• Journal of Korean Medicine Rehabilitation
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• v.25 no.4
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• pp.105-112
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• 2015

Objectives To investigate clinical effects of needle embedding acupuncture treatments for chronic low back pain patients. Methods 30 patients with chronic low back pain were recruited and randomized into two groups-the embedding acupuncture group or the placebo. At baseline, the age, height, weight, visual analogue scale (VAS), Oswestry disability index (ODI) scores were measured. And surface electromyography (SEMG) data of both erector spinae at L2, L4 level were also measured on both groups and asymmetry index (AI) were calculated. The embedding or placebo acupuncture treatment was performed on the erector spinae according to SEMG values; immediately after the first evaluation and 48 hours after the first visit. After 96 hours of intervention, the VAS, ODI score and SEMG of both erector spinae were measured again. Statistical significance was determined using the Wilcoxon signed ranks test or the Wilcoxon rank sum test. Results The mean VAS, ODI score after treatment was decreased significantly compared with baseline on both groups. And the VAS, ODI score and AI of the embedding acupuncture group was more decreased significantly than the placebo (p<0.05). Conclusions The results suggest that embedding acupuncture for chronic low back pain patients was effective on the VAS pain score, ODI score and AI of the erector spinae.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1223-1230
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• 2020

Objective: The purpose of this study was to report the effectiveness of Korean medicine (Beewha-eum) on the treatment of non-cardiac chest pain (NCCP) in a patient with non-erosive reflux disease (NERD). Methods: The patient was diagnosed with a spleen-stomach weakness pattern identified by Korean medicine and was treated with herbal medicine (Beewha-eum). The severity of symptoms was assessed with a numerical rating scale (NRS) for chest pain, self-reported dyspepsia degree (%), Korean gastrointestinal symptom rating scale (KGSRS), gastrointestinal symptom score (GIS), and Functional Dyspepsia-Quality of Life(FD-QOL) score. Results: After Beewha-eum treatment, the severity of chest pain was decreased from NRS 8 to NRS 0 and the self-reported dyspepsia degree also decreased from 100% to 65%. The KGSRS score was decreased from 49 to 35, the GIS score was also decreased from 16 to 9, and the FD-QOL score was increased from 20 to 25. Conclusions: The study findings suggested that Korean medical treatment with Beewha-eum could be an effective option for treating NCCP in patients with NERD.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.138-142
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• 2007

Background: Depression is a frequent comorbid disease of chronic pain patients. This study was conducted to evaluate the prevalence of depression and to correlate associated factors and depression in patients with lumbar spinal stenosis. Methods: The data of this survey was collected from 97 patients that visited our pain clinic for the management of lumbar spinal stenosis. Depression was examined by a self-reported survey using the Korean version of the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) and the life satisfaction scale score were also obtained. Demographic and clinical characteristics (including spouse status, employment status, smoking status, the number of patients with multiple painful areas, the number of patients with combined disease, pain duration, visual analogue scale, Roland 5-point scale and walking distance) were obtained from an interview with the patient. The patients were divided into group N ($BDI{\leq}14$, n = 43) and group 0 (BDI > 14, n = 54) according to the BDI scale. Of the 97 patients, 55,7% had a high BDI score. Results: The patients in group N had a higher rate of employment (48.0%, P < 0.05) and had higher life satisfaction scale scores ($9.4{\pm}2.5$, P < 0.01) as compared to group D patients. The BDI score showed a close correlation with employment status and the life satisfaction scale. Conclusions: Many lumbar spinal stenosis patients had high BDI scores. Employment status and the life satisfaction scale were closely correlated with the BDI score.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.95-98
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• 2011

Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.183-191
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• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.151-158
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• 2022

Purpose: There is a strong correlation between trauma and pain. Pain increases the rate of depression, posttraumatic stress disorder, and even mortality in trauma patients. Methods: This institution-based, provider-blinded and patient-blinded, observational study was conducted among trauma patients treated at Tikur Anbessa Specialized Hospital. Over the course of 3 months, this study included patients who had no prior pain management at other hospitals before presentation, and who presented within 24 hours of the traumatic event. Results: Of the 74 patients evaluated, none of the patients had their pain level scored. The researcher-provided pain scale showed a severe subjective pain score for 79.7% of the patients and a severe functional activity score for 59.5% of the patients. Analgesia was provided at an average of 55.4 minutes after presentation and all patients received either diclofenac or tramadol. Satisfactory pain reduction after analgesia was 28.8% for patients initially complaining of severe pain, 54.6% for moderate pain, and 66.7% for mild pain, with the difference being statistically significant (P<0.05). Forty percent of patients discharged home received no analgesia after the first dose provided upon presentation. Conclusions: Pain scoring was nonexistent during the course of the study. The poor utilization rate of analgesia combination and opioids led to unsatisfactory pain outcomes in patients evaluated and followed for 24 hours after presentation.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.155-159
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• 1998

Epidural neurolysis with phenol has appeared in literature since 1960. Complications due to accidental subdural block is a rare and unexpected sensory and/or motor disturbance, but it does occur. A 74 years old woman had postherpectic neuralgia for 3 weeks and VAS score of 10. She was treated with intercostal nerve block and intravenous infusion of lidocaine for 7 days and VAS score decreased to 6. To proceed further, we decided to perform epidural neurolysis with 4% phenol 1.5 ml. During thoracic epidural catherization, we encountered unexpected subdural catheterization in subdurographic finding, but we could not precisely rule out subdural catheterization. We had to check CT for exact location of catheter tip. We then performed subdural neurolysis with phenol. This procedure reduced VAS score to between 3 and 4, and we removed the catheter. She had no complication.

• The Korean Journal of Pain
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• v.27 no.4
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• pp.334-338
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• 2014

Background: Lumbar transforaminal epidural steroid injections (TFESIs) are performed to provide symptom relief in patients with radicular pain. Recent articles suggested that injected volume itself have analgesic effects and higher volumes are associated with better outcomes. To date, few studies have been conducted to investigate the effects of volume. Therefore, well-designed controlled studies were necessary to confirm the effect of volume itself on pain relief. The purpose of this study was to examine the effectiveness of a forceful saline injection on lumbar TFESI using non-particulate steroids. Methods: Fifty consecutive patients with lumbar radicular pain were enrolled. The participants were allocated into one of two groups: dexamethasone with volume (Group DV) and dexamethasone alone (Group DO). The volume was delivered by a forceful injection of 5ml of normal saline. The primary end-point for this study was a VAS pain score and modified MacNab score indicating the rate of effectiveness at the four-week follow-up. Results: There were no significant post-procedural VAS differences between two groups (P = .252). The effectiveness rate among the patients was 47.8% in DV group, 34.8% in DO group, measured by modified MacNab score. The difference was not statistically significant (P = .117). Conclusions: A forceful saline injection did not have a significant effect during the treatment of radicular pain. Further studies with greater volumes and with additional techniques would offer a more conclusive perspective.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.507-510
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• 2013

Objective : The aim of this study was to evaluate effect of pulsed radiofrequency (PRF) neuromodulation of suprascpaular nerve (SSN) in patients with chronic shoulder pain due to adhesive capsulitis and/or rotator cuff tear. Methods : The study included 11 patients suffering from chronic shoulder pain for at least 6 months who were diagnosed with adhesive capsulitis (n=4), rotator cuff tear (n=5), or adhesive capsulitis+rotator cuff tear (n=2) using shoulder magnetic resonance imaging or extremity ultrasonography. After a favorable response to a diagnostic suprascapular nerve block twice a week (pain improvement >50%), PRF neuromodulation was performed. Shoulder pain and quality of life were assessed using a Visual Analogue Scale (VAS) and the Oxford Shoulder Score (OSS) before the diagnostic block and every month after PRF neuromodulation over a 9-month period. Results : The mean VAS score of 11 patients before PRF was $6.4{\pm}1.49$, and the scores at 6-month and 9 month follow-up were $1.0{\pm}0.73$ and $1.5{\pm}1.23$, respectively. A significant pain reduction (p<0.001) was observed. The mean OSS score of 11 patients before PRF was $22.7{\pm}8.1$, and the scores at 6-month and 9 month follow-up were $41.5{\pm}6.65$ and $41.0{\pm}6.67$, respectively. A significant OSS improvement (p<0.001) was observed. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective treatment for chronic shoulder pain, and the effect was sustained over a relatively long period in patients with medically intractable shoulder pain.

• Journal of muscle and joint health
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• v.6 no.2
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• pp.242-252
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• 1999

The purpose of this study was to explore self management of pain by folk remedies in patient with chronic arthritis. The participant of this study were 90 volunteers who were visit C hospital and who want to counsel with researcher for their pain control by convenient sampling method. The results of this study were summarized as follows : The subjects were the 90 patients who had been diagnosed rehumatoid arthritis(52.5%)and osteoarthritis(47.8). 93.3% of participants were women. Mean age of participants was 53.7 and duration of arthritis was 7 years. Mean pain score was 5.5cm. Eighty five kinds of folk remedies were used for pain management. The mean cost for folk remedies was 3,723,207 won and the patients with rheumatoid arthritis paid to folk remedies as much as 3 times. The perceived effect score of pain management by folk remedies was 2.932(the range of perceived effect score were 0-10cm). Percentage of discontinue to use folk remedies was 82.8% and the major reason of discontinue to use folk remedies was no effect to pain control(50.4%). Some participants(30.5%) were experienced side effect such as exacerbation of pain(50.5%). In conculusion, chronic arthritis patients have been experienced various kind of folk remedies for the management of their pain. But the effect of pain control was very low. The important weakness of folk remedies were economical waste and loss of opportunity to treatment for arthritis. The nurse who care for arthritis should be teach about weakness of folk remedies for their pain control to the patients with arthritis.