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The treatment of certain common ailments by some of the newer remedies

Scott GW

Malayan Medical Journal, 1932;7:108-112.

Matched MeSH terms: Low Back Pain
Fulltext Discal Cyst of the Lumbar Spine: Case Report of a Rare Clinical Entity

Sanjeevan R, Prabu S, Azizul A, Abdul-Halim Y

Malays Orthop J, 2018 Jul;12(2):56-58.
PMID: 30112131 MyJurnal DOI: 10.5704/MOJ.1807.011

Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc. The patient had immediate relief of his symptoms and no postoperative complications. We recommend that endoscopic surgery can be an effective alternative to conventional open surgery for discal cyst of the lumbar spine.

Matched MeSH terms: Low Back Pain
Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia

Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.

Med J Malaysia, 2009 Sep;64(3):197-204.
PMID: 20527267 MyJurnal

A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.

Matched MeSH terms: Low Back Pain/etiology*; Low Back Pain/epidemiology
Fulltext The surgical outcome of degenerative lumbar spinal stenosis

Razak MA, Ong KP, Hyzan Y

Med J Malaysia, 1998 Sep;53 Suppl A:12-21.
PMID: 10968178

A retrospective study was conducted to assess the surgical outcomes of degenerative lumbar spinal stenosis. Twenty-five patients treated with decompressive surgery in Hospital Kuala Lumpur between January 1992 and August 1996 were reviewed. There were seven males and eighteen females. The average age was 51 years old (range 33 to 64 years old). The diagnosis of degenerative spinal stenosis was made based on the clinical features and was confirmed by radiographic findings. Ninety two percent of the patients had moderate to severe symptoms preoperatively. The types of surgery consisted of laminectomy (n = 15), laminotomy (n = 10), and laminoplasty (n = 1). The surgical outcomes were assessed based on patients' own assessment of symptoms relieved and functional returned to daily activities at least six months after the surgery. The average follow-up period was fifteen months (range 6 months to 42 months). Of these twenty-five patients, 4 (16%) claimed to have excellent results, 11 (44%) had good results, 8 (32%) reported fair, and 2 (8%) judged their surgical treatment as poor with little or no use. There was no anaesthetic, cardiovascular, or thromboembolic complications seen in this study. Four patients had recurrent claudication, one demonstrated localised arachnoiditis, and two had lumbar instability which were not documented preoperatively. One patient had L4 nerve root avulsion with dura torn and another patient had superficial wound infection. We concluded in this study that decompressive surgery offers satisfactory results in patients with moderate to severe degenerative spinal stenosis in short term follow-up.

Matched MeSH terms: Low Back Pain/etiology
The precarious use of charm needles susuk in treatment of low back pain by traditional medicine practitioners and its possible risk to patient safety

Rampal S, Tan EK, Gendeh HS, Prahaspathiji LJ, Zainal S, Amir S

Med J Malaysia, 2020 01;75(1):80-82.
PMID: 32008027

A 68-year-old female presented with a 1-month history of lower back pain with right-sided radiculopathy and numbness. She was diagnosed with lumbar spondylosis and treated conservatively with analgesia and physiotherapy. Imaging showed multiple susuk, a metal alloy, in the lower back region and other regions of the body. The patient had undergone traditional medicine consultation 10 years earlier when the susuk was inserted in the lower back as talisman. The practice of the insertion of susuk is popular in rural East Malaysia and Indonesia. These foreign bodies act as possible causes of chronic inflammation and granuloma formation. In addition, the localised heighten peril upon imaging. This report suggests that the insertion of multiple susuk as talisman carries risk to safety of patients when imaging, and this practice complicates the management of musculoskeletal disorders.

Matched MeSH terms: Low Back Pain/therapy*
Investigation of work-related musculoskeletal disorders in wall plastering jobs within the construction industry

Rahman MN, Rani MR, Rohani JM

Work, 2012;43(4):507-14.
PMID: 22927603 DOI: 10.3233/WOR-2012-1404

The aim of this study was to investigate the work-related musculoskeletal disorders (WMSDs) among workers in wall plastering jobs within the construction industry.

Matched MeSH terms: Low Back Pain/complications
Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain

Paungmali A, Joseph LH, Sitilertpisan P, Pirunsan U, Uthaikhup S

Pain Pract, 2017 11;17(8):1008-1014.
PMID: 28042685 DOI: 10.1111/papr.12552

BACKGROUND: Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain.
METHODS: A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions.
RESULTS: Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident.
CONCLUSIONS: Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain.

Matched MeSH terms: Low Back Pain/rehabilitation*
Fulltext Musculoskeletal symptoms risk factors and postural risk analysis of pineapple plantation workers in Johor

Nur Hidayah Rani, Emilia Zainal Abidin, Noor Afifah Ya'acob, Karmegam Karuppiah, Irniza Rasdi

Journal of Occupational Safety and Health, 2016;13(1):17-26.
MyJurnal

Pineapple plantation workers are exposed to strenuous physical activities. This study aims to determine the prevalence
of musculoskeletal symptoms (MSS), analyse the body postural risks related to work tasks and identify relevant MSS risk factors
among pineapple plantation workers. This was a cross-sectional study performed at a pineapple plantation in Johor in 2016. MSS,
information on socio-demographic background and occupational history were collected via structured questionnaires. Identification
and risk assessment of ergonomic hazard and postural risk analysis were performed for a subset of workers. Data were entered into
statistical software and analyse according to relevant objectives. A total of 108 workers participated in this study. The prevalence
of MSS was 87.0% and was highest for the lower back (64.8%). In terms of ergonomic hazards, Harvesting were categorised as a
task with the highest risk. Harvesting was also the task with the highest postural risk. From the multivariate analysis, lower back
pain is mainly contributed by a working tenure of 10 to 25 years (Odds Ratio, OR: 3.90; 95% Confidence Interval, CI 1.05-14.4) and
more than 25 years (OR: 7.45 (95% CI 1.26 to 44.0). Workers who worked more than 7-hour daily have a higher risk for reporting
lower back pain. Pineapple plantation workers are exposed to excessive bending, twisting and carrying of heavy loads that may be
linked to MSS. Effective preventive strategies are required to address MSS in this population in order to minimize risk for subsequent
musculoskeletal disorders.

Matched MeSH terms: Low Back Pain
Fulltext Foot reflexology therapy for non-specific low back pain condition : a protocol for a randomized controlled trial

Nor Dalila Marican, Rozita Hod, Nadiah Wan-Arfah, Azmi Hassan

Int J Public Health Res, 2018;8(1):933-938.
MyJurnal

Introduction Non-specific low back pain is one of the most common physical ailments
affecting millions of people worldwide. This condition constitutes a
significant public health problem and was listed as a prevalent health
complaint in most societies. Even though there are many anecdotal claims
for reflexology in the treatment of various conditions such as a migraine,
arthritis and multiple sclerosis, but very little clinical evidence exists for
reflexology on the management of low back pain per se. This study aims to
evaluate the effects of foot reflexology therapy as an adjunctive treatment to
the Malaysian low back pain standard care in relieving pain and promoting
health-related quality of life among people with non-specific low back pain.
Methods This is a parallel randomized controlled trial with pre and post-treatment
study design. The study setting for the intervention located at Penawar
Reflexology Center, Kuala Terengganu, Malaysia. A total of 100
participants with non-specific low back pain will be allocated to one of two
groups, using a randomization computer program of Research Randomizer.
The control group will receive low back pain standard care, while the
intervention group will receive standard care plus eight sessions of foot
reflexology therapy. The pain intensity and health-related quality of life
scores will be measured using Visual Analogue Scale and Euro-quality of
life scale respectively in both groups. The study was approved by the
Human Research Ethics Committee of University Sultan Zainal Abidin
(UHREC/2016/2/011). The study protocol was registered at
ClinicalTrials.gov, with the ID number of NCT02887430.
Measurements Outcome measures will be undertaken at pre-intervention (week 1), postintervention
(week 6) and follow-up (week 10).
Conclusions This will be the first trial to compare the foot reflexology therapy with
control group among people who medically diagnosed with non-specific low
back pain in Malaysia. The result of this study will contribute to better
management of this population, especially for Malaysia healthcare setting.

Study site: Penawar Reflexology Center, Kuala Terengganu, Malaysia

Matched MeSH terms: Low Back Pain
Fulltext Physical activity and low back pain among automotive industry workers in Selangor

Noor Sazarina Mad Isa @ Yahya, Baba Md Deros, Mazrura Sahani, Ahmad Rasdan Ismail

Malaysian Journal of Public Health Medicine, 2014;14(2):34-44.
MyJurnal

Substantial studies reported musculoskeletal disorders among the working population in the developed country, however, a limited number of studies were conducted in Malaysia. The objective of this cross sectional study was to determine the physical activity risk factors for low back pain among automotive workers in Selangor. Modified Risk Factors Questionnaire (RFQ) was used to assess physical activity with the occurrence of low back pain. The significant physical activities associated with the 12 months point prevalence are lifting weight (

Matched MeSH terms: Low Back Pain
Fulltext Personal and psychosocial risk factor for low back pain among automotive manual handling workers in Selangor, Malaysia

Noor Sazarina Mad Isa @ Yahya, Baba Md Deros, Ahmad Rasdan Ismail, Mazrura Sahani

Int J Public Health Res, 2014;4(1):412-418.
MyJurnal

Introduction It is well known that low back pain among working population is a global
problem throughout the world. However, the current situation of occupational
low back pain in Malaysia is still vague due to limited number of studies
conducted locally.

Objective A cross sectional study was conducted among three automotive industry
workers in Selangor, Malaysia from October 2010 to April 2011.
Methods This study aims to determine the prevalence and risk factors of low back pain
among automotive industry workers performing manual material handling
tasks using self-administered questionnaire survey.

Results A modified Standardised Nordic Questionnaire was used to assess low back
pain problem, to obtain personal and psychosocial risk factors information.
The prevalence of low back pain showed increment in the point prevalence of
57.9%, 49.5%, and 35.1 % for 12 months, one month, and of 7 days
respectively. Working hour, frequency of overtime, stress at work, work
pace, and faster movement were found to be significantly associated with the
12 months prevalence for low back pain.

Conclusions This finding indicates that psychosocial risk factors are associated to the
occurrence of low back pain.

Matched MeSH terms: Low Back Pain
Fulltext Prevalence and its associated factors of low back pain among foggers in a District Health Office in Malaysia

Muhamad Farhan Ab Razak, Titi Rahmawati Hamedon, Haidar Rizal Toha

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):109-109.
MyJurnal

Introduction: Low back pain (LBP) is a common symptom among working population worldwide. Foggers prone to have LBP because there are exposed to physical factors such as lifting heavy object, awkward body posture and vibration. However, LBP had never been studied among the fogger. The objective of this study was to determine the prevalence and the factors associated with LBP. Methods: A cross-sectional study was carried out in all District Health Office in Johor, Malaysia by using a validated self-administered questionnaire and anthropometric measure-ments. Chi-square or Fisher’s exact test was used for inferential statistic and multiple logistic regression was used to determine the associated factors. The significance level was determined at p < 0.05. Results: The response rate was 83.9%. Majority of them are male (99.6%), Malay (95.8%), married (85.8%) and educated up to secondary school (53.5%). Majority of respondents do not have part time job (89.6%) but they work overtime everyday (62.7%). Most of them do four hours overtime daily (77.3%). The prevalence of LBP was 68.5% among respondents. There was a significant association between doing part time job, duration of doing overtime per week, body mass index (BMI) and duration of fogging activities. Finally, the associated factors of LBP were doing overtime for more than 20 hours per week (adjusted OR=1.914, 95% CI [1.102, 3.324], p = 0.021), BMI of more than 23.00 kg/m2 (adjusted OR=2.066, 95% CI [1.090, 3.916], p = 0.026) and having no part time job (adjusted OR=0.135, 95% CI [0.031, 0.599], p = 0.021). Conclusion: Prevention needs to be initiated to change the modifiable factors of LBP in order to reduce the prevalence of LBP among them.

Matched MeSH terms: Low Back Pain
Fulltext Low back pain and associated risk factors among health science undergraduates

Mohd Nordin NA, Ajit Singh DK, Lim K

Sains Malaysiana, 2014;43:423-428.

Identification of associated risk factors is important to enable successful implementation of low back pain prevention strategies. To date, there is limited research data on back pain among young adults in Malaysia despite an increasing incidence of this disabling condition worldwide. A cross-sectional survey was conducted to determine the incidence of low back pain (LBP) and associated factors among health science undergraduates. A self-administered questionnaire was distributed to full time students of a main public university. One hundred and forty undergraduates; mean age 21.4±1.3 years, 70% female, 60% in year 3 of study, participated in the survey. The results showed that 31% spent between 6 and 8 h and another 31% spent more than 9 h sitting in a day. Twelve percent of the undergraduates rated their fitness level as ‘poor’. The incidence of LBP was 40.3% among the undergraduates. LBP incidence was associated with age (X2=12.1, p=0.007), years of study (X2=8.7, p=0.03), self-rated physical fitness (X2=7.0, p=0.02) and hours spent sitting (X2 =8.7, p=0.03). Gender, body mass index and hours spent in sports and physical activity were not associated with LBP. The findings from this study demonstrate that physical fitness and sitting duration is associated with low back pain among health science undergraduates. Health science undergraduates should improve their physical fitness, practice frequent breaks and stretching during sitting. This will help to minimize LBP related to decreased fitness levels and prolonged sitting.

Matched MeSH terms: Low Back Pain*
The effect of core stability training with ball and balloon exercise on respiratory variables in chronic non-specific low back pain: An experimental study

Mohan V, Paungmali A, Sitilertpisan P, Henry LJ, Omar FA, Azhar FZ

J Bodyw Mov Ther, 2020 Oct;24(4):196-202.
PMID: 33218511 DOI: 10.1016/j.jbmt.2020.07.007

BACKGROUND: Studies have shown the involvement of respiratory characteristics and their relationship with impairments in non-specific low back pain (NS-LBP). The effects of core stability with a combined ball and balloon exercise (CBB) on respiratory variables had not been investigated.
OBJECTIVE: To evaluate the effectiveness of CBB on respiratory variables among NS-LBP patients.
STUDY DESIGN: pre- and post-experimental study.
PARTICIPANTS: Forty participants were assigned to an experimental group (EG) [n = 20] and control group (CG) [n = 20] based on the study criteria.
INTERVENTIONS: The EG received CBB together with routine physiotherapy and the CG received routine physiotherapy over a period of 8 weeks. Participants were instructed to carry out the exercises for 3 days per week. The training was evaluated once a week and the exercises progressed based on the level of pain.
OUTCOME MEASURES: Primary outcomes were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and maximum voluntary ventilation (MVV). The secondary outcomes were measured in the numeric rating scale (NRS), total faulty breathing scale (TFBS), cloth tape measure (CTM) and lumbo-pelvic stability.
RESULTS: The MIP increased significantly among the EG when compared with that in the CG (p > 0.05).The EG showed a significant increase in MVV (p = 0.04) when compared to the CG (p = 0.0001). There was a significant reduction in pain for both groups. The MEP, TFBS, chest expansion and core stability showed no changes in either group.
CONCLUSION: CBB was effective in improving respiratory variables among NS-LBP patients.

Matched MeSH terms: Low Back Pain
Altered breathing pattern valuation relatively to dyspnea assessment and treatment for low back pain: Effects of clinical practice

Mohan V, Paungmali A, Sitilertpisan P

Musculoskelet Sci Pract, 2017 02;27:e1-e2.
PMID: 27697391 DOI: 10.1016/j.math.2016.09.004
Matched MeSH terms: Low Back Pain*
Respiratory characteristics of individuals with non-specific low back pain: A cross-sectional study

Mohan V, Paungmali A, Sitilerpisan P, Hashim UF, Mazlan MB, Nasuha TN

Nurs Health Sci, 2018 Jun;20(2):224-230.
PMID: 29421851 DOI: 10.1111/nhs.12406

Non-specific low back pain (NS-LBP) is known to cause respiratory dysfunction. In this study, we investigated alterations in breathing, respiratory strength and endurance, core stability, diaphragm mobility, and chest expansion among patients with NS-LBP and healthy individuals. The specific aim of the study was to correlate between respiratory function and other variables among NS-LBP patients. Thirty four patients with NS-LBP were matched with 34 healthy participants before undergoing total faulty breathing scale, spirometer, respiratory pressure meter, chest expansion, ultrasound, and pressure biofeedback measurements. There were signs of faulty breathing in the NS-LBP patients when compared to the healthy participants. Diaphragmatic mobility and respiratory muscle endurance were lower in the NS-LBP group. Chest expansion exhibited a significant decrease at the level of the fourth intercostal space in the NS-LBP group, but respiratory muscle strength and core stability were not significant between the two groups. Positive correlations were found to be fairly significant regarding respiratory muscle strength. The findings of this study indicated altered respiratory characteristics in the NS-LBP patients, and suggested that they would improve through respiratory exercises.

Matched MeSH terms: Low Back Pain/classification*
The science of respiratory characteristics in individuals with chronic low back pain: Interpreting through statistical perspective

Mohan V, Paungmali A, Sitilertpisan P

J Bodyw Mov Ther, 2018 01;22(1):11-12.
PMID: 29332732 DOI: 10.1016/j.jbmt.2017.03.017
Matched MeSH terms: Low Back Pain*
Manual therapy researchers are misled by natural history and placebo effects

Menke JM

Spine (Phila Pa 1976), 2014 Nov 1;39(23):1997.
PMID: 25365716 DOI: 10.1097/BRS.0000000000000585
Matched MeSH terms: Low Back Pain/therapy*
Do manual therapies help low back pain? A comparative effectiveness meta-analysis

Menke JM

Spine (Phila Pa 1976), 2014 Apr 1;39(7):E463-72.
PMID: 24480940 DOI: 10.1097/BRS.0000000000000230

STUDY DESIGN: Meta-analysis methodology was extended to derive comparative effectiveness information on spinal manipulation for low back pain.
OBJECTIVE:
Determine relative effectiveness of spinal manipulation therapies (SMTs), medical management, physical therapies, and exercise for acute and chronic nonsurgical low back pain.
SUMMARY OF BACKGROUND DATA: Results of spinal manipulation treatments of nonsurgical low back pain are equivocal. Nearly 40 years of SMT studies were not informative.
METHODS: Studies were chosen on the basis of inclusion in prior evidence syntheses. Effect sizes were converted to standardized mean effect sizes and probabilities of recovery. Nested model comparisons isolated nonspecific from treatment effects. Aggregate data were tested for evidential support as compared with shams.
RESULTS: Of 84% acute pain variance, 81% was from nonspecific factors and 3% from treatment. No treatment for acute pain exceeded sham's effectiveness. Most acute results were within 95% confidence bands of that predicted by natural history alone. For chronic pain, 66% of 98% was nonspecific, but treatments influenced 32% of outcomes. Chronic pain treatments also fit within 95% confidence bands as predicted by natural history. Though the evidential support for treating chronic back pain as compared with sham groups was weak, chronic pain seemed to respond to SMT, whereas whole systems of clinical management did not.
CONCLUSION: Meta-analyses can extract comparative effectiveness information from existing literature. The relatively small portion of outcomes attributable to treatment explains why past research results fail to converge on stable estimates. The probability of treatment superiority matched a binomial random process. Treatments serve to motivate, reassure, and calibrate patient expectations--features that might reduce medicalization and augment self-care. Exercise with authoritative support is an effective strategy for acute and chronic low back pain.

Matched MeSH terms: Low Back Pain/therapy*
Fulltext Bertolotti's syndrome: A commonly missed cause of back pain in young patients

Manmohan S, Dzulkarnain A, Nor Azlin ZA, Fazir M

Malays Fam Physician, 2015;10(2):55-8.
PMID: 27099663

Bertolotti's syndrome must be considered as a differential diagnosis for lower back pain in young people. Treatment, whether conservative or operative, is still debatable. In this paper, we report a case of a 20-year-old girl presenting with lower back pain for 8 years. We administered injection with local anaesthetic and steroid injections within the pseudo-articulation; however, the pain was relieved for 3 weeks. Surgical excision of the pseudo-articulation successfully treated her back pain and the sciatica.

Matched MeSH terms: Low Back Pain

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