Effect of Ḥijāma (wet cupping), Dalk (massage) & Bukhūr (medicated steam) in amelioration of Waja al-Zahr (non-specific low back pain) – an open prospective clinical trial

Author(s):  
Noor Zaheer Ahmed ◽  
Noman Anwar ◽  
Shahida Begum ◽  
Athar Parvez ◽  
Radhakrishnan Ezhil ◽  
...  

Abstract Objectives Low back pain is the most widespread musculoskeletal ailment and a common cause of disability worldwide. Conventional medicine typically treats low back pain with a combination of physical therapy; activity modification and rest; pain-relieving and anti-inflammatory medications which are associated with huge socioeconomic implications and adverse drug reactions. In contrast Ḥijāma, Dalk and Bukhūr are ancient medical techniques recommended in the management of musculoskeletal disorders with little or no adverse effects. To evaluate the safety and effectiveness of Ḥijāma bi’l Shart (wet cupping), followed by Dalk (Massage) with Roghan Dafli and Bukhūr (medicated steam) with Tukhm Soya (Anethum graveolens Linn) in patients of Waja al-Zahr (Non-specific Low back pain). Methods Patients of either gender in the age group of 18–50 years with low back pain persisting for four weeks or more as chief complaint were recruited in the trial. The study was GCP compliant. The duration of the protocol therapy carried out was 14 days. Results Ninty two patients of NSLBP were screened, of which 34 who fulfilled the inclusion criteria and were willing to participate in the study were recruited. Three participants were lost to follow-ups due to personal reasons and 31 patients completed the trial during the study period. Overall therapeutic response observed in this study was 97% while 3% of the patients did not respond to intervention. Conclusions The study findings imply that there is a credible evidence to ensure that the regimens intervened are safe and effective in ameliorating the symptoms of Waja al-Zahr.

Author(s):  
Manoj Sharma ◽  
Taj Haider

Low back pain is not only a leading cause of disability in the United States but also one of the most expensive to treat. Exercise proves to be inconsistent, and surgery often leads to disease reappearance. Yoga offers a holistic approach to overcome the psychological and physical aspects of low back pain. A systematic review was performed to determine the efficacy of yoga for low back pain. Study inclusion criteria were studies ( a) published in the English language, ( b) published between January 2000 and June 2012, ( c) included any form of yoga as an intervention, ( d) used any quantitative study design, and (5) measured low back pain as an outcome. Of the 13 studies included, 9 demonstrated a reduction in low back pain using yoga as part of the intervention. Limitations include lack of theory-based approaches, unclear definitions of low back pain, and multiple instruments used to measure the outcome.


2015 ◽  
Vol 16 (12) ◽  
pp. 1268-1279 ◽  
Author(s):  
Corey B. Simon ◽  
Joseph L. Riley ◽  
Roger B. Fillingim ◽  
Mark D. Bishop ◽  
Steven Z. George

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tej D Azad ◽  
Michael D Harries ◽  
Daniel Vail ◽  
Yi Jonathan Zhang ◽  
John K Ratliff

Abstract INTRODUCTION Low back pain (LBP) may affect up to 20% of the pediatric population. No specific guidelines exist regarding pharmacotherapy for acute LBP in the pediatric population. Given this observation and the lack of data available regarding pharmacotherapy for pediatric LBP, we sought to characterize patterns of opioid prescribing in the pediatric population. METHODS We used a national database to identify pediatric patients (age 5-17) with newly diagnosed with LBP between 2008 and 2015 who did not have a red flag diagnosis, had not received an opioid prescription in the 6 mo prior to diagnosis, and had 12-mo of continuous enrollment after diagnosis. We used logistic regression to model the association between sex, geographic region, categorical age, and our primary outcome, receipt of an opioid prescription in the year following diagnosis. RESULTS Our sample included 268 228 opioid-naïve pediatric patients diagnosed with LBP between 2008 and 2015. We observed that 47 631 (17.8%) patients received physical therapy, 29 903 (11.2%) patients received chiropractic manipulative therapy, 658 (0.25%) patients received epidural steroid injection, and 281 (0.10%) patients received surgery. A total of 35 274 (13.2%) pediatric LBP patients were prescribed opioids within 12 mo from their diagnosis. Opioid prescribing decreased in all age groups over the study period age group 5 to 9 decreased from 4.2% to 2.7%, age group 10 to 14 decreased from 10.3% to 7.7%, and age group 15 to 18 yr decreased from 20.9% to 17.1%. Female pediatric patients were more likely than male patients to receive an opioid prescription (OR, 1.12, P < .0001). Patients ages 10 to 14 (OR, 2.89, P < .0001) and 15 to 18 (OR, 6.98, P < .0001) were significantly more likely to be prescribed opioids compared to patients in the youngest age group. CONCLUSION To our knowledge, we report the first observational cohort study of opioids and LBP in the pediatric population. Our findings indicate that opioids are being used for newly diagnosed LBP and receipt of opioids are associated with patient demographic factors.


2011 ◽  
Vol 26 (1) ◽  
pp. 10-20 ◽  
Author(s):  
Ligia M Pereira ◽  
Karen Obara ◽  
Josilainne M Dias ◽  
Maryela O Menacho ◽  
Débora A Guariglia ◽  
...  

Objective: To perform a systematic review with meta-analyses that evaluates the effectiveness of the Pilates method on the pain and functionality outcome in adults with non-specific chronic low back pain. Data sources: The search was performed in the following databases: Medline, Embase, AMED, Cinahl, Lilacs, Scielo, SportDiscus, ProQuest, Web of Science, PEDro, Academic Search Premier and the Cochrane Central Register of Controlled Trials from 1950 to 2011; the following keywords were used: ‘Pilates’, ‘Pilates-based’, ‘back exercises’, ‘exercise therapy’, ‘low back pain’, ‘back pain’ and ‘backache.’ Review methods: The inclusion criteria were studies that assessed the effects of the Pilates method on patients with chronic low back pain. Results: Five studies met the inclusion criteria. The total number of patients was 71 in the Pilates group and 68 in the control group. Pilates exercise did not improve functionality (standardized mean difference (SMD = –1.34; 95% confidence interval (CI) −2.80, 0.11; P = 0.07) or pain between Pilates and control groups (SMD = –1.99; 95% CI −4.35, 0.37; P = 0.10). Pilates and lumbar stabilization exercises presented no significant difference in functionality (mean difference (MD) = –0.31; 95% CI −1.02, 0.40; P = 0.39) or pain (MD = –0.31; 95% CI −1.02, 0.40; P = 0.39). Conclusion: The Pilates method did not improve functionality and pain in patients who have low back pain when compared with control and lumbar stabilization exercise groups.


2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Bilal Khan ◽  
Khalid Khanzada ◽  
Sajjad Ullah ◽  
Usman Haqqani

Objectives: To know about the efficacy of trigger point injections in low back pain. Study Design: Prospective observational study. Setting: Out-patient Department of Naseer Teaching Hospital, Peshawar, and private clinic of the author. Period: March 2016 to January 2017. Materials and Methods: All patients with low back pain were evaluated. Inclusion criteria was; all patients with low back pain greater than 3 months duration whether operated or not, patients with non-radiating symptoms, patients with acceptable radiology (no listhesis, obvious stenosis/disk, albeit some degree of degeneration was acceptable), further helping points were morning exacerbations and elicitation of tender spot by the patient. The exclusion criteria was Low back pain with less than 3 months duration, obvious pathology on radiological examination, radiating symptoms, generalized low back pain without any point tenderness elicitation. The patients were sent home on medications and asked to avoid strenuous activity for a couple of weeks, they were followed after one month and asked about their pain satisfaction. Results: Approximately 2800 patients were evaluated for low back pain and of them 237 (8.46%) patients were upto the inclusion criteria, only 112 patients had agreed to have a TPI, which showed an acceptance rate of 47.25%. There were 65 males and 58 females, with a male to female ratio approaching almost 1:1. The age range was from 18 to 48 years, and the mean age was 32 years. The minimum duration of pain was 3 months and the maximum duration was 4 years, 4 patients had undergone back surgery. Almost all patients pointed out the pain spot, but a typical trigger point was elicited in 58(51.78%) patients, while morning exacerbation was present in 43(38.38%). Radiological examination was performed on all patients in the form of simple xrays and Magnetic resonance imaging scans, it was acceptable in 67%, as patients with radiating symptoms were already excluded. 10.71% (n=12) patients had some problems. Conclusion: In patients with chronic low back pain due to Myofascial Pain Syndrome (MPS) eliciting the trigger points by either elaboration through history or physical examination and treating them with a TP injection with lignocaine and a steroids has good short term results.


2011 ◽  
Vol 16 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Aaron A Puhl ◽  
Christine J Reinhart ◽  
Elisabeth R Rok ◽  
H Stephen Injeyan

OBJECTIVE: To determine whether the nonspecific effects that occur following the use of sham interventions to treat nonspecific low back pain (LBP) are large enough to be considered clinically meaningful.DESIGN: Electronic databases were searched systematically for randomized placebo-controlled trials of interventions for LBP that used sham ultrasound, sham laser or sham drug therapy as the placebo control. Study selection was accomplished via independent evaluation of scientific admissibility by three reviewers and final decisions of inclusion were based on consensus.RESULTS: None of the studies using sham ultrasound as the placebo control in the treatment of LBP were acceptable for inclusion. Twelve studies were included in the present evaluation of the placebo effect – eight trials that met the strict inclusion criteria for best evidence (three using sham laser placebo and five using sham medication placebo) and four sham medication studies that ‘just missed’ the inclusion criteria for best evidence. Although the evidence from studies using sham laser was inconclusive, the present review did find a clinically meaningful change in LBP scores following the use of sham oral medications.CONCLUSIONS: The present best-evidence review found a clinically meaningful change in pain scores following the use of sham oral medications for the treatment of nonspecific LBP. This finding suggests that further clinical research is warranted to identify which patient subgroups could benefit most from such treatment and to distinguish the true contribution of the placebo effect from other nonspecific effects.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Seyedeh Tahereh Faezi ◽  
Azarakhsh Baghdadi ◽  
Mohammad Nejadhosseinian ◽  
Maziar Moradi-Lakeh ◽  
Mir Saeed Yekaninejad ◽  
...  

Abstract Background Low back pain (LBP) is a major contributor to chronic pain and disability. The purpose of this study was to evaluate health-care access and utilization among patients with LBP in Iran. We also sought to study the pattern and characteristics of care-utilization behavior in these patients. Methods Data from the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) were used for this study. Three cities (Zahedan, Sanandaj, Yazd) were selected to represent the Iranian population, with different socioeconomic status and ethnic, cultural, and religious background. Demographic data, acute or chronic LBP, disability index, and utilizing care from conventional medicine (CM), allied health providers (AHP), and complementary and alternative medicine (CAM) providers were recorded. Results Of 9101 patients, 38.6% reported LBP. Only 3.3% did not utilize care of any kind, 66.7% referred to CM providers, 20.8% to AHP, and 9.2% to CAM care. Health-care utilization was higher in female patients, older age, higher education, and higher disability index. Conclusions The findings of this study indicate a high rate of health-care utilization among patients with LBP in Iran. CM is the most prevalent health-care resource sought by patients. These findings could be used as a framework in developing more efficient health-care programs according to the needs of specific populations.


2018 ◽  
Vol 1 (1) ◽  
pp. 24-32
Author(s):  
M Afif Baskara Emirzon ◽  
M Hasnawi Hadani ◽  
Veny Larasati

The incidence of lower back pain in the productive age population continues to increase. Various risk factors such as age, sex, smoking, and physical activity, length of work and work position can exacerbate lower back pain complaints. This study was conducted to analyze risk factors that affect the severity of low back pain in patients who perform therapy in Medical Rehabilitation Installation RSUP dr. Mohammad Hoesin Palembang period 2016-2017. The research used is analytical observation with cross-sectional technique. The sample of research is 71 respondents in Medical Rehabilitation Installation of dr. Mohammad Hoesin Palembang that meets the inclusion criteria. The data was further processed and grouped in table form. At 71 respondents found 49 respondents suffered severe NPB and 22 respondents suffered from mild NPB. The results showed that sex, physical activity, work position and duration of work had significant relationship with mild cases of low back pain (p = 0,03, p = 0,000, p = 0,00, p = 0,002). While age, smoking, BMI did not have a significant association with mild cases of low back pain (p = 0.08, p = 1.044, p = 0.690). Risk factors that affect the severity of lower back pain are male, physical weight, working position sitting or bending and length of work more than 7 hours per day.


Author(s):  
Shari Rone-Adams ◽  
Eric Shamus ◽  
Melissa Hileman

Study Design: This study utilized a single blind design in the observation of 20 initial low back evaluations performed by physical therapists. The physical therapists were blinded to what the researchers were observing. Objective: The objective of this study was to determine whether or not physical therapists were quantifying the strength of trunk flexors when the patient’s chief complaint was low back pain. Background: The literature has shown that there is a relationship between back pain and decreased strength in the abdominal muscles. Therefore, it appears important for physical therapists to evaluate the abdominal muscles in patients with low back pain. Methods and Measures: Twenty physical therapists participated in the study. The researchers observed if trunk flexor strength was quantified during the initial evaluation of 20 patients with low back pain. Following the observation, each physical therapist was given a questionnaire and asked to comment on their evaluation of the trunk flexors. Results: Of the evaluations that were observed, 15% of the physical therapists evaluated the trunk flexors and 85% did not. Conclusion: This study demonstrated that therapists did not consistently quantify abdominal strength when treating patients with low back pain.


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