• 대한추나의학회지
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• 제5권1호
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• pp.195-204
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• 2004

This paper describes possible mechanism of the somatic referred pain. The study of somatic referred pain mechanism is necessary because many patients suffer from several types of muscle pain. This review compares the somatic referred pain with MPS(myofacial pain syndrome). There are similarities between these two pain mechanisms. But the therapeutics of somatic referred pain is yet remain fully unknown. Therefore this review consider origin of variable referred pain. Also it is recommendable to study referred pain mechanism in terms with oriental medical pain concept.

• 대한추나의학회지
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• 제5권1호
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• pp.1-9
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• 2004

The purpose of this article is to contribute to study on visceral referred pain. Recently it is getting more interest in measurement of pain degree and effective treatment. We have researched on specific character of visceral referred pain, oriental medical referred pain, and some theories of the mechanism of the visceral referred pain. But therapeutics of visceral referred pain is not yet known. It will be necessary of additional study later.

• The Korean Journal of Pain
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• 제18권2호
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• pp.267-270
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• 2005

Referred pain is not localized to the site of its cause, but referred to an area that may be an adjacent distant from such a site. With respect to this, there is the possibility of misdiagnosis in the treatment of referred pain patient. We experienced a case of a 31-years-old male patient complaining of right shoulder pain, which subsided after a bursa injection. The patient revisited our clinic after 3 weeks complaining not only of right shoulder pain, but also of right upper quadrant pain and fever. He was diagnosed as having a liver abscess by an imaging study.

• The Korean Journal of Pain
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• 제26권2호
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• pp.191-194
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• 2013

Pseudoaneurysm of the abdominal wall is a possible but very rare clinical entity. It is a known complication of surgery, trauma, or arterial puncture, but it is rarely spontaneous. Even though it can usually present with a wide range of local symptoms, it can cause referred pain via spinal cord, which is cross-excited with afferent sympathetic nervous system. We report a case of right arm pain which was referred from a small abdominal pseudoaneurysm like a referred pain from gall bladder. This rare entity should be considered in the differential for pain management in case that the pain does not resolve with medication or interventional pain management.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.1-8
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• 2016

Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, these potential alternate causes should be considered. In this clinical review, we have presented a case of referred pain from the digastric muscle (Patient 1), of pulpectomized (Patient 2), and of pulpectomized pain (Patient 3) to illustrate referred, neuromodulatory, and neuropathic pain, respectively. The Patient 1 was advised muscle stretching and gentle massage of the trigger points, as well as pain relief using a nonsteroidal anti-inflammatory and the tricyclic antidepressant amitriptyline. The pain in Patient 2 was relieved completely by the tricyclic antidepressant amitriptyline. In Patient 3, the pain was controlled using either a continuous drip infusion of adenosine triphosphate or intravenous Mg2+ and lidocaine administered every 2 weeks. In each case of abnormal dental pain, the patient's diagnostic chart was used (Fig.2 and 3). Pain was satisfactorily relieved in all cases.

• The Korean Journal of Pain
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• 제20권2호
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• pp.230-234
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• 2007

A diagnosis of shoulder pain is varied and difficult to make. The initial onset of liver cancer is difficult to detect and patients typically do not complain of symptoms as most tumors are asymptomatic. If the symptoms of the patients develop, the first symptom is usually pain that extends from the abdomen to the back and shoulder. A suprascapular nerve block is used in the treatment of the referred shoulder pain due to a metastatic hepatoma, but the effectiveness of the treatment has been limited because of its short duration. Recently, the advent of pulsed radiofrequency (PRF) lesioning has proved a successful treatment for chronic refractory pain involving the peripheral nerves. We experienced a case of a 66-year-old male patient complaining of referred right shoulder pain due to metastatic liver cancer, which was relieved after PRF lesioning of the suprascapular nerve.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제60권6호
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• pp.322-325
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• 2017

Otalgia consists of primary otalgia associated with disorders of the ear itself and referred otalgia due to disorders of organs that share the same innervation with the ear. Disorders of the oral cavity and laryngopharynx served by the glossopharyngeal and vagus nerves are common causes of referred otalgia. Chest pain from myocardial infarction spreads through the afferent pain pathway, especially through the sympathetic nerves in the cardiac plexus and the phrenic nerve, resulting in a typical chest pain or referred pain in the left upper extremity. However, pain spreading through the vagus nerve can theoretically cause referred otalgia. This association between the heart and ear has not been widely acknowledged, even though a referred otalgia can occasionally be the only symptom of the tragic disease, myocardial infarction, and should be taken seriously. We report a patient who complained of left otalgia as the only symptom of myocardial infarction.

• 대한한의학원전학회지
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• 제27권2호
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• pp.119-135
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• 2014

Objectives : In order to research references on low back pain in Uihagimmun Methods : In respect of causes, symptoms and prescriptions for all kinds of low back pain, enlarging the range of references from books regarded as its references in Jiprye(集例) to books referred in Yeokdaeuihakseongssi(歷代醫學姓氏). Results : Beside of the books referred in Jiprye(集例) such as Seuideukhyobang(世醫得效方), Dangyesimbeop(丹溪心法), Okgimiui(玉機微義) and Injejikji(仁齋直指), the other reference books must be Sanghannon(傷寒論), Geumgweyoryak(金匱要略), Samingeugilbyeongbangjeungnon(三因 極一病證方論), Jebyeongwonhuron(諸病源候論), Jesaengbang(濟生方), Dongwonsihyobang(東 垣試效方), Maeginjeungchi(脈因證治), Bojebang(普濟方), Uihakjeongjeon(醫學正傳), Jeungchiyogyeol(證治要訣), Uihakgangmok(醫學綱目), Manbyeonghoechun(萬病回春), Gogeumuigam(古今醫鑑) and Susebowon(壽世保元) etc. Conclusions : Icheon(李梴), the author of Uihagimmun, referred not only to books mentioned in Jiprye but to books referred in Yeokdaeuihakseongssi. This book had important effect on making the contents of low back pain in Donguibogam(東醫寶鑑).

• 한국융합학회논문지
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• 제12권2호
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• pp.311-316
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• 2021

통증클리닉에 의뢰되어 오는 환자들의 수는 증가하는 추세에 있다. 본 연구는 3차 병원의 통증클리닉에 의뢰되어 오는 환자들을 분석하여 그 특성을 파악하고자 시행되었다. 2011년 1월부터 2015년 12월까지 전라북도 지역의 3개 대학병원 통증클리닉에 의뢰되어 온 환자 587명을 대상으로 연구를 수행하였다. 데이터는 외래 진료 기록지를 참고하여 후향적으로 수집되었다. 이들 환자를 연령, 성별, 주된 증상, 통증 위치, 동반 질환, 의뢰 부서, 의뢰 원인에 따라 분석하였다. 통증 클리닉에서는 많은 의학적 문제에 봉착하게 된다. 따라서 통증클리닉에서 표준화된 진료지침이 필요하며, 이를 위해서는 환자들의 특성을 파악할 필요가 있다. 더 많은 환자를 대상으로 한 전국단위의 연구가 이루어진다면, 환자들의 특성을 더욱 정확히 파악할 수 있을 것으로 생각된다.

• The Korean Journal of Pain
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• 제36권2호
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• pp.173-183
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• 2023

Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.