scholarly journals Low Back Pain in Hidradenitis Suppurativa: A Diagnosis Not to Miss!

2018 ◽  
Vol 10 (2) ◽  
pp. 187-189
Author(s):  
Benjamin Schnebert ◽  
Véronique del Marmol ◽  
Farida Benhadou
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hidradenitis Suppurativa ◽  
Combined Therapy ◽  
Skin Lesions ◽  
Skin Area ◽  
Low Back ◽  
Inflammatory Drugs ◽  
The Right ◽  
Altered Sensitivity

We report the case of a patient suffering from hidradenitis suppurativa since puberty and complaining of chronic low back pain associated to altered sensitivity and muscular weakness in the right leg. A diagnosis of lumbosciatica was confirmed. Symptoms were not relieved after the use of nonsteroidal anti-inflammatory drugs and analgesics. A surgical decompression was then indicated but heavily debated. Indeed, extended inflammatory and fibrotic hidradenitis suppurativa lesions were located regarding the skin area eligible for the proposed surgery. A combined therapy with clindamycine/rifampicin was started and the surgery was postponed. A complete remission of the articular symptoms was observed 1 month after the start of the antibiotherapy and the inflammatory skin lesions were greatly improved. With the presentation of this clinical case, we would like to discuss the spectrum of rheumatic disorders associated to hidradenitis suppurativa that needs to be correctly diagnosed and taken into consideration in the therapeutic management of the patient.

scholarly journals The Anatomy of the Lateral Branches of the Sacral Dorsal Rami: Implications for Radiofrequency Ablation

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. 459-464
Author(s):  
Joseph Fortin
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Radiofrequency Ablation ◽  
Sacroiliac Joint ◽  
Low Back ◽  
Sacral Foramina ◽  
Dorsal Rami ◽  
Lateral Branches ◽  
The Right ◽  
Segmental Innervation

Background: The sacroiliac joint (SIJ) is a major source of pain in patients with chronic low back pain. Radiofrequency ablation (RFA) of the lateral branches of the dorsal sacral rami that supply the joint is a treatment option gaining considerable attention. However, the position of the lateral branches (commonly targeted with RFA) is variable and the segmental innervation to the SIJ is not well understood. Objectives: Our objective was to clarify the lateral branches’ innervation of the SIJ and their specific locations in relation to the dorsal sacral foramina, which are the standard RFA landmark. Methods: Dissections and photography of the L5 to S4 sacral dorsal rami were performed on 12 hemipelves from 9 donated cadaveric specimens. Results: There was a broad range of exit points from the dorsal sacral foramina: ranging from 12:00 – 6:00 position on the right side and 6:00 – 12:00 on the left positions. Nine of 12 of the hemipelves showed anastomosing branches from L5 dorsal rami to the S1 lateral plexus. Limitations: The limitations of this study include the use of a posterior approach to the pelvic dissection only, thus discounting any possible nerve contribution to the anterior aspect of the SIJ, as well as the possible destruction of some L5 or sacral dorsal rami branches with the removal of the ligaments and muscles of the low back. Conclusion: Widespread variability of lateral branch exit points from the dorsal sacral foramen and possible contributions from L5 dorsal rami and superior gluteal nerve were disclosed by the current study. Hence, SIJ RFA treatment approaches need to incorporate techniques which address the diverse SIJ innervation. Key words: Sacroiliac joint pain, radiofrequency ablation, dorsal sacral rami, low back pain

scholarly journals Deficits in the Star Excursion Balance Test and Golf Performance in Elite Golfers with Chronic Low Back Pain

2021 ◽  
pp. 229-236
Author(s):  
Yi-Chien Peng ◽  
Chung-Yuan Hsu ◽  
Wen-Tzu Tang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Golf Swing ◽  
Control Group ◽  
Low Back ◽  
Balance Test ◽  
Star Excursion Balance Test ◽  
Pain Symptoms ◽  
The Right

The purpose of this study was to investigate whether low-handicap elite golfers with chronic low back pain (CLBP) exhibit deficits in dynamic postural control and whether CLBP affects golfers in terms of their golf swing parameters. A total of fifteen Division 1 college golfers were recruited as participants. Of these, six of whom experienced CLBP, while the remaining participants were healthy. In this study, CLBP was defined as experiencing chronic pain symptoms for more than six months. The Star Excursion Balance Test (SEBT) was administered to examine dynamic posture control in both groups. The TrackMan Golf Launch Monitor Simulator was used to collect data on the performance parameters of the swing of the participants. The results for both feet in the medial, lateral, posterior, posteromedial, and posterolateral directions indicated that the CLBP group scored lower than the control group. However, the CLBP group scored higher for the right foot in the anterolateral direction. The parameters for the club speed and ball carry of the CLBP group were lower than those of the control group. Further, the CLBP group exhibited a more upright swing plane relative to the control group. Taken together, our findings suggest that SEBT may be feasible and highly accessible to assess golf swing performance of elite players with CLBP.

scholarly journals An Intramuscular Epidermal Cyst of Erector Spinae Muscles: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Seung Won Park ◽  
Jong Han Gill ◽  
Myeong Jin Ko ◽  
Seong Hyun Wui ◽  
Seung Won Park
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Subcutaneous Tissue ◽  
Erector Spinae ◽  
Epidermal Cyst ◽  
Low Back ◽  
Palpable Mass ◽  
Spinal Magnetic Resonance Imaging ◽  
Local Tenderness ◽  
The Right

An intramuscular epidermal cyst without subcutaneous involvement is extremely rare. The patient presented with low back pain. Spinal magnetic resonance imaging indicated spindle-shaped mass in the right erector spinae muscles located at L3 to L5 level without any connection with subcutaneous tissue. The patient underwent operation for removal of intramuscular cystic lesion. The tumor was totally removed and pathologically confirmed with epidermal cyst. Unlike typical epidermal cyst, the patient had a characteristic clinical manifestation of mild low back pain without palpable mass and local tenderness.

scholarly journals Transversus abdominis and multifidus asymmetry in runners measured by MRI: a cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
pp. e000556
Author(s):  
Ulrike H Mitchell ◽  
A Wayne Johnson ◽  
Patrick J Owen ◽  
Timo Rantalainen ◽  
Daniel Belavy
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Activation ◽  
Cross Sectional Study ◽  
Transversus Abdominis ◽  
Low Back ◽  
Sectional Study ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
The Right

ObjectiveThe transversus abdominis muscle (TrA) is active during running as a secondary respiratory muscle and acts, together with the multifidus, as trunk stabiliser. The purpose of this study was to determine size and symmetry of TrA and multifidus muscles at rest and with contraction in endurance runners without low back pain.DesignCross-sectional study.SettingA medical imaging centre in Melbourne, Australia.ParticipantsThirty middle-aged (43years±7) endurance-trained male (n=18) and female (n=12) runners without current or history of low back pain.Outcome measuresMRI at rest and with the core engaged. The TrA and multifidus muscles were measured for thickness and length (TrA) and anteroposterior and mediolateral thickness (multifidus). Muscle activation was extrapolated from rest to contraction and compared with the same and contralateral side. Paired t-tests were performed to compare sides and contraction status.ResultsLeft and right TrA and multifidus demonstrated similar parameters at rest (p>0.05). However, with contraction, the right TrA and multifidus (in mediolateral direction) were 9.2% (p=0.038) and 42% (p<0.001) thicker, respectively, than their counterparts on the left. There was no TrA thickness side difference with contraction in left-handed participants (p=0.985). When stratified by sex, the contracted TrA on the right side remained 8.4% thicker, but it was no longer statistically significant (p=0.134). The side difference with contraction of the TrA became less with increasing training age.ConclusionsRight-handed long-term runners without low back pain exhibit a greater right side core muscle activation when performing an isometric contraction. This activation preference diminishes with increasing training age.

scholarly journals P.001 Transient neurapraxic radiculopathy

2017 ◽  
Vol 44 (S2) ◽  
pp. S14-S14
Author(s):  
SK Baker
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Peak Torque ◽  
Strength Testing ◽  
Low Back ◽  
Neurologic Examination ◽  
Prone Positioning ◽  
History Of ◽  
The Right ◽  
Reversible Reduction

Background: Neurapraxia is considered to be a temporary disorder of peripheral nerve conduction due to trauma that does not cause axonopathy. However, patients with radiculopathy, confirmed by MRI, who may not have active axonal damage with evidence of spontaneous activity may still report transient give-way weaknesss. In the absence of active changes on intramuscular recording a neurophysiologic consultation may fail to substantiate any significant neurologic concern. This report documents and objectifies prone positioning-induced radicular neurapraxic weakness in an elderly man. Methods: An 83-year-old gentleman was referred for neuromuscular evaluation with regards to peripheral neuropathy. He had a history of low back pain and MRI evidence of multilevel DDD and discogenic neuroforaminal narrowing. Strength testing was performed by Biodex evaluation. Routine electrophysiologic assessments were performed. Results: On neurologic examination proximal strength iwas normal with grade 4 dorsiflexion strength. Stocking-glove loss to pinprick was absent. Preliminary objective testing of the right quadriceps revealed a peak torque of 87.1 Nm. Immediately after lying prone for 3 minutes (for paraspinal EMG), his power dropped to 33.7 Nm. Strength fully recovered by 36 hrs. Conclusions: This case documents evidence of a 61% reversible reduction in torque in the right quadriceps after prone lying. Electromyographers need to be cautious with radiculopathy patients during paraspinal testing.

The prevalence and risk factors of lower back pain in emergency room nurses

2017 ◽  
Vol 2 (3) ◽  
pp. 95-110 ◽  
Author(s):  
Edyta Mikołajczyk ◽  
Zofia Kaleta ◽  
Mariusz Janusz
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Emergency Room ◽  
Sagittal Plane ◽  
The Self ◽  
Low Back ◽  
Emergency Room Nurses ◽  
The Right

Aim of the study: To assess prevalence and risk factors of low back pain (LBP) in emergency room nurses in Krakow. Materials and methods: The study comprised 30 randomly selected full time emergency nurses aged 25-58. Their BMI was calculated and measurements of linear segmental lumbar spine flexion-extension motion were performed. The visual analogue scale (VAS) was used to assess the subjective LBP degree. The self-estimated physical disability caused by LBP was assessed by means of the Roland- Morris Low Back Pain and Disability Questionnaire (RMDQ), whereas physical activity by means of the International Physical Activity Questionnaire (IPAQ). The Spearman correlation coefficient was used to determine a linear association between variables involved in the research. Results: Statistically significant correlations between BMI, LBP and the level of disability as well as between the pain intensity and the time spent in a sitting position were revealed by RMDQ. Significant correlations between the self-estimated LBP and spinal flexion in the sagittal plane, lateral flexion to the right in the frontal plane and twist to the right in the transverse plane were found. Conclusions: Moderate LBP in emergency ward nurses, which is commonly observed, slightly decreased their quality of life. A high level of physical activity and limited range of flexion were discovered in the sagittal plane. Due to the existing correlations between BMI and LBP, between the degree of disability and the intensity of pain and the range of motion, it seems appropriate to include this occupational group in the back pain prevention programme.

scholarly journals Efficacy and Safety of Duloxetine in Patients with Chronic Low Back Pain Who Used versus Did Not Use Concomitant Nonsteroidal Anti-Inflammatory Drugs or Acetaminophen: A Post Hoc Pooled Analysis of 2 Randomized, Placebo-Controlled Trials

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Vladimir Skljarevski ◽  
Peng Liu ◽  
Shuyu Zhang ◽  
Jonna Ahl ◽  
James M. Martinez
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Pooled Analysis ◽  
Analysis Of Covariance ◽  
Low Back ◽  
Substantial Evidence ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Post Hoc

This subgroup analysis assessed the efficacy of duloxetine in patients with chronic low back pain (CLBP) who did or did not use concomitant nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (APAP). Data were pooled from two 13-week randomized trials in patients with CLBP who were stratified according to NSAID/APAP use at baseline: duloxetine NSAID/APAP user (), placebo NSAID/APAP user (), duloxetine NSAID/APAP nonuser (), and placebo NSAID/APAP nonuser (). NSAID/APAP users were those patients who took NSAID/APAP for at least 14 days per month during 3 months prior to study entry. An analysis of covariance model that included therapy, study, baseline NSAID/APAP use (yes/no), and therapy-by-NSAID/APAP subgroup interaction was used to assess the efficacy. The treatment-by-NSAID/APAP use interaction was not statistically significant () suggesting no substantial evidence of differential efficacy for duloxetine over placebo on pain reduction or improvement in physical function between concomitant NSAID/APAP users and non-users.

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