Lower back pain
Lower back pain (LBP), specifically idiopathic lower back pain (ILBP), which excludes conditions such as sciatica, stenosis, or severe spinal deformation, is a widespread issue impacting individuals across various age groups. According to the National Institute of Neurological Disorders and Stroke (NINDS, a part of the National Institutes of Health in the US), LBP is a leading cause of disability globally and a major reason for missed work or limited job productivity (source: NINDS). It ranks second only to the common cold in terms of prevalence.
The societal and economic impact of ILBP is substantial, especially among individuals under 45 years old, where it is the primary cause of disability. Data from the Global Burden of Disease Study 2017, published by the Institute for Health Metrics and Evaluation (IHME), indicates that the point prevalence of ILBP can be as high as 33%, with a one-year prevalence of 73% and a lifetime prevalence exceeding 70% in many industrialized nations. In the United States, the annual incidence of LBP, including ILBP, is estimated to be between 15-20% (source: NIH). There has been an alarming increase in chronic ILBP across genders, age groups, and racial and ethnic backgrounds in recent years.
The development of disabling chronic or persistent ILBP (lasting longer than three or six months) is linked to various risk factors, including pre-existing psychological distress, disputed compensation claims, other chronic pain conditions, and job dissatisfaction. The diagnosis primarily relies on clinical assessment, with diagnostic imaging used to exclude other potential causes of LBP or confirm ILBP when uncertainty exists.
The societal and economic impact of ILBP is substantial, especially among individuals under 45 years old, where it is the primary cause of disability. Data from the Global Burden of Disease Study 2017, published by the Institute for Health Metrics and Evaluation (IHME), indicates that the point prevalence of ILBP can be as high as 33%, with a one-year prevalence of 73% and a lifetime prevalence exceeding 70% in many industrialized nations. In the United States, the annual incidence of LBP, including ILBP, is estimated to be between 15-20% (source: NIH). There has been an alarming increase in chronic ILBP across genders, age groups, and racial and ethnic backgrounds in recent years.
The development of disabling chronic or persistent ILBP (lasting longer than three or six months) is linked to various risk factors, including pre-existing psychological distress, disputed compensation claims, other chronic pain conditions, and job dissatisfaction. The diagnosis primarily relies on clinical assessment, with diagnostic imaging used to exclude other potential causes of LBP or confirm ILBP when uncertainty exists.
PerVitaShockNavi™
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Treatment Position
For extracorporeal shockwave therapy (ESWT), the patient's positioning varies based on the specific therapy and the practitioner's preference. Common positions include prone, supine, or lateral to facilitate access to the affected area of the lower back (source: British Pain Society guidelines).
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PerVitaShockNavi™
Treatment Position
For extracorporeal shockwave therapy (ESWT), the patient's positioning varies based on the specific therapy and the practitioner's preference. Common positions include prone, supine, or lateral to facilitate access to the affected area of the lower back (source: British Pain Society guidelines).
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Localization Method
The localization of the treatment site in ILBP typically involves identifying tender or painful areas using surface anatomical landmarks and tender point identification. In certain cases, imaging techniques such as ultrasound or MRI may be employed to pinpoint the exact location of the pain. Care is taken to avoid vital structures like the spinal cord and nerves (source: Royal College of Radiologists, UK).
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Treatment Parameters
When utilizing ESWT for ILBP, the energy flux density and number of impulses are customized to the individual patient's needs. These parameters may differ based on pain severity, duration of symptoms, and the patient's treatment response. Treatments are usually spaced a few days apart, and a course of treatment may consist of multiple sessions. The efficacy and safety of ESWT for ILBP have been demonstrated in numerous clinical studies, reporting improvements in pain levels and functional outcomes (source: Cochrane Database of Systematic Reviews).
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Treatment Outcome
The effectiveness of ESWT for ILBP varies among patients, but studies have consistently shown positive outcomes in reducing pain and improving functionality. The success rate of ESWT for ILBP can be comparable to other non-invasive treatment options, with some patients experiencing significant relief from their symptoms. However, it's crucial to note that the treatment response may vary based on the underlying cause of the pain and individual patient characteristics. In summary, ESWT provides a non-invasive treatment option for ILBP with proven efficacy and safety in clinical practice, as supported by multiple authoritative sources and clinical studies.
Treatment Steps
Clinical Diagnosis
Conditions I Disease Duration I Exclude Contraindications
Locate Pain Points
Palpation I X-ray I Ultrasound I MRI I Anatomical Landmarks
Set Parameters
Patient Positioning I Energy I Pressure I Frequency I Number of Treatments
SWT TREATMENT
Apply Coupling Agent on Treatment Area I Assess Pain Tolerance
Clean Up End
Remove Coupling Agent I Probe Alcohol Disinfection
Treatment Techniques
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Rotation/Semi-Static TechniquePerformed at tender points and trigger points, generally not exceeding 1,500 impulses. -
Application/Dynamic TechniqueAround the tender points or surrounding soft tissue, approximately 500 impulses.
Contraindications：
①. Patients with hemorrhagic disorders or coagulation dysfunction;
②. Local and adjacent areas with thrombosis;
③. Patients with severe cognitive impairments or mental illnesses;
④. Local areas with pacemakers;
⑤. Local areas with tumors;
⑥. Lower abdominal region of pregnant women;
⑦. Patients with ruptured or severely injured tendons and fasciae, as well as areas with the brain, spinal cord, large blood vessels, and critical nerve trunks;
⑧. Abdominal organs (especially lung tissue);
⑨. Patients with bone defects greater than 2 centimeters;
⑩. Patients with joint fluid leakage;
⑪. Pediatric patients with growing pains
* Conditions deemed unsuitable by physicians.
Adverse Reactions:
① Local hematoma, ecchymosis, and petechiae at the treatment site;
② Temporary intensification of pain at the treatment site within a short period;
③ Local numbness, needle sensation, and hypoesthesia at the treatment site;
④ High-energy extracorporeal shockwave therapy may cause local nerve and vascular damage;
* These adverse reactions generally resolve within 1 week and do not require special treatment.
② Temporary intensification of pain at the treatment site within a short period;
③ Local numbness, needle sensation, and hypoesthesia at the treatment site;
④ High-energy extracorporeal shockwave therapy may cause local nerve and vascular damage;
* These adverse reactions generally resolve within 1 week and do not require special treatment.
Disclaimer: Content Related to PerVitaShockNavi™ Operational Guidelines
The content related to the PerVitaShockNavi™ Operational Guidelines is solely for reference purposes. Specific operations should be carried out under the guidance and supervision of a professional doctor. Users are advised to consult with a healthcare professional before using any of the procedures or treatments outlined in these guidelines. By accessing and using this information, you acknowledge and agree to hold harmless the providers of this information from any liability arising from the use or misuse of the guidelines.