Various embodiments described herein relate to a canting mechanism for ambulatory support apparatus and method.
Back pain (e.g., low back pain (LBP) lasting approximately 12 weeks) affects approximately tens of millions of people in the U.S. and is the second leading cause of disability (6.8 million people). Back pain is associated with reduced activities of daily living (e.g., walking, housework, personal care) and health-related quality of life. In addition, back pain is expensive to treat and often leads to missed work days (149 million days/year) and reduced productivity, resulting in total costs of $100-200 billion/year in the U.S.
Present methods to relieve back pain are ineffective, expensive, inconvenient, and/or invasive. For example, oral medications (e.g., acetaminophen, NSAIDs, muscle relaxants, tricyclic antidepressants, antiepileptics, and corticosteroids) provide only limited and/or short-lived pain relief, and typically produce side effects (e.g., sedation, dizziness, and gastrointestinal problems). Although opioids can provide substantial short-term pain relief, they are not recommended as a treatment to control chronic back pain, since long-term use can result in dependence and severe side effects.
Exercise (including yoga, stretching, strength training) has a low level of risk and can relieve pain and improve function long-term, but patients often fail to comply with treatment regimens due to discomfort, lack of motivation, and inconvenience.
Physical manipulation (i.e., massage, spinal manipulation) has a low level of risk and can provide short-term pain relief. However, evidence for the long-term benefit of physical manipulation has been mixed. Further, frequent treatment sessions are required to maintain pain relief, which is inconvenient for patients.
Acupuncture is minimally-invasive, and studies have suggested that acupuncture can provide pain relief. However, study design in acupuncture studies has been questionable (e.g., adequacy of sham/placebo/control), and the effectiveness of acupuncture remains controversial.
Injections of steroids or anesthetic provide short-term pain relief but seldom produce long-term benefit. As well, injections of such medicines produce side effects, including increased pain, lightheadedness, headache, infection, and sea and vomiting.
Intrathecal drug therapy can be effective for reducing pain but requires an invasive) procedure and is limited h a host of frequent side effects (e.g., nausea, infection, intrathecal granuloma). Also, technical complications (i.e., problems with catheter or pump) are common and may require reoperation or removal of the device.
Surgical procedures for back pain (e.g., spinal fusion, disc replacement) are highly invasive, irreversible, carry risks of complications, and reduce pain in less than half of patients. Also, surgeries for chronic back pain frequently require reoperation.
Existing methods of electrical stimulation reduce pain by generating paresthesias (i.e., tingling sensation) overlapping the regions of pain. Pain relief using these existing methods persists only for a short time following treatment (e.g., hours to days), and this suggests that chronic pain has not been reversed. As a result, only a small percentage of patients using existing methods of electrical stimulation experienced clinically significant reductions in chronic axial low back pain post-treatment.
TENS is a non-invasive method to deliver electrical stimulation through surface electrodes to generate paresthesia coverage of the regions of pain. TENS requires frequent treatment sessions to maintain pain relief, but consistent efficacy in chronic low back pain has not been demonstrated. Although TENS can be self-administered at home, TENS systems are cumbersome and not practical for daily use. Also, TENS can activate cutaneous fibers and cause irritation and discomfort, limiting the maximum tolerable stimulation intensity and treatment duration that can be delivered and reducing the potential efficacy of the treatment.
Spinal cord stimulation is a method to deliver electrical stimulation through implanted leads connected to an implanted pulse generator to generate paresthesia coverage of the regions of pain. Spinal cord stimulation requires complex and invasive surgery to implant the leads and pulse generator. Spinal cord stimulation has a moderate rate of complications, including additional pain and hardware complications, and as a result, revision surgery, reprogramming, or removal of the stimulator is often required.
In summary, present treatments for back pain seldom provide adequate long-term relief of pain or improvements in function; carry risks of side effects and complications; and/or are invasive.
There remains room in the art of pain management for unproved system and methods to be used to assist in the treatment of back pain.
An apparatus for placing pressure on a plurality of trigger points includes a support, a first pressure element, and a second pressure element. The first pressure element is carried by the support. The second pressure element is also carried by the support. The first pressure element is moveable with respect to the support. The second pressure element is also moveable with respect to the support. The first pressure element and the second pressure element are shaped to apply a force to at an external point on a human body proximate to where a psoas muscle, an Iliacus muscle, and a rectus femorus muscle intersect. There are at least two points on the human body where the psoas muscle, the Iliacus muscle, and the rectus femorus muscle intersect. These at least two points are on the lower portion of a trunk of a human. The support can be made of any number of materials.
The apparatus for placing pressure on a plurality of trigger points can further include a back paddle carried by the support. The back paddle includes a third pressure element and a fourth pressure element. These elements are generally spaced from one another. The spacing allows the third pressure element and the fourth pressure element to straddle or extend to both sides of a person's spinal column and rest on or place a force on muscles at or near the back of the human trunk.
A method for placing pressure on a plurality of trigger points includes providing a support having a first pressure element carried by the support, and a second pressure element carried by the support, and attaching the support so that the pressure elements are positioned over trigger points near the waist of the human being. The support also includes a back paddle having elements that are placed on the human so that these elements straddle the spinal column and place pressure on muscles near the spinal column.
The invention is pointed out with particularity in the appended claims. However, a more complete understanding of the present invention may be derived by referring to the detailed description when considered in connection with the figures, wherein like reference numbers refer to similar items throughout the figures and:
The description set out herein illustrates the various embodiments of the invention and such description is not intended to be construed as limiting in any manner.
One factor in back and hip pain is frequently the psoas muscle. Many believe the psoas muscle is one of the most important muscles in the body. A number of problems may be related to the psoas muscle. The problems include low back pain, sacroiliac pain, sciatica, disc problems, spondylolysis, scoliosis, hip degeneration, knee pain, menstruation pain, infertility, and digestive problems. The list can also include biomechanical problems like pelvic tilt, leg length discrepancies, kyphosis, and lumbar lordosis.
The psoas primarily flexes the hip and the spinal column. At about 16 inches long on the average, it is one of the largest and thickest muscles of the body (in animals it is known as the tenderloin). This powerful muscle runs down the lower mid spine beginning at the 12th thoracic vertebrae connecting to all the vertebral bodies, discs and transverse processes of all the lumbar vertebrae down across the pelvis to attach on the inside of the top of the leg at the lesser trochanter. The lower portion combines with fibers from the iliacus muscle, which sits inside the surface of the pelvis and sacrum, to become the Iliopsoas muscle as it curves over the pubic bone and inserts on the lesser trochanter.
The psoas has a number of diverse functions, making it a key factor in health. The psoas functions as a hip and thigh flexor, which makes it the major walking muscle. If the legs are stationary the action of it is to bend the spine forward; if sitting, it stabilizes and balances the trunk. The lower psoas brings the lumbar vertebrae forward and downward to create pelvic tilt.
When the psoas muscle becomes contracted due to injuries, poor posture, prolonged sitting, or stress, it can alter the biomechanics of the pelvis and the lumbar, thoracic and even cervical vertebrae. Typically a dysfunctional psoas is responsible for referred pain down the front of the thigh and vertically along the lower to mid spinal column. Trigger points are found above the path of the psoas on the abdomen. Frequently the quadratus lumborum muscles develop trigger points, as well as the piriformis, gluteals, hamstrings, and erector spinae psoas.
The psoas can torque your spine to the right or left, pull it forward and twist the pelvis into various distortions. Frequently one psoas will shorten and pull the spine and/or pelvis to our dominant side. The distortions of the spine and pelvis can also show up as a short or long leg. This all results in scoliosis, kyphosis, lordosis, trigger points, and spasms in back muscles trying to resist the pulling of the psoas.
It can also pull the spine downward, compressing the facet joints and the intervertebral discs of the lumbar spine. The pressure can cause the discs to degenerate, becoming thinner and less flexible. This degeneration makes the discs more susceptible to bulging or tearing, especially with twisting and bending movements.
The psoas will stay contracted because of postural habits and trauma. The way we stand, walk and sit can distort the psoas. If we walk or stand with our chin in an overly forward position the muscle will tighten. Sitting through much of the day causes the muscle to shorten to keep us bio-mechanically balanced in our Chairs. Over time we develop a “normal” way of holding the psoas that is dysfunctional.
The first pressure element 220 and the second pressure element 222 can be made of a material that places pressure on the trigger points 122, 132. The first pressure element 220 and the second pressure element 222 can be made of plastic or rubber. In general, the rubber will have a relatively high durometer rating so that it will place a force on the trigger points 122, 132. The amount of pressure is related to the amount of force placed on the support belt. With the support belt 210 shown in
It should be noted that in this particular embodiment, the support 210 is actually formed of a first support portion 211 and a second support portion 212. The first support portion 211 is attached to one end of the back paddle 310 and the second support portion 212 is attached to the other end of the back paddle 310. The first support portion 211 and the second support portion 212 include free ends which can be connected to each other to vary the force and ultimately the pressure applied by the first pressure element 220, the second pressure element 222, the third pressure element 320 and the fourth pressure element 322. Again, the pressure elements can be made of various materials and made of various shapes with various areas to place appropriate amounts of pressure to the exterior portions of the human body.
In operation, the apparatus 300 is an ambulatory support device includes two support portions 211, 212 or straps with adjustable balls or elements 220, 222 to be positioned on the front of the user's body. The two support portions 211, 212 or straps connect to the canting mechanism of the human body 100 and allows direct, constant pressure on the sacrum within the body. The apparatus 300 allows the user to rotate about associated pivots, such as pressure points 122, 132 to allow the support paddle 310 to conform to the user's body and synchronizes the anterior pressure mechanisms on both left and right substantially simultaneously of the support belt 210 such that any anterior engagement subsides and posterior engagement dominates, respectively, of a substantially equivalent or greater magnitude. The traction of the device provides stability to the user's body 100.
The apparatus for placing pressure on a plurality of trigger points can further include a back paddle carried by the support. The back paddle includes a third pressure element and a fourth pressure element. These elements are generally spaced from one another. In one embodiment, the third pressure element and the fourth pressure element are spaced so that they can straddle or extend to both sides of a person's spinal column and rest on or place a force on muscles at or near the back of the human trunk.
An apparatus for placing pressure on a plurality of trigger points includes a support, a first pressure element, and a second pressure element. The first pressure element is carried by the support. The second pressure element is carried by the support. The first pressure element is moveable with respect to the support, and the second pressure element is moveable with respect to the support. The first pressure element and the second pressure element are also moveable with respect to each other. The support has a length so that the support can be attached around a lower portion of the trunk of a human body. The first pressure element and the second pressure element are shaped to apply an external force to at least two portions of the human body proximate to where a psoas muscle, an Iliacus muscle, and a rectus femorus muscle intersect. In one embodiment, the apparatus also includes a back paddle movably engaged with the support, a third pressure element and a fourth pressure element attached to the back paddle. The third pressure element is spaced from the fourth pressure element so that the third pressure element is placable on one side of a human spine and the fourth pressure element is placable on the other side of the human spine.
The foregoing description of the specific embodiments reveals the general nature of the invention sufficiently that others can, by applying current knowledge, readily modify and/or adapt for various applications without departing from the concept, and therefore such adaptations and modifications are intended to be comprehended within the meaning and range of equivalents of the disclosed embodiments.
It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation. Accordingly, the invention is intended to embrace all such alternatives, modifications, equivalents and variations as fall within the spirit and broad scope of the appended claims.
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