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Abstract : Chronic parotitis is salivary glanditis that occurs in the parotid gland, and the symptom is swelling and pain. We would like to report a case in which a patient’s chronic parotitis was treated by combining acupotomy therapy and herbal medicine. Treatment was intensively applied to the Acupoint TE17 area, and it is presumed that the pressure of edema was lowered. Future studies with more subjects are needed.

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Abstract : We report on the improvement of symptoms through acupotomy treatment in patients with persistent complaints of ankle pain and calcaneal region pain for calcaneal fractures. Acupotomy was performed on the adhesion site, and the patient showed improvement enough to sleep without pain medicine. This study has a limitation in that it reports only one case. Future studies with more subjects are needed.

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Abstract : Objectives: We would like to conduct retrospective study on patients who have had symptoms of spinal stenosis and whose causes were analyzed through imaging to analyze the causes in terms of diagnostic radiology. Methods: We analyzed the cause of spinal stenosis through imaging tests of patients visiting for spinal stenosis. Results: We could observe various cases caused by one of the following: disc herniation, typical stenosis with thickened yellow ligament, spondylolisthesis, disc surgery, cyst, OPLL, calcification of bulged disc, intrinsic narrowing of the spinal canal and bony spur. Conclusion: We led to the conclusion that medical imaging is essential for diagnosis and treatment of patients in the oriental clinic, as it is hard to expect significant improvements and reversible changes in stenosis with various causes, and as such stenosis may show different prognosis compared to that of general stenosis.

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Abstract : Background: The aim of this study is to expand the base and use the association’s unique treatment methods. Methods: The statistical data of one case of oriental medicine that is actually applied. Between March 2019 and May 2021. Results: Monthly sales increased by 184% in May 2021 compared to Jan 2019, and annual sales compared to the previous year also grew by more than 20% every year over two years. Conclusion: Creating package treatment products can be a way to introduce acupuncture therapy.

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Abstract : Objectives: Symptoms of numbness in the area of the hand, including fingers and palm, are one of the common symptoms that patients complain of in clinical practice. ‘3 kinds of upper extremity nerve compression test’ is a physical examination that diagnoses neurological symptoms of the hand area, such as fingers, back of the hand, and palm, and compresses the upper arm to find out the causes, and can be useful in identifying and diagnosing the causes of neurological symptoms of the hand area. Methods: ‘3 kinds of upper extremity nerve compression test’ is a method of compressing the lateral intermuscular septum to confirm the entrapment of the radial nerve, and the medial intermuscular septum, the Flexor digital superficialis arch (FDS arch) to confirm the entrapment of the ulnar nerve and the median nerve. Results: ‘3 kinds of upper extremity nerve compression test’ can diagnose whether the cause of neurological symptoms on the hand is due to entrapment below the elbow section like carpal tunnel syndrome, Flexor digitorum superficialis syndrome, Cubital tunnel and Guyon’s canal, or upper the elbow section like triangular interval and Cervical radiculopathy. Through ‘3 kinds of upper extremity nerve compression test’, it is possible to increase the accuracy of subsequent diagnosis and set the direction of treatment by identifying which lesion of Double Crush Syndrome occurs among the paths of Radial nerve, ulnar nerve, and median nerve. Conclusion: With the Pinch roll test and the Spurling test, ‘3 kinds of upper extremity nerve compression test’ was performed to confirm the condition of the entire neural path with a single diagnosis to clearly confirm where the nerve was entrapped, and through this, accurate diagnosis and treatment were possible. This study is meaningful in that it presented the standard procedure and clinical significance of the upper triad compression test for the first time.

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Abstract : Facial palsy is one of the diseases in high demand for treatment at the Korean Medicine Clinic. Facial palsy is easy to recur, and it is important to receive appropriate treatment quickly. Acupuncture is one of the representative Korean Medicine therapies for facial palsy. The effects of acupuncture are well known, but studies detailing which areas to stimulate and how to stimulate them are lacking. Therefore, we would like to review the anatomical structure of the facial region in detail and report on the method of stimulating the origin and insertion of the muscle according to the RSN acupuncture method.

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Abstract : The purpose of this paper is to prove the therapeutic effect of acupuncture, herbal acupuncture, electroacupuncture, herbal medicine, and chuna for trigeminal neuralgia that has persisted for months to years. Acupuncture, medicinal acupuncture, electroacupuncture, and chuna were treated according to the Soft Tissue Society’s unique acupuncture method, RSN acupuncture theory, for trigeminal neuralgia patients who visited Daemyung Oriental Clinic from June 2021, and the patient’s response was measured using the NRS Scale. In addition, it was attempted to confirm that there was a substantial therapeutic effect by examining whether the western medicine was taken and the number of times during the treatment process. The NRS index case1 before treatment was 9, and pain and discomfort completely disappeared with NRS 0 after 6 treatments. In the case 2, NRS 6–7 before treatment improved to NRS 0 after 6 treatments. In the case 3, NRS 9–10 to NRS 1–2 after 15 treatments improved and the treatment was terminated. Through the RSN acupuncture treatment of three relatively old patients with trigeminal neuralgia, it was confirmed that acupuncture, herbal acupuncture, electroacupuncture, herbal medicine, and chuna were effective in combination treatment with oriental medicine. It is considered that it can be applied to other trigeminal neuralgia patients.

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Abstract : The aim of this study was to report the effect of acupotomy and herbal medicine treatment for patient with head tremor. One patient with head tremor was treated with acupotomy and herbal medicine. The patient reported that the head tremor had been relived significantly. Acupotomy and herbal medicine treatment are effective on head tremor.

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Abstract : We report a case of persistent paresthesia after brachial plexus block treated by acupotomy and Chuna. This case is to report acupotomy and Chuna efficacy of paresthesia. A 82-year-old male who was suffered from paresthesia (especially chilling, pricking) that lasted about 10 years. The patient was diagnosed with carpal tunnel syndrome in 2011, feeling chills in his left hand, and treated surgery but to no avail. So the patient treated brachial plexus block, after which chills appeared on the left full arm. The patient Treated in Ona Korean medicine clinic For 42 weeks (2020-12-24 to 2021-10-08), the patient visited 46 times and was treated with acupotomy on axillary nerve branch, radial nerve branch, musculocutaneus nerve branch. Also the patient was treated with Chuna 25 times on cervical spine to restore cervical curve. After 46 times acupotomy and 25 times Chuna, Body temperature increased 4.54℃ in the Axillary region, increased 4.47℃ in the Inferior lateral brachial cutaneou nerve region, 3.69℃ in the posterior antebrachial cutaneous nerve region, 4.59℃ in the musclulocutaneous nerve region and 4.53℃ in the superficial branch of radial nerve region. And after 25 times Chuna, cervical C-curve is improved. This improvement might suggest the feasibility of acupotomy and chuna to improve paresthesia, but it is only one case report, so much more research will be needed.

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Abstract : The aim of this study was to report the effect of Korean medicine treatments with 9 Cases of cold hands/feet syndrome patients improved by Hwata 153 magnetic field thermotherapy machine. We report 9 cases of patients with cold hands/feet syndrome by using Hwata 153 magnetic field theromotherapy machine. We compared the thermal difference between the before treamt DITI pictures and after treatment DITI pictures. In addition, we estimated the subjective sensitivity changes from 10, as which the patients feel coldness just before the treatment whatever the intensity of coldness are. After treatment there have been noticeable improvement not only in the subjective satisfaction of patients but also DITI temperature changes. Hwata 153 magnetic field theromotherapymight be a recommended therapeutic option for Cold Hypersensitivity of Hands and Feet.

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Abstract : The aim of this study was to report the effect of acupuncture and Chuna manual therapy on a cervicogenic headache and tinnitus. A 61-year-old male who was suffered from right tinnitus with chronic headache and cervical pain. The patient was treated with Korean medicine therapy, including the acupuncture and Chuna manual therapy. Treatment progress was assessed using the numeric rating scale (NRS) and Digital Infrared Thermographic Imaging (D.I.T.I). For 8 weeks, the patient visited 12 times and were treated with acupuncture, liquid acupuncture and chuna therapy. After treatment, significant improvements of tinnitus, neck pain and headache were shown. Numeric rating scales of tinnitus were decreased from 8 to 1. NRS of neck pain were decreased from 8 to 2 and the frequency of headaches in patients decreased after 8 weeks treatment. This improvement might suggest the feasibility of acupuncture and chuna therapy on cervical muscles to alleviate tinnitus. Korean medicine treatment, including acupuncture and chuna therapy might be a recommended therapeutic option for cervicogenic headache and tinnitus.

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Abstract : The aim of this study was to report the effect of acupotomy treatment for patient with headache. One patient with headache was treated with acupotomy. The patient reported that the headache had been relived significantly. Acupotomy treatment is effective on headache.

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Abstract : The aim of this study was to report the effect of Korean medicine treatments with RSN acupuncture and herbal medicine on a chronic gastroesophageal reflux disease (GERD) with Insomnia. A 73-year-old female who was suffered from chronic GERD with Insomnia and nuchal pain. The patient was treated with Korean medicine therapy, including the herbal medicine and RSN acupuncture. Treatment progress was assessed using the numeric rating scale (NRS) and the fometric analysis. For 4 weeks, the patient visited 8 times and were treated with acupuncture and herbal decoction. After treatment, significant improvements of GERD, Insomnia and nuchal pain were shown. Numeric rating scales of GERD were decreased from 10 to 0. NRS of nuchal pain were decreased from 10 to 0 and Insomnia were disappeared after 4 weeks treatment. This improvement might suggest the feasibility of acupuncture on upper c-spine and t-spine to help GERD and Insomnia. Korean medicine treatment, including RSN acupuncture therpy and Herbal medicine, might be a recommended therapeutic option for chronic GERD and insomnia.

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Abstract : The purpose of this study is to report the effect of acupuncture and acupotomy as treatment strategies of sudden sensorineural hearing loss (SSNHL).We reviewed 4 patients with sudden sensorineural hearing loss who were treated with acupuncture, acupotomy and other treatment. Acupucture and acupotomy treatment have efficacy in sudden sensorineural hearing loss. Acupuncture and acupotomy can be a treatment strategies for sudden sensorineural hearing loss.

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Abstract : We’re reporting five case of patient with peripheral tinnitus treated by acupotomy and other medical care. Patients visited the clinic because their peripheral tinnitus did not improve even though they were treated at otolaryngology. We have treated the patients for acupotomy of RSN points, which are cervical spine, thoracic spine and TE-17 (Yifeng), and Other medical care. Before and after treatment, the degree of improvement was checked through pure tone audiometry of the patient, broad band noise of the patient and patient statements. Peripheral tinnitus was improved through other medical care and treatment of direct and indirect Acupotomy of points Which are the cervical spine, thoracic spine, and nerves involved in the ear, such as the vagus nerve, the glossopharyngeal nerve, the facial nerve (chorda tympani nerve, geniculate ganglion), the trigeminal nerve, sphnopalatine ganglion (SPG), superior cervical ganglion and the auditory nerve. More specially, broad band noise of the patient decreased and 6 band test of patients on pure tone audiometry was mostly improved. Lastly subjective statement of patients about tinnitus have been improved. Our treatment show that acupotomy and other medical cares have positive effect on peripheral tinnius patient. As the cases of tinnitus treatment continue to accumulate, the treatment rate is improving, but there have been many cases where it is still insufficient and does not respond to treatment at all. Therefore, more cases and research are needed in the future.

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Abstract : Background: The aim of this study is to systematically establish clinical treatment procedures for shoulder pain and to organize diagnostic methods to differentiate each disease so that clinicians can have a detailed and accurate therapeutic approach. Methods: For accurate treatment of shoulder pain, the process for differential diagnosis of diseases according to the etiology is described by applying the appropriate diagnostic method according to the treatment procedure when treating shoulder pain. Results: Shoulder pain can be divided into neurogenic, local soft tissue damage, and mixed types depending on the etiology. Neurogenic diseases can also be classified into cervical origin and local nerve damage according to their origin. Local soft tissue damage is classified into muscle damage, tendon and ligament damage, bursa damage, intra-articular damage, and structural damage of the joint. Each disease is differentially diagnosed by characteristic clinical symptoms and physical examination according to the procedure. Conclusion: For the differential diagnosis of shoulder pain, the damaged area can be identified through a physical examination according to an appropriate procedure. And for an accurate diagnosis, the disease can be confirmed by confirming the pathological change in the relevant area through the diagnostic medical image taken by the medical image equipment.

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Abstract : Although acupuncture is a therapeutic technique that has been used in the field for a long time, the anatomical location of acupuncture stimulation is still unknown. Re-cently, with the development of ultrasound-guided diagnosis/treatment technology, re-search results to improve the safety and effectiveness of various invasive procedures such as pharmacupuncture and acupotomy using real-time images in Korean medicine as well as ultrasound-guided drug injection and biopsy in modern medicine were published. In par-ticular, the development of magnetic field-based visualization technology for acupuncture, which has been difficult to observe in ultrasound images, will enable more accurate and easier information on the anatomical tissue that is actually stimulated during oriental acupuncture. In addition, it is expected that it will be an important turning point in the development of anatomical structure based 3D acupuncture, away from the existing body surface marking based 2D acupuncture.

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Abstract : Background: The aim of this study was to report the anatomical and physiological understanding for treating ophthalmic diseases with related acupoints Jeongmyeong (BL1) and Dongjaryo (GB1). Methods: The anatomical and physiological structure, and acupoints were studied by referring to the existing text. Results: The key to the treatment of ophthalmic diseases lies in the circulation of the eye and its surrounding structures. Extraocular muscles (superior rectus, inferior rectus, medial rectus, lateral rectus, inferior oblique and superior oblique), levator palpebrae muscle, iris, ciliary body, and orbicularis oculi muscle are related to circulation of blood and aqueous humor. Compression of oculomotor nerve, abducens nerve and trochlear nerve will reduce the function of the extraocular muscles and levator palpebrae muscle. Compression of ciliary ganglion will reduce the function of the iris and ciliary body. The acupoint related to this is jeongmyeong (BL1). Fluid secretion from the lacrimal gland is regulated by parasympathetic nerve fibers from the facial nerve nucleus and sympathetic nerve fibers from the superior cervical ganglion. The acupoint related to this is dongjaryo (GB1). Conclusion: Ophthalmic diseases can be treated more effectively only by understanding eye and its surrounding structures, as well as circulation of eye-related artery&vein, lymphatic circulation and innervation. Since this study is still an approach at the hypothesis level, further clinical research is needed in the future.

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Abstract : Acupuncture in the United States was known as TCM (Traditional Chinese Medicine) 50 years ago. Now, it has grown as American Acupuncture and its role in comprehensive medical therapy is increasing. The future growth in the next few years will be revolutionary compared to the development in the last 50 years. There are only about 30 states that have acupuncture licensing programs and there are only 52 acupuncture education programs producing about 1,500 acupuncturists. These are some concerns that can limit the growth of acupuncture. If American Acupuncture can provide a “low cost, high efficient” patient-centered medicine as part of comprehensive medical care, then we can expect it to produce a big change in medical policy in the United States.

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Abstract : Based on CNKI as the data source, this paper applies the knowledge map analysis method in information metrology to analyze the development status of Chinese medicine along the belt and the road, and analyzes the overall situation of related papers in the area of Chinese medicine, such as the whole volume distribution, annual distribution of articles, the author’s cooperative network analysis, and institutional cooperation network analysis, etc. at the same time, it applies the CiteSpace developed by Professor Chaomei Chen from Drexel University of the United States. Based on the co-occurrence cluster analysis, it is found that the current development of Chinese medicine is a stage of diversification and flourishing, and cooperation and development from research, education, business and other fields.

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Abstract : Pinch roll test is a physical examination that uses the fingers of the examiner to pinch the skin in the area of the skin segment where pain occurs to observe changes in the state of the senses or tissues. The Pinch roll test is a useful physical examination that allows health care worker to immediately conduct and evaluate results in primary healthcare institutions. In addition, the Pinch roll test has the advantage of being an easily applicable physical examination to distinguish whether pain is neurotic or local soft tissue damage in almost all areas of the human body. However, in the case of the pinch roll test, there is no systematic consideration of the test method or research that presented standard processes in Korea, so this paper describes this content. Through the search of domestic and foreign databases, our researchers selected a total of 16 papers using the pinch roll test as an physical examination and organize the pinch roll test’s method and applicable parts in the human body, applicable disorders in the existing literatures. Search results showed that pinch roll tests were primarily used to diagnose neuro-musculoskeletal pain, most often to identify cervical and shoulder problems such as cervicogenic headaches. In addition, this paper specifically presents the actual standard procedure of the pinch roll test for reference to clinicians.

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Abstract : Some medical questions are not appropriable to investigation by a randomized controlled trial. In these cases, researchers must select a proper study design. The case report is descriptive study which is defined the medical report of symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Although there are methodological limitations associated with retrospective study design, case report can provide important insight to the physician in the professional narratives feedback on the clinical practice. Furthermore, for upgrading case report’s quality, CARE guidelines were developed in 2013 through a consensus of experts led by the CARE group. This study aim to present how to design and write clinical case report according to CARE guideline. We anticipate this article will help authors publish a quality case report that shares their research.

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Abstract : The tibial nerve compression test is a test method that compresses the upper part of the popliteal fossa (tibial nerve’s driving pathway) to determine whether the cause of lower part of knee joint’s nerve symptom is a local problem or a problem with the spine or pelvis. Although tibial nerve compression test is an efficient method that can be used in primary medical institutions, the spread of the test method is far away due to insufficient research. Therefore, in this paper, we conducted a literature review of tibial nerve compression test and presented a protocol that can be used in clinical use.

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Abstract : Background: Korean medicine and traditional Chinese medicine (TCM) have been mistaken for not having anatomical knowledge but only accepting abstract ideas for Eastern philosophy. However, they were also developed based on anatomy through actual observations. The goal of this paper is to state that they have independent history of anatomy. Methods: Several medical classics of ancient times to Ming (明)-dynasty were reviewed for investigating independent history of anatomy in Korean medicine. Results: There remain records of anatomy in Hwangjenaekyung (黃帝內經), nankyungjipju (難經集註), ryeossichu (呂氏春秋). Also, we can identify specific details that they would not have known if they had not done dissect. For example, the size, diameter, weight, capacity, shape, location of the organs. Surgery that is requiring basic anatomical knowledge has also been performed, such as surgery when the disease is in organs, operative wound closure, and records of surgery to release pathological material. In addition, zangfutu (臟 腑圖) implies that dissection was done in the East. Conclusion: The anatomy of the East is historically different from that of the West. However, in the East, the human body was also observed based on anatomical thinking. Korean medicine also developed based on this observation.

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Abstract : Background: Fu’s subcutaneous needling (FSN) was developed in May 1996 and is a new acupuncture therapy that mainly reduces localized pain using subcutaneous acupuncture. In China, FSN is actively used. However, among acupuncture therapies, FSN is unfamiliar in Korea, has low interest, and is not used in clinical practice. Also, there are no Korean reviews on FSN. Purpose: The purpose of this study is to introduce FSN in Korea through literature analysis and treatment examples of FSN. Methods: To introduce FSN, we referred to the Korean translation book of 符仲華 (Fu), the founder of FSN. An electronic literature search of CNKI’s Chinese database was conducted 浮針 AND 符仲華 is the search expression. In the FSN procedure stage was performed by a doctor of TCM with extensive experience. Results: We consulted 21 literatures with clear explanations of FSN. As a result of consultation, FSN is based of traditional theories such as ’s acupuncture, near acupuncture, and 以痛為腧. In addition, for FSN, a trocar that overcame the limitations of acupuncture was used to facilitate the FSN procedure. Starting with tennis elbow, FSN was expanding the range of indications such as limb diseases, trunk and non-intestinal diseases, and visceral diseases. As a result of FSN procedure, we were able to obtain examples of FSN for the knee areas, and summarized them with photographic data. Conclusions/implications for Practice: Starting with this study, it is expected that research and clinical use of FSN will increase in Korea.

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Abstract : Acupuncture at the Jingming can effectively treat eye pain or glaucoma, etc. In principle, it helps the circulation in the eyeball and has the effect of lowering the elevated pressure. In fact, even in classical literatures, when needling at the Jingming point, reference depth about 1.5 cm were mentioned. Careful procedure should be taken not to puncture the ethmoid artery in the eyeball socket, and attention should be paid to avoid deep orbital bleeding. The angle should be 85 degrees outward from the eyeball. As the effect of Jingming acupuncture is good, it should be used with caution.

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Abstract : Introduction: Acupuncture treatment on backshu points have been effectively used to treat digestive diseases. Especially BL 18, BL 20 are related to digestive system of below diaphragm and BL 22 includes idea of Zhong Jia (中焦) which reflects digestive system. However there has been no systemic review considering the efficacy and safety of BL18, BL20, BL22. This protocol aims to perform a systematic review for assessing the effectiveness and safety of BL18, BL20, BL22 on digestive system in terms of soft tissue and anatomical structure. Methods: This protocol follows the guideline according to the Preferred Reporting Items for Systematic reviews and will be registered on the International Prospective Register of Systematic Reviews (PROSPERO). The following six databases will be searched from their inception to July 2021: Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, OASIS, RISS, and the China National Knowledge Infrastructure (CNKI). This review will include Randomized Controlled Trials (RCTs), Controlled clinical trial, Case series and Case report that only adress anatomical structure or needling method of BL18, BL20, BL22. Study selection, data extractionnd data analysis will be performed in order. Results and Conclusion: We propose the current protocol to summarize the methodologies of acupoints insertion of BL18, BL20, BL22 in terms of soft tissue and anatomical structure systematically.

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Abstract : Introduction: The aim of this study is to provide anatomical information of ST36 including applicable needling depth and related physiological effect. Methods: The contents about ST36 were extracted from literature. Then we investigated the clinical effect and needling feature (depth/angle) of ST36, searching on-line databases like ‘Oasis’, ‘RISS’, ‘DBpia’, ‘Pubmed’ and ‘Google scholar’ from 2008 to 2021. Results: According to the classic test, the needling depth of ST36 is 12-39 mm, that of previous research is 9-25 mm. When acupuncture is applied at that level, stimulatable anatomical structures were skin, subcutaneous tissue, lateral sural cutaneous nerve, anterior tibialis muscle, deep peroneal nerve, anterior tibial vessels, and interosseous membrane. Conclusion: The remarkable effect of ST36 is originated from stimulation of deep peroneal nerve. It is necessary for ST36 to be stimulated as 1.9-2.5 cm depth.

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Abstract : Introduction: The aim of this study is to provide anatomical information of Fengchi (GB20) including applicable needling depth and related physiological effect. Methods: The contents about GB20 were extracted from literature. Then we investigated the clinical effect and needling feature (depth/angle) of GB20, searching on-line databases like ‘Oasis’, ‘RISS’, ‘DBpia’, Pubmed’. Results: According to the classic text, the needling depth of GB20 is 9.3-46.5 mm, When acupuncture is applied at that level, stimulatable anatomical structures were skin, semispinalis capitis, rectus capitis posterior minor, rectus capitis posterior major, greater occipital nerve, third occipital nerve, suboccipital nerve, posterior atlanto-occipital membrane, occipital artery and vein, vertebral artery. Conclusion: In applying GB20 for acupuncture treatments, peripheral disorders are treated by stimulating the semispinalis capitis, the greater occipital nerve, the third occipital nerve, and central disorders are treated by stimulating the rectus capitis posterior minor, the rectus capitis posterior major, the suboccipital nerve.

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Abstract : Introduction: This study aimed to report that INR level of a patient with cardioembolic stroke taking warfarin was adjusted through herbal medicine administration without adjusting the dose of warfain. Case Presentation: This is a case of 64-year-old male patient diagnosed with cardioembolic stroke. The patient’s INR level fluctuated greatly during the our hospital stay, so we requested near university hospital to adjust the warfarin dose, but they only told that it was because of the herbal medicine and did not adjust the warfarin dose. So, we controlled the INR level by ourselves through herbal medicine administration. Conclusion: For patients taking warfarin with fluctuating INR levels, the most economical and convenient method is to adjust the warfarin dose appropriately. However, if that is not possible, it is thought that a positive effect can be achieved through the combination of herbal medicines.

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Abstract : Background: The aim of this study is to report the effort of acupuncture treatment for patient with fibromyalgia. Methods: One patient with fibromyalgia was treated with acupuncture twice a week for 9 months. Visual Analogue Scale(VAS) was used to evaluate the effect of the treatment. Results: The score of VAS was improved from 75 to 5. Conclusion: Acupuncture treatment is effective on fibromyalgia.

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Abstract : Background: The aim of this study is to report the effect of acupuncture treatment for patient with low back pain of facet joint origin. Methods: One patient with low back pain of facet joint origin was treated with acupuncture. Results: The patient reported that the pain had been relived significantly Conclusion: Acupuncture treatment is effective on low back pain of facet joint origin.