RESUMO
BACKGROUND: Chronic shoulder and neck pain is one of the most common chronic occupational disorders, with an average incidence rate of 48.5%, severely affecting patients' quality of life and ability to work. According to epidemiological research, the prevalence of chronic neck, shoulder, and low back pain in adults over the age of 45 ranges from 40 to 80%. According to reports, medical staff have a higher incidence rate than other populations, and there is a positive correlation between the grade of the medical institution and the incidence rate, making medical staff a priority group for the prevention of chronic neck, shoulder, and low back pain. By the end of 2022, China has been fully opened to epidemic prevention and control, the total number of patients in domestic hospitals has increased significantly, and resulting in medical personnel shoulting great pressure, which seriously affects the physical and mental health of medical personnel. The aim of this study was to explore the risk factors of chronic neck, shoulder and lumbar back pain in medical staff. To provide guidelines for medical staff to improve cervical and lumbar subacute pain and reduce the emergence of spinal lesions. METHODS: From January to February 2023, 602 staff members of a third-grade hospital in Zunyi City were studied by Questionnaire star. Univariate and multivariate Logistic regression were used to analyze the independent risk factors of chronic neck, shoulder and lumbar back pain in medical staff, with stepwise regression utilized to choose the optimum model. The model was selected using Akaike's information criterion (AIC) and the Hosmer-Lemeshow goodness-of-fit test. RESULTS: A total of 602 medical staff were polled, and the findings revealed that 588 cases of chronic neck, shoulder, and low back pain of varied severity had occurred in the previous 1 to 2 years, with a 97.7% incidence rate; logistic regression analysis revealed that anxiety level, frequency of bending over in the previous 1 to 2 years, whether related preventive measures were taken at work, gender, positive senior title, daily ambulation time, and whether the department they worked in organized independent influencing factors. CONCLUSION: The incidence of chronic neck, shoulder, and lumbar back pain among medical staff is high; its influencing factors are different and have not been systematically identified. Hospitals should take effective measures tailored to local conditions to improve the physical and mental health of medical staff.
Assuntos
Dor Crônica , Dor Lombar , Cervicalgia , Doenças Profissionais , Dor de Ombro , Humanos , Feminino , Masculino , Cervicalgia/epidemiologia , Adulto , Dor Lombar/epidemiologia , Dor Lombar/diagnóstico , Pessoa de Meia-Idade , Dor de Ombro/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Dor Crônica/epidemiologia , Dor Crônica/diagnóstico , China/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Incidência , Adulto Jovem , Pessoal de Saúde , EpidemiasRESUMO
BACKGROUND: Patients with chronic lumbar back pain (CLBP) often present with an altered gait profile, which is a crucial element of good functioning in everyday life. In patients with multisegmental spinal pathologies and incongruity between radiologic imaging and clinical presentation, inpatient gradual diagnostics (IGD) is performed to determine the precise origin of the disabling pain. The underlying principle of IGD is the assumption that by locally administering an analgesic and anti-inflammatory agent to possible surgical target areas, the surgical effect can be temporarily simulated. The conclusions drawn from IGD are, however, mostly based on the patients' subjective feedback about pain relief. RESEARCH QUESTION: The aim of this study was to evaluate whether reported pain relief during IGD can be objectified by gait analysis. We hypothesized that patients with greater pain relief during IGD would show greater improvement in their pathologic gait and stance. METHODS: Treadmill gait and stance analyses were prospectively performed on CLBP patients before and after a one-week IGD. Self-report measures included the numeric pain rating scale (NRS) and the Oswestry Disability Index (ODI). RESULTS AND SIGNIFICANCE: Compared with a reference group (nâ¯=â¯28), IGD patients (nâ¯=â¯57) at admission showed reduced velocity, cadence, step length, and swing phase (pâ¯<â¯.01 each). Their stance phase was increased by 5% of the gait cycle, and a more asymmetrical total load distribution during stance was observed. No difference was seen in stride width or foot rotation. While many patients reported good pain relief during IGD, no correlation was observed between subjective improvement and treadmill measures. We can thus confirm a pathologic gait profile in patients with CLBP. Based on our findings, gait analysis would not yet seem suitable to objectify IGD results. The short time interval between admission and discharge may not suffice to change a pathological gait that has developed over years.
Assuntos
Marcha/fisiologia , Dor Lombar/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestésicos Locais , Anti-Inflamatórios , Dor nas Costas , Bupivacaína , Feminino , Análise da Marcha , Hospitalização , Humanos , Injeções Epidurais , Injeções Intra-Articulares , Dor Lombar/diagnóstico , Dor Lombar/tratamento farmacológico , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Medição da Dor , Autorrelato , Resultado do Tratamento , TriancinolonaRESUMO
We present a detailed description of the surgical technique and the preliminary results of an endoscopic denervation for patients with chronic low back pain (CLBP) originating from the facet joints (FJ). Endoscopic denervation of the medial branches of the dorsal rami supplying the FJ has recently been appraised as providing excellent intraoperative visualization and long term pain relief for these patients. Conventional endoscopic rhizotomy has been expanded to include a the precise localization of 3D navigation. A surgical description and the results of our first four patients treated with 3D navigated endoscopic rhizotomy (3DNER) are presented. Four patients with a mean age of 59years and a follow-up time of 2months were included. All patients reported pain reduction in the immediate postoperative period, while three patients (75%) had long lasting relief. The patient without persisting relief had previously sustained a lumbar disc prolapse and only achieved minor pain relief with preoperative FJ infiltration, compared to the significant relief that was seen in the other patients. In contrast to conventional rhizotomy, 3DNER enables the surgeon to ablate more precisely and extensively, which is especially useful if scar tissue is present from previous injuries or surgeries. When successful, this technique may provide long lasting pain relief, especially if the preoperative FJ infiltrations are followed by a substantial pain reduction.
Assuntos
Imageamento Tridimensional/métodos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Neuroendoscopia/métodos , Rizotomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Dor Lombar/diagnóstico por imagem , Dor Lombar/cirurgia , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Tomografia Computadorizada por Raios X/métodosRESUMO
@#Objective To explore the rehabilitation effect of the Thera-Band Systems of progressive exercise on chronic lumbar back pain of the athletes.Methods 45 athletes with the soft tissue lesion were tested for pain and the function of lumbar back muscle was evaluated. Then all cases were trained with Thera-Band Systems.Results After training, the scores of pain and function evaluation of lumbar back muscle decreased significantly.Conclusion Thera-Band Systems of progressive exercise has the obvious and positive effects on chronic lumbar back pain and muscular proprioception of the athletes.