Objective: Lateral epicondylitis (LE) is a common painful problem of the elbow. This study was conducted to evaluate and compare the effectiveness of extracorporeal shock wave therapy (ESWT) and lowintensity laser therapy in LE treatment. Material and Methods: The study included 60 LE patients. Subjects were divided into two groups randomly. Group 1 received ESWT, while group 2 received laser therapy. Presence of lateral epicondyle tenderness, elbow pain, and hand grip strength (HGS) were evaluated at the beginning and at 4 and 12 weeks. Elbow pain was evaluated with the Short-Form McGill pain questionnaire (SF-MPQ). Results: The patients with tender lateral epicondyle were not significantly different between groups at each time point. Both groups had improvement on HGS evaluated at the 4 th and 12 th weeks, but in the ESWT group, the improvement was significantly higher. All SF-MPQ parameters improved significantly after each therapy evaluated at the 4 th and 12 th weeks. However, mean visual analog scale, present pain intensity, affective pain subscale, and total pain scale scores were significantly lower in the ESWT group at the 4 th and 12 th weeks. Conclusion: Both ESWT and laser therapy are effective and safe treatment options for LE; however, ESWT seems to be more efficient in pain reduction and improvement of functions. Key Words: Lateral epicondylitis, laser, ESWT, elbow Özet Amaç: Lateral epikondilit (LE), kolun yaygın ağrılı bir problemidir. Bu çalışmadaki amacımız, ekstrakorporeal şok dalga tedavisi (ESWT) ve düşük doz lazer tedavisinin etkinliğini araştırmak ve tedavi etkinliklerini karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya alınan 60 hasta randomize olarak 30 kişilik iki gruba ayrıldı. Birinci gruba ESWT, diğerine lazer tedavisi uygulandı. Hastalar başlangıçta, 4 ve 12. haftalarda lateral epikondilde hassasiyet varlığı, dirsekte ağrı ve el kavrama gücü (EKG) parametreleri ile değerlendirildi. Dirsekteki ağrı Kısa form-McGill ağrı anketi (KF-MAA) ile değerlendirildi. Bulgular: Tedavi sonrasındaki kontrollerde lateral epikondil hassasiyetinde, gruplar arasında anlamlı farklılık saptanmadı. Dördüncü ve 12. haftalarda yapılan değerlendirmelerde her iki grupta gelişmeler görüldü, fakat bu düzelme ESWT grubunda daha belirgindi. Kısa form-McGill ağrı anketinin tüm parametrelerinde 4 ve 12. haftalarda her iki tedavide anlamlı iyileşmeler elde edildi. Bununla birlikte KF-MAA'nın görsel ağrı skalası, total ağrı yoğunluğu, toplam ağrı oranı ve affektivite alt skala skorları 4 ve 12. haftalarda ESWT grubunda anlamlı oranda daha düşük idi. Sonuç: Ekstrakorporeal şok dalga tedavisi ve lazer tedavileri, LE'de etkili ve güvenli yöntemlerdir. Ancak ağrının azalması ve fonksiyonel iyileşmede ESWT daha etkili görünmektedir.
[Purpose] The aim of the present study was to investigate and compare the effects of
whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome.
[Subjects and Methods] Sixty outpatients (30 per group) with complex regional pain
syndrome participated. They received 15 treatment 5 days per week for 3 weeks. The outcome
measures were the visual analogue scale for pain, edema, range of motion of the wrist
(flexion and extension), fingertip-to-distal palmar crease distance, hand grip strength,
and pinch strength. All parameters were measured at baseline (week 0) and at the trial end
(week 3). [Results] There were significant improvements in all parameters after therapy in
both groups. The whirlpool bath group showed significantly better improvements in the
visual analogue score, hand edema, hand grip strength, wrist range of motion (both flexion
and extension), fingertip-to-distal palmar crease distance, and the three-point and
fingertip pinch strengths than the neuromuscular electrical stimulation group; however,
the lateral pinch strengths were similar. [Conclusion] Both whirlpool bath and
neuromuscular electrical stimulation are effective in the treatment of complex regional
pain syndrome, but the efficacy of the whirlpool bath treatment was better.
Study DesignRetrospective.PurposeThis study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia.Overview of LiteratureMany women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.MethodsWe examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).ResultsFifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.ConclusionsAge, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results.
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