• Title/Summary/Keyword: Pain response

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Radiofrequency Facet Joint Denervation in the Treatment of Low Back Pain: Relationship with the Diagnostic Block (요부 후지낵측지 고주파 열응고술: 진단적 차단과의 연관성)

  • Shim, Jae-Chol;Seung, Ik-Sang
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.218-224
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    • 2001
  • Background: Response to diagnostic blocks does not consistently predict the outcome of interventional facet denervation. We investigated the relationship between pain relief by the percutaneous radiofrequency denervation of the lumbar zygapophysial joints with the result of facet joint diagnostic local anesthetic injection in patients with back pain originating from the lumbar zygapophysial joint. Methods: There were 35 patients enrolled, with ranging in age from 25 to 76 years ($52.6{\pm}12.7$ years, mean ${\pm}$ SD). We studied 7 men (20%) and 28 women (80%). All patients underwent double diagnostic block of $L_{3/4}$, $L_{4/5}$ and $L_5-S_1$ facet joint with 0.5% bupivacaine. The 35 patients fell into the following group. (1) Group A (n = 16): those who felt clear relief (pain free with Likert scale) from the double diagnostic block (2) Group B (n = 19): 11 patients who were always equivocal in their response to the double diagnostic block and 8 patients who were either pain free or equivocal in their response to the double diagnostic block. All 11 patients were done the facet joint denervation. The effect on the pain was evaluated with 4 point Likert scale 1, 6 and 12 weeks after the procedure. We evaluated the relationship between the pain response to diagnostic block and the pain relief with facet joint denervation. Results: Significant correlation was observed between the response to diagnostic block and pain relief with facet denervation (P < 0.05). We found no correlation between the categories of spinal operation and pain response to facet denervation (P value > 0.05). Conclusions: A satisfactory result of lumbar facet joint denervation can be obtained in many patients, especillay in patients whose pain were relieved by the diagnostic double facet joint block. It may be said that facet joint denervation for mechanical low back pain using radiofrequency thermocoagulation is a safe, easy, and repeatable technique.

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Effect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings

  • Choi, Ji Won;Lim, Hyung Woo;Lee, Jin Young;Lee, Won Il;Lee, Eun Kyung;Chang, Choo Hoon;Yang, Jae Young;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.96-102
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    • 2016
  • Background: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.

The Clinical Experiences of Laser Therapy of Patients with Pain (치료용 레이저를 이용한 통증치료 경험(II))

  • Chae, Ki-Young
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.142-146
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    • 1991
  • One hundred twenty patients with acute and chronic pain treated by a low power laser were divided into several groups by their pathology and evaluated according to their response rate to laser therapy through a follow-up study. 1) The ages of the patients were between the early twenties and late forties (71.7%), and there was no differences between sexes. 2) The spinal pathology group was the most common(52.5%) and the articular pathology group occupied next (14.2%). 3) The average duration of Laser therapy was about 20 days and response to the therapy appeared about the eighth day. 4) The response to the therapy in the spinal pathology group appeared about the eighth day and the average duration of therapy was about 18 days. 5) The response to the therapy in the articular pathology group appeared about the eighth day and the average duration of therapy was about 28 days. 6) The response rate of the spinal pathology group was 81.0%, and remarkable symptom relief was noted when compaired to a 58.7% response rate in the control group, 7) The response rate of the articular pathology group was 82.4%, which was similar to the control group. 8) The response rate of the miscellaneous group was 87.0%, and remarkable symptom relief was noted when compaired to a 66.7A response rate in the control group. 9) The mean response rate of all patients treated by a low power laser was 82.5% and that of the control group was 70.5%. Laser therary proved to be an effective treatment modality for acute and chronic pain.

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Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study

  • Kwon, Hyun-Jung;Jang, Kyunghwan;Leem, Jeong-Gil;Shin, Jin-Woo;Kim, Doo-Hwan;Choi, Seong-Soo
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.479-486
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    • 2021
  • Background: Prior studies have reported that 40%-90% of the patients with celiac plexus-mediated visceral pain benefit from the neurolytic celiac plexus block (NCPB), but the predictive factors of response to NCPB have not been evaluated extensively. This study aimed to identify the factors associated with the immediate analgesic effectiveness of NCPB in patients with intractable upper abdominal cancer-related pain. Methods: A retrospective review was performed of 513 patients who underwent NCPB for upper abdominal cancer-related pain. Response to the procedure was defined as (1) a decrease of ≥ 50% or ≥ 4 points on the numerical rating scale (NRS) in pain intensity from the baseline without an increase in opioid requirement, or (2) a decrease of ≥ 30% or ≥ 2 points on the NRS from the baseline with simultaneously reduced opioid consumption after NCPB. Logistic regression analysis was performed to determine the factors associated with successful responses to NCPB. Results: Among the 513 patients included in the analysis, 255 (49.8%) and 258 (50.2%) patients were in the non-responder and responder group after NCPB, respectively. Multivariable logistic regression analysis showed that diabetes (odds ratio [OR] = 0.644, P = 0.035), history of upper abdominal surgery (OR = 0.691, P = 0.040), and celiac metastasis (OR = 1.496, P = 0.039) were the independent factors associated with response to NCPB. Conclusions: Celiac plexus metastases, absence of diabetes, and absence of prior upper abdominal surgery may be independently associated with better response to NCPB for upper abdominal cancer-related pain.

Peripheral Intravenous Injection Pain in Hospitalized Children (입원 아동의 말초정맥 주사시 통증 반응)

  • Jeong, Jun Hee;Ahn, Hye Young
    • Perspectives in Nursing Science
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    • v.11 no.2
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    • pp.144-152
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    • 2014
  • Purpose: The purpose of the study is to offer necessary data to develop nursing interventions to reduce intravenous injection pain and uneasiness among hospitalized children. Methods: A total of 200 patients aged 1-72 months were selected. Pain during intravenous cannulation was assessed using the Procedural Behavior Checklist (PBCL) and the Faces Pain Rating Scale (FPRS). Data were analyzed by t-test and ANOVA using the SPSS/WIN 12.0. Results: Younger patients showed higher pain response than older patients (F=33.87, p<.001). Children with respiratory diseases showed higher responses in FPRS and PBCL than children without respiratory disease (F=4.17, p=.017; F=25.31, p<.001, respectively). Children of preschool age showed higher pain response during IV cannulation than the comparison group (t=2.04, p=.045). Children who had previous experiences with hospitalization and injections showed higher response to pain than those without these experiences (t=2.05, p=.045). In regards to FPRS, patients who were recannulated showed more painful restarts compared with patients injected just once (t=-3.60, p<.001). In regards to PBCL, infants and toddlers (t=-4.88, p<.001) and preschoolers (t=-3.86, p<.001) showed high pain scores during recannulation. Conclusion: A sick child's response to pain may be worse as they feel more pain over time. These characteristics should be considered for development of nursing interventions.

The Clinical Experiences with Laser Therapy in Pain Patients (치료용 레이저를 이용한 통증치료 경험)

  • Chae, Ki-Young;Kim, Hae-Kyu;Kim, Inn-Se
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.30-35
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    • 1989
  • Two hundred patients with acute and chronic pain were treated with a low power laser and 115 patients among them were divided into several groups by their pathology and evaluated their response rate to the laser therapy was evaluated through follow-up study. 1) The ages of patients were between the early twenties and late sixties, and there was no differences between sexes. 2) Degenerative spondylosis and chronic lumbar sprain were the most common diseases among those patients. 3) The average duration of therapy was about 16 days and response to the therapy appeared from the fourth day of laser therapy. 4) Acute lumbar sprain and acute spinal compression fracture showed rapid response to laser therapy. 5) The spinal pathology group was the most common at 37.5% of cases and the response rate to laser therapy was the lowest at 58.7%. 6) The articular pathology group occupied 24.6% and the response rate was the highest at 81.3%. 7). The response rate of the posttraumatic and postsurgical pathology group was 76.5%. 8) The response rate of the tendinous and sports pathology group was 75%. 9) The response rate of the miscellaneous group was 66.7%. 10) The mean response rate of all patients was 71.6%.

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Study on Effects of Combined Exercise for Fall-related Physical Fitness and Pain Response (낙상체력과 통증반응을 위한 복합운동의 효과에 관한 연구)

  • Kang, Hyun-Joo
    • Journal of Digital Convergence
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    • v.11 no.1
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    • pp.389-394
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    • 2013
  • The purpose of this study was to investigate the effects of combined exercise program on fall-related physical fitness and pain response in elderly people. Fall-related physical fitness consisted of the 7 performance test items by Senior Fitness Test Manual. Pain response was measured by visual analog scale (VAS sore: 0=no pain, 10=extremely unsatisfactory). The combined exercise program was performed for about one hour per day, 4 times a week over a period of 10 weeks. As the result of this study, flexibility, agility, and right balance were significantly increased. The various characteristics of pain were considerably improved on pain symptom, leg pain when walking, pain symptom when sitting, and pain symptom in daily living. In conclusion, there has been a substantial improvement in 10 weeks by combined exercise program.

A Study on the Response Differences to the Sasang Constitution Questionnaire by Sasang Constitutions in Adult Women with Menstrual Pain (월경통 환자를 대상으로 환자용 사상체질진단 설문지의 체질별 응답차이 연구)

  • Na, Young-Ju;Kang, Seok-Hwan;Kim, Jong-Won;Jeon, Soo-Hyung
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.4
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    • pp.330-337
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    • 2016
  • Objectives The purpose of this study was to investigate whether the menstrual pain affect the Sasang constitutions questionnaire response in adult women. Methods Using a structured menstrual history questionnaire, we evaluated the degree of menstrual pain of 550 adult women who participated in this clinical trial. Based on the survey we classified them into menstrual pain group and control group. They filled out SSCQ-P (Sasang Constitution Questionnaire for Patients) and we had compared the difference in response by Sasang constitutions. From 329 women in menstrual pain group and 212 women in control group, 541 questionnaire was analyzed statistically by their constitutions. Results 7 questions in Soyangin, 11 questions in Taeeumin and 20 questions in Soeumin were statistically significant in response between menstrual pain group and control group. Conclusions Soyangin's menstrual pain shows less influence on SSCQ-P than Taeeumin and Soeumin. Taeeumin who has Taeyangin's appearances and characteristics has more menstrual pain. In Soeumin, menstrual pain may result in negative and less expressive characteristics.

The Neuromodulation of Neuropathic Pain by Measuring Pain Response Rate and Pain Response Duration in Animal

  • Kim, Jinhyung;Lee, Sung Eun;Shin, Jaewoo;Jung, Hyun Ho;Kim, Sung June;Chang, Jin Woo
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.6-11
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    • 2015
  • Objective : Neuropathic pain causes patients feel indescribable pain. Deep Brain Stimulation (DBS) is one of the treatment methods in neuropathic pain but the action mechanism is still unclear. To study the effect and mechanism of analgesic effects from DBS in neuropathic pain and to enhance the analgesic effect of DBS, we stimulated the ventral posterolateral nucleus (VPL) in rats. Methods : To observe the effect from VPL stimulation, we established 3 groups : normal group (Normal group), neuropathic pain group (Pain group) and neuropathic pain+DBS group (DBS group). Rats in DBS group subjected to electrical stimulation and the target is VPL. Results : We observed the behavioral changes by DBS in VPL (VPL-DBS) on neuropathic pain rats. In our study, the pain score which is by conventional test method was effectively decreased. In specific, the time of showing withdrawal response from painful stimulation which is not used measuring method in our animal model was also decreased by DBS. Conclusion : The VPL is an effective target on pain modulation. Specifically we could demonstrate changes of pain response duration which is not used, and it was also significantly meaningful. We thought that this study would be helpful in understanding the relation between VPL-DBS and neuropathic pain.

Clinical Study on Immediate Response after Acupuncture on Local Acupoints and Distal Acupoints for Neck Pain Patients (경항통 환자에 대한 원위취혈 및 근위취혈의 침치료 직후 효과에 대한 비교 연구)

  • Lee, Hwi-Yong;Song, Beom-Yong;Yook, Tae-Han;Kang, Ji-Sook;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.183-192
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    • 2008
  • Objectives : The purpose of this study was to compare immediate response after acupuncture on Local Acupoints group and Distal Acupoints group for neck pain patients. Methods : From January 2nd 2008 to August 31th 2008, 10 neck pain patients were divided into 2 groups. One group(test I group) was taken Local Acupoints, and the other group(test II group) was taken Distal Acupoints. To check immediate response and satisfaction of needling, visual analog scale(VAS), range of motion(ROM), clinical evaluation grade and five-point likert scale were used before and after treatment. Results : Both acupuncture therapy showed immediate response and good effect on neck pain. And test I group showed more immediate response than test II group on all categories. Conclusions : Local Acupoints group can be recommended as an immediate and useful therapy to treat neck pain.

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