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Abstrak :
Nyeri punggung bawah acute merupakan keluhan terbanyak kelima di fasilitas pelayanan kesehatan di Amerika Serikat, dan 30% berkembang menjadi nyeri kronis. Sebesar 60-90% penduduk Amerika Serikat mempunyai keluhan nyeri punggung bawah, dan 50% diantaranya mengeluhkan nyeri yang berulang dalam satu tahun. Nyeri punggung bawah memiliki efek psikologis dan sosial terhadap pasien. Secara ekonomi nyeri punggung bawah ini membebani negara terkait biaya yang harus dikeluarkan dalam penanganan nyeri punggung bawah. Penilaian derajat nyeri penting dilakukan pada setiap pasien dengan keluhan nyeri punggung bawah dan American Pain Society menetapkan menyertakan nyeri sebagai tanda vital kelima dalam pemeriksaan terhadap nyeri punggung bawah sejak tahun 1990. Penilaian terhadap nyeri memberikan informasi yang lebih baik terhadap efek terapi, atau keberhasilan dari terapi nyeri. Penelitian ini bertujuan untuk mengetahui hasil evaluasi derajat nyeri dengan Numeric Rating Scale (NRS) pada kasus nyeri punggung bagian bawah (low back pain) yang mendapat intervensi nyeri di Departemen Bedah Saraf RS Cipto Mangunkusumo Jakarta tahun 2012 -2014. Penelitian dilakukan menggunakan desain Cross Sectional Analitik, terhadap data sekunder berupa data rekam medis pasien dengan kasus nyeri punggung bawah yang berkunjung ke poliklinik Bedah Saraf Rumah Sakit Cipto Mangunkusumo Jakarta, dalam periode tahun 2012 sampai dengan tahun 2014. Responden dalam penelitian ini berusia 17 tahun ke atas. Analisis data menggunakan analisis univariat dan bivariat. Dari hasil analisis data diperoleh 57,2% pasien nyeri punggung bawah yang mendapat intervensi nyeri berusia 40 - 59 tahun, dan 52,4% diantaranya berjenis kelamin perempuan. Dari hasil pemeriksaan MRI didapatkan 66,7% dengan gambaran protrusion diskus dengan penekanan. Sebesar 71,4% pasien mendapatkan terapi kombinasi LESI dan MBN dan 95,2% pasien yang mendapatkan intervensi nyeri mengalami perbaikan skala nyeri dan dapat bertahan sampai dengan 1 tahun. Hasil analisis multivariat menunjukkan bahwa Tidak terdapat hubungan bermakna antara gambaran MRI dengan prosedur intervensi nyeri dan jenis nyeri, tapi terdapat hubungan bermakna antara jenis nyeri dengan prosedur intervensi nyeri.

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Acute lower back pain is the fifth most complaints in health care facilities in the United States, and 30% develop into chronic pain. Amounting to 60-90% of the US population has low back pain, and 50% of them complained of recurring pain in one year. Lower back pain has psychological and social effects on patients. Economically lower back pain is related to the state burdening costs to be incurred in the treatment of lower back pain. Assessment of the degree of pain is important in any patient with low back pain and the American Pain Society set to include pain as the fifth vital sign in the examination of lower back pain since 1990. Assessment of pain provide better information to the therapeutic effect, or the success of therapy pain. This study aims to know the results of the evaluation of the degree of pain with Numeric Rating Scale (NRS) in the case of lower back pain (low back pain) who received the intervention of pain in the Department of Neurosurgery Cipto Mangunkusumo in 2012 -2014. The study was conducted using Analytical cross sectional design, due to the secondary data from medical records of patients with low back pain who visited the clinic Neurosurgery Cipto Mangunkusumo Hospital in Jakarta, in the period of 2012 to 2014. The respondents in this study aged 17 above. Analysis of data using univariate and bivariate analyzes. From the analysis of the data obtained 57.2% of patients with low back pain who received the intervention pain aged 40-59 years, and 52.4% of them were female. From the results obtained 66.7% of MRI examinations with a disc protrusion with 71.4% of patients receive combination therapy LESI and MBN and 95.2% of patients who received the pain intervention experienced decreasing scale of pain scale and last up to 1 year. Multivariate analysis showed that there is no significant relationship between MRI image with pain interventional procedures and types of pain, but there is a significant relationship between the type of pain with pain interventional procedures.

Abstrak :
Latar belakang : Nyeri punggung bawah (NPB) merupakan masalah kesehatan kerja yang tinggi pembiayaannya. Nyeri punggung bawah merupakan penyebab tersering keterbatasan aktifitas pada mereka yang berusia kurang dari 45 tahun dan penyebab kedua tersering kunjungan ke dokter. Setiap tahun 2% populasi pekerja tidak masuk kerja akibat NPB, dan waktu yang hilang akibat NPB berkisar 4 jam setiap pekerja per tahun. Pada pekerjaan perawatan lapangan golf di PT. X, gangguan muskuloskeletal (termasuk gangguan NPB) menyebabkan bertambahnya kerugian perusahaan akibat bertambahnya biaya pengobatan yang harus dikeluarkan dan juga bertambahnya hari kerja yang hilang. Berdasarkan hal ini, sangatlah menguntungkan mengetahui faktor-faktor yang berhubungan dengan nyeri punggung bawah pada pekerja perawatan lapangan golf. Metode : Disain penelitian adalah studi kros seksional. Jumlah responden 111 orang dipilih secara stratified random sampling dari kelompok pekerja perawatan lapangan golf. Pengumpulan data berdasarkan wawancara, pemeriksaan fisik dari pengamatan baik posisi tubuh waktu bekerja (BRIEF Survey) maupun adanya pajanan getaran seluruh tubuh, yang dilaksanakan bulan Mei-Agustus 2005. Hasil : Prevalensi NPB pada penelitian ini 56,75 %. Faktor yang memiliki hubungan bermakna dengan NPB adalah kebiasaan olahraga (OR suaian : 4,829 ; 95 % CI : 1,927 - 12,050), berikutnya pelatihan kerja (OR suaian: 0,172; 95% CI: 0,051-0,584) dan jenis pekerjaan (OR suaian: 2,358 ; 95 % Cl ; 1,095 - 5,078). Hasil pengamatan waktu kerja menunjukkan bahwa kegiatan kerja pada bagian perawatan lapangan golf merupakan kegiatan yang dinamis dan bervariasi. Para pekerja tidak harus terus menerus dalam posisi membungkuk, demikian juga pekerja dengan peralatan mesin yang menyebabkan getaran seluruh tubuh, tidak terus menerus terpajan getaran karena dapat beristirahat. Kesimpulan dan Saran : Ada hubungan bermakna antara kebiasaan berolahraga, pelatihan kerja dan jenis pekerjaan dengan terjadinya nyeri punggung bawah. Kegiatan-kegiatan olahraga bagi para pekerja perawatan lapangan golf perlu dilanjutkan untuk meningkatkan pencegahan terjadinya NPB. Disamping itu perlu diupayakan pelatihan kerja yang terkait dengan upaya K3.

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Background: Low back pain is an occupational health problem, which is most costly. Low back pain is most frequent cause of activity limitation in people younger than 45 years of age, and the second most frequent reason for physician visits. Every year, about 2% of employed population loses time from work because of low back pain and that lost time averages 4 hours per worker per year. Among the employees of golf course maintenance in P.T. X, the musculoskeletal disorders (which involve low back pain) cause to decrease the profit of the company by increasing the total expenses for the cost of employee?s health care and the time away from work. Based on this problem, it is so benefit to know sonic factor, which found among (he job of golf course maintenance that can be the related factor to low back pain. Method: The design of this research is cross sectional study. Hundred eleven respondent were selected from 265 of total golf course maintenance?s workers. Data was collected through conducting interview, filling out questionnaire, performing physical examination, and observation of working posture (BRIEF Survey) or whole body vibration in working time duration, that took time from May until August 2005. Result: Prevalence of low back pain in this study was 56,75% (63 persons of 111 respondents). The physical exercise behavior relates to low back pain significantly (adjusted OR: 4.829; 95% CI: 1.927-12.050), also the job training (OR:0. 172; 95% CI 0.051-0.584) and the occupation (OR: 2.358; 95% CI: 1.095-5.078). Observation in working time duration showed that the job of golf course maintenance were dynamic and varied. The workers had not to be always in flexi position, neither to be always exposed to whole body vibration; they could take a rest any time. Conclusion and suggestion: This study revealed that the factor that related to low back pain is physical exercise behavior, job training and the occupation. The program of physical exercise should be continued to decrease the prevalence of low back pain among worker of golf course maintenance. It is also necessary to modify the content of the work method in job training in accordance with the aspect of occupational safety and health.

Abstrak :
ABSTRAK
The physiotherapy statistics from the Saraburi Hospital in Thailand show that patients with chronic lower back pain from muscle tearing have a higher tendency toward chronic pain, requiring continuous treatment. Most physiotherapists use radial shockwave therapy (RSWT) or radial pulse therapy to treat patients with chronic muscle tears. The aim of this study was to determine the immediate efficacy of RSWT on patients with lower back pain caused by chronic muscle strain. The purpose of this work is to assess the effectiveness of RSWT in the treatment of chronic back muscle pain. The type of this research is quasi-experimental research study. The location is this study is Physical Therapy Clinic at the Saraburi Hospital in Thailand. The study participants had pain intensities of greater than 5 out of 10. The experimental group (30 patients) received RSWT to the lower back for 10-15 minutes once a week for 6 weeks. The control group (30 patients) received ultrasound (US) treatments to the lower back using the semi-static technique with gel, but without turning the machine on, for 15 minutes once a week for 6 weeks. Both groups were taught to avoid bending and carrying heavy loads, as well as the correct way to lift heavy objects. None of the patients received medications, injections, massages, or acupuncture. The pain levels in both groups at work and at rest were measured using a visual analog scale. The treatment results were evaluated and compared at the 1st, 4th, and 6th treatments. The patient satisfaction was assessed at the 6 treatments as follows: 1 = most, 2 = high, 3 = moderate, 4 = low, and 5 = minimum. The effects on daily life and career performance were measured before the study and at the end as follows: 1 = most, 2 = high, 3 = moderate, 4 = low, 5 = minimum, and 6 = no effect. A statistical analysis was performed on the demographic data as well as on the pain level comparisons. The results of the RSWT and US treatments were measured while the patients were resting and working at 1, 4, and 6 months. Twelve and 18 of the patients were cured, respectively. In the US groups, 6 patients were statistically significantly better at the , , and treatments (but no cures). The post-treatment satisfaction was not significantly different between the RSWT and US groups. Consequently, the use of RSWT to treat chronic muscle strain can reduce pain immediately, and it can cure pain completely in some cases. Therefore, it should be used to treat more patients with chronic muscle strain. It should also be considered for use in chronic pain cases in which the patient does not respond to other conservative treatments.