• 제목/요약/키워드: a pain

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복합부위통증 증후군 II형(CRPS Type II) 환자의 치험 -증례 보고- (Clinical Experience of a Complex Regional Pain Syndrome Type II Patient -A case report-)

  • 윤건중;김종렬
    • The Korean Journal of Pain
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    • 제9권2호
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    • pp.426-429
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    • 1996
  • Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

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Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • 제29권4호
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Nicotine dependence and the International Association for the Study of Pain neuropathic pain grade in patients with chronic low back pain and radicular pain: is there an association?

  • Schembri, Emanuel;Massalha, Victoria;Spiteri, Karl;Camilleri, Liberato;Lungaro-Mifsud, Stephen
    • The Korean Journal of Pain
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    • 제33권4호
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    • pp.359-377
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    • 2020
  • Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain. Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were completed. A control group (n = 50) was recruited. Results: There was a significant difference between current smokers and nonsmokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP "definite/probable" neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of "definite/probable" increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score. Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.

남녀별 및 실험자의 성별에 따른 동통역치와 동통내성의 차이 (Sex Differences in Pain Threshold and Pain Tolerance and the Effects of Experimenter Gender on Pain Report)

  • Yun-Kyung Hur;Jae-Kap Choi
    • Journal of Oral Medicine and Pain
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    • 제20권1호
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    • pp.97-103
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    • 1995
  • The purpose of this study was to evaluate the effect of experimenter gender on pain report as well as the sex differences in pain threshold and pain tolerance. Cold pressor test and pressure pain threshold (PPT) test were performed on forty dental students by both of a male and a female experimenter separately with 1 day interval. The obtained results were as follows : There were no differences in pain threshold and pain tolerance between males and females when they were examined by the same gender experimenter in the cold pressor test, but when they were examined by the opposite gender experimenter the pain threshold of males was significantly higher than females. When the pain threshold was measured by the same gender experimenter, using a algometer, there was no differences in PPT between males and females. However, when the same measurements were done by the opposite gender experimenter, the PPT of males was significantly higher than females at anterior temporalis and inferior masseter. For cold pressor test, females tended to report lower levels of pain threshold and pain tolerance to a male experimenter than a female, but the differences were not significant. Although both pain threshold and pain tolerance were increased when males were examined by a female experimenter in the cold pressor test, the statistical significance was found only in pain tolerance. When subjects were examined by the opposite gender experimenter in the PPT text, females reported significantly higher levels of pain at inferior masseter and males reported significantly lower levels of pain at anterior temporalis and inferior masseter.

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Effectiveness of virtual reality immersion on procedure-related pain and anxiety in outpatient pain clinic: an exploratory randomized controlled trial

  • Joo, Young;Kim, Eun-Kyung;Song, Hyun-Gul;Jung, Haesun;Park, Hanssl;Moon, Jee Youn
    • The Korean Journal of Pain
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    • 제34권3호
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    • pp.304-314
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    • 2021
  • Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients' satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

동통 평가도구 개발을 위한 연구 -한국 통증 어휘별 강도 순위의 유의도 및 신뢰도 검사- (A Study for Development of a Korean Pain Measurement Tool(II). A Study for Testing Ranks of Words in each Subclass of a Korean Pain Measurement Tool)

  • 이은옥;송미순
    • 대한간호학회지
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    • 제13권3호
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    • pp.106-118
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    • 1983
  • The main purpose of this study is to systematically classify words indicating pain in terms of their ranks in each subclass. This study is a part of developing a Korean Pain Measurement Tool. This study didnot include exploration of each word's dimension such as sensory or affective. Eighty three Korean words tentatively classified in 19 subclasses in previous study were used for this study. At least three to six words were included in each subclass and the words were randomly placed in which each subject indicates their rank of pain degree. One hundred and fifty nursing students and one hundred clinical nurses were requested to indicate the rank of each word. One hundred and sixteen students and eighty three nurses completed the ratings for analysis. The data were collected from June 1983 to July 1983. The data using ordinal scale were analyzed by Friedman ANOVA to test significant difference between rank means. All of pain words indicated significant rank mean difference in all of 19 subclasses. Some of the words were either cancelled or replaced by other words, or rearranged for their ranks. Subclasses of which words were cancelled were 1) Simple stimulating pain, 2) Punctuate pressure, 3) peripheral nerve pain, 4) radiation pain, 5) punishment-related pain, and 6) suffering-related pain. Subclasses of which words were replaced or rearranged were 1) incisive pressure, 2) constrictive pressure, 3) dull pain, 4) tract pain, 5) digestion-related pain and 6) fear-related pain. Four subclasses such as traction pressure, thermal, cavity pressure, and fatigue- elated pain indicated significant differences among rank means in each subclasses and showed no visible overlaps of the ranks among means. Further research is needed using high level measurement of pain degree of each word and more sophisticated analysis of the pain degrees. Three pain words which would be related to chemical stimulation were newly explored and included as a new subclass. Through this study, the total number of subclasses increases from 19 to 20 and the total number of Korean words in the scale decreases from 83 to 80.

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삼차신경통 환자에서 알코올 신경차단의 장기 추적 결과 (Long-term Outcome of Trigeminal Nerve Block with Alcohol for the Treatment of Trigeminal Neuralgia)

  • 한경림;김찬;김도완;조외경;조혜원
    • The Korean Journal of Pain
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    • 제19권1호
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    • pp.45-50
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    • 2006
  • Background: Recently trigeminal nerve block with alcohol (TnbA) for the treatment of trigeminal neuralgia (TN) has come to be known as a procedure with a short-term effect and high complications. There has been none of report about long-term outcome of TnbA for TN. The objective of this prospective study for the long-term results of TnbA was to analyse the pain free duration and complication after the administration of blocks and compare them in the first block and subsequent blocks. Methods: From March 1996 to May 2005, 304 consecutive patients with primary trigeminal neuralgia were treated with TnbA including supraorbital nerve block, infraorbital nerve block, maxillary nerve (V2) block, mandibular nerve (V3) block, and V2 and V3 at the same time and were prospectively followed up every two months for 10 years. Results: The mean value of pain free duation of 1st, 2nd and 3rd TnbA were 43, 38 and 48 months, respectively using Kaplan-Meier analysis. The probability of pain recurrence in 1 and 3 years after the 1st, 2nd and 3rd blocks were 25%, 25%, 20% and 53%, 54%, 34%, respectively. The pain free durations of first and subsequent blocks were not statistically different. Complications were reported at 36 (11.8%), 5 (4.2%), and 0 in 1st, 2nd and 3rd blocks. Conclusions: TnbA showed the relatively long duration of pain free and low incidence of complications. Repeated TnbA has pain free duration as long as the 1st block and less complications as well. TnbA is a valuable treatment of TN as a percutaneous procedure.

전이성 간암으로 인한 어깨통증 환자에서 박동성 고주파술 경험 - 증례보고 - (Pulsed Radiofrequency Lesioning of the Suprascapular Nerve for Referred Shoulder Pain due to Metastatic Liver Cancer - A case report -)

  • 김형태;장인수;한상지;이준학;권영은
    • 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.

류마티스 관절염 환자의 통증대처, 통증 및 우울정도의 관계 (The Relationship among the degrees of pain coping strategies, Pain and Depression of patients with Rheumatoid Arthritis)

  • 박경;최순희
    • 근관절건강학회지
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    • 제5권2호
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    • pp.253-264
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    • 1998
  • This study has done for the purpose of investigation among the degrees of pain coping strategies, pain, and depression of patients with rheumatoid arthritis. The subjects of this study were 214 patients diagnosed with rheumatoid arthritis. The data were collected from september 4 to 16, 1995 by questionnaires. The data were analysed by the use of frequency, t-test, Pearson Correlation Coefficients, ANOVA, and Duncan test. The results Were as follows ; 1. The mean score of pain was 213.5(range : 4-390) and that of depression was 21.4 (range : 1-50). The mean score of passive pain coping strategies was 30.2(range : 11-48) and that of active pain coping strategies was 18.6(range : 7-33) 2. The passive pain coping degree showed a positive correlation with the pain degree (r=.475, p=.0001) and the active pain coping degree showed a inversive correlation with that(r= -.296, p=.0001). The passive pain coping degree showed a positive correlation with the depression degree (r=.425, p=.0001) and the active pain coping degree showed a inversive correlation with that(r=-.299, p=.0001). The pain degree showed a positive correlation with the depression degree(r=.374, p=.0001).

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척추 전이암에 의한 천추 압박골절의 경피적 천추성형술 -증례보고- (Percutaneous Sacroplasty for the Sacral Insufficiency Fracture Caused by Metastasis)

  • 권원일;한경림;김찬;주은진
    • The Korean Journal of Pain
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    • 제21권3호
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    • pp.229-232
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    • 2008
  • Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.