Dataset Information

The Role of Decreased Hip IR as a Cause of Low Back Pain in a Golfer: a Case Report.

ABSTRACT:

Background

Among golf injuries, low back pain (LBP) is the most common compliant for both professional and amateur golfers. Hip rotational range of motion (ROM) might be related to LBP in those who repeatedly place specific activity rotational demands on the hip in one direction. Coordination of timing of movement (neural control) between the hip and lumbopelvic region during trunk movements is critical for normal mechanics. Altered timing can contribute to areas of high tissue loading and can lead to LBP symptoms seen during active lower limb movement tests. Patient was a 42-year-old male recreational golfer who presented with low back pain and decreased hip internal rotation ROM.

Methods

With the use of manual physical therapy to increase hip ROM and lumbar stabilization therapeutic exercises, the patient was able to return to pain-free golf and to better his handicap by three strokes.

Results

Significant improvement was seen in his Oswestry outcome score, and a (-) prone instability test was noted.

Conclusion

It is recommended to address hip ROM limitations in those experiencing low back pain while golfing. Rapid spinal rotation may produce large spinal loads, but this is likely not the major contributor to low back pain in golfers. Mechanical factors may play a larger role.

SUBMITTER: Reinhardt G

PROVIDER: S-EPMC3772174 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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Publications

The Role of Decreased Hip IR as a Cause of Low Back Pain in a Golfer: a Case Report.

Reinhardt Gregory G

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20130824 3

<h4>Background</h4>Among golf injuries, low back pain (LBP) is the most common compliant for both professional and amateur golfers. Hip rotational range of motion (ROM) might be related to LBP in those who repeatedly place specific activity rotational demands on the hip in one direction. Coordination of timing of movement (neural control) between the hip and lumbopelvic region during trunk movements is critical for normal mechanics. Altered timing can contribute to areas of high tissue loading a ...[more]

PMID: 24426881

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Project description:BACKGROUND:Long-term opioid treatment for chronic non-cancer pain has become controversial, given the increasing prevalence of opioid dependence. However, there is little information on therapeutic strategies for this condition in Japanese patients. Here, we present a case of successful management of iatrogenic opioid dependence with tramadol in a patient with chronic low back pain. CASE PRESENTATION:A 68-year-old male suffering from intractable low back pain was referred to our pain clinic. He was previously treated in another hospital with transdermal fentanyl patches 6?mg/day and fentanyl sublingual tablets (100??g as required) for this condition. On the basis of medical examination, including a review of the patient's medical history, physical examination, X-ray, and his family statement, we diagnosed him with iatrogenic opioid dependence due to inadequate fentanyl use. Then, we developed a treatment plan consisting in fentanyl detoxification with a weak opioid, tramadol. At first, the use of fentanyl sublingual tablets was interrupted after obtaining informed consent. Then, we reduced the dose of transdermal fentanyl 1?mg per 4-5?days replacing with oral sustained-release tramadol. The patient developed mild to moderate withdrawal symptoms during this period, which could be effectively managed by supportive treatments. The hospital psychiatry liaison team continuously provided the patient and his wife with information, counseling, and education regarding the treatment of opioid dependence. Throughout the detoxification process, his reported pain did not exacerbate, even slightly improved over time. The final prescription was sustained-release tramadol 300?mg/day without fentanyl, and his activities of daily living drastically improved. However, unfortunately, he died due to an aortic dissection of stent-graft edge 65?days after surgery. CONCLUSIONS:Our case highlighted that sustained-release tramadol could be effectively applied as a detoxification agent for iatrogenic opioid dependence in patients with chronic non-cancer pain.

Dataset Information

The Role of Decreased Hip IR as a Cause of Low Back Pain in a Golfer: a Case Report.

Background

Methods

Results

Conclusion

Publications

The Role of Decreased Hip IR as a Cause of Low Back Pain in a Golfer: a Case Report.

Similar Datasets

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