• Title/Summary/Keyword: Complex pain

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Concurrence of Malignant Peripheral Nerve Sheath Tumor at the Site of Complex Regional Pain Syndrome Type 1 - A Case Report -

  • Jeong, Yeong Ho;Choi, Eun Joo;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.160-163
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    • 2013
  • Malignant peripheral nerve sheath tumors (MPNSTs) are very rare sarcomas derived from various cells in the peripheral nerve sheath. Malignant peripheral nerve sheath tumors have a known association with neurofibromatosis type 1. Diagnosis of MPNSTs is difficult in patients with chronic pain, when MPNST occurs at an overlapping area of chronic pain. Therefore, the diagnosis can be missed unless clinicians pay attention to the possibility of this disease. Here in, we report a case of concurrent malignant peripheral nerve sheath tumor with complex regional pain syndrome type 1. A 44-year female patient, who was diagnosed with complex regional pain syndrome (CRPS) type 1 in her left ankle, visited our clinic because of aggravated pain. The cause of the aggravated pain was revealed as concurrent MPNST in the left common peroneal nerve territory, which overlapped the site of pain from CRPS.

Clinical Experience of a Complex Regional Pain Syndrome Type II Patient -A case report- (복합부위통증 증후군 II형(CRPS Type II) 환자의 치험 -증례 보고-)

  • Yoon, Keon-Jung;Kim, Jong-Lul
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.426-429
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    • 1996
  • Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

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A Case Report on the Effect of Peripheral Body Temperature Increase and Pain Relief in a Patient with Complex Regional Pain Syndrome Type 1 Improved by Buja-tang and Aconitum ciliare Decaisne Pharmacopuncture (부자탕과 초오약침을 병행한 한방복합치료로 호전된 복합부위통증 증후군 제1형 환자의 말초체온 상승 및 통증 경감 효과에 관한 증례 보고)

  • Lee, Jung Min;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.189-196
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    • 2022
  • The aim of this study was to investigate the effect of complex Korean medicine treatment especially Buja-tang and Aconitum ciliare decaisne pharmacopuncture on patients with type 1 complex regional pain syndrome caused after a traffic accident. The patients was treated with Buja-tang, Aconitum ciliare decaisne pharmacupuncture, acupuncture and physical therapy during 20 days of hospitalization. Numerical rating scale (NRS), short form McGill pain questionnaire (SF-MPQ), body temperature measurement of the foot, manual muscle test (MMT) were used for assessment. After treatments, NRS of burning pain in the left ankle decreased from 8 to 4-5 and NRS of burning pain in the right ankle decreased from 7 to 4-5. Also, SF-MPQ results, foot temperature measurement and MMT showed improvement during hospitalization. This study shows that complex Korean medicine treatment especially Buja-tang and Aconitum ciliare decaisne pharmacopuncture are effective in alleviating symptoms in patients with type 1 complex regional pain syndrome.

Caudal Neuromodulation with the Transforaminal Sacral Electrode (InterStim): Experience in a Pain Center Regarding 12 Implants

  • Guardo, Laura Alonso;Gala, Carlos Cano;Poveda, David Sanchez;Juan, Pablo Rueda;Sanchez Montero, Francisco Jose;Garzon Sanchez, Jose Carlos;Lamas, Juan Ignacio Santos;Sanchez Hernandez, Miguel Vicente
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.23-28
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    • 2016
  • Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

The Effect of Epidural Ketamine in Complex Regional Pain Syndrome Occuring after Lumbar Epidural Block -A case report- (요부경막외차단술 후 발생한 복합부위 통증증후군에서의 경막외 Ketamine의 효과 -증례 보고-)

  • Ock, Kyung-Jong;Han, Kyung-Rim;Kim, Jin-Soo;Kim, Chan;Kim, Eun-Young
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.251-254
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    • 2000
  • A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

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The Effect of Exercise Program on pain of Patients with Chronic Low Back Pain (운동프로그램이 만성요통 환자의 통증에 미치는 효과)

  • Jang Chel;Lee Geon-Cheol;Chung Hyun-sung
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.80-89
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    • 2004
  • To investigated the effect of the exercise program in patients with chronic low back pain, 40 patients paticipated in this experiment, who were applied for the simple exercise program and the complex exercise program respectively. The interval change of?pain?from pre-test and post-test over 7 weeks and the difference between two experimental groups are the follows : 1) There was statistically significant differences at comparison with pain in simple exercise group during weeks except first week(p<.05). 2) In complex exercise group, there was statistically significant differences at comparison with pain during each week. (p<.05) 3) There was not significant difference between simple exercise group and complex exercise group in pain by exercise period. 4) There was more significant change in complex exercise group than simple exercise group. but there was not statically significant differences between them.

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Management of Complex Regional Pain Syndrome Type 1 with Barbiturate Coma Therapy -A case report- (Barbiturate 혼수 요법(Coma Therapy)을 이용한 제1형 복합부위통증증후군 치험 -증례보고-)

  • Park, Tae Kyu;Han, Kyung Ream;Shin, Dong Wook;Lee, Young Joo;Kim, Chan
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.213-217
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    • 2006
  • Although various treatments for complex regional pain syndrome (CRPS) have been proposed, no well recognized treatment for CRPS has been established. Herein, a case using barbiturate coma therapy for the refractory pain management of a 24-year-old male patient, who suffered from constant stabbing and burning pain, with severe touch allodynia in the left upper extremity following blunt trauma on his forearm is described. Interventional treatments, including permanent spinal cord stimulation and large doses of oral medications, were performed. However, the pain could not be controlled, which lead to frequent emergency room treatment for about 1 month prior to his therapy. He then underwent barbiturate coma therapy due to the uncontrollable pain, with repeated sedation therapy due to his outrageous behavior. His pain became increasingly tolerable and the allodynia was markedly decreased after 5 days of coma therapy.

A Review of Research on the Effects of Acupuncture and Moxibustion Treatment to Complex Regional Pain Syndromes (복합부위통증증후군의 침구치료 효과에 대한 연구동향 고찰)

  • Kim, Ho Sun;Bae, Young Hyun;Kim, Hae Sol;Suh, Chang Yong;Kim, No Hyeon;Yang, Kyu Jin;Lee, Gi Bum
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.137-148
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    • 2016
  • Objectives : This study was performed to review articles concerning acupuncture or moxibustion treatment for Complex Regional Pain Syndromes. Methods : On-line databases including PubMed, Cochrane Library, Ovid-EMBASE, NDSL and OASIS were searched to find articles concerning acupuncture or moxibustion treatment for Complex Regional Pain Syndromes. Several overlapping articles and those not relevant to the topic were excluded, as well as review articles and commentaries. Results : 16 case reports were selected through the procedure, all of which presented successful treatment cases of Complex Regional Pain Syndromes with acupuncture and moxibustion. Most of them presented one single patient case and were published in Korea. However, almost half of them were printed in English, and had been continuously published since 2005. It was remarkable that pharmacopuncture was predominantly used to treat Complex Regional Pain Syndromes. Also, we noted that Chinese scalp acupuncture needs to be studied further as two successful cases were presented from the U.S army. Conclusion : The results show that several case reports have been published regarding Complex Regional Pain Syndromes treated with acupuncture and moxibustion. However, all of them were case reports which are given low status in Evidence-Based Medicine. We expect that a more diverse range of articles, including case control studies, cohort studies and randomized controlled trials will be performed in the near future, and that a unified outcome measure will be developed for Complex Regional Pain Syndromes.

Reduction in mechanical allodynia in complex regional pain syndrome patients with ultrasound-guided pulsed radiofrequency treatment of the superficial peroneal nerve

  • Chae, Won Soek;Kim, Sang Hyun;Cho, Sung Hwan;Lee, Joon Ho;Lee, Mi Sun
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.266-269
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    • 2016
  • The superficial peroneal nerve is vulnerable to damage from ankle sprain injuries and fractures as well as surgery to this region. And it is also one of the most commonly involved nerves in complex regional pain syndrome type II in the foot and ankle region. We report two cases of ultrasound-guided pulsed radiofrequency treatment of superficial peroneal nerve for reduction of allodynia in CRPS patients.

The clinical observation of 1 case of the Complex Regional Pain Syndrome (소염약침으로 치료한 복합부위통증증후군(CRPS) type I 환자 1례 증례보고)

  • Lee, Eun-Jung;Yoon, Il-Ji
    • Journal of Haehwa Medicine
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    • v.18 no.1
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    • pp.109-116
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    • 2009
  • Objective: The objective of this study is to observe the effect of anti-inflammatory herbal acupuncture on the Complex Regional Pain Syndrome Methods : Anti-inflammatory herbal acupuncture, A-Shi Point, Sa-am acupunture were used to treat shoulder pain & ROM(range of movement)disorder, chest pain, finger's causalgic pain. We evaluated the patient through VAS(Visual Analog Scale) daily and Physical Examinations Results & Conclusions : After 42days of treatment, shoulder pain was decreased from VAS10 to VAS3, chest pain was decreased from VAS10 to VAS1.5, finger's causalgic pain was decreased from VAS10 to VAS2.5. and the patient showed that the ROM(range of movement) of shoulder was better, oriental treatment is good method for pain relief and better movement.

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