• The Korean Journal of Pain
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• v.35 no.2
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• pp.209-223
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• 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes. This study aimed to investigate the impact of COVID-19 on patients with chronic pain. Methods: Patients with chronic pain from 23 university hospitals in South Korea participated in this study. The anonymous survey questionnaire consisted of 25 questions regarding the following: demographic data, diagnosis, hospital visit frequency, exercise duration, time outside, sleep duration, weight change, nervousness and anxiety, depression, interest or pleasure, fatigue, daily life difficulties, and self-harm thoughts. Depression severity was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was used to investigate the relationship between increased pain and patient factors. Results: A total of 914 patients completed the survey, 35.9% of whom had decreased their number of visits to the hospital, mostly due to COVID-19. The pain level of 200 patients has worsened since the COVID-19 outbreak, which was more prominent in complex regional pain syndrome (CRPS). Noticeable post-COVID-19 changes such as exercise duration, time spent outside, sleep patterns, mood, and weight affected patients with chronic pain. Depression severity was more significant in patients with CRPS. The total PHQ-9 average score of patients with CRPS was 15.5, corresponding to major depressive orders. The patients' decreased exercise duration, decreased sleep duration, and increased depression were significantly associated with increased pain. Conclusions: COVID-19 has caused several changes in patients with chronic pain. During the pandemic, decreased exercise and sleep duration and increased depression were associated with patients' increasing pain.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.327-335
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• 2022

Background: The pathophysiology of fibromyalgia (FM) involves many mechanisms including central nervous system sensitization theory, autonomic nervous system (ANS) dysfunction, and recently small fiber neuropathy. While the small fiber neuropathy itself can cause ANS dysfunction and neuropathic pain (NP), it is still unknown whether ANS problems have an association with severity of disease and NP in patients with FM. The aim of this study was to evaluate ANS dysfunction in FM patients and to explore possible associations of ANS dysfunction with disease severity and NP. Methods: Twenty-nine FM patients and 20 healthy controls were included in this cross-sectional study. Participants were tested using sympathetic skin responses (SSR) and R-R interval variation analyses for sympathetic and parasympathetic ANS dysfunction, respectively. Disease severity and somatic symptoms of patients with FM were evaluated using the ACR-2010 scales and Fibromyalgia Impact Questionnaire, and NP symptoms were evaluated using the Pain Detect Questionnaire and Douleur Neuropathique questionnaire. Results: FM patients were found to have ANS dysfunction characterized by increased sympathetic response and decreased parasympathetic response. SSR amplitudes were found to be correlated with a more severe disease. Although nonsignificant, NP severity tended to be associated with a decrease in sympathetic and parasympathetic activities. Conclusions: ANS dysfunction may play a role in the pathophysiology of FM. The trend of decreased ANS functions in FM patients exhibiting NP contradicts the notion that FM is a sympathetically maintained NP and may be explained with small fiber involvement.

• Physical Therapy Korea
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• v.23 no.1
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• pp.38-45
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• 2016

Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.224-231
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• 2000

Background: Currently, the number of patients visiting pain clinics is increasing with the augmented concerns of the patients about management of pain. We conducted this study in order to comprehend the characteristics of the patients visiting pain clinics and to find a method to further raises the public's awareness about pain treatment. Methods: We surveyed 497 new patients who had visited pain clinic of Kyungpook national university hospital from August 1998 to July 1999. We analysed these patients about their age, sex, chief complaint, duration of pain complaints, resident district, educational level and route of visiting pain clinic by use of questionnaire. Results: In age distribution, the largest proportion (29.8%) were in their 60's. Low back pain was the most common chief complaint (33.0%), the highest (43.7%) percentage of patients had complained of pain for over 6 months. Two thirds of the patients lived in urban area. Patients who were educated to only elementary school level made up the largest group with 35.3%. Referrals from former patients who had visited our pain clinic and had received treatment. Conclusions: As increasing patients who have pain complaints are related to social advanced age, it is prudent to consider the characteristics of age related pain complaints. And we have to guide the pain patients to have more earlier treatments using mass media because there is still insufficient general information about pain clinic and pain managements.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.288-303
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• 2021

Background: Complex regional pain syndrome (CRPS) is an intractable pain disease with various symptoms. Here, we investigated the disease status, work life, sleep problems, medical insurance, economic status, psychological problems, and quality of life (QOL) of CRPS patients. Methods: CRPS patients from 37 university hospitals in South Korea were surveyed. The survey questionnaire consisted of 24 questions on the following aspects of CRPS patients: sex, age, occupation, cause of injury, activities of daily living (ADL), pain severity, sleep disturbance, level of education, economic status, therapeutic effect, and suicidal ideation. Additionally, the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions, was used to identify the status of QOL. Results: A total of 251 patients completed the questionnaire. According to the survey, 54.2% patients could not perform ADL on their own. Over the previous week, the mean pain score was 7.15 ± 1.78 (out of a total of 10 points); 92.1% of patients had sleep disorders and 80.5% had suicidal ideation, with most patients suffering from psychological problems. The average for each domain of WHOQOL-BREF was as follows: 21.74 ± 14.77 for physical, 25.22 ± 17.66 for psychological, 32.02 ± 22.36 for social relationship, and 30.69 ± 15.83 for environmental (out of a total of 100 points each). Occupation, ADL, sleep time, therapeutic effect, and suicidal ideation were statistically correlated with multiple domains. Conclusions: Most patients had moderate to severe pain, economic problems, limitations of their ADL, sleep problems, psychological problems, and a low QOL score.

• Journal of Acupuncture Research
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• v.35 no.2
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• pp.81-87
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• 2018

Background: The purpose of the present study was to evaluate efficacy and patient satisfaction of acupuncture or Chuna therapy for back pain. Methods: Amongst all the patients with back pain who had been treated at Sun-cheon korean medicine hospital, Dong-shin university, only patients that had received either acupuncture or Chuna manual therapy between September 1 and October 31, 2017 were selected and their medical charts retrospectively analyzed. A questionnaire was used in the investigation that consisted of a numeric rating scale (NRS), the Oswestry low-back pain disability index (ODI), general, emotional, conversational, and technical satisfaction. The questionnaire was completed before treatment and at weekly intervals (approximately). Treatment efficacy was analyzed using the first and last questionnaires. The last questionnaire was also used to establish patient satisfaction. The data were analyzed using SPSS for Windows version 21.0. Results: The NRS, Current degree of pain (ODI-1), and total ODI were significantly decreased in both the acupuncture and Chuna groups. The differences in NRS, ODI-1, and total ODI changes between treatment groups were not significant. There were no statistically significant differences between the acupuncture and Chuna groups in terms of general, emotional, conversational, and technical satisfaction. Conclusion: Acupuncture treatment significantly reduces NRS and ODI in patients who have back pain without structural transformation, and Chuna therapy significantly reduces NRS and ODI-1 in patients who have back pain with structural transformation. These results indicate that further studies should be conducted in more patients and over a longer period.

• Clinical Pain
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• v.19 no.1
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• pp.16-22
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• 2020

Objective: Recent studies have shown that repetitive peripheral magnetic stimulation (rPMS) reduces pain in various conditions. This pilot study aimed to investigate the effects of rPMS depending on the pain characteristics. Method: Adult patients aged 19~85 years evaluated at our institution between September 1, 2017 and February 28, 2018 for subacute to chronic musculoskeletal pain equivalent to a numeric rating scale of 3 or higher for at least one month were enrolled. Pain scores as determined using a numeric rating scale at baseline and at the end of treatment were set as the primary outcome. Additionally, we classified the pain into nociceptive, intermediate, or neuropathic pain using the PainDETECT questionnaire and compared the responsiveness to rPMS according to the type of pain. Results: The average pain scores significantly decreased after the 2-week rPMS treatment in all enrolled subjects (p<0.001). There was no statistically significant difference in pain reduction between groups divided by PainDETECT questionnaire. Conclusion: This study suggests that rPMS could safely relieve various types of pain.

• Journal of Oral Medicine and Pain
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• v.13 no.1
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• pp.71-84
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• 1988

The author examined 206 temporomandibular disorders patients, who visited department of Oral Diagnosis and Oral Medicine in Seoul National University Hospital during the period from May 1st 1987 to April 30th 1988, clinically and radiologically and with prepared questionnaire. By clinical and radiological examination, the patients were divided into 2 groups(the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome: the patient with temporomandibular joint internal derangement only). The symptom severity index and contributing factors were examined with the questionnaire, and differences in 2 groups were studied. The conclusions are followings : 1. The symptom severity index presenting the severity of symptom was higher and the scope of symptom was wider in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction compared to the patients with temporomandibular joint internal derangement only. 2. Emotions, behaviors, cognitions, and social factors were more undesirable in the patients with temporomandibular joint internal derangement and myofacial pain dysfunction syndrome or with myofacial pain dysfunction syndrome than the patients with temporomandibular joint internal derangement only.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.1
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• pp.18-25
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• 2007

Objective: The Purpose of this study is the factive and descriptive research to identify the factors affecting the functional disability of the chronic low back pain patients. We investigated the effect of ODI by the Questionnaire and questioned an 70 patients who were back pain unit at G university hospital in D city from March to May, 2007. The functional disorder in this study were based on the Oswestry Disability Index(ODI) lower back pain disability questionnaire by fairbank(1980), and these data were proceeded by using SPSS/WIN version 10.0. Result: 1. The functional disorder in accordance with age, gender, academic background, occupation, diagnosis, pain cause, pain experience, treatment duration had no significantly similar difference statistically(p>0.05). 2. The functional disorder in accordance with duration of painful generation had statistically significance(P<0.05). Conclusion: we could verify that duration of painful generation affect on the factors affecting the functional disability of the low back pain patients.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.3
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• pp.61-74
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• 2010

Objectives : The purpose of this study is to find out the effects of flexion-distraction technique on low back pain. Methods : The 40 patients were divided into 2 groups: group a was treated except flexion-distraction technique and group B was treated with flexion-distraction technique. Both groups were treated with acupuncture treatment, physical therapy and manipulation. Patients were evaluated by McGill pain questionnaire-short form(SF-MPQ), visual analogue scale(VAS), Oswestry disability index(ODI) and pain disability index(PDI). Results : 1. Both Groups were significantly decreased in VAS and ODI after 3 weeks of treatment. 2. Group B compared with Group A was significantly decreased in SF-MPQ, VAS, ODI and PDI after 3 weeks of treatment. Conclusions : We found out that flexion-distraction technique is considered to be effective and useful on low back pain.