• The Korean Journal of Pain
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• v.31 no.1
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• pp.3-9
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• 2018

Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation. Other substances, not used in the treatment of pain, such as proton pump inhibitors, antiemetics, and diuretics are also associated with long QT syndrome. When the possible benefits of therapy outweigh the associated risks, slow dose titration and electrocardiography monitoring are recommended.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.292-295
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• 2006

The diagnosis of chronic abdominal pain due to abdominal cutaneous nerve entrapment can be elusive. Tenderness in patients with abdominal pain is naturally assumed to be of either peritoneal or visceral origin. Studies have shown that some patients suffer from prolonged pain in the abdominal wall and are often misdiagnosed, even after unnecessary and expensive diagnostic tests, including potentially dangerous invasive procedures, and treated as having a visceral source for their complaints, even in the presence of negative X-ray findings and atypical symptoms. Abdominal cutaneous nerve entrapment syndrome is rarely diagnosed, which is possibly due to failure to recognize the condition rather than the lack of occurrence. The accepted treatment for abdominal cutaneous nerve entrapment syndrome is a local injection, with infiltration of anesthetic agents coupled with steroids. Careful history taking and physical examination, in conjunction with the use of trigger zone injections, can advocate the diagnosis of abdominal cutaneous nerve entrapment and preclude any unnecessary workup of these patients. Herein, 3 cases of abdominal cutaneous nerve entrapment syndrome, which were successfully treated with local anesthetics and steroid, are reported.

• The Korean Journal of Pain
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• v.31 no.4
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• pp.277-288
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• 2018

Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI). Results: Both groups had similar results with significant improvement (${\geq}50%$ pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.63-67
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• 2014

Background: Epiduroscopic laser neural decompression (ELND) has been performed as a treatment tool for chronic refractory low back pain and/or radicular pain. There are some studies about the usefulness of epiduroscopy for post lumbar surgery syndrome, however, few studies about the effectiveness of epiduroscopy for patients without back surgery. We compared the satisfaction of patients who underwent ELND for chronic low back pain and/or radicular pain after back surgery and for the same symptoms without surgery. Methods: We compared the degree of satisfaction of patients after ELND between who had underwent the lumbar spine surgery and who had not retrospectively by chart reviewing. We divided 39 patients who had received ELND into two groups, one is the group of patients who got the lumbar surgery (group 1), and the other is the group of patients who did not (group 2). Their medical records including age, sex, previous treatment, duration of illness, degree of symptom relief were investigated. We compared each items between two groups. Results: The number of patients in group 1 was 17, and group 2 was 22. In group 1, 16 patients (94.1%) showed more than 'Acceptable', and 19 patients (86.4%) showed more than 'Acceptable' in group 2. There is no significant differences statistically in percentage of patients who showed more than 'Acceptable' in the satisfaction after ELND between two groups. Conclusions: ELND provided satisfaction (more than 85%) for patients with chronic low back pain and/or leg pain regardless of previous back surgery history.

• The Korean Journal of Pain
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• v.23 no.2
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• pp.147-150
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• 2010

Background: Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measurements in patients with chronic low back pain or radiculopathy. Methods: ESR and hsCRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hsCRP and ESR were measured prior to lumbar epidural steroid injection. Results: The mean ESR was 18.8 mm/h and mean hsCRP was 1.1 mg/L. ESR had a correlation with age. Conclusions: A significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.

• Herbal Formula Science
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• v.15 no.2
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• pp.179-186
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• 2007

The irritable bowel syndrome(IBS) is the most common gastrointestinal disorder in clinical practice and is characterized by abdominal pain associated with a chronic disturbance of defecation. The subject is a-69-year-old man who has abdominal pain, chronic diarrhea. anorexia. general weakness and has been diagnosed as irritable bowel syndrome. We diagnosed this patient as the Gastrointestinal Phlegm(食痰) and prescribed Jengjengamiyijin-tang (Zhengchuanjiaweierchen-tang). In the result, we had improvement of his symptoms.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.800-809
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• 2008

Objective : Although chronic prostatitis/chronic pelvic pain syndrcme(CP/CPPS) is a common disease, there is no consensus on the etiology or pathology and treatment. This was a double-blinded, placebo-controlled, randomized clinical trial, investigating the therapeutic effects of the traditional Korean medicine, Bosingunyang-tang(BSGYT). Method : Participants who met US National Institutes of Health (NIH) consensus criteria for CP/CPPS were entered after applying inclusion/exclusion criteria. They were randomized to the BSGYT or placebo group. and treated three times a day for 6 weeks. NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) was used to estimate the clinical symptoms of CP/CPPS. Prostaglandin E2 and ${\beta}$-endorphin in prostatic fluid, collected by 2-glass pre-massage and post-massage test, were analyzed as factors associated with pain and inflammation. Result : The mean decrease in NIH-CPSI total score of the BSGYT group was 11.0 points, which is 5.7 points more than the placebo group. (Mann Whitney test P=0.038) Also the BSGYT group showed three times higher response rate than the placebo group in NIH-CPSI pain subscale score. (Fisher's exact test P=0.027) In those responders, prostaglandin E2 decreased significantly. (Wilcoxon's signed-ranks test P=0.037). No specific side effects were observed. Conclusion : After a 6-week treatment period, BSGYT improved clinical symptoms of CP/CPPS patients by decreasing PGE2 level in prostatic fluid.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.127-131
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• 2014

Skeletal muscles which are the largest part of human body may develop pain and dysfunction. The myofascial pain syndrome that has trigger points as a unique characteristic is a major cause of morbidity. Trigger points are focal, hyperirritable painful areas located in a taut band of skeletal muscle. They produce local area pain and a referred pattern pain and often accompany chronic joint dysfunction. Various modalities are used to inactivate trigger points in myofascial pain syndrome. Trigger-point injection has been shown to be one of the most effective treatment modality to provide prompt relief of symptoms. This review article presents general concept of myofascial pain syndrome and technique of trigger point injection.

• Journal of Acupuncture Research
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• v.39 no.1
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• pp.53-58
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• 2022

Fat pad syndrome is a knee joint condition/disease where acute or chronic inflammation occurs in the fat pad of the knee joint, and it is a cause of anterior knee pain. Fat pad syndrome usually occurs concurrently with other conditions/diseases to collectively cause anterior knee pain. No study to date has reported the treatment of anterior knee pain solely due to fat pad syndrome. Here, we report a case of fat pad syndrome of the knee joint as the sole cause of anterior knee pain in a 49-year-old woman who received integrated Korean medicine treatments (pharmacopuncture, acupuncture, herbal medicine, deep fascial meridian therapy, and chuna). Using patient-reported pain scale scores, the level of the patient's pain was relieved, and her mobility improved. Integrated Korean medicine treatments could be effective for patients who have fat pad syndrome of the knee joint.