• Title/Summary/Keyword: severe pain

Search Result 1,458, Processing Time 0.024 seconds

Management of Complex Regional Pain Syndrome Type 1 with Barbiturate Coma Therapy -A case report- (Barbiturate 혼수 요법(Coma Therapy)을 이용한 제1형 복합부위통증증후군 치험 -증례보고-)

  • Park, Tae Kyu;Han, Kyung Ream;Shin, Dong Wook;Lee, Young Joo;Kim, Chan
    • The Korean Journal of Pain
    • /
    • v.19 no.2
    • /
    • pp.213-217
    • /
    • 2006
  • Although various treatments for complex regional pain syndrome (CRPS) have been proposed, no well recognized treatment for CRPS has been established. Herein, a case using barbiturate coma therapy for the refractory pain management of a 24-year-old male patient, who suffered from constant stabbing and burning pain, with severe touch allodynia in the left upper extremity following blunt trauma on his forearm is described. Interventional treatments, including permanent spinal cord stimulation and large doses of oral medications, were performed. However, the pain could not be controlled, which lead to frequent emergency room treatment for about 1 month prior to his therapy. He then underwent barbiturate coma therapy due to the uncontrollable pain, with repeated sedation therapy due to his outrageous behavior. His pain became increasingly tolerable and the allodynia was markedly decreased after 5 days of coma therapy.

Effectiveness and Safety of Korean Medicine for Trigeminal Neuralgia: A Case Report

  • Bae, Ji Min;Kim, Dae Hun;Lee, Byung Ryul;Yang, Gi Young
    • Journal of Acupuncture Research
    • /
    • v.34 no.1
    • /
    • pp.59-66
    • /
    • 2017
  • Objectives : This study aims to report the effectiveness and safety of Korean medicine with thread embedding acupuncture in the treatment of trigeminal neuralgia (TN). Methods : A 73-year-old man who had suffered from severe facial pain for one year and who had had a healthy tooth extracted due to the pain is reported. He could not eat or sleep due to the severe pain. Acupuncture, thread embedding acupuncture, cupping, herbal steam, and herbal medicines were used for the treatment. Numeric Rating Scale (NRS) and adverse events were checked daily, and other outcomes (Baseline Evaluation, Visual Analogue Scale [VAS], Short Form Health Survey 36-Bodily Pain [SF-36 BP], and Patient Global Assessment [PGA]) were measured at hospital admission and discharge. During the follow-up examinations, his pain was evaluated roughly, without using any formal measurements, on the basis of a global assessment. Results : All measured parameters, including pain, quality of life, and patient satisfaction were noted to have improved at the time of discharge compared to admission: VAS from 10 to 1.5, NRS from 7-8 to 1-2, and SF-36 BP from 0 to 22.5, and the patient's global assessment was somewhat improved. He did not take any analgesics after discharge and noted only mild adverse events, like pain where the acupuncture and thread embedding acupuncture needles were inserted. His pain relief was maintained for 6 months. Conclusion : Korean medicine with thread embedding acupuncture might be a safe and effective treatment for TN. In the future, larger sample sizes and high quality randomized clinical trials are warranted to confirm its efficacy and safety.

Scrambler Therapy for Patients with Cancer Pain - Case Series -

  • Park, Hong Sik;Sin, Woo Kyung;Kim, Hye Young;Moon, Jee Youn;Park, Soo Young;Kim, Yong Chul;Lee, Sang Chul
    • The Korean Journal of Pain
    • /
    • v.26 no.1
    • /
    • pp.65-71
    • /
    • 2013
  • More than 80% of cancer patients experience cancer pain. Among them, more than 50% experience moderate to severe pain. To control cancer pain, a variety of methods have been used, including medications and nerve blocks. In some patients, however, it is impossible to perform nerve blocks due to caner metastasis into the epidural space, while in other patients, opioid dose escalation is impossible due to opioid side effects; thus, cancer pain management is difficult. Scrambler therapy is a novel approach for pain control that uses EKG-like pads, which are applied above and below the site of pain. Scrambler therapy synthesizes 16 different types of nerve action potentials that provide "non-pain" information via cutaneous nerves. The advantages of this treatment are that it is non-invasive and safe and has no significant side effects. In this case series, we report the treatment results of using scrambler therapy in three cancer patients with intractable pain.

Pain-relieving Effect of the PAS Release Applied to Tender Points (압통점에 적용한 파스이완술이 통증에 미치는 영향)

  • Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
    • /
    • v.5 no.1
    • /
    • pp.53-58
    • /
    • 1999
  • PURPOSE; The main purpose of physical therapy is to minimize patient's pain. So this study aimed at evaluating the effect of PAS release applied to tender points in reducing pain of musculoskeletal lesion persons. METHOD; The PAS (capsicum plaster) Release applied at 48 tender points to relieve and assessment pain threshold by Harold Gottlieb's pain scale that was composed of Negligible sensation 4.00, Mild sensation 3.00, Moderate sensation 2.00, Severe sensation 1.00. RESULT; Results show that PAS release was 84.6% effect in achieving a gradual decrease of pain sensitivity at the tender points where it was applied, suggestion a cumulative analgesic effect through sessions. CONCLUSION; This study suggests that PAS release applied to tender points can be effective in relieving soft tissue pain through theses have not become asymptomatic, all referred significant pain relief(p <0.05) after study and at the end of PAS release therapy.

  • PDF

A Patient with Kikuchi's Disease: What Should Pain Clinicians Do?

  • Park, Kyeong-Eon;Kang, Se-Bin;Ok, Seong-Ho;Shin, Il-Woo;Sohn, Ju-Tae;Chung, Young-Kyun;Lee, Heon-Keun
    • The Korean Journal of Pain
    • /
    • v.25 no.3
    • /
    • pp.188-190
    • /
    • 2012
  • Kikuchi's disease (KD) is an idiopathic and self-limiting necrotizing lymphadenitis that predominantly occurs in young females. It is common in Asia, and the cervical lymph nodes are commonly involved. Generally, KD has symptoms and signs of lymph node tenderness, fever, and leukocytopenia, but there are no reports on treatment for the associated myofacial pain. We herein report a young female patient who visited a pain clinic and received a trigger point injection 2 weeks before the diagnosis of KD. When young female patients with myofascial pain visit a pain clinic, doctors should be concerned about the possibility of KD, which is rare but can cause severe complications.

Association between Prognosis of Low Back Pain Patients with Severity of Abnormal Lumbar Lordosis (한방병원에 입원한 요통 환자의 요추 전만각, 요천각 변화의 심각도에 따른 예후 분석 연구)

  • Han, Su-Bin;Kim, Eun-San;Kim, Hyo-Jun;Jo, Hoo-In;Kim, Mi-hye;Lee, Nam-Woo;Han, Jeong-Hun;Park, Byung-Hak;Son, Jae-Min;Kang, Do-Hyeon;Min, Tae-Woon;Lee, Hyun-Jun;Ahn, Jae-Seo;Lee, Han-Sol
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.30 no.4
    • /
    • pp.143-154
    • /
    • 2020
  • Objectives To analyze the prognosis of patients with low back pain according to the severity of abnormal lumbar lordotic angle and Ferguson's angle. Methods Data from electronic medical record of a total of 199 patients hospitalized in Korean medicine hospital were analyzed. With the sagittal view of lumbar spine X-ray, lumbar lordotic angle was defined as the angle between the superior endplate of L1 with the inferior endplate of L5. Ferguson's angle was defined as the angle between the superior surfaces of the sacral with a horizontal line. 'Measure Cobb's Angle Tool' of 'INFINITT PACS' was used to measure both angles. Lumbar lordotic angle and Ferguson's angle were subdivided into five sections. The number of days from onset and the duration of hospitalization were analyzed in each section. Results Severe hypolordotic lumbar lordotic angle group were found to have longer medical history and hospitalization duration than the control group. The ratio of long-term hospitalization (over 15 days) and chronic medical history (over 180 days) of patients with severe hypolordotic Ferguson's angle were significantly higher than the control group. The ratio of patients with chronic medical history (over 180 days) was significantly higher in severe hyperlordotic Ferguson's angle group than the control group. Conclusions Severe hypolordotic lumbar lordotic angle was related to patient's prognosis. Both severe hyperlordotic and severe hypolordotic Ferguson's angle were found to be related to patient's prognosis. However, a moderate loss of lumbar lordotic angle and Ferguson's angle was not related to prognosis of low back pain patients.

The Rectus Abdominis Syndrome -A case report- (직복근 증후군 환자에서의 치료 경험 -증례 보고-)

  • Park, Jin-Woo;Kim, Jeong-Hun;Shin, Yong-Chool;Jeong, Soon-Ho;Choe, Young-Kyun;Kim, Young-Jae;Shin, Chee-Mahn;Park, Ju-Yuel
    • The Korean Journal of Pain
    • /
    • v.13 no.1
    • /
    • pp.123-125
    • /
    • 2000
  • Rectus abdominis syndrome is the abdominal pain which occurs in the distribution of the medial or lateral cutaneous branch of the 7~12th intercostal nerves. It is frequently cause that results in unnecessary pain and expense to patient. The physical examination is difficult because of severe abdominal pain. We must have attention to the possibility that patients with abdominal pain, in whom no intra- abdominal cause is founded, may suffer from this presumed nerve entrapment syndrome. If we can find the cause of pain in the abdominal rectus muscle, no evaluation and surgery are required and therapy can be simple.

  • PDF

Management of Complex Regional Pain Syndrome Type 1 With Total Spinal Block

  • Ok, Se-Jin;Yang, Jong-Yeun;Son, Ju-Hyung;Jeong, Won-Ju;Lee, Yoon-Sook;Kim, Woon-Young;Park, Young-Cheol
    • The Korean Journal of Pain
    • /
    • v.23 no.1
    • /
    • pp.70-73
    • /
    • 2010
  • Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient’s continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.

Sacral Nerve Stimulation for Treatment of Chronic Intractable Anorectal Pain -A Case Report-

  • Yang, Kyung-Seung;Kim, Young-Hoon;Park, Hue-Jung;Lee, Min-Hye;Kim, Dong-Hee;Moon, Dong-Eon
    • The Korean Journal of Pain
    • /
    • v.23 no.1
    • /
    • pp.60-64
    • /
    • 2010
  • Despite recent methodological advancement of the practical pain medicine, many cases of the chronic anorectal pain have been intractable. A 54-year-old female patient who had a month history of a constant severe anorectal pain was referred to our clinic for further management. No organic or functional pathology was found. In spite of several modalities of management, such as medications and nerve blocks had been applied, the efficacy of such treatments was not long-lasting. Eventually, she underwent temporary then subsequent permanent sacral nerve stimulation. Her sequential numerical rating scale for pain and pain disability index were markedly improved. We report a successful management of the chronic intractable anorectal pain via permanent sacral nerve stimulation. But further controlled studies may be needed.

Atypical Trigeminal Neuralgia : Case Report (비정형 삼차신경통의 치험례)

  • Lee, Dong-Sik;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
    • /
    • v.25 no.2
    • /
    • pp.229-234
    • /
    • 2000
  • The patient, 62-years-old woman, had a constant dull pain in the right mandible and an intermittent spontaneous burning sensation of the mouth. The pain began 6 months ago. About 5 years ago, a trauma in her right mandible which was so severe that kept her in the hospital for 2 days. This was followed by mouth opening disturbance with pain for about 2 years. However, she did not have a treatment for the temporomandibular disorder symptoms. After then, she experienced the trigeminal neuralgia characterized by an electrical pain which lasted about 30 minutes in her right face and head when touching the skin or hair. After taking a year course treatment of trigeminal neuralgia, the symptom disappeared. The pain was a constant dull pain and a intermittent burning pain which are contradictory. And the pain responded to various modalities such as physical therapy, anti-inflammatory drug, carbamazepine, and amitriptyline, among which carbamazepine was most effective. The diagnosis was clinically made as an atypical trigeminal neuralgia. The term 'atypical' is used when there is something unknown and the problem is not identified. It is thought that an atypical pain may be approached in the perspective of chronic pain, neuropathic pain, and myofascial pain, the mchanisms of which are poorly understood. As the knowledge of pain physiology improves, there needs to be modification and re-evaluation. Pain disorders must be classified on the basis of an understanding of the underlying mechanism and etiology.

  • PDF