• Title/Summary/Keyword: Persistent Pain

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Treatment of Chronic Myofascial Pain with Botulinum Toxin : Case Report (보툴리눔 톡신을 이용한 만성 근막통증의 치료 증례)

  • Hong, Seong-Ju;Yoon, Chang-Lyuk;Ahn, Jong-Mo;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.35 no.3
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    • pp.221-227
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    • 2010
  • MyoFascial Pain Syndrome(MFPS) is defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs). Myofascial pain is a common cause of persistent regional pain such as neck pain, shoulder pain, headaches, and orofacial pain. Clinicians who deal with orofacial pain must also understand the role of myofascial pain. This case report presents the treatment of botulinum toxin A for chronic myofascial pain.

Ganglion Impar Block in the Management of Rectal Tenesmoid Pain (항문 이급후중의 치료에 있어 외톨이 신경절 차단)

  • Kim, Soo-Kwan;Ahn, Cheol-Soo;Cho, Yong-Roew;Lim, So-Young;Shin, Keun-Man;Hong, Soon-Yong;Choi, Young-Ryong
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.226-228
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    • 1996
  • Rectal tenesmus is a persistent, painful and ineffectual sensation of straining at stool or opening of the bowels. The pain is usually spasmodic in nature and most commonly encountered in patients with carcinoma of the rectum or other pelvic organs. In 1988, Bristowand Foster reported that patients with severe spasmodic painful tenesmus were relieved with chemical sympathectomy. In 1990, Plancarte introduced block of Ganglion impar. This technique is proposed as an alternative means of managing localized perineal pain of sympathetic origin. Ganglion impar block was performed on a 54-year-old female patient when analgesic or psychotropic drugs failed to control the symptoms of post-traumatic severe spasmodic painful tenesmus. Postoperatively, patient was free of tenesmoid pain for only 7 days. We then performed neurotomy by RF lesion generator which provided complete pain relief.

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Meta-analysis on the Effects of Exercise Therapy and Physiotherapy on Pain in Korean Patients with Chronic Low Back Pain (만성요통환자를 대상으로 운동치료 및 물리치료가 통증에 미치는 효과에 대한 메타분석)

  • Kim, Sung-Kyu;Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.30 no.1
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    • pp.63-72
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    • 2020
  • Objective: The purpose of this study was to investigate meta-analysis on the effects of exercise therapy and physiotherapy on pain in korean patients with chronic low back pain. Method: Meta-analysis was performed on the type and method of treatment. A total of 23 experimental studies were coding into 31 individual studies, into types, methods, visual analogue scale (VAS), each pre/post value of the effect size was calculated by meta-analysis. Results: Sling exercise, stretching, thermal therapy, kinesio-taping, lumbar stabilization exercise, electrotherapy is large effect size (ES ≥ .08). In addition, big effects occurred in order of treatment period is more than 9 weeks, three times a week. Conclusion: Our results indicated that persistent treatment of chronic back pain is the most effective method of self-sufficiency rather than temporary relief.

Direct Carotid Cavernous Fistula of an Adult-Type Persistent Primitive Trigeminal Artery with Multiple Vascular Variations

  • Jin, Sung-Chul;Park, Hyun;Kwon, Do-Hoon;Choi, Choong-Gon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.226-228
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    • 2011
  • We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF.

Thoracoscopic Treatment of Spontaneous Pneumothorax (흉강경을 이용한 기흉의 치료)

  • 김광호
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.261-264
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    • 1991
  • The result of thoracotomy for recurrent and persistent pneumothorax is usually excellent. However the patients undergone thoracotomy suffer from postoperative chest pain and require long postoperative recovery period. Also the operative incision scar gives the patients cosmetic problems. Subpleural blebs are usually causes of pneumothorax. They can be reached through the thoracoscope without thoracotomy and can be ablated by electrical cautery through it. Six patients with recurrent and persistent pneumothorax were managed thoracoscopic-ally. Five patients were successful and one case was failed. The failed case was explored 21 days after thoracoscopy. Follow-up period was from one to eight months. Although the follow-up period was short, thoracoscopic management of recurrent and persistent pneumothorax is thought to be good for preventing thoracotomy.

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A case of Nutcracker Syndrome Associated with Proteinuria (단백뇨를 동반한 Nutcracker 증후군 1례)

  • Son Jin-Tae;Rho Kwang-Sik;Kim Pyung-Kil;Kim Mung-Jun
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.166-169
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    • 1997
  • The nutcracker syndorme refers to compression of the left renal vein between the aorta and the superior mesentric artery which results in renal vein, left gonadal vein varices, hematuria and left sided flank pain. We report this experience of 11yr-11mon of girl has typical Nutcracker syndrome with persistent proteinuria and without typical hematuria. According to the renal biopsy for persistent proteinuria, biopsy shows pathologic findings similar to minimal change nephrotic syndrome. All symtpoms relieved without any specific treatments but she had no response to steroid treatment for persistent proteinuria. Now she was followed up through OPD base without symptom and consideration of surgical intervention.

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Persistent Gingival Swelling and Fistula Obscured Horizontal Root Fracture: A Case Report

  • Juyeon, Cho
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.147-151
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    • 2022
  • Horizontal root fracture (HRF) is a result of trauma to teeth and periodontium, which implies severe injury to cementum, dentin, and pulp. This is a rare case of HRF in the maxillary lateral incisor of a 62-year-old male who only presented persistent gingival swelling, fistula, and dull pain at first. An apical radiolucency of unknown origin turned out to be a result of hidden HRF at the coronal third level that was later visualized radiographically during endodontic treatment. The tooth was scheduled to be extracted upon the patient's agreement. The purpose of this report is to alert clinicians about the importance of diagnosing HRF through thorough clinical and radiographic examinations. Where there is persistent fistula without proper cause, HRF should be considered as a causative factor, and the diagnosis could be effective with aid of cone beam computed tomography, electronic root apex locator, as well as other clinical signs.

Superoxide and Nitric Oxide Involvement in Enhancing of N-methyl-D-aspartate Receptor-Mediated Central Sensitization in the Chronic Post-ischemia Pain Model

  • Ryu, Tae-Ha;Jung, Kyung-Young;Ha, Mi-Jin;Kwak, Kyung-Hwa;Lim, Dong-Gun;Hong, Jung-Gil
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.1-10
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    • 2010
  • Background: Recent studies indicate that reactive oxygen species (ROS) are involved in persistent pain, including neuropathic and inflammatory pain. Since the data suggest that ROS are involved in central sensitization, the present study examines the levels of activated N-methyl-D-aspartate (NMDA) receptors in the dorsal horn after an exogenous supply of three antioxidants in rats with chronic post-ischemia pain (CPIP). This serves as an animal model of complex regional pain syndrome type-I induced by hindpaw ischemia/reperfusion injury. Methods: The application of tight-fitting O-rings for a period of three hours produced CPIP in male Sprague-Dawley rats. Allopurinol 4 mg/kg, allopurinol 40 mg/kg, superoxide dismutase (SOD) 4,000 U/kg, N-nitro-L-arginine methyl ester (L-NAME) 10 mg/kg and SOD 4,000 U/kg plus L-NAME 10 mg/kg were administered intraperitoneally just after O-ring application and on the first and second days after reperfusion. Mechanical allodynia was measured, and activation of the NMDA receptor subunit 1 (pNR1) of the lumbar spinal cord (L4-L6) was analyzed by the Western blot three days after reperfusion. Results: Allopurinol reduced mechanical allodynia and attenuated the enhancement of spinal pNR1 expression in CPIP rats. SOD and L-NAME also blocked spinal pNR1 in accordance with the reduced mechanical allodynia in rats with CPIP. Conclusions: The present data suggest the contribution of superoxide, produced via xanthine oxidase, and the participation of superoxide and nitric oxide as a precursor of peroxynitrite in NMDA mediated central sensitization. Finally, the findings support a therapeutic potential for the manipulation of superoxide and nitric oxide in ischemia/reperfusion related pain conditions.

What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

  • Manchikanti, Laxmaiah;Staats, Peter S.;Nampiaparampil, Devi E.;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.75-87
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    • 2015
  • Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

Raiofrequency Neurotomy for Lumbar Facet Joint Pain in the Patients with Failed Back Surgery Syndrome (척추수술 후 증후군 환자에서 관찰된 추간관절통에 대한 고주파신경절리술)

  • Lee, Jeong Hoon;Shim, Jae Chol
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.151-155
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    • 2005
  • Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.