• Journal of Korean Medicine Rehabilitation
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• v.28 no.2
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• pp.121-126
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• 2018

Atypical facial pain is persistent facial pain in the absence of clinical neurological deficit. We experienced two patient who are diagnosed atypical facial pain with Classification of International Headache Society. They were treated by acupuncture at their cervical and facial region. After treatment, their Pain intensity numerical rating scale(PI-NRS) is decreased and EuroQol five dimensions questionnaire(EQ-5D) score is increased. Treatment of acupuncture at cervical and facial region could be effective for easing the clinical symptoms of atypical facial pain. Further studies are needed to find effective treatment for atypical facial pain.

• Archives of Plastic Surgery
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• v.42 no.4
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• pp.499-502
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• 2015

• The Korean Journal of Pain
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• v.29 no.4
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• pp.239-248
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• 2016

Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.

• Korean Journal of Oriental Medicine
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• v.12 no.3 s.18
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• pp.49-58
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• 2006

Although the usage of acupuncture for pain has increased in recent years, the mechanisms of acupuncture analgesia (AA) remain unclear. The lack of suitable experimental animal models for persistent pain, which show clear AA, has been the major stumbling block in the investigation of the physiological mechanisms of AA. In the present study, we test AA in two knee arthritis models induced by injection of CFA or carrageenan as persistent pain models. After induction of arthritis, the rat subsequently showed a reduced stepping force of the affected limb for the next several days. Electroacupuncture (EA) was applied to an acupuncture point each on the contralateral forelimb for 30 minutes under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next several hours. EA produced a significant improvement of stepping force of the foot lasting for at least 2 hours when applied to LR2 in CFA model, and applied to ST36 in carrageenan model, but both points did not produce any significant effects in each other model. Further experiments showed that intraperitoneal pretreatment of naltrexone, a non-selective opioid antagonist, did not reduced the EA-induced improvement of stepping force in both of two models. These data suggest that EA produce analgesic effect in knee arthritic pain and the analgesic effect is specific to the acupuncture point depending on painful conditions.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.325-331
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• 2013

Botulinum neurotoxin(BoNT) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Recently, the therapeutic use of BoNT have expanded to include a wide range of medical and dental conditions. Botulinum neurotoxin type A(BoNT/A) is used off-label in the orofacial region to treat primary and secondary masticatory and facial muscle spasm, severe bruxism, facial tics, orofacial dyskinesias, dystonias, and hypertrophy of the masticatory muscles. Local hematoma, infection, and persistent pain in the injection site are the site-of-injection side effects. Medication-related side effects are adjacent muscle weakness, slurred speech, an alteration in the character of the saliva, and severe headaches. In most cases, these complications are not persistent and bothersome. We reported a case report of a patient who had transient anterior open bite after BoNT/A injection on masseter muscles to treat the refractory myofascial pain.

• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.202-208
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• 2024

Objective : Failed back surgery syndrome (FBSS) is a common long-term complication following spine surgeries characterized by chronic persistent pain; different strategies of management were employed to deal with it. This clinical trial aims to compare the efficacy of Pregabalin and Gabapentin in the management of this condition. Methods : A double-blind, randomized, comparative study (clinical trial registry NCT05324761 on 11th April 2022) with two parallel arms with Pregabalin and Gabapentin were used in arms one and two, respectively. Visual analog scale was used for basal and endpoint assessment of pain. T-test and analysis of covariance were used to deal with different variables. A pairwise test was used to compare pairs of means. Results : Of 66 patients referred to the trial, 64 were eligible, with 60 patients completing the 30 days trial. Both pregabalin and gabapentin effectively reduce pain, with significant p-values of 0.001 for each group. However, the pregabalin group was superior to gabapentin in pain reduction (p=0.001). Gender was an insignificant factor (p=0.574 and p=0.445 for the pregabalin and gabapentin groups, respectively, with a non-significant reduction (p=0.393) for both groups in total. Location of stenosis before surgery and type of surgery performed show non-significant effect on pain reduction for both groups. Conclusion : Both pregabalin and gabapentin effectively and safely relieve neuropathic pain associated with FBSS; pregabalin was significantly more effective irrespective of the patients' gender.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.146-149
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• 1998

Herpes zoster is a viral disease characterized by skin rash and persistent pain. Early treatment with epidural analgesia provides very effective pain relief and reduces the incidence of postherpetic neuralgia. However, epidural analgesia in elderly, deliberated or hypovolemic patients may complicate circulatory depression such as hypotension and bradycardia. Even if temporary, a major decrease in blood pressure may decrease coronary blood flow of patients with arteriosclerosis and ischemic accident may occur. We experienced a case of unstable angina pectoris after lumbar epidural blockade in a herpes zoster patient with chronic stable angina pectoris.

• The Journal of Korean Physical Therapy
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• v.35 no.6
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• pp.163-166
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• 2023

A 30-year-old male novice golfer was diagnosed with a clay-shoveler's fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler's fractures.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.217-225
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• 2009

As Pain is a comprehensive, biopsy chosocial phenomenon, improved understanding and successful management of pain need assessment of health-related quality of life and psychological states. The purpose of this study was to evaluate pain severity and pain-related interference to daily lives for patients with non-dental, orofacial pain(OFP) and a possible relation of OFP with psychological morbidity. Relation with such factors as gender, age, pain duration and diagnosis was also assessed. Inclusion criteria was all new patients with non-dental OFP attending the oral medicine.orofacial pain clinic of Dankook University Dental Hospital over 3 months' period, who completed the questionnaires of the Brief Pain Inventory (BPI) and Hospital Anxiety and Depression Scale (HADS). Prior to the first consultation, the patients were asked to fill out the questionnaire in the waiting room and were diagnosed through consultation and clinical examination. Total subjects were 163 with M:F ratio of 1:1.5 and mean age of 34.6${\pm}$17.7 years. Mean duration of pain was 13.3${\pm}$26.2 months and all patients were divided into; Trigeminal Neuralgia group (TN, N=8), Neuropathic Pain group (NeP, N=9), Persistent Idiopathic Facial Pain group (PIFP, N=8), and Temporomandibular Disorders group (TMD, N=138), subdivided into muscle problem (TMD-m, N=73), joint problem (TMD-j, N=24) and muscle-joint combined problem (TMD-c, N=41). OFP patients showed moderate pain severity and moderate pain-related interference. There was no gender difference in overall pain severity and interference and levels of anxiety and depression. Elderly patients aged ${\geq}$ 60 years showed higher pain severity (p<0.05). Patients with chronic pain ${\geq}$ 3 months reported more increased level of anxiety and depression than those with acute pain (p<0.05). Compared to TMD patients, patients with TN, NeP and PIFP suffered from higher level of pain and pain-related interference and reported higher level of anxiety and depression (p<0.05). Pain interference was closely correlated with their pain severity and with psychometric properties such as anxiety and depression. Pain severity was weakly correlated with levels of anxiety and depression. The results suggest a need for psychosocial assessment and support for successful management of OFP in addition to control of pain itself.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.293-296
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• 2009

Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.