ABSTRACT
Ischaemic pain counts among the most difficult to treat pains in palliative care. Ischemic pain is frequently severe, and usually resistant to available analgesics. Treatment of this condition is difficult, especially when the condition is inoperable. A 36-year-old woman with the diagnosis of systemic lupus erythematosus with severe ischemic pain in the lower leg due to vascular problems presented to Akhtar Hospital. The patient was arranged for lumbar sympathetic block which was performed in two stages with one week interval. In the procedure, a long needle with No.22 gauge and the length of 15 cm was used. Under view of fluoroscopy guide, 10 cc marcaine 0.125% was injected. In the second stage, 5 cc of marcaine 0.25% and 5 cc of phenol 0.6% were used. Pain improvement was observed immediately after neurolytic lumbar sympathetic block. Three-month follow up period revealed improvement of quality of life. Lumbar sympathetic block is considered as a safe and useful technique. Clinically, the technique is effective for pain relief in patients who develop lower leg pain due to vasculitis.
Subject(s)
Humans , Female , Adult , Lumbosacral Plexus , Ischemia , Leg/blood supply , Pain , Disease Management , Lupus Erythematosus, Systemic , VasculitisABSTRACT
Low back pain is one of the most common musculoskeletal disorders, which is prevalent among the public population. Depending on the severity of the patients' pain, different treatments are selected for them. Few studies have addressed, so far, the therapeutic effects of laser in such pains and different results have been published in this regard. The aim of this study is to investigate the therapeutic effect of low intensity laser therapy [LILT] on these diseases. Sixty patients are randomly divided into three groups, one received low intensity laser therapy [LILT], the second group the low intensity laser and physical exercises simultaneously and the other the laser placebo and physical exercises simultaneously. Laser therapy was performed for 6 weeks, two sessions per week. Pain and disability were measured and compared, at 0, 6 and 12 weeks after the treatment in the three groups. Patient's disability in groups 1 and 2 at week 6 showed a significant improvement compared to the beginning of the study. [Group I, P=0.02, P=0.012, group II, P=0.031, P=0.042, respectively].The rate of pain and disability at the week 12 improved significantly compared to the week 6 of the study in each group of 1 and 2. [Group I, P=0.002, P=0.02, group II, P=0.043, P=0.02, respectively]. In the comparison of the groups at week 12, the values of pain [P=0.02] and disability [P=0.03] had improved in group I [laser therapy accompanied with physical exercise]. Our Results revealed that laser therapy accompanied with physical exercise can be the most effective way for improving the chronic back pains including pain relief and reduction of disability in the patients