• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.66-70
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• 2014

Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion block with a significant relief of his pain. The second patient complained of a cold sensation and severe unexpected pain in the lower extremity of the contralateral side after anterior lumbar interbody fusion and was treated with lumbar sympathetic block. We aimed to describe sympathetically maintained pain as one of the important causes of early postoperative pain and the treatment option chosen for these cases in detail.

• 대한통합의학회지
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• 제8권1호
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• pp.47-56
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• 2020

Purpose : The purpose of this study was to determine the effects of upper extremity volume, pain, and range of motion after participation in thera-band exercises according to the hand grip type in patients with breast cancer with upper extremity edema. We also aimed to determine the most efficient type of grip. Methods : The subjects were 10 female patients diagnosed with stage 2 breast cancer who had stage 2 lymphedema. Randomly, 5 patients each were allocated to the experimental and control groups. For six weeks, the patients in both the experimental and control groups exercised daily. In both groups, manual lymph drainage was applied for 1 hour. Afterward, patients in the experimental group placed their hands in the thera-band ring and exercised with their fingers outstretched. Patients in the control group exercised while holding the thera-band ring with a finger. Both the experimental group and the control group underwent measurements of the circumference of the upper extremity, pain, and range of motion of the shoulder joint at weeks 1, 2, 4, and 6 before and after exercise. Results : The upper arm circumference decreased by more in the experimental group in all weeks than before than that in the control group, and there was a statistically significant difference at 6 weeks. Compared with the difference between pre-exercise and 6 weeks post-exercise, the change in pain significantly decreased in the experimental group and showed a statistically significant difference. The shoulder range of motion increased in extension, external rotation, and internal rotation compared with that in the control group, and there was a statistically significant difference. Although the operating range increased in flexion and abduction, there were no statistically significant differences. Conclusion : In this study, we found that thera-band exercises with an open-hand grip are more efficient than thera-band exercises with a closed-hand grip in edema reduction, pain, and range of motion. In addition, it was found that it was more effective to continue the thera-band exercises with open-hand grip extended for at least 6 weeks rather than for a short time.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.240-243
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• 2017

The incidence of contrast media extravasation has been increasing gradually. Most contrast media extravasations only can cause pain, swelling and erythema. However, in more severe cases, skin necrosis, ulceration, or compartment syndrome may occur, often necessitating a surgery. Early diagnosis and treatment should be established on the spot in order to avoid such a severe damage. We present a case of 42-year-old woman with a compartment syndrome in the right upper extremity caused by extravasation of computed tomography contrast media.

• The Korean Journal of Pain
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• 제10권2호
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• pp.274-277
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• 1997

The complex regional pain syndrome(CRPS) exhibit symptoms such as: abnormal skin color, temperature change, abnormal pseudomotor activity, edema. If CRPS is not treated appropriately at acute stage, then the affected extremity may become a useless, painful appendage. Treatment of CRPS by sympathetic blockade may be achieved by repeated intravenous regional guanethidine blocks, repeated anesthetic sympathetic blocks, surgical sympathectomy or oral sympatholytic therapy. We treated 29-year-old male patient with CRPS of left upper extremity by continuous cervical epidural blockade. Due to wound infection and dislocation of the epidural catheter, we inserted an implantable port system to inject the mixture of local anesthetics and small amount of morphine. After 10 months of treatment, patient was cured of symptoms and signs of CRPS and was able to resume a normal life.

• Safety and Health at Work
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• 제1권1호
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• pp.37-42
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• 2010

Over years it has been increasingly concerned with how upper extremity musculoskeletal disorders (UEMSDs) are attributed to psychosocial job stressors. A review study was conducted to examine associations between UEMSDs and psychosocial work factors, and to recommend what to consider for the associations. For studies in which the job demand-control-support (DCS) model or its variables were specifically employed, published papers were selected and reviewed. A number of studies have reported relationships between UEMSDs symptoms and psychosocial exposure variables. For example, the findings are: higher numbness in the upper extremity was significantly attributed to by less decision latitude at work; work demands were significantly associated with neck and shoulder symptoms while control over time was associated with neck symptoms; and the combination of high psychosocial demands and low decision latitude was a significant predictor for shoulder and neck pain in a female working population. Sources of bias, such as interaction or study design, were discussed. UEMSDs were shown to be associated with psychosocial work factors in various studies where the job DCS model was addressed. Nonetheless, this review suggests that further studies should be conducted to much more clarify the association between UEMSDs and psychosocial factors.

• Clinical Pain
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• 제20권1호
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• pp.25-29
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• 2021

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

• The Korean Journal of Pain
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• 제13권2호
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• pp.187-190
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• 2000

Background: From our clinical experience, there were some problems in paratracheal stellate ganglion block at 6th cervical level (C 6 SGB), for example, lesser change in blood flow of the upper extremity and more occurrence of hoarseness. This study was undertaken to compare the various effectiveness of C 6 SGB and paratracheal stellate ganglion block at 7th cervical level (C 7 SGB). Methods: Forty patients were equally divided into 2 groups. In the Group I, patients were undertaken C 6 SGB with 0.25% bupivacaine 6 mL and in the Group II, patients were undertaken C 7 SGB with 0.25% bupivacaine 6mL. The skin temperature of index finger was measured before and after SGB and the warm sensation on face and upper extremity, hoarseness and upper extremity paralysis were studied. Results: The skin temperature of index finger was increased significantly from $33.95{\pm}0.89^{\circ}C$ to $34.51{\pm}0.90^{\circ}C$ in the Group I and from $33.94{\pm}0.82^{\circ}C$ to $35.38{\pm}0.66^{\circ}C$ in the Group II (P<0.05) The increase of skin temperature of index finger after procedure was $0.56{\pm}0.09^{\circ}C$ in the Group I and $1.44{\pm}0.02^{\circ}C$ in the Group II. The increase of skin temperature of index finger in the Group II was more statistically significant than Group I (P<0.05). The occurance of hoarseness in the Group II was significantly less than in the Group I. There was no significant difference in warm sensation on face and upper extremity and paralysis of upper extremity in both Groups. Conclusions: C 7 SGB showed better sympathetic block effect on upper extremity than C 6 SGB and hoarseness did not occur in C 7 SGB.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.142-148
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• 2016

Purpose: The aim of this pilot study was to determine the effect of soft tissue technique (STT) in Axillary Web Syndrome (AWS) following sentinel Lymph Node Biopsy in breast cancer patients by examining the upper extremity function, range of motion, and pain. Methods: Nineteen patients with breast cancer-related AWS were evaluated. STT was performed on the symptom area for treatment of AWS symptoms. We evaluated AWS symptoms and pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, glenohumeral joint (GHJ) flexion and abduction range of motion (ROM) with or without elbow extension. Results: Visual analyses of the data suggest a modest effect of STT in improving GHJ flexion, abduction ROM with or without elbow extension, DASH for upper extremity function, and Pain. The statistically significant improvement in baseline observed for pain, DASH, and ROM data made it impossible to assess the effects of STT on those outcomes. There were no adverse events. Conclusions: STT may be an effective and safe treatment option for AWS patients recovering from breast cancer treatment; however, further research is needed.

• The Korean Journal of Pain
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• 제8권2호
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• pp.312-318
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• 1995

Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

• The Korean Journal of Pain
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• 제14권1호
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• pp.123-125
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• 2001

A 50-year-old female patient developed severe right neck and upper extremity pain, hyperesthesia and allodynia during cervical epidural block. Her pain was diagnosed as neuropathic nature. She was treated with repeated stellate ganglion block (SGB) and electrical stimulation (EST). After 3 weeks of treatment, symptomatic relief was achieved, but a mild degree of hyperesthesia and motor weakness was remained. However, she refused all treatment. So treatment was stopped. In a follow-up done, 15 weeks after the nerve injury, she had recovered without complications.