acupuncture or placebo acupuncture remains controversial.Therefore,in the future,it is necessary to consider the selection of appropriate efficacy evaluation methods in clinical trials that reflect the therapeutic advantages of acupuncture.
基金supported by the California Institute for Regenerative Medicine under EDUC4-12751(Giselle Kaneda)DISC2-14049(Dmitriy Sheyn)+1 种基金Additional support was provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award numbers R01AR066517(Debiao Li)R01AR082041(Dmitriy Sheyn).
文摘Chronic lower back pain(LBP)is the leading cause of disability worldwide.Due to its close relationship with intervertebral disc(IVD)degeneration(IVDD),research has historically focused more on understanding the mechanism behind IVDD while clinical efforts prioritize pain management.More recently,there has been a shift toward understanding LBP as a distinct pathological entity.This review synthesizes current knowledge on discogenic LBP,combining known pathophysiology,molecular mechanisms,risk factors,diagnostic challenges,and available experimental models.IVDD is a complex,multifactorial process involving biochemical,mechanical,and inflammatory changes within the disc,leading to structural breakdown and potential discogenic pain.Key mechanisms include extracellular matrix degradation,upregulation of inflammatory mediators,immune cell infiltration,and aberrant nerve and vascular ingrowth.However,not all cases of IVDD result in LBP,highlighting the need for further investigation into the cellular,molecular,and biomechanical factors contributing to symptom development.Current diagnostic tools and experimental models for studying discogenic LBP remain limited,impeding the development of targeted treatments.Existing therapies primarily focus on symptom management rather than addressing underlying disease mechanisms.
文摘Objective:The objective of this study is to explore the current situation of nurses’participant activation for self-management of low back pain,analyze its influencing factors,and provide a reference for improving the participant activation for self-management of low back pain.Materials and Methods:A cross-sectional study was conducted with 5,120 nurses recruited through convenience sampling from hospitals across 25 provinces and municipalities in China.Participants completed two standardized instruments:General Information Questionnaire which collected demographic characteristics and work-related factors,and the Participant Activation for Self-Management of Back Pain Questionnaire which measured activation levels across three dimensions(including self-management beliefs,self-management awareness,and knowledge related to low back pain).Results:The score of nurses’participant activation for low back pain self-management was 38.00(33.00,44.00).The results of multiple linear regression showed that nurses of different gender,age,and professional titles,whether they had administrative positions,and whether they had back pain in the past year were influencing factors of nurses’participant activation for low back pain management.Conclusion:The overall participant activation for self-management of low back pain is at a medium level.Their self-management awareness is strong,but their beliefs about management of low back pain are insufficient.Targeted intervention measures can be taken to improve their activation for management of back pain and reduce the incidence of occupational low back pain.
基金Supported by the National Natural Science Foundation of China:Novel Dynamic Regulation Method of Acupoint Stimulation Based on Injectable Magnetic Gel for Myocardial Ischemia-Reperfusion Injury (No. 82074560)Effect Evaluation of Different Combinations of Acupuncture Techniques (No. 8207152951)Sanqin Talent Special Support Program:Leading Talent Project for Technological Innovation (No. 2024)
文摘OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife)in the treatment of nonspecific low back pain(NLBP),providing evidence-based medical support for clinical treatment.METHODS:Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed,Web of Science,Chinese Biomedical Literature Database,Embase,and the Cochrane Library.Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool,and the data were analyzed using STATA 15.1.RESULTS:This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale(VAS),improvement in dysfunction using the oswestry disability index(ODI),and the effective rate.Blood-letting[surface under the cumulative ranking curve(SUCRA)=81.4]exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator,followed by cupping(SUCRA=70.4)and moxibustion(SUCRA=58.5).Scrapping therapy(SUCRA=77.7)had the most significant effect on improving NLBP-related functional impairment,followed by moxibustion(SUCRA=59.8),and then bloodletting(SUCRA=58.2).The effective rates of warm acupuncture(SUCRA=78.0),scrapping therapy(SUCRA=77.2)and blood-letting(SUCRA=58.6)were better than those of acupuncture(SUCRA=12.0),especially for cold and wet NLBP.These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.CONCLUSION:Blood-letting was the most effective treatment for relieving pain,and scrapping therapy was the most effective treatment for improving dysfunction.Warm acupuncture was the preferred treatment for cold and wet NLBP.However,further high-quality clinical studies are needed for validation.
文摘BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients’health-related quality of life(HRQoL).Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen’s Device can relieve chronic low back pain,there have been no randomised controlled trials for these indications.AIM To evaluate the efficacy of Dr Allen’s Device in lumbar disc herniation(LDH)and non-specific low back pain(NSLBP).METHODS A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH(n=28)or NSLBP(n=27),out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group.The intervention was treatment with Dr Allen’s Device for 3 mo.Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire.RESULTS Thermobalancing therapy with Dr Allen’s Device showed a significant reduction in pain in the treatment group(P<0.001),with no recorded adverse effects.Both pain assessment scales showed a significant improvement in patients’perception of pain indicating improvement in HRQoL.CONCLUSION The out-of-hospital use of Thermobalancing therapy with Dr Allen’s Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects,improves the level of activity and HRQoL among patients with LDH and NSLBP.This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.
文摘Objective To observe the therapeutic difference in treatment of Irishmen with discogenic low back pain （arthritis of cold-damp syndrome type） between heat-sensitive acupoint and acupuncture. Methods Eighty-two patients were randomly assigned to the heat-sensitive group （43 cases） and the acupuncture group （39 cases）. Corresponding heat-sensitive points in the lumbosacral area were selected in the heat-sensitive group. Then moxibustion was performed at the heat-sensitive acupoint, thus conducting the moxibustion sensation. The treatment was ended when the sensation conduction was finished. If there appeared no moxibustion sensation, moxibustion at the corresponding painful point was lasted for 30 min. Needling was performed in the acupuncture group at corresponding Jiájǐ（夹 脊 EX-B 2）, Back-shu point, Wěizhōng （委中 BL 40）; matching points included Huántiào （环跳 GB 30）, Fēngshì（风市 GB 31）, Yánglíngquán （阳陵泉 GB 34）, Zhìbiān （秩边 BL 54）, etc. The waste was irradiated with TDP after needling, with the maintaining time of 30 min. The treatment was carried out twice weekly, four weeks as one therapeutic course. The therapeutic effect was statistically calculated after 8-week treatment. Results Nineteen cases were clinically cured, 20 improved, 4 failed, and the effective rate 90.7%（39/43） in the heat-sensitive group, while 9 clinically cured, 25 improved, 5 failed, and the effective rate 87.2%（34/39） in the acupuncture group. Signif icant difference was shown in the clinically cured case by 2 test （P0.05）. Conclusion Heat-sensitive acupoint was superior to traditional acupuncture in treatment Irishmen with discogenic low back pain.
基金supported by the National Natural Science Foundation of China(30870829)
文摘As sciatica and low back pain are among the most common medical complaints, many studies have duplicated these conditions in animals. Chronic compression of the dorsal root ganglion （CCD） is one of these models. The surgery is simple： after exposing the L4/L5 intervertebral foramina, stainless steel rods are implanted unilaterally, one rod for each vertebra, to chronically compress the lumbar dorsal root ganglion （DRG）. Then, CCD can be used to simulate the clinical conditions caused by stenosis, such as a laterally herniated disc or foraminal stenosis. As the intraforaminal implantation of a rod results in neuronal somal hyperexcitability and spontaneous action potentials associated with hyperalgesia, spontaneous pain, and mechanical allodynia, CCD provides an animal model that mimics radicular pain in humans. This review concerns the mechanisms of neuronal hyperexcitability, focusing on various patterns of spontaneous discharge including one possible pain signal for mechanical allodynia - evoked bursting. Also, new data regarding its significant property of maintaining peripheral input are also discussed. Investigations using this animal model will enhance our un-derstanding of the neural mechanisms for low back pain and sciatica. Furthermore, the peripheral location of the DRG fa-cilitates its use as a locus for controlling pain with minimal central effects, in the hope of ultimately uncovering analgesics that block neuropathic pain without influencing physiological pain.
基金Supported by Special Funds of Fujian Provincial Finance Department and Education Department:x2018002Clinical Special Project of School Management of Fujian University of Traditional Chinese Medicine:xb2020150。
文摘Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.
基金supported by the Research Fund from National Science and Technology Infrastructure Program of the People's Republic of China, 2006BA106B08
文摘Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.
基金Supported by the Olympic Games scientific research project of the General Administration of Sport of China No.2011A020the National Natural Science Foundation of China(No.61172007/F010810)
文摘OBJECTIVE:To observe the therapeutic effect of lumbar tender point deep tissue massage plus lumbar traction on chronic non-specific low back pain using change in pressure pain threshold,muscle hardness and pain intensity as indices.METHODS:We randomly divided 64 patients into a treatment group(32 cases) and a control group(32 cases).Two drop-outs occurred in each group.Patients in the treatment group received tender point deep tissue massage plus lumbar traction and patients in the control group received lumbar traction,alone.We used a tissue hardness meter/algometer and visual analog scale(VAS) to assess the pressure pain threshold,muscle hardness and pain intensity.RESULTS:Following treatment,we obtained the following results in the treatment and control groups,respectively:the pressure pain threshold difference was 1.5±0.8 and 1.1±0.7;the muscle hardness difference was 4.2±1.6 and 3.5±1.3;and the VAS score difference was 1.9±0.9 and 1.4±0.8.Compared to the control group,the treatment group had higher pressure pain threshold(t=2.09,P<0.05),and lower muscle hardness(t=2.05,P<0.05) and pain intensity(t=2.46,P<0.05).CONCLUSION:Lumbar tender point deep tissue massage combined with lumbar traction produced better improvement in pressure pain threshold,muscle hardness and pain intensity in patients with chronic non-specific low back pain than with lumbar traction alone.
文摘Based on extensive accumulated evidence and using the Grading of Recommendations Assessment, Development and Evaluation（GRADE） system, we have developed clinical practice guidelines for the use of acupuncture to treat low back pain（LBP）. In the guidelines, we considered the objective and scope of this guide, the diagnostic criteria and syndrome differentiation standards of traditional Chinese medicine and western medicine for LBP, the treatment principles of acupuncture, intervention opportunities for acupuncture, and recommendations for use of different acupuncture therapies for acute/subacute and chronic LBP.
