• Title/Summary/Keyword: 복합 통증

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Implantable Intrathecal Drug Delivery Pump in Complex Regional Pain Syndrome Patient -A case report- (복합부위통증증후군 환자에게 시행한 매몰식 펌프를 이용한 지주막하강 내 약물투입 -증례보고-)

  • Seo, Kyung Soo;Han, Kyung Ream;Kim, Sae Young;Park, Kyeong Eon;Kim, Chan
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.74-77
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    • 2009
  • Implantable intrathecal pump is one of the therapeutic options for intractable pain. A 24-year-old male with complex regional pain syndrome was suffering from right lower extremity pain. He had all modalities of treatment including spinal cord stimulator. However, his pain had been worse in the past 6 months. His visual analogue pain scale (VAS) was 8-10 and he could not sit or walk. Only opioid was thought to be effective. Then, intrathecal pump was considered. We estimated the minimal effective dose of spinal morphine before implantation. 0.3 mg of morphine was injected intrathecally as a starting dose. Dosage had been increased up to 0.8 mg in 10 days. His VAS score decreased from 8 to 5. He could sleep without pain and walk with crutch. Therefore, intrathecal pump was inserted. He could tolerate to pain. This case suggests that intrathecal morphine delivery can provide effective treatment for intractable non-malignant pain.

Effect of Dipsaci Radix on Pain In Complex Region Pain Syndrome (실험적으로 유발한 복합부위통증증후군 모델에서 속단이 통증에 미치는 영향)

  • Kim, Kyung-Yoon;Jeong, Hyun-Woo;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.3
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    • pp.678-684
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    • 2009
  • It was reported that Dipsaci Radix has decrease pain effect on the Complex Region Pain Syndrome(CRPS). the CRPS was induced by unilateral loose occlusion in 4 part of the sciatic nerve of the rats. For the fingding significantly change on CRPS rats were divided into 4 different experimental groups. and each groups were induced CRPS. Experimental group I (control group; n=15), experimental group II (100 mg/kg Dipsaci Radix dieted rats; n=15), experimental group III (300 mg/kg Dipsaci Radix dieted rats; n=15), and experimental group IV(500 mg/kg Dipsaci Radix dieted rats; n=15). The study of Dipsaci Radix concentration was that foot withdrawal threshold to the thermal stimuli(Hot plate test), foot withdrawal threshold to the mechanical stimuli(von Frey's filament) and immunohistochemistry staining that were substance P. Hot plate test and von Frey Filament were increase in experimental group II, III, IV than group I, especially group III was most significantly change than group II and IV in post-hoc(Duncan's multiple range). and In immunohistochemistry observation; group I showed increase in the group II, III, IV. especially group III had the minimal level of the substance P expression while the experimental group II, III. These results suggested that the Dipsaci Radix dieted made the decrease of pain in CRPS.

Clinical assessment to the dental treatment of bruxism: literature review (이갈이 환자의 치과 치료에 관한 임상적 접근을 위한 문헌 고찰)

  • Choi, Yu-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.1
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    • pp.36-44
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    • 2014
  • Bruxism is a much-discussed clinical issue in dentistry. Although bruxism is not a life-threatening disorder, it can influence the quality of human life, especially through dental problems, such as, frequent fractures of dental restorations and pain in the orofacial region. This research has a goal to investigate the diagnostic methods of bruxism, to provide an appropriate information about various treatment in clinical situation, and to evaluate the effect and the usefulness of those methods. There is no certain remedy for bruxism that is a technically efficient and definitely reliable diagnosis and treatment. So, the primary purpose is to prevent the oral and maxilofacial tissue injuries from bruxism and to relieve the pain and symptom. Therefore, Combining various reversible treatments together, such as behavior modification, Oral appliances therapy and physiotherapy, is recommended. For a bruxism treatment in dental field, more researches about the factors influencing on diagnosis and cure are necessary.

Comparison of the Diagnostic Validity of Real and Absolute Skin Temperature Differences for Complex Regional Pain Syndrome (복합부위통증증후군 진단 시 좌우 체온 차이의 실제값과 절대값의 진단적 타당도 비교)

  • Nahm, Francis Sahngun;Lee, Pyung Bok;Park, Soo Young;Kim, Yong Chul;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.146-150
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    • 2009
  • Background: A skin temperature difference is one of the variables used in the diagnosis of complex regional pain syndrome. However, there have been no reports as to whether the real (${\Delta}T$) or absolute value ($|{\Delta}T|$) of skin temperature differences should be used in the diagnosis of complex regional pain syndrome. This study was conducted to compare the diagnostic validity of ${\Delta}T$ with $|{\Delta}T|$ for complex regional pain syndrome using receiver operating characteristic curves (ROC). Methods: Infrared thermographic images were obtained from the 144 patients who were suspected to have CRPS in a unilateral limb. After ${\Delta}T$ and $|{\Delta}T|$ calculation from the thermographic image, ROCs of ${\Delta}T$ and $|{\Delta}T|$ were developed, and the areas under the curve (AUC) for the ROC curves were compared. Results: AUCs of ${\Delta}T$ and $|{\Delta}T|$ were 0.520 and 0.746 respectively, this difference was statistically significant (P < 0.001). Conclusions: Absolute skin temperature difference shows greater validity in the diagnosis of CRPS than ${\Delta}T$. Therefore, $|{\Delta}T|$ is more useful when comparing the skin temperature of CRPS patients.

Moxibustion Therapy for the Pain Relief in Patient with Type I CRPS: a Case Report (뜸치료의 제 1형 복합부위통증증후군 환자에 대한 통증완화 효과: 증례 보고)

  • Cho, Hyun-Woo;Shin, Byung-Cheul;Shin, Mi-Suk;Hwang, Eui-Hyoung;Sul, Jae-Uk
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.3
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    • pp.79-87
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    • 2011
  • Objectives : The aim of this study was to observe the pain relief effect of moxibustion therapy in a patient with complex regional pain syndrome(CRPS). Methods : A male with type I CRPS, 48-year-old, who suffered from severe pain and paresthesia on his legs despite of treatments of oral medications and spinal cord stimulation was treated by indirect moxibustion following Korean medicine dianosis. Total 20 moxibustion treatments(once daily, 5 days a week, for 4 weeks) were given on the 4 acupoints(both side) where known to be effective fro the CRPS. Visual analogue scale(VAS), digital infrared thermal imaging(DITI), Beck depression index(BDI) were evaluated before and after the treatments. Pain relief, thermal changes on affected legs, and improvement of depression scale were observed after the treatments. Results : As for DITI, right thigh showed low temperature compared with left on before the treatments. While after the treatments, DITI showed similar temperature in both legs at discharge day. Conclusions : Though it is a case report, moxibustion therapy might have pain relief effect. Further rigorous case series and controlled trials are warranted.

Complex Regional Pain Syndrome followed by Artery and Vein Puncture -A report of 2 cases- (동정맥 천자 후 발생한 복합부위통증증후군의 치료 -증례보고-)

  • Ahn, Gyu Yul;Han, Kyung Ream;Lee, Hyun Tak;Kim, Yeui Seok;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.66-70
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    • 2007
  • No definitive etiology or risk factors have been identified that predispose individuals to developing complex regional pain syndrome (CRPS). We experienced two cases of CRPS developed after arterial and venous puncture which were done in regular medical work. A 35-years old female patient was suffered from pain and allodynia with swelling at right hand and wrist after radial artery puncture for monitoring of blood pressure during general anesthesia. A 24-years old male patient had pain and swelling with allodynia at the right fingers and arm after median cubital vein puncture for blood sampling. They did not have proper pain management as CRPS patients in the past weeks and months after their pain occurred. They were diagnosed as CRPS and started undergoing various interventional procedures, which led to improve their pain condition. Our cases suggest that CRPS could develop without any proved tissue damage in routine medical practice. In conclusion, health care workers should be educated in knowledge about the uncommon medical condition and proper consultation to pain specialist when it happens.

Comparison of the Two Impairment Classes Publicized by the American Medical Association in Complex Regional Pain Syndrome Patients (복합부위통증증후군 환자에서 미국의사협회 영구장애평가지침에서 제시된 장애등급 평가방법의 비교)

  • Shin, Hwa Yong;Choi, Yong Min;Nahm, Francis Sahngun;Park, Seong Joo;Koo, Mi Suk;Suh, Jeong Hun;Sim, Sung Eun;Jo, Ji Yon;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.148-153
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    • 2007
  • Background: Complex regional pain syndrome (CRPS) is not regarded as an impairment in Korea. Guidelines for rating this impairment are under development by the Korean Academy of Medical Science based on that of the American Medical Association (AMA). However, no studies have been done on the validity of these guidelines in Korea. We therefore evaluated the validity of these guidelines using the criteria from the chapter on the central and peripheral nervous system (CNS-PNS class) and the worksheet for calculating total pain-related impairment score (TPRIS class). Methods: TPRIS and CNS-PNS classes were calculated through interviews of 28 CRPS patients. The correlation between the two classes was calculated. Results: TPRIS class and CNS-PNS class were well correlated (r = 0.593, P < 0.05). Conclusions: Both TPRIS or CNS-PNS classes were well correlated and could be used for evaluation of impairment. However, the CNS-PNS class is simpler and quicker to complete.

Cervical and Thoracic Spinal Cord Stimulation in a Patient with Pediatric Complex Regional Pain Syndrome -A case report- (소아 복합부위통증증후군 환자에서 경부와 흉부 척수 자극술 -증례보고-)

  • Park, Jung Ju;Moon, Dong Eon;Park, Seung Jae;Choi, Jung Il;Shim, Jae Chol
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.60-65
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    • 2007
  • Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

Oral symptoms experienced by adolescents based on Body Mass Index (체질량지수에 따른 청소년의 구강증상 경험)

  • Kim, Young-Suk
    • Journal of the Korea Convergence Society
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    • v.12 no.3
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    • pp.317-323
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    • 2021
  • The purpose of this study was to analyze the oral symptoms experienced by adolescents according to Body Mass Index. We analyzed the data using the Korea Youth Risk Behavior Web-based Survey and conducted complex-sample descriptive statistics on 55,728 participants. The prevalence of sensitive teeth, tooth pain, gingival bleeding, and swelling was highest in the overweight group (36.8%, 23.9%, and 19.2%) and lowest in the underweight group (34.6%, 20.8%, and 17.0%) (p<0.001). Tooth pain, gingival bleeding, and swelling were significantly higher (all 1.08) in the overweight group than in the normal group. Halitosis was 1.19-and 1.43-higher in the overweight and obese groups, respectively. The relationship between systemic diseases and oral health among adolescents should be further investigated.

Effect of combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back Pain (도수 교정과 안정화 운동 복합적용이 만성 허리통증 환자의 통증과 척추 만곡도에 미치는 영향)

  • Jang, Jae Sun;Kim, Yong Nam
    • Journal of Korean Physical Therapy Science
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    • v.29 no.2
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    • pp.38-47
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    • 2022
  • Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.