• 제목/요약/키워드: musculoskeletal systemic pain

검색결과 13건 처리시간 0.029초

갱년기 장애의 심한 근골격계 통증을 생활사건 스트레스와 연관지어 고찰한 치험1례 (A Therapeutic Case Report of Serious Musculoskeletal Systemic Pains of the Menopausal Disorder Studied in Connection with the Life Event Stress)

  • 정선형;이진무;이창훈;조정훈;장준복;이경섭
    • 대한한방부인과학회지
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    • 제21권2호
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    • pp.252-262
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    • 2008
  • Purpose: This paper is aim to report that menopausal disorder can be effectively diagnosed and treated by referring to the life event stress of patient. Methods: Researchers got a grip on the life event stress of patient by using medical examinations by interview and compared the conditions of patient before and after treatment by using Kupperman's Index. The prescription of the Gamidangguisu-san hap samhap-tang( Jiaweidangguixu-san he sanhetang) and the Gamisoyo-san (Jiaweixiaoyao-san) and the acupuncture therapy and the moxibustion therapy were used for the treatment. Results: The serious musculoskeletal systemic pains, which includes back pain, lumbago, and myalgia, and other menopausal troubles were improved remarkably. Conclusion: The menopausal disorder could be caused by not only the change of hormone but also complex factors of environmental matters which includes social cultural surroundings, mentality etc. Therefore the life event stress could be one of critical factors of menopausal disorder. The diagnosis and treatment considering the life event stress could be effective method to relieve patient's menopausal disorder.

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작업성 근골격계질환의 VDT 증후군에 관한 고찰 (A Review on VDT Syndrome of Work-Related Musculoskeletal Disorders)

  • 양영애;허진강;김현희;이규창;이주상;정신호;안창식;심재훈
    • 대한물리치료과학회지
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    • 제11권4호
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    • pp.20-28
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    • 2004
  • The studys purpose were the effects of work posture, treatment method and prevention for Video Display Terminal(VDT) workers in Work-Related Musculoskeletal Disorders(WMSD) The results were as follows: 1. The prevalence rate of VDT workers in WMSD was $20{\sim}40%$. The complaint was mostly shoulder, neck, and hack area pain 2. VDT worker used to forward flexed posture and then affect of increase of muscle fatigue and pain 3. When exercise therapy PT and ADL training, were used workers decrease in pain, muscle strength, balance training, endurance strength and relief of psychiatricIn conclusion, VDT worker need good health and posture to rest and exercise with time space and treatment. It is best to prevent WMSD. VDT workers need health management by itself and systemic rehabilitation program by speciality therapist.

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근골격계 질환에서 통증 조절을 위한 마약성 진통제 및 항우울제 (Opioids and Antidepressants for Pain Control in Musculoskeletal Disease)

  • 박세진;김우섭;장태동
    • 대한정형외과학회지
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    • 제55권1호
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    • pp.1-8
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    • 2020
  • 고령화의 진행 및 근골격계 질환의 증가로 인해 여러 가지 수술적 치료 방법을 포함한 침습적인 치료 방법이 증가되고 있으나 수술적 치료 시행 전 보존적 치료는 충분히 시행되어야 한다. 보존적 치료 중에서 통증 조절을 위한 약물 치료는 오래 전부터 보존적 치료의 가장 대표적인 치료 방법으로 사용되어 왔고 여전히 가장 흔히 사용되는 방법이다. 통증 조절을 위한 약물로는 아세트아미노펜(acetaminophen), 비스테로이드성 항염증제(non-steroidal anti-inflammatory drugs), 스테로이드(steroid), 마약성 진통제(opioid), 항우울제(antidepressants) 등이 있으며 저자는 마약성 진통제 및 항우울제에 대해서 살펴보고자 한다. 통증으로 인해 말초 부위에 있는 통각 수용체에 자극이 전달되면 통증은 중추 신경계로 전달되는 상향성 경로(ascending pathway)를 거쳐 대뇌에 전달되고 대뇌는 통증을 조절하기 위해 하향성 조절 경로(descending pathway)를 통해 엔도르핀(endorphin)과 같은 내인성 마약성 진통제를 분비하게 된다. 마약성 진통제라는 것은 마약성 진통제 수용체(receptor)에 작용하는 물질을 통틀어서 일컫는 말로 마약성 진통제는 세 가지의 수용체가 존재하며 조직이나 환자의 전신 상태에 따라서 각각의 수용체에 대한 친화성이 달라진다. 이와는 달리 항우울제는 중추신경계의 시냅스에 작용하여 통증을 조절하는 상향성 경로를 조절하는 것이 주된 기전으로 만성통증과 신경병성 통증에 효과적이며 이는 마약성 진통제 계열과 효과가 유사한 것으로 알려져 있다. 본 종설에서는 이러한 마약성 진통제와 항우울제의 효과적인 사용 방법, 사용 시 유의점 및 부작용 등에 대해 다루고자 한다.

소아 추나에 대한 국내·외 연구 동향 (Domestic and Foreign Research Trend on the Pediatric Chuna Treatment)

  • 이진화;한재경;김윤희
    • 대한한방소아과학회지
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    • 제29권4호
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    • pp.67-76
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    • 2015
  • Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.

일개 한방병원에 내원한 산욕초기 산모의 한국표준질병·사인분류 분석 (Korean Standard Classification of Diseases of Early Postpartum Women in a Korean Medicine Hospital)

  • 김평화
    • 대한한방부인과학회지
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    • 제32권1호
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    • pp.73-84
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    • 2019
  • Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

전완부의 점액섬유육종과 직장의 선암이 동반된 동시성 다발성 원발성 종양 (Synchronous Double Primary Malignant Neoplasm Consisted of Myxofibrosarcoma of the Forearm and Adenocarcinoma of Rectum)

  • 정기연;전영수;한정수;최일헌
    • 대한골관절종양학회지
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    • 제14권2호
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    • pp.146-151
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    • 2008
  • 근골격계와 소화기계에 동반된 다발성 원발성 종양은 매우 드물다. 52세 남자 환자에서 전완부의 점액섬유육종과 직장의 선암이 동반된 동시성 이중성 원발성종양이 발견되었다. 환자는 1년전부터 발생한 전완부의 통증 및 부종을 주소로 내원하였다. 전완부의 병변은 조직학적으로 점액섬유육종으로 확진되었다. 전신적 검사상 결장경 검사에서 직장의 선암이 발견되었으며 CT 검사상 폐로의 전이와 심장내 종양이 발견되었다. 병리학적 확정진단 후에 전완부의 수술적 절제술과 술 전,후 항암화학요법을 시행하였으며, 환자는 술 후 2달 후에 종양 색전에 의한 폐동맥혈전색전증으로 사망하였다. 저자들은 매우 드문 근골격계와 소화기계에 동반된 다발성 원발성 종양 1례를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다.

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섬유근통 증후군에 대한 문헌고찰 (The Literature Review of FibroMyalgia Syndrome)

  • 김명철;김진상
    • The Journal of Korean Physical Therapy
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    • 제16권4호
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    • pp.23-37
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    • 2004
  • Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

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병원종사자의 VDT증후군 자각증상과 건강영향에 관한 연구 (A Study on Health Effects of VDT Syndrome in Hospital Workers)

  • 이승환;정병곤;이규찬;이광철;배성복
    • 핵의학기술
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    • 제16권2호
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    • pp.87-98
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    • 2012
  • Purpose : This study aims to examine hospital employees' subjective symptoms of VDT syndrome (Video display terminal syndrome) and figure out their effects on health conditions and correlations. Materials and Methods : This study used a structured self-administering questionnaire and gained data from 125 subjects. The questionnaire consists of total 62 questions, and they went through real number, percentage, ${\chi}^2$-terst, t-test, one-way ANOVA, and logistic regression analysis. Results : Regarding the difference in the types of subjective symptoms of VDT syndrome by jobs, there was statistically significant difference in ophthalmic symptoms, systemic symptoms, and musculoskeletal symptoms. About the correlation between the subjective symptom points of VDT syndrome by the types of symptoms, there was statistically significant correlation all in skin trouble, backache, upper limb muscle pain, lower limb muscle pain, fatigue in the head and eyes, and depression or anxiety disorders. There was significant correlation between the subjective symptom points of VDT syndrome and subjective health conditions. Conclusion : Hospital employees' subjective health conditions had significant correlation with subjective symptom points of VDT syndrome. This result shows that as radiologists' and also other hospital employees' working conditions change into VDT environment, VDT syndrome gradually appears more and more. This implies that it is needed to designate not only radiologists but also all the other hospital employees as jobs exposed to the working environment of VDT syndrome and provide preventive measures, education, and publicity for it afterwards.

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수근관 증후군에서 적외선 체열 검사의 진단적 유용성 (Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome)

  • 박지현;이장우;이상억;김병희;박덕호
    • Clinical Pain
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    • 제18권2호
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    • pp.70-75
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    • 2019
  • Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.

고령환자의 구강내과 진료실태 (Epidemiologic Study on the Elderly Patients Visited Oral Medicine)

  • 홍성주;강승우;유지원;윤창륙;조영곤;안종모
    • Journal of Oral Medicine and Pain
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    • 제34권2호
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    • pp.133-141
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    • 2009
  • 평균수명의 연장으로 인한 고령인구의 증가 추세에 맞추어 65세 이상 고령환자의 구강내과 진료실태를 조사하기 위해 2007년 1월 1일부터 2008년 7월 18일까지 조선대학교 치과병원 구강내과에 내원한 만 65세 이상인 600명의 환자의 성별, 연령, 주소, 전신질환, 진단명, 치료, 타 과에서의 의뢰여부 및 의뢰한 과의 종류를 조사하였다. 연령조사에서 65세${\sim}$74세 63.7%, 75${\sim}$84세 32.2%, 85세 이상 4.2%의 비율로 나타났으며, 여성이 남성보다 더 많았다. 환자의 주소로는 구강연조직문제(44.1%)와 구강악안면통증(39.0%)이 주로 많았으며, 전신질환으로는 순환기계 질환(30.1%), 근골격계 질환(16.8%), 내분비계 질환(12.8%), 소화기계 질환(10.1%)이 많았다. 진단명은 구강 내 연조직질환(32.0%)과 측두하악관절장애의 관절장애(24.1%)와 근육장애(18.1%)가 많았으며, 내원한 환자에게 시행된 치료는 약물치료(43.9%)와 근이완요법을 포함한 물리치료(24.2%)가 주로 시행됐다. 전체 내원환자의 14.2%가 타 의료기관에서 작성한 의뢰서를 지참하여 내원하였거나, 같은 치과병원 내 타 과에서 의뢰되어 구강내과에 내원하였다. 이상의 연구를 통해 65세 이상 고령환자의 구강내과 진료실태에 대한 파악이 가능했으며, 향후 이루어질 고령환자에 대한 연구에 있어서 본 연구 결과가 도움이 되기를 기대한다.