• Title/Summary/Keyword: Post-treatment pain

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Repetitive transcranial magnetic stimulation in central post-stroke pain: current status and future perspective

  • Riva Satya Radiansyah;Deby Wahyuning Hadi
    • The Korean Journal of Pain
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    • v.36 no.4
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    • pp.408-424
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    • 2023
  • Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.

Clinical studies on neck pain 4 cases associated with kyphotic cervical curvature (Kyphotic cervical curvature로 인한 항통(項痛) 4례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Cho, Hyun-Yeul;Bae, Eun-Jeong;Lee, Kyung-Min;Lee, Jeong-Hoon;Soe, Jung-Chul;Han, Sang-Won
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.230-239
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    • 2002
  • Kyphotic cervical curvature, straghtening is commonly caused by trauma, muscle spasm without trauma and wrong posture, etc. Objective : This study is performed to evaluate the clinical effect of neck pain associated with Kyphotic cervical curvatre on cervical x-ray lateral view. Methods : One of the many causes, We examined the patients with neck pain & upper back pain who visited to Department of Acupuncture & Moxibustion, Gumi Oriental Hospital of Kyung-San University from 16th June 1999 to 22th June 2000. Pre and post treatment, We evaluated the cervical angle, Jochumsen's method, VAS(visual analogue scale) and effective score of treatment. Results & Conclusion : 1. Kyphotic cervical curvature is mainly caused by wrong posture during long term, sudden trauma, etc. therfore, postcervical muscles and tendon are injuryed by strong stress. So, muscle imbalance and pain is occured. 2. On these cases, The improvement index for pre/post treatment showed 28/42, 10/15, 9/30, 28/42 degree in cervical angle. Jochumsen's method showed -1/+2, -9/-3, -5/-2, -1/+2mm. Afer treatment VAS is 2, 1, 1, 1 and effective score of treatment is above good. The results suggest that treatments of Oriental Medicine(Acupuncture & Moxibustion, Chu-Na, Cupping and Physical therapy) are effective methods for neck pain with kyphotic cervical curvature on cervical x-ray lateral view.

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The effect of human mesenchymal stem cell injection on pain behavior in chronic post-ischemia pain mice

  • Yoo, Sie Hyeon;Lee, Sung Hyun;Lee, Seunghwan;Park, Jae Hong;Lee, Seunghyeon;Jin, Heecheol;Park, Hue Jung
    • The Korean Journal of Pain
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    • v.33 no.1
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    • pp.23-29
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    • 2020
  • Background: Neuropathic pain (NP) is considered a clinically incurable condition despite various treatment options due to its diverse causes and complicated disease mechanisms. Since the early 2000s, multipotent human mesenchymal stem cells (hMSCs) have been used in the treatment of NP in animal models. However, the effects of hMSC injections have not been studied in chronic post-ischemia pain (CPIP) mice models. Here, we investigated whether intrathecal (IT) and intrapaw (IP) injections of hMSCs can reduce mechanical allodynia in CPIP model mice. Methods: Seventeen CPIP C57/BL6 mice were selected and randomized into four groups: IT sham (n = 4), IT stem (n = 5), IP sham (n = 4), and IP stem (n = 4). Mice in the IT sham and IT stem groups received an injection of 5 μL saline and 2 × 104 hMSCs, respectively, while mice in the IP sham and IP stem groups received an injection of 5 μL saline and 2 × 105 hMSCs, respectively. Mechanical allodynia was assessed using von Frey filaments from pre-injection to 30 days post-injection. Glial fibrillary acidic protein (GFAP) expression in the spinal cord and dorsal root ganglia were also evaluated. Results: IT and IP injections of hMSCs improved mechanical allodynia. GFAP expression was decreased on day 25 post-injection compared with the sham group. Injections of hMSCs improved allodynia and GFAP expression was decreased compared with the sham group. Conclusions: These results suggested that hMSCs may be also another treatment modality in NP model by ischemia-reperfusion.

Efficacy of Glycopyrrolate in Primary Hyperhidrosis Patients

  • Lee, Hyun-Ho;Kim, Do-Won;Kim, Do-Wan;Kim, Chan
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.28-32
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    • 2012
  • Background: Primary hyperhidrosis is a disorder of excessive sweating, which shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oral glycopyrrolate is one of the treatments available. There are a few published studies on the use of glycopyrrolate given orally in the treatment of hyperhidrosis. Methods: Thies is study was a review of case notes in a series of 36 patients with primary hyperhidrosis. We made a comparison between the Keller's scale score of a pre-glycopyrrolate medication group and the Keller's scale score f a post-glycopyrrolate medication group. The Milanez de Campos score, Short Form_36 (SF-36) score, Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the two groups. Results: In the post-glycopyrrolate medication group, there were declines in Keller's scale, and Milanez de Campos scale score and BAI score (P < 0.001). In addition, there were increases in SF_36 score in the post-glycopyrrolate medication group (P = 0.03) However, no changes were seen in, BDI score and ANS score in the post-glycopyrrolate medication group (P < 0.001). Conclusions: Glycopyrrolate is an effective initial method of treating primary hyperhidrosis that, reduces anxiety and improve patients' quality of life.

Effects on Pressure Pain and Tactile Threshold by Auricular TENS at Shenmen Point (신문 반응점에 적용한 외이 경피신경전기자극이 압통각 및 촉각역치에 미치는 영향)

  • Jung, Dae-In
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.1
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    • pp.59-70
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    • 2004
  • The purpose of this study were to determine the changes between pre, during, intermed, post of each two groups of 16 persons and to compare the effect of transcutaneous electrical nerve stimulation(TENS) at shenmen of auricular point on experimental pressure pain and tactile threshold measured at both ulnar styloid process and medial malleoli. Sixteen healthy adult men and women, aged 20 to 28 years, were assigned randomly to eight of one groups. Control group received TENS to exception of auricular point. Experimental group received TENS to shenmen of auricular point. Experimental pressure pain and tactile pain threshold at the both ulnar styloid process and medial malleoli was determined with algometer and von frey filament before 10 minute, during 10 minute, intermediate and post 30 min of treatment. In pressure pain and tactile threshold showed a statistically significant increase(p<0.05) ipsilateral and contralateral of treatment group. These results suggest that TENS at shenmen of auricular point has the capability to higher pressure pain and tactile threshold in whole body.

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Effects of Skin Mobilization on Pain and Joint Range Improvement in Patients with Axillary Web Syndrome: A Single Case Report

  • Choi, Suhong;Lee, Sangyeol
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.112-115
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    • 2021
  • Objective: This study was conducted to apply skin mobilization to patients with Axillary web syndrome following breast cancer resection and to see the resulting changes in pain and joint range of motion. Design: Single case study,pre-post comparison. Methods: The subject was a female patient in her 40s who performed a mastectomy after being diagnosed with breast cancer, and then complained of uncomfortable pain from the shoulder joint to the axilla and limited range of motion. To implement a skin mobilization, the palms were adhered to the inner half of the arm, the arms were raised to a pain-free extent, and skin mobilization was performed. The skin was pulled in the direction of axilla and kept for 5 seconds 10 times for a total of 2 sets. Immediate changes in range of motion and pain were identified. Results: Following skin mobilization, there was an immediate increase in range of motion (pre 116°, post 140°) and a decrease in pain (NRS pre 5, post 2). And also uncomfortable pain, which is hard to define in words, also seems to have improved. Conclusions: Skin mobilization, which considers skin mobility for patients with Axillary web syndrome, can be considered for improving range of motion and restoring function in patients with pain due to fibrous bands around veins and lymphatic vessels, and is recommended as a new intervention method not used as a conventional treatment.

Clinical Study of Sobokchugeo-tang's Effects on 4 Cases of Complications of Post-hysterecomy (자궁절제술 후 후유증상을 소복축어탕을 중심으로 치료한 증례 보고)

  • Kim, Ji-Eun;Yang, Seung-Jeong;Cho, Seong-Hee;Park, Kyung-Mi;Song, U-Rim;Jung, Jung-Su
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.189-196
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    • 2014
  • Objectives: This study was reported to confirm the effect of Sobokchugeo-tang (SC) on complications of post-hysterecomy. Methods: Four women who were operated a hysterectomy within a month were enrolled in this study. They complained of abdominal pain, lumbago, both leg numbness, dizziness, etc. And received oriental treatments to decrease pain and improve the symptoms. Sobokchugeo-tang 3 times a day was prescribed, their complcation were decreased compared with first visit. Results: A hysterecomy can lead to comlications. They complained of various symptoms. After the treatment, abdominal pain, both leg numbness were rapidly decreased and lumbago, dizziness were improved too. Conclusions: These clinical cases indicated that sobokchugeo-tang was effective in the treatment of women who undertaken a hysterecomy.

Treatment of Atypical Facial Pain with Stellate Ganglion Block (비정형 안면통에서의 성상신경절 차단 치료)

  • Jeon, Young Hoon;Kim, Ji Hyun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.3
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    • pp.173-175
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    • 2014
  • Atypical facial pain is loosely used term to describe some chronic facial pain when the symptoms do not exactly and entirely fit one diagnostic criteria. In many cases of pain disorders, sympathetic system is involved, such as in conditions which symptoms mimic post-herpetic neuralgia or complex regional pain syndrome. We report a case of a patient with atypical facial pain following the reduction of temporomanidbular joint dislocation. The atypical pain which was resistant to analgesic medication was successfully managed with stellate ganglion block. Therefore we suggest that stellate ganglion block can be an effective treatment method for controlling atypical facial pain.

Comparative study of Acupuncture, Bee Venom Acupuncture and Bee Venom Herbal Acupuncture on the treatment of Post-stroke Hemiplegic Shoulder Pain (견관절 동통을 호소하는 중풍편마비 환자에 대한 체침, 봉독침 및 봉약침 치료효능의 비교연구)

  • Eom, Jae-Yong;Won, Seung-Hwan;Kwon, Ki-Rok;Lee, Hyang-Sook
    • Journal of Pharmacopuncture
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    • v.9 no.1
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    • pp.139-154
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    • 2006
  • Objective : This experiment was conducted to evaluate the effectiveness of Acupuncture, Bee Venom Acupuncture (BVA) and Bee Venom Herbal Acupuncture (BVHA) on post-stroke hemiplegic shoulder pain. Methods : 30 patients were randomly allocated into Acupuncture group, BVA group and BVHA group and was monitored weekly for 4 weeks; initial($T_0$), 1 week($T_1$), 2 weeks($T_2$), 3 weeks($T_3$) and 4 weeks($T_4$). Results : Visual analogue scale of shoulder pain showed significant decrease in BVA and BVHA groups compared to the Acupuncture group at T4 evaluation. Painless passive ROM of shoulder external rotation and Fugl-Meyer Motor Assessment of Upper Limb motor function showed significant increase in all groups. Modified Ashworth scale of the spasticity of upper limb showed no differences between the three groups. Conclusion : BVA & BVHA appears to be an effective in treating post-stroke hemiplegic shoulder pain. Further clinical studies must be done to obtain more concrete findings.

The Effects of Spinal Decompression Therapy on Pain and Disability in Patients with Chronic Low Back Pain

  • Oh, Hyun-Ju;Jeon, Chun-Bae;Jeong, Mu-Geon;Choi, Seok-Joo
    • The Journal of Korean Physical Therapy
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    • v.29 no.6
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    • pp.299-302
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    • 2017
  • Purpose: The purpose of this study was to examine the effects of spinal decompression therapy on pain and disability in patients with chronic low back pain. Methods: Twenty patients with chronic low back pain were divided into an experimental group (spinal decompression therapy, n=10) and a control group (conservative physical therapy, n=10). Both groups were treated three times a week over a four-week period. Results: The comparison of between-group changes post-treatment revealed statistically significant lower levels of pain and disability in the experimental group than the control group. The comparison of within each group changes before and after the treatment showed statistically significant declines in pain and disability indexes of both groups. Conclusion: Spinal decompression therapy may be an effective intervention for improving pain and disability in patients with chronic low back pain.