• Title/Summary/Keyword: Chronic lower pain

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Clinical and Electromyographic Study of the Effects of Ultrasonic Wave and Microwave Diathermy Treatment on the Craniomandibular Disorder Patients (두개하악장애 환자에 대한 초음파와 극초단파 심부투열치료 효과의 임상 및 근전도학적 연구)

  • Hye-Jin Lee;Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.16 no.1
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    • pp.103-111
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    • 1991
  • This study was performed to observe the effect of micro-wave diathermy and ultrasonic-wave diathermy on the craniomandibular disorder patients. 19 patients were classified into 12 acute and 7 chronic groups according to the duration of 6 months. They were treated with micro-wave diathermy and ultrasonic-wave diathermy for 2 weeks and pain, maximum comfortable opening, active range of motion were checked before and after therapy. Electromyographic activities of temporal and masseter muscles were also measured at physiologic rest position, clenching and mastication before and after therapy. The obtained results were as follows : 1. After treatment, pain were reduced and active range of motion and maximum comfortable opening were increased. 2. Temporoal and masseter muscle activities of post-treatment in rest position, clenching and mastication were lower than those of pre-treatment. 3. In rest position, temporal and masseter muscle activities of pre-treatment on affected sides were higher than those on unaffected sides, but there were no differences in muscle activities between affected ad unaffected sides on clenching and mastication in pre and post-treatment respectively. 4. There were no significant differences in active range of motion, pain and maximum comfortable opening between acute and chronic groups in pre and post-treatment but there were significant differences between pre-treatment and post-treatment in acute and chronic groups respectively. 5. Muscle activities of masseter and temporal muscles in acute and chronic patients were reduced in rest position after treatment.

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Newly Developed Urinary Retention and Motor Weakness of Lower Extremities in a Postherpetic Neuralgia Patient

  • Lee, Mi Hyun;Song, Jang Ho;Lee, Doo Ik;Ahn, Hyun Soo;Park, Ji Woong;Cha, Young Deog
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.76-79
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    • 2013
  • During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.

Anti-allodynic Efficacy of NMDA Antagonist Peptide and Noradrenaline Alone and in Combination in Rodent Neuropathic Pain Model

  • Nasirinezhad, Farinaz;Hosseini, Marjan;Salari, Sajad
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.96-104
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    • 2015
  • Background: The present experiment was conducted to identify the cooperative effect of serine histogranin (SHG) and noradrenaline in alleviating peripheral neuropathic pain. Methods: Chronic constriction injury of the right sciatic nerve was used to induce chronic neuropathic pain. For drug delivery, a PE10 tube was inserted into the subarachnoid space. Acetone drops and a $44^{\circ}C$ water bath were used to evaluate the cold and heat allodynia, respectively. Placing and grasping reflexes were used to assess the locomotor system. Results: SHG at 0.5 and $1{\mu}g$significantly (P < 0.05) decreased the thermal allodynia. The cold allodynia was also significantly reduced by intrathecal injections of 0.5 (P < 0.05) and $1{\mu}g$(P < 0.001) of SHG. $1{\mu}g$of noradrenaline, but not $0.5{\mu}g$, significantly alleviated the cold (P < 0.01) and thermal (P < 0.05) allodynia. The ameliorating effect of noradrenaline or SHG disappeared when the two compounds were administrated in equal concentrations. A significant difference (P < 0.01 in the acetone and P < 0.05 in the heat) was observed in the groups under equal doses of the two compounds, with a lower effectiveness of the combination therapy. Conclusions: Our findings suggest that the simultaneous administrations of noradrenaline and SHG do not result in synergistic analgesia, and combination therapy may not be a good approach to the treatment of chronic neuropathic pain syndrome.

Transcranial direct current stimulation for spinal cord injury-associated neuropathic pain

  • Li, Caixia;Jirachaipitak, Sukunya;Wrigley, Paul;Xu, Hua;Euasobhon, Pramote
    • The Korean Journal of Pain
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    • v.34 no.2
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    • pp.156-164
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    • 2021
  • Several types of pain occur following spinal cord injury (SCI); however, neuropathic pain (NP) is one of the most intractable. Invasive and non-invasive brain stimulation techniques have been studied in clinical trials to treat chronic NP following SCI. The evidence for invasive stimulation including motor cortex and deep brain stimulation via the use of implanted electrodes to reduce SCI-related NP remains limited, due to the small scale of existing studies. The lower risk of complications associated with non-invasive stimulation, including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), provide potentially attractive alternative central neuromodulation techniques. Compared to rTMS, tDCS is technically easier to apply, more affordable, available, and potentially feasible for home use. Accordingly, several new studies have investigated the efficacy of tDCS to treat NP after SCI. In this review, articles relating to the mechanisms, clinical efficacy and safety of tDCS on SCI-related NP were searched from inception to December 2019. Six clinical trials, including five randomized placebo-controlled trials and one prospective controlled trial, were included for evidence specific to the efficacy of tDCS for treating SCI-related NP. The mechanisms of action of tDCS are complex and not fully understood. Several factors including stimulation parameters and individual patient characteristics may affect the efficacy of tDCS intervention. Current evidence to support the efficacy of utilizing tDCS for relieving chronic NP after SCI remains limited. Further strong evidence is needed to confirm the efficacy of tDCS intervention for treating SCI-related NP.

Adductor canal block versus intra-articular steroid and lidocaine injection for knee osteoarthritis: a randomized controlled study

  • Ming, Lee Hwee;Chin, Chan Soo;Yang, Chung Tze;Suhaimi, Anwar
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.191-201
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    • 2022
  • Background: This study aimed to assess the efficacy of the adductor canal block (ACB) in comparison to intra-articular steroid-lidocaine injection (IASLI) to control chronic knee osteoarthritis (KOA) pain. Methods: A randomized, single-blinded trial in an outpatient rehabilitation clinic recruiting chronic KOA with pain ≥ 6 months over one year. Following randomization, subjects received either a single ACB or IASLI under ultrasound guidance. Numerical rating scale (NRS) scores for pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were recorded at baseline, 1 hour, 1 month, and 3 months postinjection. Results: Sixty-six knees were recruited; 2 were lost to follow-up. Age was normally distributed (P = 0.463), with more female subjects in both arms (P = 0.564). NRS scores improved significantly for both arms at 1 hour, with better pain scores for the IASLI arm (P = 0.416) at 1st month and ACB arm at 3rd month (P = 0.077) with larger effect size (Cohen's d = 1.085). Lower limb function improved significantly in the IASLI arm at 1 month; the ACB subjects showed greater functional improvement at 3 months (Cohen's d = 0.3, P = 0.346). Quality of life (QoL) improvement mirrored the functional scores whereby the IASLI group fared better at the 1st month (P = 0.071) but at the 3rd month the ACB group scored better (Cohen's d = 0.08, P = 0.710). Conclusions: ACB provides longer lasting analgesia which improves function and QoL in chronic KOA patients up to 3 months without any significant side effects.

The Effects of Trunk Stability Exercise on Functional Movement, Dynamic Balance Ability and Trunk Stability in Patients with Chronic Back Pain (체간 안정성 운동이 만성 요통 환자의 기능적 움직임과 동적 균형능력 및 체간 안정성에 미치는 영향)

  • Jung, Jooyeon;Kim, Taegyu;Kim, Sooyong
    • Journal of the Korea Convergence Society
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    • v.11 no.3
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    • pp.245-252
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    • 2020
  • The present study aimed to identify the effects of the trunk stability exercise on functional movement, dynamic balance, and trunk stability in patients with chronic low back pain, and to compare the difference among yoga exercise, pilates exercise and core exercise. Forty-three patients with chronic low back pain were divided into three groups; 15 yoga groups, 15 pilates groups, and 13 core exercise groups. All subjects were tested the Functional movement, dynamic balance, and trunk stability using Functional Movement Screen (FMS), Lower Quater Y-Balance Test (YBT-LQ) and Trunk Stability Test (TST), respectively, and after each 8-week exercise program was applied, all variables were retested. After exercising during 8 weeks, FMS, YBT-LQ and TST scores of all three groups were significantly improved, compared to before, but there were no interaction effect among three groups depending on application of exercise program. These results showed that yoga, pilates and core exercise help to improve functional movement, dynamic balance and trunk stability in adults with chronic low back pain.

Change to Pain's Level of Chronic Back pain patient With Hamstring Shortening in 27year's old After Application to Active Therapeutic Movement (ATM) and Sling Exercise-Case study (슬괵근 단축이 있는 27세 남자 만성요통환자의 ATM, 슬링운동치료 적용 후 통증수준의 변화-사례연구)

  • Yu, Woung-Sik;Jeon, Cha-Sun;Won, Sang-Hee
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.64-71
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    • 2009
  • Purpose: to purpose prevent to dysfunction and decrease to pain level use to active therapeutic movement and sling manual, stability exercise in shortening hamstring chronic back patient. Methods: The patient's complain was Buttock and Lower Back Pain due to dysfunction posture work. The subject's initial Pain Scale was 60 of 100(VAS). The Subject Treatment to Sling Mobility exercise, Home exercise, ATM, Sling Stability exercise, sensory motor training During 8weeks for 18 times. Results: The result was Visual Analog Scale(VAS)was decreased 10 of 100 after treatment. Conclusion: Visual Analog Scale(VAS)was decreased 10 of 100 after treatment. Functional Leg Length Was recover to same level. Trunk Flexibility was increase to 18cm. Active Knee Extension ankle was decrease to $15^{\circ}$ limit range of motion due to Lt. Hamstring Shortening limit range of motion $30^{\circ}$. GPS(Gobal Postural System)test was recover to same level. This case study need to sufficient data and times.

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Effect of the Preoperative Intercostal Nerve Block in a Rat Model of Postthoracotomy Pain (흉강절제술 후 통증모델에서 수술 전 늑간신경차단의 효과)

  • Park, Chul Ho;Kim, Doo Hwan;Lee, Jae Do;Kim, Joung Uk;Leem, Jeong Gill;Lee, Cheong;Shin, Jin Woo
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.106-111
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    • 2008
  • Background: Chronic pain after thoracotomy has been recently reproduced in a rat model that allows investigating the effect of potentially beneficial drugs that might reduce the incidence of allodynia or alleviate pain. Local anesthetics produce antinociception in normal animals and alleviate mechanical allodynia in animals with nerve injury although their mechanisms of action may differ in these situations. Our purpose of this study was to test whether the preoperative intercostal nerve block of bupivacaine could prevent the development of allodynia in a rat model of chronic postthoracotomy pain. Methods: All male Sprague-Dawley rats were anesthetized and the right 4th and 5th ribs were exposed surgically. The pleura were opened between the ribs to which a retractor was placed and was opened 10 mm in width. Retraction was maintained for one hour. Total 1 mg of 0.5% bupivacaine was injected at the intercostal nerves before (n = 17) or after (n = 16) surgery. A control group (n = 25) that underwent rib retraction did not receive any drug. Rats were tested for mechanical allodynia using calibrated von Frey filaments applied around the incision site during the three weeks following surgery. Results: The incidence of development of mechanical allodynia in the group that received intercostal injection with bupivacaine before surgery was significantly lower than that in the control group (P < 0.05). Conclusions: Preoperative intercostal nerves block around the surgical incision before thoracotomy may decrease the incidence of postthoracotomy pain syndrome.

The Effect of the Lumbar Segmental Mobilization Technique on Chronic Low Back Pain Patients' the Characteristics of the Muscles, and Limited of Stability (허리의 분절적 가동기법이 만성 허리통증 환자의 근육 특성과 안정성 한계에 미치는 영향)

  • Yang, Daejung;Uhm, Yohan
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.191-202
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    • 2020
  • Purpose : The purpose of this study is to examine the effect of the segmental mobilization technique of the lower back on the characteristics of the muscles and limited of stability of chronic backache patients. Methods : The subjects of the study were 30 chronic back pain patients who were divided into groups of 15, a manual therapy group (Group I) and a spinal decompression therapy group (Group II), via random assignation. The subjects had 15 minutes of superficial heat therapy, 15 minutes of interference wave therapy, and 5 minutes of ultrasound therapy for conservative physical therapy. Additionally, manual therapy and spinal decompression therapy were administered to each group for 30 minutes, 5 times a week for 8 weeks. Before intervention, the characteristics of the muscles and limited of stability of the muscles were analyzed. After 8 weeks of intervention, the above items were re-measured in the same manner and analyzed between groups. Results : The results of comparative analysis of the characteristics of the muscles and limited of stability between groups showed that there were statistically significant differences. The manual therapy group (Group I) showed significant differences in characteristics of the muscles compared to the spinal decompression therapy group (Group II). The manual therapy group (Group I) showed significant differences in limited of stability compared to the spinal decompression therapy group (Group II). Conclusion : The result confirmed that manual therapy was more effective in the characteristics of the muscles and limited of stability. Based on this study, additional studies are necessary on the effect of various techniques of manual therapy on muscle activity and muscle thickness in chronic back pain patients. In order to develop an effective manual therapy program, studies using a variety of evaluations are needed.

Impact of general anesthesia type on chronic postsurgical pain following video-assisted thoracoscopic surgery for lung cancer: a retrospective propensity-matched cohort study

  • Soo-Hyuk Yoon;Seungeun Choi;Susie Yoon;Kwon Joong Na;Jaehyon Bahk;Ho-Jin Lee
    • The Korean Journal of Pain
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    • v.37 no.4
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    • pp.354-366
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    • 2024
  • Background: Anesthetic agents are potential modifiable factors that can mitigate chronic postsurgical pain (CPSP) development. This study aimed to investigate the association between propofol-based total intravenous anesthesia (TIVA) and the occurrence of CPSP following video-assisted thoracoscopic surgery (VATS) for lung cancer resection. Methods: This single-center retrospective cohort study included adult patients with lung cancer who underwent elective VATS between January 2018 and December 2022. Patients were divided based on the maintenance anesthetic used (propofol vs. sevoflurane). The primary outcome was the presence of CPSP, defined as any level of surgical site pain recorded within 3-6 months postoperatively. The authors investigated the association between anesthetic agents and CPSP using propensity score matching with stabilized inverse probability of treatment weighting (sIPTW) to adjust for confounders. Additionally, multivariable logistic regression was used to further adjust for intraoperative opioid use that sIPTW could not account for. The robustness of these associations was evaluated using the E-value. Results: Of the 833 patients analyzed, 461 received propofol and 372 sevoflurane. The overall incidence of CPSP was 43.3%. After sIPTW, the use of TIVA was significantly associated with a lower incidence of CPSP (odds ratio [OR]: 0.75, 95% confidence interval [CI]: 0.57-0.99, P = 0.041), and remained significant after adjusting for intraoperative remifentanil equivalent dose (OR: 0.73, 95% CI: 0.55-0.96, P = 0.026). The E-values were 1.08 and 1.17, respectively. Conclusions: Propofol-based TIVA is associated with reduced CPSP occurrence in VATS for lung cancer. Further prospective studies are needed to confirm the results.