scholarly journals EUS-Guided Versus Percutaneous Celiac Neurolysis for the Management of Intractable Pain Due to Unresectable Pancreatic Cancer: A Randomized Clinical Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1666
Author(s):  
Won Jae Yoon ◽  
Yul Oh ◽  
Changhoon Yoo ◽  
Sunguk Jang ◽  
Seong-Sik Cho ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Back Pain ◽  
Cancer Patients ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intractable Pain ◽  
Point Reduction ◽  
Pain Scores ◽  
Numerical Rating

Although endoscopic ultrasound-guided celiac neurolysis (EUS-CN) and percutaneous celiac neurolysis (PCN) are utilized to manage intractable pain in pancreatic cancer patients, no direct comparison has been made between the two methods. We compared the efficacy and safety of EUS-CN and PCN in managing intractable pain in such patients. Sixty pancreatic cancer patients with intractable pain were randomly assigned to EUS-CN (n = 30) or PCN (n = 30). The primary outcomes were pain reduction in numerical rating scale (NRS) and opioid requirement reduction. Secondary outcomes were: successful pain response (NRS decrease ≥50% or ≥3-point reduction from baseline); quality of life; patient satisfaction; adverse events; and survival rate at 3 months postintervention. Both groups reported sustained decreases in pain scores up to 3 months postintervention (mean reductions in abdominal pain: 0.9 (95% confidence interval (CI): −0.8 to 4.2) and 1.7 (95% CI: −0.3 to 2.1); back pain: 1.3 (95% CI: −0.9 to 3.4) and 2.5 (95% CI: −0.2 to 5.2) in EUS-CN, and PCN groups, respectively). The differences in mean pain scores between the two groups at baseline and 3 months were −0.5 (p = 0.46) and −1.4 (p = 0.11) for abdominal pain and 0.1 (p = 0.85) and −0.9 (p = 0.31) for back pain in favor of PCN. No significant differences were noted in opioid requirement reduction and other outcomes. EUS-CN and PCN were similarly effective and safe in managing intractable pain in pancreatic cancer patients. Either methods may be used depending on the resources and expertise of each institution.

scholarly journals NUMERICAL RATING SCALE AS A PREDICTOR OF AN UNDERLYING PATHOLOGY IN PEDIATRIC BACK PAIN USING MAGNETIC RESONANCE IMAGE AS DIAGNOSTIC TOOL

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
Eduardo A. Lindsay ◽  
Gerardo Olivella ◽  
Manuel Rodríguez ◽  
Edwin Burgos-Rossy ◽  
Natalia Torres-Acevedo ◽  
...  
Keyword(s):  
Back Pain ◽  
Magnetic Resonance Image ◽  
Rating Scale ◽  
Chronic Back Pain ◽  
Numerical Rating Scale ◽  
Children And Adolescent ◽  
Constant Pain ◽  
Neurological Exam ◽  
Numerical Rating ◽  
Underlying Pathology

Background & Objectives: Recently, constant and night pain has been discarded as adequate clinical markers to predict the presence of an underlying pathology in pediatric back pain. The pain intensity has been recognized as an important domain in the pain assessment. Numerical Rating Scale (NRS) is one of the most common validated tools to assess pediatric pain intensity in children above 8 years of age. The aim of this study is to assess NRS as a predictor of underlying pathologies found by magnetic resonance image (MRI) in pediatric back pain. We hypothesize that a higher NRS score is associated with a high sensitivity, specificity and likelihood ratio to identify the present of organic pathology in pediatric chronic back pain. Methodology: After obtaining Institutional Review Board approval, a retrospective electronical medical record review was conducted. All pediatric patients who reported back pain lasting > 4 weeks between 2009 to 2018 were enrolled in the study. As per regular protocol, a pediatric orthopedic surgeon evaluated all patients who presented with back pain. After a non-diagnostic history, physical examination and spinal x-ray; spine MRI was order. Pain was graded with the use of NRS from 0 to 10. Patients were divided in two groups: NRS (1-5) & NRS (6-10). Variables such as gender, age, pain frequency, night pain, neurological exam, and the presence of an underlying pathology were compared between both groups. Patients that presented with injury due to trauma, previous diagnosis of back pain or cervical pain were excluded. Results: A total of 467 patients were evaluated in the study. Mean age of subjects was 15 years; 69% being female. An underlying pathology was identified in 131/315 (41.6%) patients with NRS (6-10), and 55/152 (36.2%) patients with NRS (1-5) (P=0.27). Patients with NRS (6-10) had two times more probability of suffering constant pain (P<0.03) and three times more likely of having an abnormal neurological examination (P<0.05). See table 1. Conclusion: Evaluation and treatment of children and adolescent with chronic back pain is challenging. Our study shows a strong association between NRS high (6-10) and constant pain and/or abnormal neurological exam. However, the use of NRS of (6-10) was not found as adequate predictor for the presence of an underlying organic pathology in children and adolescent patients. Therefore, physicians should not rely only high NRS score to recommend advance imaging study to assess chronic back pain in children and adolescent patients. Summary [Table: see text]

scholarly journals Single vertebral manipulative therapy (Kitchener’s Technique): a new technique for treatment of acute and subacute spinal root compression

2021 ◽  
Vol 11 (2) ◽  
pp. 31-35
Author(s):  
Nabil Kitchener
Keyword(s):  
Back Pain ◽  
Physical Functioning ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Roland Morris Disability Questionnaire ◽  
Spinal Root ◽  
Functional Scale ◽  
Manipulative Therapy ◽  
Numerical Rating ◽  
Disability Questionnaire

Introduction: Spinal Root Compression Syndromes (SRCS) are common, costly, and significant cause of long-term sick leave and work loss. There is No consensus on the best approach. One intervention often used is manipulative therapy. Objective: The aim of this study was to determine if Single Vertebral Manipulative Therapy (Kitchener’s Technique) (SVMT) is effective in alleviating pain levels and regaining physical functioning in comparison to standard medical care (SMC), among 18-55-year-old active working personnel. Methods: Prospective, longitudinal, 2-arm controlled study comparing SMC plus SVMT (32 patients) with only SMC (21 patients). The primary outcome measures were changes in root-related pain on the numerical rating scale and physical functioning at 6 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS). Results: Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus SVMT group than in the SMC group at both week 2 (P<0.001) and week 6 (P=0.001). Mean numerical rating scale pain scores were also significantly better in the group that received SVMT. Adjusted mean back pain functional scale scores were significantly higher (improved) in the SMC plus SVMT group than in the SMC group at both week 2 (P<0.001) and week 6 (P=0.001). Conclusion: Results suggest that SVMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only SMC, for patients aged 18-55 years with SRCS.

scholarly journals Association between telecommuting environment and low back pain among Japanese telecommuting workers: A cross-sectional study

2021 ◽  
Author(s):  
Ryutaro Matsugaki ◽  
Keiji Muramatsu ◽  
Seiichiro Tateishi ◽  
Tomohisa Nagata ◽  
Mayumi Tsuji ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cross Sectional Study ◽  
Mixed Effects ◽  
Low Back ◽  
Sectional Study ◽  
Cross Sectional ◽  
Numerical Rating

Objectives: We evaluated the relationship between telecommuting environment and low back pain (LBP) among desk-based workers in Japan. Methods: This cross-sectional study included 3,663 desk-based, telecommuting workers. LBP was assessed using a 0 to 10 numerical rating scale. The telecommuting environment was evaluated using subjective questions. Mixed-effects logistic regression analysis was used. Results: Mixed-effects logistic model results revealed that not having a place or room to concentrate on work, desk not well-lit enough for work, not having enough space on the desk to work, not having enough legroom, and not having comfortable temperature and humidity conditions in the workspace were significantly associated with higher odds of LBP. Conclusions: Our findings suggest that telecommuting environment is associated with the prevalence of LBP.

scholarly journals Laughter and Stress Relief in Cancer Patients: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. H. Kim ◽  
Y. H. Kim ◽  
H. J. Kim
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Alternative Therapy ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Numerical Rating ◽  
Anxiety Depression

The purpose of this study was to examine the effect of a therapeutic laughter program and the number of program sessions on anxiety, depression, and stress in breast cancer patients. A randomized controlled trial was conducted involving 31 patients who received four sessions of therapeutic laughter program comprised and 29 who were assigned to the no-program control group. Scores for anxiety, depression, and stress were measured using an 11-point numerical rating scale. While no change was detected in the control group, the program group reported reductions of 1.94, 1.84, and 2.06 points for anxiety, depression, and stress, respectively (p<0.01,p<0.01, andp<0.01). Scores decreased significantly after the first therapeutic laughter session (p<0.05,p<0.01, andp<0.01). As the therapeutic laughter program was effective after only a single session in reducing anxiety, depression, and stress in breast cancer patients, it could be recommended as a first-line complementary/alternative therapy.

scholarly journals A study to assess the effectiveness of Acharya Technique on low back pain among women

2020 ◽  
Vol 11 (3) ◽  
pp. 3005-3008
Author(s):  
KalaBarathi S ◽  
Mohana S
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Demographic Variable ◽  
Numerical Rating Scale ◽  
Sampling Technique ◽  
Low Back ◽  
Medical Issues ◽  
Age Related ◽  
Numerical Rating

Back pain is the most widely recognised medical consultation in all the nations. It meddles with an individual’s satisfaction and general working. Back pain is a too fundamental issue that can extend from a dull, consistent pain to an unexpected, sharp pain that can leave individuals crippled. It can come on abruptly from a mishap, a fall, or lifting something extraordinary or it can grow gradually, maybe as the consequence of age-related changes to the Spine. Those instincts and behavioural patterns are now codified into Acharya technique for back pain and Spinal & Nervous rejuvenation. The Save India association is conducting camps week after week without involving any fee for every one of the individuals, who are experiencing Back pain. All the same, people with other medical issues can also learn them and help themselves to enjoy perfect health and that as well with no depressions, fatigues or strain. Those who are destitute and are worn out on running from pillar to post and have spent a ton in treating back pain would now be able to plan to appreciate ideal wellbeing through this nature fix treatment which can properly be known as a therapy beyond all therapies. Hence the study is aimed to assess the effectiveness of Acharya technique on low back pain among women. Quantitative approach with Experimental Research design was employed with 60 samples which matched the inclusion criteria were selected by purposive sampling technique. A demographic variable was collected by using multiplechoice questionnaires by structured questionnaires, and the level of pain was assessed by using the Numerical Rating Scale. The results of the study are out of 60 samples 37 [61.66%] had moderate pain, 23 [38.33%] had mild pain, and none had severe pain.

scholarly journals PENGARUH SENAM HAMIL TERHADAP NYERI PUNGGUNG PADA IBU HAMIL

2020 ◽  
Vol 10 (1) ◽  
pp. 1259-1265
Author(s):  
Uun Kurniasih
Keyword(s):  
Back Pain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Purposive Sampling ◽  
Post Test ◽  
Numerical Rating

Salah satu ketidaknyamanan yang sering timbul pada kehamilan adalah nyeri punggung. Nyeri punggung merupakan gangguan yang banyak dialami oleh ibu hamil sepanjang masa-masa kehamilan hingga periode pasca natal . Salah satu upaya yang bisa dilakukan untuk mengurangi nyeri punggung selama kehamilan adalah dengan melakukan senam hamil. Penelitian ini bertujuan untuk mengetahui skala nyeri sebelum dan sesudah dilakukan senam hamil dan untuk mengetahui pengaruh senam hamil terhadap nyeri punggung pada ibu hamil di UPTD Puskesmas Mundu Kabupaten Cirebon Tahun 2018.Penelitan ini menggunakan desain penelitian quasi eksperimen dengan pretest–posttest with control group. Pengambilan sampel menggunakan purposive sampling dengan jumlah sampel 28 responden, 14 subjek untuk kelompok intervensi dan 14 subjek untuk kelompok  kontrol. Teknik pengumpulan data dengan cara observasi. Sedangkan instrumen yang digunakan adalah Numerical Rating Scale (NRS). Analisa data yang digunakan adalah uji Mann – Whitney.Hasil Penelitian ini menunjukkan bahwa hasil dari pre test dan post test pada kelompok kontrol mayoritas dengan intensitas nyeri sedang yaitu 7 orang (50%) dan nyeri berat yaitu 6 orang (42%), sedangkan pada melompok intervensi mayoritas nyeri ringan yaitu 7 orang (50%) dan nyeri sedang yaitu 7 orang (50%). Berdasarkan analisa statistik didapatkan niai p value adalah  0,001 maka Ho ditolak dan Ha diterima artinya senam hamil efektif menurunkan intensitas nyeri punggung pada ibu hamill di UPTD Puskesmas Mundu Kabupaten Cirebon tahun 2018Kata Kunci   : Senam, nyeri punggung, ibu hamil  ABSTRACTLow Back pain is one of the discomfort which often occurred during pregnancy. Lowback pain is a condition experienced by many pregnant women troughout pregnancy period to the post  delivery period. One of the solutionto address this issue is by doing exercise for pregnancy women. The studi was conducted to find out the effect of pregnancy exercisseto reduce low back paint issue.This studi aims to determine the scalae of pain before and after pregnancy exercise and to determine the effect of pregnancy exercise againt back pain in pregnancy women in UPTD puskesmas Mundu Cirebon Regency 2018. This research uses quasi experimental research design with Pretest –Posttest with Control Group. Sampling using purposive sampling with the number of samples of 28 respondent, 14 for the intervention group and 14 subjects for the control group. Data collection techniques by observation. While the instrument used is the Numerical Rating Scale (NRS). The data analysis used is Mann –Whitney test. The resukt of this study indicate that resukt of pre-test and post-test in the mayoritycontrol group with moderate pain intensisity of 7 people (50%) and severe pain that is 6 people (42,9%), while in the intervention group the majority of mild pain 7 peiple (50%). Based on statistical analysis in the value of p value is 0,001, then H0 is rejected reduce the intensity of back pain in pregnant women in UPTD Puskesmas Mundu Cirebon  2018.Keywords: Exercise, back pain, pregnancy women

scholarly journals Ultrasound-Guided Sacroiliac Joint Injection Technique

2008 ◽  
Vol 4;11 (8;4) ◽  
pp. 543-547
Author(s):  
Professor Dominic Harmon
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Chronic Lower Back Pain ◽  
Transverse Orientation ◽  
Ultrasound Guided ◽  
Lower Back ◽  
Numerical Rating

We describe a case report and technique for using a portable ultrasound scanner and a curvilinear transducer (4-5MHz) (SonoSite Micromaxx SonoSite, Inc. 21919 30th Drive SE Bothwell W. A.) to guide sacroiliac joint (SIJ) injection. A 42-year-old male presented with chronic lower back pain centered on his left SIJ. His pain averaged 7 out of 10 (numerical rating scale). For the ultrasound-guided SIJ injection the patient was placed in the prone position. The ultrasound transducer was oriented in a transverse orientation at the level of the sacral hiatus. Here the sacral cornuae were identified. Moving the transducer laterally from here, the lateral edge of the sacrum was identified. This bony edge was followed in a cephalad direction with the transducer maintained in a transverse orientation. A second bony contour, the ileum, was identified. The cleft between both bony contours represented the sacroiliac joint. This was found at 4.5 cm depth. Real-time imaging was used to direct a 22G spinal needle into the SIJ, where solution was injected under direct vision. The patient’s pain intensity decreased to a 2 out of 10 (numerical rating scale). Function improved and the patient was able to return to work. These improvements were maintained at 16 weeks. Ultrasound guidance does not expose patients and personnel to radiation and is readily accessible. Ultrasound-guided SIJ injections may have particular applications in the management of chronic lower back pain in certain clinical scenarios (e.g. pregnancy). Future studies to demonstrate efficacy and reproducibility are needed. Key words: Technique, visualization, real-time, ultrasound, sacroiliac joint.

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