• The Korean Journal of Pain
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• v.10 no.2
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• pp.214-219
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• 1997

Background: Epidural neural blockade with local anesthetics combined with steroids has been in clinical trials for patients with low back pain. But pain treatment of low back pain remains somewhat problematic. Many patients with low back pain have epidural fibrosis and adhesions proved with magnetic resonance imaging(MRI) examination. These findings might play an important role in the origin of back pain. Present study was aims to investigate the effect of epidural adhesiolysis in patients with low back pain. Methods: We investigated 76 patients suspected with epidural fibrosis and adhesion was suspected. Nerve pathology was demonstrated and epidural fibrosis suspected or proved with MRI examination. 17G needle specially designed by Racz was inserted at sacral hiatus and catheter was inserted untill its tip was located at lesion site under fluoroscopic guidance. Injection of contrast dye was achieved and prospected spread of agents. Injection of 0.25% bupivacaine, triamcinolone, and 10% hypertonic saline via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) post-epidural adhesiolysis 3 days, 1 week, and 3 months. We also looked for complication of epidural adhesiolysis. Results: Statistical analysis(Friedman nonparametric repeated measures test and Dune's multiple comparison test) demonstrated NRS was significantly less during 3 months after epidural adhesiolysis(P<0.05). Especially, there is a extremely significance in post-epidural adhesiolysis 3 days (P<0.001). Only four patients reported any complications the most common symptom among three persistent headache but disappeared after a few months without residual sequelae. Conclusion: We conclude epidural adhesiolysis is a safe and effective method of pain therapy for low back pain with proven lumbo-sacral fibrosis and adhesion. A direct visualization by epiduroscopy may be more useful to the resulting functional changes after epidural adhesiolysis.

• The Journal of Korean Physical Therapy
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• v.24 no.2
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• pp.82-89
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• 2012

Purpose: In this study, the effects of stability exercise, extracorporeal shock wave therapy, and taping on pain and function in patients with myofascial pain syndrome of upper trapezius were compared. Methods: The subjects were divided into the stability exercise, ESWT and the taping treatment group and the clinical outcomes were evaluated by visual analog scale (VAS), pressure pain threshold (PPT) and a constant-murley scale (CMS) at pre-treatment and post-treatment. Paired t-test and ANOVA was used for statistical analysis. Results: All groups were statistical significance in the change in visual analog scale (p<0.05). The difference between the ESWT group and taping group was statistical significance in the change in pressure pain threshold (p<0.05) except for the taping group. Using the constant-murley scale, the stability exercise group showed a significant decrease in pain, and a significant increase in ROM, ADL, strength, total score of shoulder (p<0.05); however, the ESWT group showed no difference on ADL. In addition, there was no difference in strength for the taping group. The comparison of the effect between the stability exercise group, ESWT group and taping group in CMS showed a statistical significant difference in pain, ADL and ROM (p<0.05). Conclusion: These results indicate that stability exercise, ESWT and taping could be considered an effective and efficient treatment modality for myofascial pain syndrome of upper trapezius.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.88-95
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• 2015

Background: Patients suffering from non-cardiac chest pain (NCCP) can interpret their chest pain wrongly despite having received a correct diagnosis. The objective of this study was to compare the efficacy of the relaxation method with metaphor therapy for reducing irrational beliefs and pain severity in patients with NCCP. Methods: Using a randomized controlled trial, 33 participants were randomly divided into a relaxation training group (n= 13), a metaphor therapy group (n = 10), and a control group (n = 10), and were studied for 4 weeks. The two tools used in this research were the Brief Pain Inventory (BPI) index for determining the degree of pain and the short version of the Jones Irrational Belief Test. Metaphor therapy and a relaxation technique based on ${\ddot{O}}$st's treatment were used as the interventions. The collected data were analyzed with a multivariate analysis of covariance (MANCOVA), a Chi-square test, and the Bonferroni procedure of post-hoc analysis. Results: The relaxation training method was significantly more effective than both metaphor therapy and the lack of treatment in reducing the patients' beliefs of hopelessness in the face of changes and emotional irresponsibility, as well as the pain severity. Metaphor therapy was not effective on any of these factors. In fact, the results did not support the effectiveness of metaphor therapy. Conclusions: Regarding the effectiveness of the relaxation method as compared with metaphor therapy and the lack of treatment in the control group, this study suggests that relaxation should be paid greater attention as a method for improving the status of patients. In addition, more studies are needed to determine the effectiveness of metaphor therapy in this area.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.122-128
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• 2018

Purpose: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and Methods: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration. Results: The three-dimensional (3D) magnitudes of translational uncertainties (mean ${\pm}$ 2 standard deviation) were $3.7{\pm}3.5mm$ (SE), $0.9{\pm}0.9mm$ (preRE), $1.2{\pm}1.5mm$ (postRE), $1.4{\pm}2.4mm$ (IM1), and $0.9{\pm}1.0mm$ (IM2), and average angular differences were $1.1^{\circ}{\pm}1.2^{\circ}$ (SE), $0.9^{\circ}{\pm}1.1^{\circ}$ (preRE), $0.9^{\circ}{\pm}1.1^{\circ}$ (postRE), $0.6^{\circ}{\pm}0.9^{\circ}$ (IM1), and $0.5^{\circ}{\pm}0.5^{\circ}$ (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test). Conclusion: In spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.45-54
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• 2021

Background: The purpose of this study was to investigate the effects of flexi-bar exercise on shoulder pain, dysfunction, quality of life, and range of motion of women with breast cancer surgery. Methods: A total of 42 female patients who had breast cancer were included in this study. By drawing lots, subjects were divided into a flexi-bar exercise group (FBG, n=21) and a general breast cancer group (GBG, n=18). The effects of flexi-bar exercise on patients were evaluated in terms of the visual analogue scale (VAS), the shoulder pain and disability index (SPADI), the European organization for the research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30), the breast cancer specific EORTC quality of life questionnaire (EORTC QLQ-BR23), and range of motion (ROM), all of which were measured pre- and post- intervention followed by evaluation. Results: A significant increase was pain, functional disability level, quality of life, ROM within the two groups (p<.01). There were pain, functional disability level, quality of life, ROM post test then invention were significant between the two groups(p<.01). Conclusion: The flexi-bar exercise has a positive treatment effect on breast cancer patients.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.228-235
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• 2019

The purpose of this study is to report the clinical effect of Korean medicine on a patient who experienced headaches and nausea after post-concussion syndrome. The patient was treated with herbal medicine (Oryung-san, Hwangryunhaedok-tang-tablet) and acupuncture for four weeks. As a result, the pain degree compared to the day of hospitalization of headache and nausea and pain rating score of headache decreased after treatment. Therefore, this case is useful for describing Korean medicine treatment for headache and nausea after post-concussion syndrome, and further case reports and studies will be needed in the future.

• Journal of Haehwa Medicine
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• v.22 no.2
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• pp.155-162
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• 2014

Objective : The purpose of this study was to investigate the effects of acupuncture treatment on frequently adopted acupuncture point and self exercise therapy for lumbar sprain patient Methods : For this study, a retrospective chart review was conducted. Data are derived from lumbar sprain patients who have received hospital treatment in Daejeon Univ. Cheon-Ahn Korean Hospital. All patients were treated with acupuncture treatment on high frequency acupuncture point (BL25, BL23, BL24, GB30, BL40, BL26, BL60, GB34), physical therapy and herbal medicine and self exercise therapy(Swiss ball exercise, Lumbar stabilization exercise.) We measured visual analogue scale(VAS), Oswestry disability index(ODI), Pain threshold twice(pre-treatment and post-treatment) on 1st day and 5 days later. Results : After being treated, lumbar sprain patients were meaningful improved in VAS, ODI, pain threshold The VAS score, ODI score were statistically decreased after treatment and the pain threshold was statistically increased after treatment. Conclusion : In this study, treatment on frequently adopted acupuncture point and self exercise therapy were effective on lumbar sprain patient.

• Physical Therapy Korea
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• v.2 no.2
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• pp.66-72
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• 1995

The purpose of this study was to determine a more effective method for shoulder pain reduction. Forty-five normal subjects were randomly assigned to one of 3 groups a control group, an acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) group, and a silver spike point(SSP) group. Each person in the ALTENS and SSP groups was measured for pressure pain threshold before and after a 20 minute treatment. The control group was also checked for pressure pain threshold before and after a 20 minute period but no "treatment" was given. The major findings were as follows ; 1)The ALTENS and SSP groups showed significant differences before and after treatment but the control group showed no significant difference. 2)When the three groups were compared, the only significant difference was between the SSP group and the control group. As mentioned above, it may be concluded that both ALTENS and SSP therapy were effective in reducing shoulder pain when measured directly after treatment. However, SSP did not show any superior effect. Further study should be done to determine the effective the maintained pain reduction with post-treatment time lapse.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.57-61
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• 2013

Background: Olfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment. Methods: This was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale. Results: Out of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was $9.6{\pm}0.7$, VAS-A was $5.1{\pm}4.2$, and VAS-C was $2.7{\pm}$2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%). Conclusions: SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

• Journal of Korean Neurosurgical Society
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• v.57 no.2
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• pp.123-126
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• 2015

A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.