• Title/Summary/Keyword: Tension headache

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Current understanding of nociplastic pain

  • Yeong-Min Yoo;Kyung-Hoon Kim
    • The Korean Journal of Pain
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    • v.37 no.2
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    • pp.107-118
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    • 2024
  • Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

Relationship between job-stress and temporomandibular joint disorder in dental hygienists (치과위생사의 직무 스트레스와 턱관절 장애 자각증상의 상관성 연구)

  • Jeong, Eun-Young;Kim, Myung-Rae
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.3
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    • pp.381-390
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    • 2014
  • Objectives : The purpose of the study is to investigate the relationship between job-stress and temporomandibular joint(TMJ) disorder in dental hygienists. This study will provide the basic data to improve the working condition and the quality of life. Methods : The subjects were 229 dental hygienists at general hospitals in Seoul, Korea. A self-reported questionnaire was filled out from May 20 to June 20, 2013. The questionnaire consisted of 4 questions of demographic features, 11 questions for TMJ symptoms and 5 questions for job stress. The data were analyzed by frequency analysis, chi-square test, Mann-Whitney U test and multiple job-stress logistic regression analysis using SPSS version 21.0. Results : During the last six months, 53.3%(122 persons) of the dental hygienists had TMJ disorder symptoms including joint noise(40.6%, 93 persons), TMJ pain(31.4%, 71 persons) and limitation of TMJ(21.8%, 50 persons). Job-stress is divided into two ranges including high stress group(4.3-5.0 points) and low stress group(0.0-3.6 points) in TMJ pain and joint noise(p<0.05). TMJ pain was closely related to low back pain, pelvis pain and tension headache arising from the uncomfortable working posture. Conclusions : It is necessary to prevent the job stress in the dental hygienists by the improvement of working condition, emotional stability, and frequent postural change.

Impact of the Radiation Absorbed dose on the Microelements of Tissues in Living Bodies (방사선 선량이 생체 내 조직에서 미량원소에 미치는 영향)

  • Ji, Tae-Jeong;Kwak, Byung-Joon
    • The Journal of the Korea Contents Association
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    • v.11 no.8
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    • pp.204-210
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    • 2011
  • We looked into the content change of microelements participating in the metabolism among the impacts of radiation energy on living bodies. We irradiated X-rays of 1 Gy, 5 Gy and 10 Gy to the whole bodies of mice, and then analyzed the liver tissues. We found that the microelement content had changed in some elements compared with the control group. When it came to changes by radiation dose, there was no significant change with the absorbed level of 1 Gy, but the higher absorbed levels of 5 Gy and 10 Gy reduced the content of Ca and Mn. In particular, the Ca content was reduced the most, apparently causing symptoms such as muscle tension and chronic headache, etc. The increased element was Al, which was found to have increased by 100%. In regard to the content change according to the time elapsed after irradiation, the contents of Fe, Ba, etc. showed the tendency of reduction. The content of Cd, a harmful element, increased by 25%, and it seemed that the element was involved in the calcium metabolism. Therefore, cell damage by radiation energy is determined to have an impact on the content change of microelements and considered to be partly related to a cause of precursor symptoms.

A Case Report of Referral Pain on Mandibular Toothache Originated from Myofascial Pain (근막동통으로 인한 하악 구치부 연관통의 임상증례)

  • Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.455-460
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    • 2007
  • Majority of toothache is caused by abnormality of pulpal or periodontal tissues. However, there are numerous nonodontogenic sources that may be responsible for pain felt in the tooth. Nonodontogenic toothache may result from muscle, maxillary sinus, neuropathic, neurovascular, even cardiac and psychogenic problems. Myofascial pain is one of the most common abnormality characterized by palpation of a hard band which acts as the trigger point that causes stiffness and fatigue of the muscle, referral pain in tooth, tension-type headache, and hyperalgesia. Masseter muscle particularly induce referral pain in maxillary and mandibular molars. This case reported the treatment of the pain in right mandibular molar originated from myofascial pain of the right masseter. The pain is improved by general and reversible treatments such as muscle exercise, physical therapy, and medication. Nonodontogenic toothache should undergo proper differential diagnosis in order to avoid unnecessary dental treatments, such as endodontic, periodontic treatment, and tooth extraction, which would fail to alleviate the symptom of the patient.

The Effect of Ipidural Pain Block After Thoracotomy (개흉술후 지속적 경막외마취가 통증감소에 미치는 영향)

  • 최덕영;원경준
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.809-814
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    • 1997
  • Continuous epidural pain block with a local anesthetic agents is a commonly employed technique for pain relief after thoracotomy. In this study, we evaluated the effectiveness of the continuous epidural pain block in 19 patients undergoing elective lateral or posterolatrral thoracotomy with control group(n=19) from November 1994 to July 1995, Epidural lidocaine and morphine mixtures were injected via an epidural catheter as a bolus after operation, and then bupivacaine and morphine mixtures were injected continuously following 5 or 6 days. The pain score, upper arm elevation(ROM score), and respiratory rate were significantly changed(P<0.05) from 30min after injection. The CO2 tension of arterial blood was decreased significantly(P<0.05) from 2hr after injection. The postoperative hospital days were decreased significantly(P<0.05). Side effects of the epidural pain block were urinary retention(n= 10), urticaria(n=2) and a case of headache. There was no postoperative lung atelectasis. We conclude that the continuous epidural pain block is good for prevention of the postoperative lung complication and early recovery after thoracotomy.

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Review of the Large-Scale Clinical Researches on Acupuncture in Germany: ASH, ART, ARC, and GERAC (2000년부터 독일에서 수행된 대규모 침 임상연구들에 대한 고찰: ASH, ART, ARC, GERAC)

  • Yoon, Juyeon;Han, Kuk-In;Jeong, Jinsu;Lee, Seungho;Jang, Insoo
    • Korean Journal of Acupuncture
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    • v.30 no.1
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    • pp.21-26
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    • 2013
  • Objectives : The purpose is to introduce the recent large-scale clinical researches for safety, efficacy and effectiveness of acupuncture in Germany. Results : In 2000, the German Federal Committee of Physicians and Health insurer proposed that large research initiatives on acupuncture, Acupuncture Model Projects(Modellvorhaben Akupunktur), could be conducted by health insurance companies for several pain that acupuncture is syndromes to justify the insurance-based reimbursement. Accordingly, 4 clinical researches were carried out; the Acupuncture Safety and Health economics studies(ASH), the Acupuncture Randomised Trial(ART), the Acupuncture in Routine Care studies(ARC), and the German Acupuncture trial(GERAC). Meanwhile, ASH is a prospective observational study for safety and costs. ART and GERAC are composed of RCTs for efficacy. ARC includes 6 pragmatic RCTs with additional non-randomized cohort study for effectiveness. We investigated the papers related to them and discussed about the outcomes. The researches showed that acupuncture is effective in practice for several chronic conditions such as migraine, tension-type headache, chronic low back pain, osteoarthritis of knee, dysmenorrhea, and allergic rhinitis. Based in part on them, the German health authorities decided that acupuncture would be included into routine reimbursement by social health insurance funds for chronic low back pain and chronic osteoarthritis of the knee in 2006. Conclusions : The German clinical researches may suggest the clues for establishing the evidence of acupuncture treatment.

The Effects of Decreasement of Blood Pressure on Hypertension Patients by Moxibustion (애구(艾灸)가 고혈압(高血壓) 환자(患者)의 혈압강하(血壓降下)에 미치는 영향(影響))

  • Lee, Byung-Hoon;Kim, Cheol-Hong;Seo, Jung-Chul;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Ahn, Chang-Beohm
    • Journal of Acupuncture Research
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    • v.18 no.5
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    • pp.70-76
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    • 2001
  • Objective : In order to study effects of decreasement of blood pressure on hypertension patients by moxibustion a clinical study was performed. Methods : Moxibustion at Quchi(LI11), Guanyan(CV4) 10 times on 25 hyper tension patients who were treated via opd on Dong-Eui Oriental Medical Hospital. Results : 1. After 10 times moxibustion at Quchi(LI11), Guanyan(CV4),the systolic blood pressure were decreased 16.5% degree. 2. After 10 times moxibustion at Quchi(LI11), Guanyan(CV4),the diastolic blood pressure were decresed 26.6% degree. 3. Subjective symptoms(i.e. headache, dizziness, heat in the upper part of the body, dyspnea etc) were decresed after 10 times moxibustion at Quchi(LI11), Guanyan(CV4). Conclusion : Continous Moxibustion at Quchi(LI11), Guanyan(CV4) implies decreasement of blood pressure and improvement of subjective symptoms.

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A Systematic Review and Meta-analysis of Acupuncture Trials in Republic of Korea that Used Sham Acupuncture as a Control Group (거짓침을 대조군으로 사용한 국내 침 임상시험에 대한 체계적 고찰과 메타분석)

  • Kim, Jung-Eun;Kang, Kyung-Won;Kim, Tae-Hun;Lee, Seung-Hoon;Kim, Joo-Hee;Baek, Seung-Min;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.28 no.6
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    • pp.1-17
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    • 2011
  • Objectives : This study aimed to review randomized controlled trials of acupuncture performed in South Korea that used sham acupuncture as a control group. Methods : The following databases were searched through the end of September 2011: Koreanstudies information service system (KISS), Korean medical database (KMbase), national discovery OR science leaders (NDSL), oriental medicine advance searching integrated system (OASIS), and research information service system (RISS). The following search terms were used: acupuncture AND (sham or placebo). The reference lists of searched articles and Korea institute of oriental medicine (KIOM) reports(2005~2009) were identified. The following data were extracted: year/first author, disease, number of participants, blinding, intervention, outcome, and result. Where appropriate, we performed meta-analysis. The methodological quality was assessed according to the Jadad scale and 'risk of bias' by Cochrane Handbook procedure. Results : Twenty-nine studies were included in this review. In eighteen studies, penetrating sham controls were used as the control intervention, whereas the remaining eleven studies adopted non-penetrating sham controls such as the Park Sham Device or blunt auricular acupuncture. Nine studies showed statistically significant difference in outcomes. Twelve studies concerning insomnia after stroke, chronic tension-type headache, idiopathic Parkinson's disease, Hwa-Byung, and smoking cessation were included in meta-analysis. A meta-analysis of insomnia after stroke only found significant difference(MD -4.31, 95% Cl -6.19 to -2.42, $p$<0.00001). In general, all of the studies showed low methodological quality(Jadad score: mean 2.1). Risk of bias by Cochrane Handbook procedure varied. Conclusions : The results of this study could not suggest conclusive evidence that acupuncture is more effective than sham acupuncture in several diseases. In the future, more studies with rigorous acupuncture trials using sham controls should be conducted.

Life Event Stress and Coping Strategy in Patient with Atopic Dermatitis (아토피 피부염 환자의 생활사건 스트레스와 대처방식)

  • Han, Duck-Hyun;Choi, Han-Gyu;Kee, Baik-Seok;Nam, Bum-Woo;Seo, Seong-Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.226-232
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    • 1999
  • Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.

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The Experience of Parents Whose Child is Dying with Cancer (암 환아 부모의 경험에 대한 질적 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.491-505
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    • 1992
  • The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

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