Efficacy of Trigger Point Injections in Patients with Lumbar Disc Hernia without Indication for Surgery

Study DesignProspective comparative study.PurposeTo investigate the efficacy of gluteal trigger point (TP) injections with prilocaine in patients with lumbosacral radiculopathy complaining of gluteal pain.Overview of LiteratureTP injections can be performed using several anesthetic agents, primarily lidocaine and prilocaine. While several studies have used lidocaine, few have used prilocaine.MethodsA total of 65 patients who presented at the polyclinic with complaints of lower back pain with lumbar disc herniation (based on physical examination and magnetic resonance imaging) and TPs in the gluteal region were included in this prospective comparative study. Group 1 comprised 30 patients who were given TP injections, a home exercise program, and oral medications, and group 2 comprised 35 patients who were only treated with a home exercise program and oral medications. The patients' demographic data, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores were recorded, and these data were evaluated at 1- and 3-month follow-ups.ResultsThe ODI and VAS scores of both groups significantly decreased initially and at the follow-up examinations, but the decreases were more marked in group 1.ConclusionsWe obtained better results with TP injections than only a home exercise program and oral medications in patients with radiculopathy and TPs in the gluteal region

Clinimetric properties of the Turkish translation of a modified neck disability index

<p>Abstract</p> <p>Background</p> <p>Neck pain is a common problem that can greatly affect a person's activities of daily living. Functional status questionnaires are important in assessing this effect, and are used to follow up neck pain management programs. The Neck Disability Index (NDI) is the first-created scale for neck pain-related disability and is widely translated and in common used in many countries. Our aim is investigate to clinometric properties of a Turkish version of modified NDI and to give a choice in daily practise of versions to be used.</p> <p>Methods</p> <p>The modified NDI was applied to 30 patients for reliability. 185 patients participated in the validity study. All patients were recruited from the outpatient clinic of our department. The scale was translated by the forward and backward translation procedure according to the COSMIN criteria. The test was repeated at 48 hours interval for reliability study. SPSS-10.0, software was used for statistical analyses. The Intraclass correlation coefficient was used for the test- retest reliability of the modified NDI. Cronbach α was used for internal consistency. Factor analysis was used for construct validity. The validity of the modified NDI with respect to the SF-36, HAD, VAS pain, VAS disability was assessed using Spearman correlations.</p> <p>Results</p> <p>The Intraclass correlation coefficient between first and second (within 48 hours) evaluation of test (rs) was 0.92. Questions 1,4,6,8,10 were shown to have excellent reliability. (rs > 0.9). Question 10 was the most frequently challenged question because "recreational and social activities" do not have not the same meanings in Turkey than in western countries. This required that detailed explanations be provided by the investigators. Cronbach's alpha for the total index was 0.88. A single factor accounting for 80.2% of the variance was obtained. Validity studies demonstrated good and moderate correlations (rs) among NDI, HAD, VAS, physical function subtitle of SF 36 (0.62, 0.76, 0.68).</p> <p>Conclusions</p> <p>The modified NDI-Turkish version is a reliable and valid test and is suitable for daily practise.</p

Clinimetric properties of the Turkish translation of a modified neck disability index

Background: Neck pain is a common problem that can greatly affect a person's activities of daily living. Functional status questionnaires are important in assessing this effect, and are used to follow up neck pain management programs. The Neck Disability Index (NDI) is the first-created scale for neck pain-related disability and is widely translated and in common used in many countries. Our aim is investigate to clinometric properties of a Turkish version of modified NDI and to give a choice in daily practise of versions to be used

Efficacy of Some Combined Conservative Methods in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Clinical and Electrophysiological Trial

Objectives: In this study, we aimed to compare the efficacy of some conservative methods in combination with dexamethasone iontophoresis, ultrasound therapy or placebo iontophoresis (without dexamethasone) in the treatment of mild carpal tunnel syndrome (CTS)

ERECTILE DYSFUNCTION IN MALE PATIENTS WITH TRAUMATIC SPINAL CORD INJURY

Objective: To assess the sexual function of male patients with spinal cord injury (SCI) in comparison with healthy control subjects and to find out whether there was a relationship between International Index of Erectile Function (IIEF) scores and clinical parameters regarding SCI

Comparison of the therapeutic efficacy of TENS versus intra-articular hyaluronic acid injection in patients with knee osteoarthritis: A prospective randomized study

Knee osteoarthritis (OA) is perceived as a major public health problem, and today, various treatment modalities are used to manage this condition. The purpose of this study was to assess and compare the efficacy of transcutaneous electrical nerve stimulation (TENS) and intra-articular hylan G-F 20 (Synvisc (R); Genzyme Corporation, Ridgefield, NJ) in patients with symptomatic knee OA. A total of 60 patients with primary knee OA were randomized into 2 treatment groups. TENS was applied for 3 weeks in the first group, and in the second group, hylan G-F 20 was injected intra-articularly once a week for 3 weeks. Patients were then followed for 6 months. Disease severity was measured with the Lequesne Index. Efficacy in terms of pain, functional status, and quality of life was assessed through analysis of changes in Western Ontario and McMaster Universities Osteoarthritis Index WOMAC) and Short Form 36 Health Survey (SF-36) scores. Adverse events were monitored throughout the study. WOMAC pain scores were improved at the first control visit in the TENS group and in the viscosupplementation group; this improvement was statistically significant. WOMAC stiffness scores showed a statistically significant decrease in the TENS group at the first control visit. Stiffness did not decrease during the first month in the second group; however, these patients exhibited improvement during the sixth month after injection. Physical function scores and SF-36 total scores did not change in either group after treatment. Pain relief was observed at the first month and continued throughout the 6-month follow-up period in both groups. Stiffness decreased by the sixth month in both groups. Improvement in WOMAC physical function scores was greater in the intra-articular hylan group than in the TENS group at the end of follow-up; however, quality of life was not improved in either group. These therapies used in combination may alleviate symptoms in patients with OA

The reliability of Turkish translation of quick exposure check (QEC) for risk assessment of work related musculoskeletal disorders

Work Related Musculo-Skeletal Disorders (WRMSDs) are a common health problem and one of the major causes of disability. Exposure to risk factors of musculoskeletal disorders and the change in exposure can be measured by observational assessment techniques. One of the techniques is QEC ( Quick Exposure Check), which was developed by Li and Buckle in 1998. We designed this study to translate QEC to Turkish and investigation of QEC's reliability among cleaners. The study was conducted among 20 cleaners who were randomly chosen from 200 subjects working at Istanbul University, Istanbul Medical Faculty Hospital. Test-retest reliability of QEC was investigated by intraclass correlation coefficient ( ICC) and Bland Altman method. The reliability coefficients of QEC items were found between 0.589 and 1. Among those QEC items, wrist hand position, back position, using vehicle, work period, were found statistically the most reliable between measurements. The items' reliability of QEC was generally fair to good. For this reason, we suggest that, QEC would be helpful for evaluation of WRMSD risk assessment to those who work in the field of work health and safety in the industry of Turkey

Reliability of the Turkish version of the hospital anxiety and depression scale in the people with traumatic spinal cord injury

BACKGROUND: Emotional problems are common in spinal cord injury (SCI). Self report questionnaires are easy and useful for screening the emotional status in clinical practice