• 동의생리병리학회지
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• 제25권5호
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• pp.870-875
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• 2011

Arthritis of the knee is the most common type of joint inflammatory disorder and it is associated with pain and inflammation of the joint capsule. The aim of present study was to investigate the endogenous effect of low intensity laser acupuncture on collagen-induced arthritis in rats. Forty Sprague-Dawley rats were randomly divided into normal group, arthritis group, low laser group with 10 rats in each group. Arthritis in rats was induced by subcutaneous injection of type II collagen combined with complete Freund's adjuvant. Here we investigated the effects of low intensity laser therapy in experimentally induced rat knee arthritis. To evaluate preventive and therapeutic effects of low intensity laser acupuncture on collagen-induced arthritis rats. In collagen induced arthritic rats, there was significant increase in rat paw volume and decrease in body weight increment, whereas low intensity laser therapy groups, showed significant reduction in paw volume and normal gain in body weight. The altered biochemical parameters(blood urea, serum creatinine, total proteins and acute phase proteins) in the arthritic rats were significantly brought back to near normal by the low intensity laser therapy. Therefore, low intensity laser acupuncture may be a useful treatment in the prevention and treatment of collagen-induced arthritis.

• The Korean Journal of Physiology
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• 제19권2호
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• pp.227-232
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• 1985

Previously, we had reported that the electrical stimulation of peripheral nerve with stimlatory parameters of 20 V strength and 2 Hz frequency for 60 min resulted in reducing the pain reaction. The present study was performed to evaluate if the pain reaction was affected by the peripheral nerve stimulation with different stimulatory parameters in the decerebrated cat. The flexion reflex was used as an index of the pain reaction. The reflex was elicited by stimulating the sural nerve (stimulus strength of 20 $V\;\times\;0.5$msec) and recorded as a compound action potential from the motor nerve innervated to the posterior biceps femoris muscle. The common perneal nerve was selected as a peripheral nerve on which the electrical stimulation of various intensities and frequencies was applied. The results are summarized as follows : 1) The peripheral nerve stimulation with 100 mV strength, regardless of frequencies, did not affect the pain reaction induced by the sural nerve stimulation. 2) When the stimulus of 1V intensity and slow frequency (2 Hz) was applied to the peripheral nerve for 30 min or 60 min, the pain reaction was significantly reduced comparing to the control. However, this reduced pain reaction by the peripheral nerve stimulation was not reversed by the injection of naloxone (0.02 mg/kg) 3) High frequency stimulus (60 Hz) of 1V intensity for 30 or 60 min did not show any effects of affecting the pain reaction. These results suggest that the stimulus of relatively high intensity (at least 1V) and low frequency (2 Hz) is needed to elicite the analgesic effect by the peripheral nerve stimulation. By the 1V stimulus, $A\delta$ nerve fiber is activated. Therefore, an $A\delta$ or smaller nerve fibers must be activated for showing analgesia by the peripheral nerve stimulation. However, the mechanism of analgesia by the $A\delta$ nerve activation alone was not related to the endogeneous morphine system since the reduced pain reaction by the $A\delta$ fiber activation alone was not reversed by the treatment of naloxone.

• 종양간호연구
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• 제2권1호
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• pp.36-49
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• 2002

The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.50-58
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• 2022

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

• Journal of Oral Medicine and Pain
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• 제40권3호
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• pp.89-95
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• 2015

All living organisms have a biological clock that orchestrates every biological process and function, and this internal clock operates following a circadian rhythm. This biological clock is known to influence various clinical indicators such as blood pressure and body temperature. Also, the fluctuation of signs and symptoms of diseases including pain disorders are affected by circadian rhythm. It has been reported that the pain intensity of various somatic and neuropathic pain disorders show unique pain patterns that depend on the passage of time. The generation of pain patterns could be explained by extrinsic (e.g., physical activity, tactile stimulation, ambient temperature) and also intrinsic factors (neural and neuroendocrine modulation) that are related to the circadian rhythm. It is important to recognize and identify the individual pain pattern in pain therapy to approve treatment outcome. Moreover, chronotherapeutics which considers pain patterns and pharmacokinetics in context of the circadian rhythm could produce greater analgesia in response to medication. However, only a limited number of studies handle the issue of pain patterns according to circadian rhythm and chronotherapeutics in the orofacial region. The present review intends to reflect on the most recent and relevant data concerning the bidirectional relation between pain disorders of the orofacial region and circadian patterns.

• The Korean Journal of Pain
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• 제12권2호
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• pp.238-241
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• 1999

Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1; metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.

• The Korean Journal of Pain
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• 제36권1호
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• pp.84-97
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• 2023

Background: The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods: Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results: One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions: This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.

• 셀메드
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• 제12권2호
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• pp.6.1-6.5
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• 2022

Objectives: Sciatica is a musculoskeletal pain sensed in the leg along with the distribution of the sciatic nerve, which is sometimes accompanied by low back pain and is most commonly caused by a disc herniation. In the Unani system of Medicine, Irq-un-Nasa (Sciatica) is defined as the pain which starts from the hip joint and descends towards the foot. It is a type of Waja-ul-Mafasil which is developed due to the accumulation of Khilt-e-Dam or Khilt-e-Balgham ghaleez in the hip joint. The conventional system of Medicine offers several medications and surgeries to manage sciatica with limited clinical evidence of effectiveness. These cases aim to provide insight into the effects of Fasd (Venesection) in Irq-un-Nasa. Case Presentation: Fasd was performed in the saphena minor vein of two clinically diagnosed patients with sciatica after the initial assessment. Two sittings of Fasd, once a week in each patient, were performed, followed by telephonic assessments for two months. The intensity of sciatic pain reduced with subsequent sittings of Fasd, and there was no recurrence of any symptoms and signs again during complete follow-up. Conclusion: Based on the results of the present case report, it appears that such cases of Irq-un-Nasa can be managed with Fasd, and the quality of life of such patients can also be improved.

• Journal of Oral Medicine and Pain
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• 제45권2호
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• pp.23-28
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• 2020

Purpose: Temporomadibular disorders (TMDs) can result in chronic pain, which is often associated with psychological and sleep disturbance. Increased levels of psychological and sleep impairments are often related with poor treatment outcomes. The purpose of the present study was to evaluate clinical features, psychological profiles and the prevalence of clinical insomnia in TMD patients with chronic pain and to suggest an effective treatment approach. Methods: A total of 200 TMD patients who had visited the Pusan National University Hospital dental clinic for treatment of their pain were recruited from June 2018 through December 2019. TMD patients were classified into an acute (n=100) and chronic (n=100) group and compared the clinical symptoms. The primary diagnosis of TMD were categorized as TMD with joint pain group (TMD_J), TMD with muscle pain group (TMD_M) and TMD with joint-muscle mixed pain group (TMD_JM). Self- report measures of sleep quality and psychological profiles were evaluated via the Insomnia Severity Index (ISI) and the Korean Stress Response Inventory (SRI). Independent t-tests, Mann-Whitney U-tests, and chisquared test were used for the statistical analysis. Results: Chronic TMD patients showed higher pain intensity, as well as higher prevalence of related symptoms (headache, musculoskeletal pain) and myogenous pain. They also had significantly higher scores in all SRI parameters and a higher percentage of clinical insomnia than acute TMD patients. Conclusions: Based on the above results, psychological profiles and sleep quality assessments are necessary to provide essential data that will allow for improved treatment of chronic TMD patients.

• The Korean Journal of Pain
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• 제34권4호
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• pp.454-462
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• 2021

Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.