• Journal of Pharmacopuncture
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• v.4 no.3
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• pp.109-117
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• 2001

Objective : There has been no known report on the pain shock after administering Korean bee-venom therapy. Three accounts of pain shock were observed at the Sangji university affiliated Oriental medicine clinic from July 2001 through September 2001. This thesis will inform clinical progression and cautions on administering Korean bee-venom therapy. Methods: We were able to witness different patterns of pain shock during the treatment of degenerative knee joint, progressive oral paralysis, and A.L.S. In order to reduce heat toxicity of the bee venom, needling points were first massaged with the ice for 10 minutes before injecting $0.1{\sim}0.2cc$ of the bee venom. Points of injection were ST36, LI11, LI4 and others. Pain shock occurred after injecting on inner xi-an, outer xi-an and LI4. The phenomena associated with pain shock was recorded in chronological order and local changes were examined. Results: Through examining 3 patients with the pain shock, we managed to observe clinical progression, duration, and time linked changes on specific regions. We also managed to determine sensitive needling points for the pain shock. Conclution: Following results were obtained from 3 patients with the pain shock caused by Korean bee-venom therapy from July 2001 to September 2001. 1. Either positive or negative responses were shown after the pain shock. For case 1, extreme pain was accompanied with muscular convulsion and tremble, ocular hyperemia, delirium, stiffening of extremities, and hyper ventilation which all suggest positive responses. For case 2 and 3, extreme pain was accompanied with facial sweating, asthenia of extremities, pallor face, dizziness, weak voice, and sleepiness which are the signs of negative responses. 2. The time required to recover to stable state took nearly an hour (including sleeping time) and there was no side effect. 3. Precautions required to prevent the pain shock includes full concentration from the practitioner, accurate point location, precise amount of injection, physiological condition and psychological stability of the patient 4. Coping with the pain shock should be similar with a needle shock, and since extreme pain is accompanied, sufficient psychological rest must be provided. 5. Pain shock occurs because the patient cannot tolerate stimulation on the needling point. Thus, symptoms were similar to the needle shock in addition to excruciating pain. Further investigation and research must be done to have better understanding of an immune response and the pain shock associated with Korean bee-venom therapy.

• Korean Journal of Applied Biomechanics
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• v.31 no.1
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• pp.16-23
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• 2021

Objective: The purpose of the study was to compare the acceleration and shock attenuation (SA) of the runners with/without low back pain (LBG vs. NLBG) while running at 2.5 m/s, 3.0 m/s, 3.5 m/s and 4.0 m/s. Method: 15 adults without low back pain (age: 23.13±3.46 years, body weight: 70.13±8.94 kg, height: 176.79±3.68 cm, NLBG) and 7 adults with low back pain (age: 27.14±5.81 years, body weight: 73.10±10.74 kg, height: 176.41±3.13 cm, LBG) participated in this study. LBG was recruited through the VAS pain rating scale. All participants ran on an instrumented treadmill (Bertec, USA). Results: The LBG shows statistically greater vertical acceleration at the distal tibia during running at 3.5 m/s and 4.0 m/s and greater shock attenuation from the distal tibia to the head during running at 3.5 m/s compared with the NLBG during running (p<.05). As the speed increased, there was a statistically significant increase in vertical/resultant acceleration and shock attenuation for both groups. Conclusion: The findings indicated that the runners with low back pain (LBG) experience greater impact and shock attenuation compared with non-low back pain group (NLBG) during fast running. However, it is still inconclusive whether high impact on the lower extremity during running is the main cause of low back pain in the population. Thus, it is suggested that the study on low back pain should observe the characteristics of impact during running with individuals' low back pain experience and clinical symptoms.

• Physical Therapy Korea
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• v.28 no.1
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• pp.53-58
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• 2021

Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.280-283
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• 2015

Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.183-190
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• 2012

Purpose : The purpose of this study was to evaluate whether extracorporeal shock wave therapy (ESWT) is an effective treatment for myofascial pain syndrome (MPS) of upper trapezius. Methods : Study subject were 20 patients (7 male and 13 female). The patients were evaluated by assessing of pain and function using visual analog scale (VAS) and pressure pain threshold (PPT) and Constant-Murley scale (CMS). Statistical analysis was used paired T-test to know significance probability between pre-test and post-test. Results : There was no statistical significance in the change in PPT. But, VAS scores were significantly improved after ESWT (p<.05). Using the Constant-Murley score, this study showed a significant decrease in pain and a significant increase in range of motion of shoulder (p<.05). Conclusion : These results indicate that extracorporeal shock waves therapy could be considered as an effective and efficient treatment modality for myofascial pain syndrome of upper trapezius.

• PNF and Movement
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• v.18 no.1
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• pp.117-126
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• 2020

Purpose: The purpose of this study was to investigate the effects of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in patients diagnosed with lateral epicondylitis and to provide an effective intervention method for lateral epicondylitis. Methods: Twenty patients with lateral epicondylitis were randomly assigned to the ESWT group (n = 10) and the stretching exercise group (n = 10). Interventions in both groups were performed six times twice a week for three weeks. The visible analog scale (VAS) was used to measure pain change. A dynamometer was used to measure grip strength (GS). Patient-rated tennis elbow evaluation (PRTEE) was used to measure the upper-extremity function. Results: There were significant differences in pain, grip strength, and upper-extremity function in both groups before and after intervention (p < 0.05). There were also significant differences in pain, grip strength, and upper-extremity function between the groups after intervention (p < 0.05). Conclusion: This study showed very positive improvement in pain, grip strength, and upper-extremity function after ESWT in patients with lateral epicondylitis. Therefore, ESWT can be recommended for patients with lateral epicondylitis.

• PNF and Movement
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• v.18 no.2
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• pp.245-254
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• 2020

Purpose: The study investigated the effects of extracorporeal shock wave therapy with myofascial release techniques (ESWT+MFR) on pain, movement, and function in patients with myofascial pain syndrome. Methods: Forty participants with upper trapezius trigger points were recruited and randomly allocated to two groups: an experimental group (n = 20) and a control group (n = 20). The experimental group performed the ESWT+MFR, and the control group performed only myofascial release techniques. Each group was treated for 15 minutes, twice a week for four weeks. Pain was assessed using a visual analogue scale and a pressure pain threshold measure. Movement was assessed by cervical range of motion, and cervical and shoulder function were assessed on the Constant-Murley Scale and the Neck Disability Index before and after treatment. Results: The results indicate statistically significant improvements in the two groups on all parameters after intervention as compared to baseline (p < 0.05). As compared to the control group, the experimental group showed statistically significant improvements on the visual analogue scale and pressure pain threshold, cervical range of motion (except rotation), and on the Neck Disability Index (p < 0.05). Conclusion: The ESWT+MFR is more effective than myofascial release techniques for pain, movement, and function in patients with myofascial pain syndrome and would be clinically useful for physical therapists treating myofascial pain syndrome.

• Kosin Medical Journal
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• v.33 no.2
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• pp.245-251
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• 2018

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.142-147
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• 2014

Objective: This study aims to investigate high energy and low energy extracorporeal shockwave therapy (ESWT) and which one is more effective for shoulder pain. Design: Single blind randomized controlled trial. Methods: Fifty two subjects with upper trapezius (UT) trigger point (TrP) participated in this study. They were allocated to high energy (n=26) and low energy group (n=26). This study applies ESWT and investigates the changes of pressure pain threshold (PPT) and visual analogue scale (VAS). The high and low energy groups received focused piezo electric type ESWT 4 Hz, 1,000 pulses and 0.351 and $0.092mJ/mm^2$ respectively. Outcome measures of PPT and pain was measured by algometer and pain VAS. These measurements were performed before and after treatment. Results: The PPT value was significantly increased in both groups after treatment (p<0.05) and VAS scores were significantly decreased after treatment in both groups (p<0.05). However, there were no significant differences between groups. Conclusions: ESWT is an effective treatment for the application of the UT TrP. Although there were significant effects of extracorporeal shock wave therapy on PPT and VAS scores, there were no signficant differences between high and low energy extracorporeal shock wave therapy.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.356-362
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• 2022

Objective: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment alternative to surgery for various musculoskeletal diseases that have traditionally been difficult to treat conservatively, including calcific tendinitis, tennis elbow, and plantar fasciitis. This study evaluated the effect of focused and radial shock wave therapy for calcific tendinitis of the shoulder. Design: Randomized controlled study Methods: Forty participants with calcific tendinitis were randomized into focused shock wave therapy (FSWT, n=20) and radial shock wave therapy (RSWT, n=20) groups. Patients were examined before and one week after treatment. Pain intensity was subjectively assessed using the visual analogue scale and function was assessed using the Constant-Murley score (CMS) and range of motion (ROM). Results: The results showed a significant decrease in pain and significant increase in shoulder mobility and function in both groups. However, FSWT was significantly more effective than RSWT, based on CMS and ROM assessment. Conclusions: Although it is possible to raise the energy intensity of RSWT to increase the depth at which the energy becomes dispersed, higher energy intensity is associated with a greater risk of severe neurovascular damage, and that high-intensity stimulation can cause adverse effects such as pain and petechiae. Therefore, FSWT is considered to be a safe and effective method for treating tendinous lesions while minimizing adverse effects. In conclusion, both FSWT and RSWT can reduce pain and increase mobility and function. FSWT can be considered as an alternative for calcific tendinitis of the shoulder.