• Title/Summary/Keyword: Sciatic pain

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Effect of Capsaicin on Causalgiform Pain in the Rat

  • Kim, Kwang-Jin;Jeon, Byeong-Hwa;Kim, Won-Sik;Park, Kyung-Ran;Choi, Sae-Jin
    • The Korean Journal of Physiology
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    • v.26 no.2
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    • pp.143-150
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    • 1992
  • The purpose of this study is to obtain the effective concentration of capsaicin to relieve pain with no change in the number of C-fibers and its effective duration for pain relief. Capsaicin has been used extremely as a experimental tool and as topical medications for acute or chronic tissue injuries and partial nerve injury is the main cause of causalgiform pain disorders in humans. Here, the left sciatic nerve was ligated unilaterally at the high level of the thigh to prepare an animal model of this pain condition. The rat developed guarding behavior of the ipsilateral hind paw within a few hours after the operation and this behavior was maintained for several months thereafter, suggesting the possibility of spontaneous pain. These animals were divided into two groups(4-week & 8-week) and each group was subdivided into five groups by different concentration (0.05, 0.1, 0.5, 1.0 & 2.0%). Each capsaicin concentration was treated locally on the spinal cord-side of the ligated nerve and the foot withdrawal latency was measured. Thereafter, the dorsal roots of L5 were removed from both sides immediately after in tracardial perfusion for the counting of C-fibers by the histological procedure. There were no significant differences in the foot-withdrawal latency and the number of C-fibers between the left side treated with 0.05% capsaicin and the right side treated with the vehicle. However, latencies of the left sides treated with 0.1, 0.5, and 1.0% capsaicin increased significantly throughout 4-6 weeks with almost no change in the number of C-fibers, and the latencies showed the trends to approach slowly to those of the conditions after operation. The latency of subgroup treated with 2.0% increased by approximate 10% more than that of the right side throughout 8 weeks, and the number of C-fibers decreased by about 30% or more These results suggest that the elevated latency with capsaicin(0.1-1.0%) treatment is due to the inhibition of impulse transmission throughout the primary afferent fiber and the data from 2.0% are due to partial destruction of C-fibers. Therefore, capsaicin concentrations from 0.1% to 1.0% are probably very effective for the treatment of causalgiform pain with almost no destruction of C-fibers.

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A Mid-Term Follow-Up Result of Spinopelvic Fixation Using Iliac Screws for Lumbosacral Fusion

  • Hyun, Seung-Jae;Rhim, Seung-Chul;Kim, Yong-Jung J.;Kim, Young-Bae
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.347-353
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    • 2010
  • Objective : Iliac screw fixation has been used to prevent premature loosening of sacral fixation and to provide more rigid fixation of the sacropelvic unit. We describe our technique for iliac screw placement and review our experience with this technique. Methods : Thirteen consecutive patients who underwent spinopelvic fixation using iliac screws were enrolled. The indications for spinopelvic fixation included long segment fusions for spinal deformity and post-operative flat-back syndrome, symptomatic pseudoarthrosis of previous lumbosacral fusions, high-grade lumbosacral spondylolisthesis, lumbosacral tumors, and sacral fractures. Radiographic outcomes were assessed using plain radiographs, and computed tomographic scans. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and questionnaire about buttock pain. Results : The median follow-up period was 33 months (range, 13-54 months). Radiographic fusion across the lumbosacral junction was obtained in all 13 patients. The average pre- and post-operative ODI scores were 40.0 and 17.5, respectively. The questionnaire for buttock pain revealed the following : 9 patients (69%) perceived improvement; 3 patients (23%) reported no change; and 1 patient (7.6%) had aggravation of pain. Two patients complained of prominence of the iliac hardware. The complications included one violation of the greater sciatic notch and one deep wound infection. Conclusion : Iliac screw fixation is a safe and valuable technique that provides added structural support to S1 screws in long-segment spinal fusions. Iliac screw fixation is an extensive surgical procedure with potential complications, but high success rates can be achieved when it is performed systematically and in appropriately selected patients.

Effects of Araliae Continentalis Radix Pharmacopuncture on a Neuropathic Pain Rat Model (독활 약침이 신경병리성 통증 유발 흰쥐에 미치는 영향)

  • Kim, Myung Sik;Kim, Jae Hong;Youn, Dae Hwan;Cho, Myoung Rae
    • Korean Journal of Acupuncture
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    • v.37 no.2
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    • pp.104-121
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    • 2020
  • Objectives : Since neuropathic pain shows a variety of symptoms via various mechanisms, there are many difficulties in treatment and various treatments have been tried. This study was conducted to investigate the effects of Araliae Continentalis Radix pharmacopuncture (ACR) on neuropathic pain. Methods : After dividing the white rats into six groups, the sciatic nerves of five groups except the normal group were excised to induce neuropathic pain. Except normal and control group, the other four groups were given: saline (Saline group), ACR 1.100 mg/kg (ACR 1 group), ACR 2.743 mg/kg (ACR 2 group), and ACR 5.486 mg/kg (ACR 3 group) at GB30, twice a week for a total of six times in three weeks. Withdrawal response react time and force intensity, c-Fos, TNF-α, IL-6, and IFN-γ were observed to investigate the efficacy of ACR in each group. Body weight, WBC, RBC, HGB, PLT, AST, ALT, BUN, and Cr changes were observed to check the safety of ACR. Results : Both withdrawal response react time & force intensity were significantly increased in the ACR2 and ACR3 groups at 3 weeks. C-Fos tended to decrease in all ACR groups and significantly decreased in ACR3 group. In blood serum, TNF-α showed a tendency to decrease in all ACR groups and a significant decrease in ACR3 group. But IL-6 and IFN-γ did not change significantly in all experimental groups. In the spinal cord, IFN-γ was significantly decreased in the ACR3 group. But TNF-α and IL-6 were not significantly changed in all experimental groups. Body weight was not changed significantly in all experimental groups. RBC increased significantly in ACR2 group, HGB increased in ACR3 group, and PLT increased significantly in all experimental groups. ALT significantly decreased in ACR1 group, and there were no significant changes in AST, BUN, and Cr in all experimental groups. Conclusions : At high concentrations, ACR pharmacopuncture reduced c-Fos, and TNF-α in the blood serum and IFN-γ in the spinal cord thereby suppressed allodynia. More in-depth studies about pharmacopuncture concentration or mechanism are needed.

The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.33-39
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    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

Effect of Minocycline on Activation of Glia and Nuclear Factor kappa B in an Animal Nerve Injury Model

  • Gu, Eun-Young;Han, Hyung-Soo;Park, Jae-Sik
    • The Korean Journal of Physiology and Pharmacology
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    • v.8 no.5
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    • pp.237-243
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    • 2004
  • Glial cells are activated in neuropathy and play a key role in hyperalgesia and allodynia. This study was performed to determine whether minocycline could attenuate heat hyperalgesia and mechanical allodynia, and how glial cell activation and nuclear factor kappa B (NF-kappaB) were regulated by minocycline in a model of chronic constriction of sciatic nerve (CCl). When minocycline (50 mg/kg, oral) was daily administered from 1 day before to 9 days after ligation, heat hyperalgesia and mechanical allodynia were attenuated. Furthermore, when minocycline treatment was initiated 1 or 3 days after ligation, attenuation of the hypersensitive behavior was still robust. However, the effect of attenuation was less when minocycline was started from day 5. In order to elucidate the mechanism of pain attenuation by minocycline, we examined the changes of glia and NF-kappaB, and found that attenuated hyperalgesia and allodynia by minocycline was accompanied by reduced microglial activation. Furthermore, the number of NF-kappaB immunoreactive cells increased after CCI treatment and this increase was attenuated by minocycline. We also observed translocation of NF-kappaB into the nuclei of activated glial cells. These results suggest that minocycline inhibits activation of glial cells and NF-kappaB, thereby attenuating the development of behavioral hypersensitivity to stimuli.

Treatment Effects of Upper Body Traction (V-trac) for the HIVD (요추추간판 탈충증에 대한 상체견인(V-trac)의 치료효과 연구)

  • Kim, Myung-Joon;Park, Ji-Whan
    • Journal of Korean Physical Therapy Science
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    • v.2 no.4
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    • pp.749-761
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    • 1995
  • The purpose of this study was to analyze the effects of V-trac on the clinical characteristics of patients who suffered from HIVD. The data were collected from 500 cases who had lumbar disc problems, from August, 1993 to July, 1995. The results of study were as follows; 1. Total patients statistics; mean age is 38 years, average duration of symptom is 5.4 years. 2. Symptomatic effects; HNP is 89.5 %, spinal stenosis is 55.1 %, and mean effects of total symptom is 80.0 %. 3. Pain relief effects; 1st session is 85.0 %, 7 th sessions are 89.3 %. 4. Back muscle improved effects; 10 sessions are 25.6 % rather than 1st session patients. 5. Sciatic scoliosis correction effect; Corrected scoliosis is improved 86.6 % by the 14 sessions V-trac. 6. Psychological effects; mental vigour is 51.2 %, emotional stability is 57.4 %, well-being is 72.5 %, comfortable sleeping is 60.2 %. 7. Follow-up states after V-trac therapy; Good conditions are 72.0 %, less conditions are 28.0 % after 1 month.

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A Case Report of Three Yogaktong(腰脚痛) Patients Treated with Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring (X-선상(線像) 배수혈 진단을 통한 요각통의 침구(鍼灸) 치험 3례(例))

  • Hong, Seung-Won;Lee, Yong-Seob
    • Korean Journal of Acupuncture
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    • v.23 no.2
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    • pp.79-88
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    • 2006
  • Objectives : Yogaktong is the genernal term of lowback and sciatic pain. Simpley this is not for the syndrom or illiness but for the symptoms. In this study, the effect of Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring for three patients with Yogaktong(腰脚痛) were evaluated. Methods : After treatment with the Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring for one time, we evaluated the effect by the figure of x-ray measuring and complaints of patients. Results : In three cases, the change in the figure declined dramatically and symptoms of patients got better after one treatment. Conclusions : Acupuncture and Moxibustion Treatment by Analysing Su-point(背兪穴) compared with X-ray measuring was effective. It will be attempted to the patients with it.

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Effects of Somatostatin on the Responses of Rostrally Projecting Spinal Dorsal Horn Neurons to Noxious Stimuli in Cats

  • Jung, Sung-Jun;Jo, Su-Hyun;Lee, Sang-Hyuck;Oh, Eun-Hui;Kim, Min-Seok;Nam, Woo-Dong;Oh, Seog-Bae
    • The Korean Journal of Physiology and Pharmacology
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    • v.12 no.5
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    • pp.253-258
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    • 2008
  • Somatostatin (SOM) is a widely distributed peptide in the central nervous system and exerts a variety of hormonal and neural actions. Although SOM is assumed to play an important role in spinal nociceptive processing, its exact function remains unclear. In fact, earlier pharmacological studies have provided results that support either a facilitatory or inhibitory role for SOM in nociception. In the current study, the effects of SOM were investigated using anesthetized cats. Specifically, the responses of rostrally projecting spinal dorsal horn neurons (RPSDH neurons) to different kinds of noxious stimuli (i.e., heat, mechanical and cold stimuli) and to the $A{\delta}$ -and C-fiber activation of the sciatic nerve were studied. Iontophoretically applied SOM suppressed the responses of RPSDH neurons to noxious heat and mechanical stimuli as well as to C-fiber activation. Conversely, it enhanced these responses to noxious cold stimulus and $A{\delta}$-fiber activation. In addition, SOM suppressed glutamate-evoked activities of RPSDH neurons. The effects of SOM were blocked by the SOM receptor antagonist cyclo-SOM. These findings suggest that SOM has a dual effect on the activities of RPSDH neurons; that is, facilitation and inhibition, depending on the modality of pain signaled through them and its action site.

The study of difference between HIVD group and simple low back pain group by Current Perception Threshold test (요추추간판탈출증군과 단순요통군간의 Current Perception Threshold상의 차이에 관한 연구)

  • Kim Cheol-Hong;Lee Byung-Hoon;Kwon Hye-Yeon;Lim Chun-Woo;Seo Jung-Chul;Youn Hyoun-Min;Song Choon-Ho;Jang Kyung-Jeon;Ahn Chang-Beohm
    • Journal of Acupuncture Research
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    • v.18 no.6
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    • pp.59-69
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    • 2001
  • Objective : The aim of this study is to assess the ability of the CPT test to dignosis radiculopathy in Korean with NeuvalTM CPT database. Method : Electrical stimulation(at 2000, 250, and 5Hz) using Neurometer was applied to the 19 patients who felt back and sciatic pain with herniated intervertevral disc(HIVD) of L-spine, dignosisd by lumbar CT or MRI, and the 33 patients who felt only back or hip or leg pain without HIVD, stenosis, spondylolisthesis which causing radiculopathy. The test sites were toe1, toe3 and toe5 related to L4, L5 and S1 nerve roots. Results : The mean values of the CPT of HIVD group was stiatically lower than LBP group at toe1-250Hz, toe3-2000Hz, 250Hz and toe5-250Hz, 5Hz. The grading CPT score of HIVD group was stastically higher than LBP group at the toe3(L5). The VAS of HIVD group was stastically higher than LBP group. Conclusion : These results suggest that the CPT test can be a valuable testing for diagnosing radiculopathy in Korean. In using CPT test further study is needed for the diagnosis and evaluation of sensory nerve dysfunction in the musculoskeletal disease.

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Research trends and clinical applications of neural mobilization in Korea: A scoping review (신경가동술의 국내 연구 동향과 임상적 활용: 주제범위 문헌고찰)

  • Lee, Eun-Kyung;Kim, Jin-Hyun;Lee, Jung-Han;Cho, Eun-Byul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.1
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    • pp.53-66
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    • 2021
  • Objectives The purpose of this scoping review is to investigate the trends and gaps in existing research on neural mobilization in Korea and to suggest further directions for study. Methods A scoping review was sequentially conducted according to the five steps outlined by Arksey and O'Malley, and the PRISMA-ScR checklist. We searched five domestic databases (RISS, DBpia, KISS, ScienceON, and KMBASE) and identified relevant literature reported until April 15, 2021. The key search terms used were "Neural mobilization" and "Neurodynamic". Results Of the 1383 studies identified in the search, 50 were finally selected. Of these, 45 studies were in the field of medicine and pharmacy and physical therapy as the most common sub-field. Thirty-eight of the 50 studies (76%) were randomized controlled trials. Neural mobilization was most frequently used in the treatment of stroke (n = 13) and of various neuromusculoskeletal diseases such as cervical radiculopathy (n = 8) and low back pain (n = 5). The main targets of neural mobilization were the median nerve (n = 20) and sciatic nerve (n = 14). The most commonly used technique for neural mobilization was that developed by Butler and Jones in 1991 (n = 10). Conclusions This is the first scoping review of neural mobilization in Korea. We believe that further research on neural mobilization with other types of research design is necessary to investigate the utility of neural mobilization and to establish standard protocols. Our findings indicate that neural mobilization can be considered as an intervention for neuromusculoskeletal diseases in Korean medicine.