• 대한정형외과 초음파학회지
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• 제7권2호
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• pp.127-131
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• 2014

인체에서 가장 큰 기관인 골격근은 통증과 기능장애를 초래할 수 있는데, 통증 유발점이라는 특징적인 병변을 가지는 근막 통증 증후군이 골격근의 가장 흔한 병적 상황 중의 하나이다. 통증 유발점은 골격근 내의 taut band라고 불리는 띠안에 존재하는 과민한 통증성 국소 병변으로 국소 통증 뿐만 아니라 연관통 및 만성적인 관절운동 제한과도 동반된다. 다양한 치료법들이 시도되었으나 통증 유발점 주사법이 가장 효율적인 치료법으로 사용되고 있으며 이 종설에서는 근막 통증 증후군의 일반적 병인과 통증 유발 주사의 방법에 대하여 소개하고자 한다.

• Journal of Oral Medicine and Pain
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• 제25권3호
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• pp.325-329
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• 2000

근막동통은 발통점과 중추흥분효과가 나타나는 국소적 근육성 동통이다. 발통점은 근육의 일부나 건 부착점에 나타나는 부위로서 단단한 띠로서 느껴지고 촉진시 통증을 유발한다. 통증은 관련된 발통점의 위치에 따라 연관된 부위에 나타난다. 이러한 근막 발통점에 따른 증상은 약한 기능이상부터 일상생활이 어렵게 되는 정도의 심한 통증까지 다양하다. 이의 발생에는 국소적 근육이상, 심부 동통, 심리적 스트레스의 증가, 수면장애와 전신적인 요인들도 관여한다. 일반적으로 치료는 보존적인 처치로써, fluoro-methane 같은 vapocoolant spray를 사용하는 사용하여 분사신장하는 방법이 있으며, 국소적인 주사, 마사지, 초음파, 온열요법등이 있다. 여러 환자에서 근막동통을 가지는 환자에 분사신장요법을 시행한 결과 대부분 환자에서 증상의 개선을 보였다. 근막동통의 치료시 분사신장요법은 매우 보존적인 처치로 임상가의 적용과 접근이 쉬우며, 환자로 하여금 치료에 따른 불안감을 줄이면서 만족을 느낄 수 있는 치료로 사료된다. 그러나 만성 환자의 경우 분사신장요법의 치료결과에 대한 만족도가 높지 않았다. 분사신장 용법은 근막동통을 가진 환자 모두에서 효과적이지는 않으나 치료의 도입으로, 근막동통을 진단시에 일차적으로 사용할 수 있는 안정한 보존적인 용법으로 사료된다.

• The Korean Journal of Pain
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• 제12권2호
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• pp.263-267
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• 1999

We have observed retroperitoneal hematoma after trigger point injections of quadratus lumborum in a patient with chronic low back pain. Severe flank pain and dyspnea was observed three hours after injection of local anesthetic and steroid to the trigger point of quadratus lumborum muscle. There was fuge hematoma in abdominal CT image around the right kidney, which displaced and compressed the kidney anteriorly. Following infusion of contrast media, extravasation through renal vein and IVC was notified. Patient had a past history of having been treated with platelet aggregation inhibitor and lower dose aspirin treatment after cerebral ischemia for a year, but coagulative function was within normal range. Patient was admitted 12 days for bed rest, pain control and transfusion. We need to take greater care with a frequent aspiration and exact direction of needle, during trigger point injection of quadratus lumborum, particu right side, to avoid vascular injury.

• The Korean Journal of Pain
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• 제20권1호
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• pp.74-77
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• 2007

The trigger point injection technique is widely used in pain clinics for the treatment of acute and chronic pain. Yet it has a variety of complications such asvasovagal syncope, total spinal anesthesia, paralysis, root block, pneumothorax, needle breakage, skin infection, and hematoma formation. Among them, the simultaneous occurrence of psoas and epidural abscesses is extremely rare. We report here on a patient who was diagnosed with epidural and psoas abscesses after paravertebral trigger point injection.

• The Korean Journal of Pain
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• 제12권1호
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• pp.75-80
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• 1999

Background: Despite tension type headache is popular, the exact mechanism and method of treatment are not certain yet. So, we supposed the basic mechanism of tension type headache is myogenic, and did Tienchu acupoint block, occipital nerve block, and trigger point injection in tension type headache patients. Methods: Fifty-seven tension type headache patients were treated with local anesthetics and small dose of steroid. The intensity of pain and effect of every treatment was evaluated as Verbal Rating Score (VRS; 0~10) before and after every treatment. Evaluation of treatment was based on the time of treatment (1,2 times, 3 times, 4,5 times). Goal of treatment was VRS reaching below two point and it was considered as treated state. Results: Symptom improvement rates of each treatment were 90% (1, 2 times), 91% (3 times), 70% (4, 5 times) respectively. VRS reduction more than 50% rates were 60%, 64%, 60% respectively. Treated state (VRS<2) rates were 33%, 27%, 30% respectively. Conclusion: Tienchu acupoint block, occipital nerve block, trigger point injection were sorts of most effective and simply applicable modalities of treatment in tension type headache.

• The Korean Journal of Pain
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• 제12권2호
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• pp.195-199
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• 1999

Background: At present, there is no reliable objective test for the diagnosis of myofascial trigger points (MFTP). We evaluated the usefulness of skin resistance point finder for the diagnosis of MFTP. Methods: 40 subjects with clinical MFTPs at the upper trapezius muscle were included in this study. Using skin resistance point finder (UNIQUE S-2010$^{(R)}$, Seik medical, Korea), we tried to find out the point of low skin resistance. At three different current level, sensitivity and specificity of this method for the diagnosis of clinically identified MFTP was evaluated. Pressure threshold for pain of low skin resistance point was measured using Pressure Threshold Meter$^{(R)}$ (Pain Diagnostics and Thermography, U.S.A.). 3 groups of point detected at different current were compared in mean pressure threshold. Results: Fixed single current of skin resistance point finder showed variable sensitivity and specificity. But, by adjusting current level, skin resistance point finder detected all of 40 clinically identified MFTPs. Although it is partially statistically significant, the mean pressure threshold of points detected at high current was high. Conclusion: Skin resistance finder can be used as objective diagnostic tool of MFTPs. There is possibility that it can be useful in evaluating treatment effect. However, more investigation is necessary.

• 융합정보논문지
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• 제9권3호
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• pp.104-111
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• 2019

본 연구의 목적은 대체의학기술인 SUKI(Superficial Using Ki energy Instrument) 점압법을 활용한 특정근육(상부승모근 trigger point) 부분을 자극하여 스트레스를 받은 뇌파의 변화를 알아보고자 실시하였다. 연구방법은 스트레스에 의해 승모근통증을 호소하는 12명의 남녀 대학생을 대상으로 실시하였다. 상부승모근 통증유발점에 SUKI를 사용하기 전후의 특정영역의 뇌파를 측정하였다. SUKI자극시간은 3min 자극한 후 각 부위별로 비교하였으며(FP2, F3, F4, FP1, T3, T4, P3, P4), 실험기간은 총 5회 실시하였다. QEEG-S 뇌파측정기를 이용하였고, 데이터 수집을 위해 Telescan(LXE 5208) 프로그램을 사용하였다. 자료분석은 SPSS 22.0 version을 사용하였고, 점압법 전후 차이를 비교하기 위하여 대응표본 t-검정(paired t-test)을 실시하였으며, 통계학적인 유의수준은 p<.05로 설정하였다. 연구결과는 다음과 같다. FP2, F3, F4(*p<0.049, *p<0.042, *p<0.019)는 뇌파는 유의하게 나타났고, FP1, T3, T4, P3, P4는 유의하지 않았다. 따라서 SUKI 대체의학기술에 의한 뇌스트레스 감소 효과가 있었다. 추후 SUKI 대체 의학의 지속적인 연구가 요청된다.

• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.221-227
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• 2015

In this study, Multi-Array Electrodes (MAE) and Programmable Multi-channel Electrical Stimulator (PMES) were implemented for firing Trigger Points (TPs) of the patient with Myofascial Pain Syndrome (MPS). MAE has 25 Ag/AgCl electrodes arranged in the form of array ($5{\times}5$) fabricated with flexible pad, which are applicable to be easy-attached to curved specific region of the human body. PMES consisted of 25 channels. Each channel was to generate various electric stimulus patterns (ESPs) by changing the mono-phasic or bi-phasic of ESP, On/Off duration of ESP, the interval between ESP, and amplitude of ESP. PMES hardware was composed of Host PC, Stimulation Pattern Editing Program (SPEP), and Multi-channel Electrical Stimulator (MES). Experiments were performed using MAE and PMES as the following. First experiment was performed to evaluate the function for each channel of Sub- Micro Controller Unit (SMCU) in MES. Second experiment was conducted on whether ESP applied from each channel of SMCU in PMES was focused to the electrode set to the ground, after applying ESP being output from each channel of SMCU in PMES to MAE.

• The Korean Journal of Pain
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• 제8권2호
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• pp.272-278
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• 1995

Headache is a common disease of the general population. But the main problem in any study of headache has been that of defining the disease entities. In 1988, the Headache Classification committee of the International Headache Society introduced operational diagnostic criteria for all headache disorders into 13 major group; migraine, tension-type headache, cluster headache and chronic paroxysmal hemicrania etc. Sjaastad was the first to describe "cervicogenic headache", one of various head pain syndromes that probably originate in the cervical spine. Between March 1995 and June 1995, we studied 78 out-patients of the Department of Neuro pain clinic, Sanggye Paik Hospital, Inje university. We divided the patients into three study group: Fifty-three patients with tension-type headache, 13 with cervicogenic headache, and 12 with migraine headache. The reponse of trigger point injection and $C_2$-ganglion block in patients was investigated. We paid particular attention to the response of trigger point injection in patients of the three group. The effect of trigger point injection was more marked in tension-type headache group than in the other categories. The pain reduction after $C_2$-ganglion block was more marked in cervicogenic headache group than in the others.

• 대한정형외과스포츠의학회지
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• 제1권2호
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• pp.115-117
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• 2002

목적: 척추에통증을유발하는주된원인인근육질(Muscle Quality)의저하를향상시키는데있어서비교적안정적인방법(약물혹은수술이아닌요법)을시행하여치료중조직손상과부작용을최소화하면서신속한치료가이루어지는치료방법을찾는데주안점을두었다. 대상및방법: 임상실험기간은6주이었으며대상은평균연령34세(17 $\~$ 42세), 남녀30명,발병된지1년이상지난만성요통환자로서, 치료방법은근육마사지요법과운동요법을선택하였다.1군은근육마사지요법만을시행하였고, 2군은운동요법만을시행하였으며, 3군은근육마사지요법과운동요법을동시에병행하였다. 결과: 유연성측정결과와InBody 3.0에서의체성분결과를토대로분석한결과근육마사지요법만을시행한1군은즉각적인호전현상은보였으나시간경과후6일안으로다시이전의증상이원상복귀되어증상이개선되었다고보기는어려워보였다.한편운동요법만을시행한2군은연령에따른개인차는있었고6주안에만족할만한개선결과를보이지는않았지만증상개선이서서히이루어지고있었다. 그러나근육마사지요법과운동요법을병행한3군은1군과2군의실험결과와2단계이상의통증지수향상이관찰되었다. 결론: 요통의주된원인이되는근육질(Muscle Quality)의향상은근육질에긍정적인영향을주는모든요법중어느한가지를사용하는것보다는보다다각적인치료방법을개발하여적용시킬필요성이있다고사료된다.