• Title/Summary/Keyword: Complex pain

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A Feature of Producing the Symptom Complex Related to Pain and Discomfort by the Experimental Isometric Unilateral Canine Biting in Adult Females within Normal Masticatory Function (정상 성인 여성에 있어 실험적 견치부 등척성편측교합에 의한 동통성 증상 발현 현상)

  • Lee, Jeong Yeon;Shin, Geum Baek
    • Journal of Oral Medicine and Pain
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    • v.12 no.1
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    • pp.53-61
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    • 1987
  • In order to evaluate the effect of unilateral tooth clenching, the author observed a feature of producing the symptom complex related to pain and discomfort by the isometric unilateral canine biting under force of 5kg(FS) in Korean 31 adult females within normal masticatory function who were divided into the bilateral, the right and the left group according to their habitual sides of mastication, and analyzed the observed data statistically. The obtained results were as follows: 1. The duration of the isometric unilateral canine biting maintained before the occurrence of symptom complex related to pain and discomfort 66.72 seconds at right side and 39.50 seconds at left side in a group of subjects with bilateral habitual mastication. And the difference of the duration between of unilateral biting side was almost significant (P<0.05). 2. The most frequent region of occurrence of symptom complex related to pain and discomfort by the isometric unilateral canine biting was the contralateral superficial masseter muscle in a group of subjects with bilateral habitual mastication.

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Do Severity Score and Skin Temperature Asymmetry Correlate with the Subjective Pain Score in the Patients with Complex Regional Pain Syndrome?

  • Jeon, Seung Gyu;Choi, Eun Joo;Lee, Pyung Bok;Lee, Young Jae;Kim, Min Soo;Seo, Joung Hwa;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.339-344
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    • 2014
  • Background: The diagnostic criteria of complex regional pain syndrome (CRPS) have mainly focused on dichotomous (yes/no) categorization, which makes it difficult to compare the inter-patient's condition and to evaluate the intra-patient's subtle severity over the course of time. To overcome this limitation, many efforts have been made to create laboratory methods or scoring systems to reflect the severity of CRPS; measurement of the skin temperature asymmetry is one of the former, and the CRPS severity score (CSS) is one of the latter. However, there has been no study on the correlations among the CSS, temperature asymmetry and subjective pain score. The purpose of this study was to evaluate whether there is any correlation between the CSS, skin temperature asymmetry and subjective pain score. Methods: Patients affected with CRPS in a unilateral limb were included in this study. After making a diagnosis of CRPS according to the Budapest criteria, the CSS and skin temperature difference between the affected and unaffected limb (${\Delta}T$) was measured in each patient. Finally, we conducted a correlation analysis among the CSS, ${\Delta}T$ and visual analogue scale (VAS) score of the patients. Results: A total of 42 patients were included in this study. There was no significant correlation between the ${\Delta}T$ and VAS score (Spearman's rho = 0.066, P = 0.677). Also, the CSS and VAS score showed no significant correlation (Spearman's rho = 0.163, P = 0.303). Conclusions: The ${\Delta}T$ and CSS do not seem to reflect the degree of subjective pain in CRPS patients.

Perioperative Pain Management in the Patient with Complex Regional Pain Syndrome -A case report- (복합부위통증증후군 환자의 이환 부위 수술 전후의 통증관리 -증례보고-)

  • Jo, Ji Yon;Lee, Mi Geum;Lee, Hyo Min;Choi, Yun Suk;Yun, Hey Jeong;Lee, Chul Joong;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.218-222
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    • 2006
  • Complex regional pain syndrome (CRPS) is a syndrome of pain and sudomotor or vasomotor instabilities. The perioperative pain management in CRPS patients is very important, as surgery can aggravate preexisting symptoms, especially when performed around the lesion site. Despite the increasing interest in CRPS research, little is known about the optimal perioperative treatment strategy for CRPS patients. Herein, the case of a female CRPS patient, who underwent elective surgery at the lesion site, is reported. As a preemptive analgesia, the patient was satisfactorily managed with two weeks of patient-controlled epidural analgesia, initiated 2 days prior to surgery. The techniques for the prevention of perioperative pain, including preemptive analgesia, as well as its importance, are discussed.

The Effect of Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome (복합부위통증증후군 환자에서 척수자극술의 효능)

  • Kim, Won Young;Moon, Dong Eon;Choi, Jin Hwan;Park, Chong Min;Han, Seong Min;Kim, Shi Hyeon
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.152-158
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    • 2006
  • Background: Complex regional pain syndrome (CRPS) is a painful, disabling disorder for which no proven treatment has been established. The purpose of this investigation was to assess the evidence of the efficacy of spinal cord stimulation (SCS) in the management of pain in CRPS patients. Methods: Between March 2004 and June 2006, 11 patients with CRPS were treated with SCS. The visual analog scale (VAS) score for pain (0⁣-10) and pain disability index (PDI) were obtained in all patients prior to treatment, and 1, 3 and 6 months post-implantation. Results: All 11 patients, 5 men and 6 women, with a median age and duration of CRPS of 44 years and 48.8 months, respectively, successfully received a lead implantation for SCS. The mean VAS pain score prior to the treatment was 85.5 out of 100 mm. After SCS implantation, the mean VAS pain scores were 49.5, 57.0 and 56.0 at 1, 3 and 6 months after the procedure, respectively. The mean pain score for allodynia was decreased by 50%, with a significant reduction of the PDI also observed after the treatment. Conclusions: Our current study suggests that SCS implantation is a safe and effective method in the management of CRPS patients.

Implantable Intrathecal Drug Delivery Pump in Complex Regional Pain Syndrome Patient -A case report- (복합부위통증증후군 환자에게 시행한 매몰식 펌프를 이용한 지주막하강 내 약물투입 -증례보고-)

  • Seo, Kyung Soo;Han, Kyung Ream;Kim, Sae Young;Park, Kyeong Eon;Kim, Chan
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.74-77
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    • 2009
  • Implantable intrathecal pump is one of the therapeutic options for intractable pain. A 24-year-old male with complex regional pain syndrome was suffering from right lower extremity pain. He had all modalities of treatment including spinal cord stimulator. However, his pain had been worse in the past 6 months. His visual analogue pain scale (VAS) was 8-10 and he could not sit or walk. Only opioid was thought to be effective. Then, intrathecal pump was considered. We estimated the minimal effective dose of spinal morphine before implantation. 0.3 mg of morphine was injected intrathecally as a starting dose. Dosage had been increased up to 0.8 mg in 10 days. His VAS score decreased from 8 to 5. He could sleep without pain and walk with crutch. Therefore, intrathecal pump was inserted. He could tolerate to pain. This case suggests that intrathecal morphine delivery can provide effective treatment for intractable non-malignant pain.

Comparison of the Two Impairment Classes Publicized by the American Medical Association in Complex Regional Pain Syndrome Patients (복합부위통증증후군 환자에서 미국의사협회 영구장애평가지침에서 제시된 장애등급 평가방법의 비교)

  • Shin, Hwa Yong;Choi, Yong Min;Nahm, Francis Sahngun;Park, Seong Joo;Koo, Mi Suk;Suh, Jeong Hun;Sim, Sung Eun;Jo, Ji Yon;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.148-153
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    • 2007
  • Background: Complex regional pain syndrome (CRPS) is not regarded as an impairment in Korea. Guidelines for rating this impairment are under development by the Korean Academy of Medical Science based on that of the American Medical Association (AMA). However, no studies have been done on the validity of these guidelines in Korea. We therefore evaluated the validity of these guidelines using the criteria from the chapter on the central and peripheral nervous system (CNS-PNS class) and the worksheet for calculating total pain-related impairment score (TPRIS class). Methods: TPRIS and CNS-PNS classes were calculated through interviews of 28 CRPS patients. The correlation between the two classes was calculated. Results: TPRIS class and CNS-PNS class were well correlated (r = 0.593, P < 0.05). Conclusions: Both TPRIS or CNS-PNS classes were well correlated and could be used for evaluation of impairment. However, the CNS-PNS class is simpler and quicker to complete.

Cervical and Thoracic Spinal Cord Stimulation in a Patient with Pediatric Complex Regional Pain Syndrome -A case report- (소아 복합부위통증증후군 환자에서 경부와 흉부 척수 자극술 -증례보고-)

  • Park, Jung Ju;Moon, Dong Eon;Park, Seung Jae;Choi, Jung Il;Shim, Jae Chol
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.60-65
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    • 2007
  • Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

Successful removal of permanent spinal cord stimulators in patients with complex regional pain syndrome after complete relief of pain

  • Lee, Su Jung;Yoo, Yeong Min;You, Jun A;Shin, Sang Wook;Kim, Tae Kyun;Abdi, Salahadin;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.47-50
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    • 2019
  • Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.