• Title/Summary/Keyword: 통증치료

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Pain Disorder Associated with Psychological Factors - Case Report and Review - (심리적 요인과 관련된 통증장애 - 증례 및 고찰 -)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.166-175
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    • 2002
  • Recently many researches support the use of traditional psychiatric treatments in the management of chronic pain. Chronic pain is a significant public health problem and frustrating to everyone affected by it. Psychiatrists offer skills with treatments now recognized as effective in the management of chronic pain. In addition to the diagnosis and treatment of psychiatric co-morbidity, the application of psychological treatments to chronic pain, and the development of interdisciplinary efforts to provide comprehensive health care to the patient disabled with chronic pain, psychiatrists have particular skill in pharmacological treatment that have proven efficacy for a variety of chronic pain conditions. With their expertise in the use of psychoactive medication plus their interest in the personal and family dynamics of patients, psychiatrists have the capacity to be involved in the treatment of patients with chronic pain. So, the author reported three cases of patient with pain disorder associated with psychological factors, and reviewed to propose that psychiatrists in Korea should take an active role in the care of these patients.

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Pain and Stress (통증과 스트레스)

  • Sihn, Woo-Yong;Yu, Bum-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.29-34
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    • 2007
  • Pain is subjective and greatly influenced by prior experiences, but it is real. Pain associated with an organic(objective) pathology is more easily explained and treated. However, atypical or unexplainable pain is usually a source of greater confusion and frustration. Pain may be divided into four general diagnostic categories. 1) pain with anatomic features and objective findings 2) pain with anatomic features and without objective findings 3) pain with non-anatomic features associated with stress and somatization 4) pain with non-anatomic features associated with perceived physical injury. There is a well-established relationship between emotional, physical and/or sexual abuse history and development of chronic pain. It has been suggested that the link between somatization and abuse involves a paradoxical pattern of hiding feelings and reality, while seeking acknowledgment of suffering. History of abuse may physiologically and developmentally increase a person's susceptability to pain and organic changes can be associated with psychogenic disease. Patients with chronic pain should be treated with multidisciplinary approaches including exercise, meditation, cognitive therapy, medications, and biofeedback. Cognitive therapy alters patient's cognition and management of pain and alleviates pain, especially associated with stress. Antidepressants are the most commonly used medications and pain control effects have no relation with mood changes. Biofeedback with relaxation training, exercise and meditation may also be effective in pain control.

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Treatments of Complex Regional Pain Syndrome(CRPS) (복합부위 통증증후군의 치료)

  • Yang, Jong-Yeun
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.2
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    • pp.57-61
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    • 2010
  • The complex regional pain syndrome(CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, knowledge concerning its natural history and mechanism remains very limited. Many current rationales in treatment of CRPS are mainly dependent on efficacy originate in other common conditions of neuropathic pain. This article introduces various treatments for CRPS, but few studies of high methodological quality have been carried out into the effects of those treatments. I think early recognition and a multidisciplinary approach to management seems important in obtaining a good outcome.

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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Effect of Spinal Stabilization Exercise and Manual Therapy on Visual Analogue Scale and Oswestry Disability Index in Acute or Subacute Patients with Low Back Pain (척추안정화운동과 도수치료가 급성기 또는 아급성기 허리통증 환자의 통증지수와 오스웨스트리 장애지수에 미치는 영향)

  • Park, Eun-Young;Kim, Won-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1792-1798
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    • 2013
  • The purpose of this study was to investigate effect of type of physical therapy (spinal stabilization exercise and manual therapy) on pain index and disability index in acute and subacute patients with low back pain (LBP). 23 patients with LBP participated and were randomly assigned. Manual therapy and spinal stabilization exercise was applied for 15-minute sessions occurred 3 sessions a week, for 4 weeks. All subjects received conservative therapy for 30-minute. Visual analogue scale (VAS) and Korean version of Oswestry disability index (ODI-K) were measured before and after treatment. There was significant difference in VAS and ODI-K between before and after both treatment (p<.05). There was significant difference in change rate of VAS between manual therapy and spinal sabilization exercise (p<.05), but not in change rate of ODI-K (p>.05). Thus, it is suggested that spinal stabilization exercise is helpful to reduce pain safely in acute and subacute patients with LBP.

A Review of Occupational Therapy Approach for Complex Regional Pain Syndrome (복합부위통증증후군의 작업치료적 접근에 관한 고찰)

  • Choi, Yoo-Im;Park, Soo-Hyun
    • The Journal of the Korea Contents Association
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    • v.10 no.1
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    • pp.286-294
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    • 2010
  • Complex Regional Pain Syndrome(CRPS) is a chronic neruopathic pain syndrome, most frequently encountered after trauma, nerve injury, fracture, cerebral vascular accident(CVA), spinal injury, and surgery to a limb, and affected by diverse factors such as disease process, intervention method, and other biopsychosocial components. Occupational therapy as a multidisciplinary treatment approach may be potentially useful when simultaneously targeting such biological, psychological, and social components. Biological treatment can focus on increasing functional use of extremity for promoting independence. Psychological intervention can include relaxation/biofeedback training and cognitive-behavioral treatments, and social approach can focus on recreational therapy and vocational rehabilitation. Occupational therapy will encourage functional restoration, pain management, and regaining of psychological components with collaboration between different disciplines.

A study on the treatment of muscle pain using a high-frequency pain treatment device (고주파 통증치료기를 이용한 근육통 치료에 대한 연구)

  • Jae-Hyun Jo
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.3
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    • pp.152-160
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    • 2023
  • After the recent COVID-19 outbreak, more and more people are paying attention to health care. Many people feel uncomfortable in life due to muscle pain after sports or exercise as a hobby and often take a break from exercise. After exercising for a long time or exercising excessively, pain appears throughout the body within 24 to 48 hours after exercise. This pain is called delayed onset muscle soreness (DOMS). In this study, the effectiveness of the pain relief of delayed onset myalgia was verified by using a high-frequency pain therapy device that generates deep heat. EMG was measured before and after pain treatment at ordinary times, RMS values were obtained through analysis, statistical analysis was performed using the SPSS program, and it was judged to be statistically significant. In addition, statistical analysis of the RMS value between normal and after pain treatment was conducted to confirm that there was no significance, and to confirm how much it returned to normal after pain treatment. In addition, since the standards for pain are different for each person even if the size of the same pain is the same, the NRS questionnaire for the size of pain was conducted, and the size of pain felt by the subjects was analyzed using the SPSS program and statistical significance was obtained. Therefore, as a result of this study, the high-frequency pain therapy device generated deep heat in the pain area to raise the temperature, and expanded the arteries and capillaries to increase blood flow, thereby increasing blood circulation and metabolism, and alleviating the pain of delayed onset muscle pain.

The Effects of Aromatic Oil on Shoulder Pain in the Middle-aged Woman Patients (중년 여성 환자의 견관절 통증에 대한 아로마 오일의 효과)

  • Park, Kyung-Soon;Han, Dong-Wook
    • Journal of Korean Physical Therapy Science
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    • v.12 no.4
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    • pp.11-24
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    • 2005
  • 대전에 소재하는 C 대학교 병원의 물리치료실에 2003년 5월 9일부터 2004년 10월 20일까지 내원한 환자들 중 견부 통증의 진단으로 치료를 받은 환자 가운데 중추신경계에 손상 병력이 없고, 치료사와 의사소통이 가능한 인지 능력을 가졌으며, 실험에 참가하기로 동의한 환자를 대상으로 내원한 순서에 따라 아로마 초음파군, 아로마군, 초음파군에 각각 30명씩을 배정하여 실험한 결과, 치료의 횟수가 증가함에 따라 통증의 정도를 알아보는 시각적 통증 점수가 감소하였으며(p<0.001), 군 간에 통증 감소의 정도도 차이가 있었다. 사후 검정을 보면 아로마 초음파군과 아로마군의 통증 감소의 정도가 초음파군에 비해 높았다(p<0.001). 또한 치료의 횟수가 증가함에 따라 McGill-Melzac 통증 점수 역시 감소하였으며(p<0.001), 군 간에 차이는 없었지만, 교호작용을 고려하면 아로마를 사용한 군에서 감소 폭이 더 큰 것으로 해석할 수 있다. 압통계의 역치 역시 치료의 횟수가 증가함에 따라 모든 군에서 상승하였으며(p<0.001), 군 간에 역치 증가의 정도에도 차이가 있었는데(p<0.05), 사후 검정을 보면 아로마 초음파군이 아로마군에 비해 역치 증가의 폭이 더 컸다. 따라서 압통계의 역치 증가는 아로마 보다는 초음파에 더 영향을 받는 것으로 생각할 수 있다. 이상의 결과로 볼 때 아로마 오일은 주관적이고, 정서적인 통증을 검사하는 시각적 통증 점수와 McGill-Melzac 점수에 많은 영향을 미치는 반면 조직의 회복에 의해 상승하는 압력 역치를 검사하는 압통계의 수치에는 영향을 적게 미침을 확인할 수 있었으며, 반면 초음파는 주관적, 정서적인 통증의 감소보다는 실제 조직이 회복되면서 감소하는 통증에 더 많은 영향을 미치는 것을 알 수 있었다.

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Effect of Transcutaneous Electrical Nerve Stimulation on Muscle Activity of Upper Trapezius in Subjects With Myofascial Pain Syndrome (상부 승모근 근막 통증 환자에게 경피신경자극이 근 활성도에 미치는 영향)

  • Koh, Eun-Kyung;Kwon, Oh-Yun;Kim, Young;Jung, Do-Young;Seo, Hyoun-Soon
    • Physical Therapy Korea
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    • v.9 no.4
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    • pp.69-76
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    • 2002
  • 본 연구에서는 상부 승모근의 근막통증(myofascial pain syndrome; MPS)를 대상으로 이완상태에서 근 활성도를 측정해보고, 통증을 감소시키는 데 주로 이용되는 경피신경자극 치료 후 근 활성도에 어떠한 영향을 미치는지 알아보기 위해 실시하였다. 본 연구의 대상자는 근막 통증으로 진단을 받은 총 10명을 대상으로 실시하였다. 주관적 시각 척도(visual analogue scale; VAS)와 압통 역치 측정계(pressure threshold meter)를 이용하여 경피신경자극 전, 후 통증의 정도를 평가하였고, 표면 근전도를 이용하여 이완시 근 활성도를 측정하였다. 치료 기구는 경피신경자극기(TENS: HAT-2000)를 이용하였다. 치료 전과 비교하여 VAS는 통증이 심한 쪽과 약한 쪽 모두에서 유의하게 감소하였으며(p<.05), 압통 역치는 통증이 심한 쪽과 약한 쪽 모두에서 유의한 차이가 없었고(p>.05), 근 활성도는 통증이 심한 쪽에서 유의하게 감소하였다(p<.05).

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Adult Idiopathic Scoliosis Treated by Acupuncture : A case report (침 치료로 호전된 특발성 척추 측만증 환자의 증례보고)

  • Jo, Jun-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.1
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    • pp.21-25
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    • 2012
  • 목적: 이 증례 보고는 성인 특발성 측만증 환자에 있어서 등의 통증과 척추 만곡에 대한 침 치료의 효과를 보고하기 위한 것이다. 방법: 증례의 환자는 25세 여자 환자로 9년 동안 우측 흉추 측만증과 등과 허리의 통증이 있었다. 1주일에 3번, 3주간 침 치료를 시행했고, 치료 전후로 Whole spine x-ray를 촬영하였으며, 환자의 통증 정도를 Visual Analog Scale(VAS)로 평가하였다. 내원시 Cobb angle은 $22^{\circ}$였고, 관상면 균형은 -3.0cm, 쇄골각은 $-3.5^{\circ}$였다. VAS 8의 통증을 호소하였다. 결과: Cobb angle은 $5^{\circ}$ 감소하였고, 관상면 균형은 1.4cm, 쇄골각은 $1.7^{\circ}$ 회복되었다. 등과 허리의 통증은 VAS 8에서 VAS 3으로 감소하였다. 결론: 침 치료는 특발성 척추 측만증 환자에 있어서 등과 허리의 통증뿐만 아니라 척추 측만을 개선시키고 관상면 균형 회복에도 효과적이다.

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