Short-term swimming exercise attenuates the sensitization of dorsal horn neurons in rats with NGF-induced low back pain

2018 ◽  
Vol 22 (8) ◽  
pp. 1409-1418 ◽  
Author(s):  
G. de Azambuja ◽  
U. Hortscht ◽  
U. Hoheisel ◽  
M.C. Oliveira Fusaro ◽  
S. Mense ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Dorsal Horn ◽  
Swimming Exercise ◽  
Low Back ◽  
Short Term ◽  
Dorsal Horn Neurons

scholarly journals Prevention and reversal of latent sensitization of dorsal horn neurons by glial blockers in a model of low back pain in male rats

2017 ◽  
Vol 118 (4) ◽  
pp. 2059-2069 ◽  
Author(s):  
Juanjuan Zhang ◽  
Siegfried Mense ◽  
Rolf-Detlef Treede ◽  
Ulrich Hoheisel
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Nerve Growth Factor ◽  
Dorsal Horn ◽  
Microglial Activation ◽  
Low Back ◽  
Astrocyte Activation ◽  
Dorsal Horn Neurons ◽  
Resting Activity ◽  
Stimulation Of

In an animal model of nonspecific low back pain, recordings from dorsal horn neurons were made to investigate the influence of glial cells in the central sensitization process. To induce a latent sensitization of the neurons, nerve growth factor (NGF) was injected into the multifidus muscle; the manifest sensitization to a second NGF injection 5 days later was used as a read-out. The sensitization manifested in increased resting activity and in an increased proportion of neurons responding to stimulation of deep somatic tissues. To block microglial activation, minocycline was continuously administered intrathecally starting 1 day before or 2 days after the first NGF injection. The glia inhibitor fluorocitrate that also blocks astrocyte activation was administrated 2 days after the first injection. Minocycline applied before the first NGF injection reduced the manifest sensitization after the second NGF injection to control values. The proportion of neurons responsive to stimulation of deep tissues was reduced from 50% to 17.7% ( P < 0.01). No significant changes occurred when minocycline was applied after the first injection. In contrast, fluorocitrate administrated after the first NGF injection reduced significantly the proportion of neurons with deep input (15.8%, P < 0.01). A block of glia activation had no significant effect on the increased resting activity. The data suggest that blocking microglial activation prevented the NGF-induced latent spinal sensitization, whereas blocking astrocyte activation reversed it. The induction of spinal neuronal sensitization in this pain model appears to depend on microglia activation, whereas its maintenance is regulated by activated astrocytes. NEW & NOTEWORTHY Activated microglia and astrocytes mediate the latent sensitization induced by nerve growth factor in dorsal horn neurons that receive input from deep tissues of the low back. These processes may contribute to nonspecific low back pain.

scholarly journals The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jan Wilke ◽  
Robert Schleip ◽  
Werner Klingler ◽  
Carla Stecco
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Dorsal Horn ◽  
Morphological Changes ◽  
Low Back ◽  
Dorsal Horn Neurons ◽  
Potential Source ◽  
Stimulation Of

The lumbodorsal fascia (LF) has been proposed to represent a possible source of idiopathic low back pain. In fact, histological studies have demonstrated the presence of nociceptive free nerve endings within the LF, which, furthermore, appear to exhibit morphological changes in patients with chronic low back pain. However, it is unclear how these characteristics relate to the aetiology of the pain. In vivo elicitation of back pain via experimental stimulation of the LF suggests that dorsal horn neurons react by increasing their excitability. Such sensitization of fascia-related dorsal horn neurons, in turn, could be related to microinjuries and/or inflammation in the LF. Despite available data point towards a significant role of the LF in low back pain, further studies are needed to better understand the involved neurophysiological dynamics.

Critical analysis and unique management of Gridhrasi w.s.r. to Sciatica - A Case Report

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Rangarajan B. ◽  
Dr. Muralidhara .
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Total Population ◽  
The Body ◽  
Walking Distance ◽  
Common Symptom ◽  
Low Back ◽  
Short Term ◽  
Lower Back

Gridhrasi (Sciatica) is a disorder in which low back pain is found, that spreads through the hip, to the back of the thigh and down the inside of the leg. Mechanical low back pain (LBP) remains the second most common symptom related reason for seeing a physician. 85% of total population will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. There are many causes for low back pain, however true sciatica is a symptom of inflammation or compression of the sciatica nerve. The sciatica nerve carries impulses between nerve roots in the lower back and the muscles and nerve of the buttocks, thighs and lower legs. Compression of a nerve root often occurs as a result of damage to one of the discs between the vertebrae. In some cases, sciatic pain radiate from other nerves in the body. This is called referred pain. Pain associated with sciatica often is severe, sharp and shooting. It may be accompanied by other symptom, such as numbness, tingling, weakness and sensitivity to touch. There is only conservative treatment giving short term relief in pain or surgical intervention with side effect. But these are not successful and therefore those who are suffering from this are always in search of result oriented remedy. Walking distance and SLR test were taken for assessment parameter, VAS score was adopted for pain. Before treatment patient was not able to walk even 4 to 5 steps due to severe pain, was brought on stretcher and his SLR was 30° of right side. After 22 days of treatment he was able to walk up to 500 meters without any difficulty, SLR was changed to 60° and patient had got 80 % relief in pain. This case report showed that Ayurvedic protocol is potent and safe in the treatment of Gridhrasi.

scholarly journals Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Activity Limitations ◽  
Low Back ◽  
Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

scholarly journals Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20190006
Author(s):  
Maha Emad Ibrahim ◽  
Magdy Ahmed Awadalla ◽  
Aziza Sayed Omar ◽  
Mohammad al-Shatouri
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Control Group ◽  
Low Back ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Short Term ◽  
F Wave ◽  
Epidural Steroid ◽  
Caudal Epidural

Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml−1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

scholarly journals Acute and Short-Term Effects of Dry Needling in Patients with Chronic Nonspecific Low Back Pain and Hamstring Tightness: A Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mahnaz Bazzaz-Yamchi ◽  
Soofia Naghdi ◽  
Amin Nakhostin-Ansari ◽  
Monavar Hadizadeh ◽  
Noureddin Nakhostin Ansari ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pilot Study ◽  
Study Design ◽  
Effect Sizes ◽  
Medium Effect ◽  
Low Back ◽  
Dry Needling ◽  
Short Term ◽  
Short Term Effects

Background. Chronic nonspecific low back pain (LBP) is one of the common health issues. Hamstring tightness contributes to the development of LBP. This study aimed to investigate the acute and short-term effects of deep dry needling (DN) in patients with chronic nonspecific LBP and hamstring muscle tightness. Methods. A single-group pretest-posttest clinical study design was followed. The outcome measures were the visual analog scale (VAS), passive knee extension (PKE) test, finger-floor distance (FFD) test, and functional rating index (FRI). Patients underwent one session of deep DN of three points on both hamstring muscles, each point for one minute. Patients were assessed before (T0), immediately after (T1), and one week after DN (T2). The FRI was assessed at T0 and T2. Results. Ten women with a mean age of 21.1 years (SD = 1.6) participated in the study. Significant large effect sizes in VAS pain reduction (d = 1.25) and PKE hamstring tightness were obtained (hamstring: right, d = 0.82; left, d = 0.88) at T2. Medium effect sizes were obtained for FFD (d = 0.45) and FRI (d = 0.72) at T2. Conclusion. A single session of deep DN improved pain and function and increased hamstring flexibility. This pilot study supports the use of DN in patients with LBP and hamstring tightness; however, future research with a rigorous study design of randomized controlled trial is required to confirm the findings. This trial is registered with IRCT20180511039612N1.

scholarly journals Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university’s employees with non-specific low back pain: A pilot study

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Nermeen Mohamed Abdelhalim ◽  
Ahmed Fathy Samhan ◽  
Walid Kamal Abdelbasset
Keyword(s):  
Electromagnetic Field ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Low Back ◽  
Pulsed Electromagnetic Field ◽  
Middle Aged ◽  
Short Term ◽  
Pulsed Electromagnetic ◽  
Pulsed Electromagnetic Field Therapy

Objective: Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health–Related Quality of Life (HRQOL). Methods: Forty-two University’s employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment. Results: All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05). Conclusions: PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university’s employees with nonspecific LBP. doi: https://doi.org/10.12669/pjms.35.4.49 How to cite this:Abdelhalim NM, Samhan AF, Abdelbasset WK. Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university’s employees with non-specific low back pain: A pilot study. Pak J Med Sci. 2019;35(4):---------.  doi: https://doi.org/10.12669/pjms.35.4.49 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Graded Activity and Graded Exposure for Persistent Nonspecific Low Back Pain: A Systematic Review

2010 ◽  
Vol 90 (6) ◽  
pp. 860-879 ◽  
Author(s):  
Luciana G. Macedo ◽  
Rob J.E.M. Smeets ◽  
Christopher G. Maher ◽  
Jane Latimer ◽  
James H. McAuley
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Confidence Intervals ◽  
Controlled Trials ◽  
Low Back ◽  
Short Term ◽  
Minimal Intervention ◽  
Randomized Controlled ◽  
Graded Exposure ◽  
Graded Activity

Background Graded activity and graded exposure are increasingly being used in the management of persistent low back pain; however, their effectiveness remains poorly understood. Purpose The aim of this study was to systematically review randomized controlled trials that evaluated the effectiveness of graded activity or graded exposure for persistent (&gt;6 weeks in duration or recurrent) low back pain. Data Sources Trials were electronically searched and rated for quality by use of the PEDro scale (values of 0–10). Study Selection Randomized controlled trials of graded activity or graded exposure that included pain, disability, global perceived effect, or work status outcomes were included in the study. Data Extraction Outcomes were converted to a scale from 0 to 100. Trials were pooled with software used for preparing and maintaining Cochrane reviews. Results are presented as weighted mean differences with 95% confidence intervals. Data Synthesis Fifteen trials with 1,654 patients were included. The trials had a median quality score of 6 (range=3–9). Pooled effects from 6 trials comparing graded activity with a minimal intervention or no treatment favored graded activity, with 4 contrasts being statistically significant: mean values (95% confidence intervals) for pain in the short term, pain in the intermediate term, disability in the short term, and disability in the intermediate term were −6.2 (−9.4 to −3.0), −5.5 (−9.9 to −1.0), −6.5 (−10.1 to −3.0), and −3.9 (−7.4 to −0.4), respectively. None of the pooled effects from 6 trials comparing graded activity with another form of exercise, from 4 trials comparing graded activity with graded exposure, and from 2 trials comparing graded exposure with a waiting list were statistically significant. Limitations Limitations of this review include the low quality of the studies, primarily those that evaluated graded exposure; the use of various types of outome measures; and differences in the implementation of the interventions, adding to the heterogeneity of the studies. Conclusions The available evidence suggests that graded activity in the short term and intermediate term is slightly more effective than a minimal intervention but not more effective than other forms of exercise for persistent low back pain. The limited evidence suggests that graded exposure is as effective as minimal treatment or graded activity for persistent low back pain.

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