• 제목/요약/키워드: shoulder and arm pain

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운동조절과 근력강화 운동이 유방절제술 후 견관절의 기능부전으로 유발된 견관절 충돌 증후군에 미치는 영향 (The Effects of Motor Control and Strengthening Exercise on Secondary Shoulder Impingement Syndrome at Postmastectomy)

  • 배영현;이석민
    • 한국산학기술학회논문지
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    • 제13권5호
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    • pp.2240-2250
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    • 2012
  • 본 연구의 목적은 운동조절과 근력강화 운동이 유방절제술 후 기능부전이 악화되어 유발된 견관절 충돌 증후군 환자에게 미치는 영향을 알아보고자 한다. 유방절제술 후 기능부전이 악화되어 이차적으로 유발된 1-2단계 견관절 충돌 증후군 20명을 무작위로 실험군 10명, 대조군 10명으로 나누었다. 두군 모두 보조적 치료 4주간 주당 4회 40분씩 받았다. 실험군은 추가적으로 운동조절과 근력강화 운동을 60분간 실시하였다. 평가 측정은 실험군과 대조군 모두 실험 전과 후에 악력, 통증강도, 상지둘레, 상지의 불편감정도와 관절가동범위를 측정하였다. 본 연구의 결과는 실험군과 대조군간에 관절가동범위, 상지의 불편감정도에서 유의한 차이(p<.05)를 보였고 악력, 통증강도, 상지둘레는 유의한 차이를 보이지 않았다. 이런 결과들은 운동조절과 근력강화 복합운동프로그램이 유방절제술 후 기능부전이 악화되어 이차적으로 유발된 견관절 충돌 증후군에 안전하면서 효과가 높은 방법임을 알 수 있었다.

주관절의 정형 물리치료 (Elbow Orthopaedic Physical Therapy)

  • 박지환
    • 대한정형도수물리치료학회지
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    • 제1권1호
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    • pp.65-74
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    • 1995
  • There is no line of demarcation between the shoulder and elbow regions. Pain In the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct localization is good. Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements. 1. Four. Passive extension, flexion, pronation, supination-full range, LOM, painful, painless. 2. Four. Resisted extension, flexion, pronation, supination-strong, weak, painful, painless. 3. Two. Resisted flexion, extension at the wrist-painful, painless. The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affected is not functionally a part of the elbow (i. e. Tennis elbow and Golfer's elbow).

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후측면으로 거대 탈출된 경추부 추간판 탈출증 환자에게 Dekompressor®를 이용한 경피적 수핵 감압술 -증례보고- (Percutaneous Cervical Discectomy using Dekompressor® to the Patient with Posterolateral Extrusion Disc -A case report-)

  • 조대현;김상진;김명희
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.253-256
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    • 2006
  • Cervical disc herniation is one of the most common causes of neck, shoulder and arm pain. There are many treatments for a cervical disc herniation, such as rest, physical therapy, medication, epidural steroid injection and surgery. However, conservative treatments sometimes have limited effectiveness, and a surgical discectomy is often associated with numerous complications. Nowadays, a percutaneous discectomy, using a $Dekompressor^{(R)}$, has been used in herniated disc patients, but a posterolateral extruded disc is not an indication. Herein, our experience using a 19 G $Dekompressor^{(R)}$, on a 52 year-old male patient with a left C6-⁣7 posterolateral extruded disc, is reported. Decompression was successfully performed, and the pain and range of motion was immediately improved.

림프마사지(MLD)가 유방암 절제술을 한 여성의 상지 부피에 미치는 영향 (The Effects of Manual Drainage Lymph (MLD) on the Volume of the Upper Extremities of Women with Breast Cancer)

  • 이민지;권오국;양영식;김용진;이호준
    • 대한정형도수물리치료학회지
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    • 제25권1호
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    • pp.53-61
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    • 2019
  • Background: This study aimed to investigate the effects of manual lymph drainage (MLD) on women with breast cancer and lymph edema. Methods: This study was carried out with a total of 23 women with breast cancer and lymph edema. By drawing lots, women were assigned to either the manual drainage group (MLD, n=12), a control group (n=11). Outcomes such as the arm size, visual analogue scale, shoulder pain and disability index, and functional assessment cancer therapy-breast (FACT-B) were measured to 0 week, 2 weeks, 4 weeks, and 8 weeks intervention for both groups. Results: A significant difference was found in the arm size, pain, functional disability level, and quality of life between the two groups and time(p<.01). Significant difference in functional disability level between 2 and 8 weeks at 4 weeks and 8 weeks for pain(p<.01), and the quality for life was significantly different at all time points (p<.01). Conclusions: Applying MLD treatment to women with breast cancer proved to have a positive effect.

경추부 신경근병증으로 오인된 신경통성 근위축증 -증례보고- (Neuralgic Amyotrophy Considered as Cervical Radiculopathy -A case report-)

  • 박찬도;김준우;최종범;이민정;문지연;이평복
    • The Korean Journal of Pain
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    • 제22권2호
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    • pp.171-175
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    • 2009
  • Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1 3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4 5 and C5 6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.

Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair

  • Imai, Takaki;Gotoh, Masafumi;Fukuda, Keiji;Ogino, Misa;Nakamura, Hidehiro;Ohzono, Hiroki;Shiba, Naoto;Okawa, Takahiro
    • Clinics in Shoulder and Elbow
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    • 제24권2호
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    • pp.80-87
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    • 2021
  • Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

수술실 간호사의 부위별 근골격계 자각증상 (The Subjective Musculoskeletal Symptoms of Operating Room Nurses)

  • 박현희;이꽃메
    • 한국직업건강간호학회지
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    • 제14권2호
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    • pp.164-170
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    • 2005
  • Purpose: The present study attempted to find subjective musculoskeletal symptoms of operating room nurses (OR nurses) and then to use them as basic data for prevention and management of musculoskeletal symptoms of OR nurses. Method: This study was an exploratory research, and data were collected from OR nurses working in 8 polyclinics in Korea from July 26 to August 19, 2004, using a self-report questionnaire. The questionnaire contains items concerned with subjective musculoskeletal symptoms include ones with the presence of symptoms and with the degree of discomfort, in the joints such as neck, shoulder, arm/elbow, hand/wrist/finger and waist. For data collection, the aim of the study was explained to the operating room managers to obtain their help, and these questionnaires were sent to hospitals, and were retrieved by post. 271(90.3%) questionnaires were returned among those sent to 300 nurses. 249 questionnaires excluding 22 insufficient ones such as no response were used for data analysis. Data were analyzed using SPSS WIN 12.0. Subjective musculoskeletal symptoms were analyzed in the number and percentage. Result: 187(75.1%) nurses said they 'had' subjective musculoskeletal symptoms and 62 (24.9%) said they had 'nothing'. 130(52.2%), 125 (50.2%), 113 (45.4%), 86(34.5%), and 42 (16.9%) nurses had subjective musculoskeletal symptoms in waist, shoulder, hand/wrist/finger, neck, and arm/elbow, respectively. 51(27.3%) and 136 (72.7%) nurses complained of the pain in one site, and in two or more sites, respectively. In particular, 51% and 47.4% nurses said that they were 'discomforted' due to the pain in waist and in shoulder, respectively. Conclusion: Subjective musculoskeletal symptoms which OR nurses complained of were significant. This may cause difficulty in nursing tasks in the operating room. So various arrangements have to be made for OR nurse with subjective musculoskeletal symptoms at an early stage.

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Primary Fibromyalgia Syndrome 환자의 치험례 -증례 보고- (Treatment of Primary Fibromyalgia Syndrome Patient -A case report-)

  • 허후만;박상민;김용익;박욱
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.138-142
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    • 1998
  • Fibromyalgia syndrome is defined as a diffuse, aching musculoskeletal pain associated with multiple and discrete predictable tender points along with stiffness. A primary form associated without any disease is uncommon compared to the secondary diffuse fibrositis. We witnessed a case of a primary fibromyalgia syndrome. A 28-year-old woman was suffering from pain on posterior neck, right shoulder, upper back, left hand and arm for two years. She also complained of morning stiffness, fatigue, and headache. We treated her with stellate ganglion block with 0.25% bupivacaine, medication that included amitriptyline, TENS and superlizer. We also recommended aerobic exercise.

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Can manipulation under anesthesia alone provide clinical outcomes similar to arthroscopic circumferential capsular release in primary frozen shoulder (FS)?: the necessity of arthroscopic capsular release in primary FS

  • Lee, Seung-Jin;Jang, Jun-Hyuk;Hyun, Yoon-Suk
    • Clinics in Shoulder and Elbow
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    • 제23권4호
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    • pp.169-177
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    • 2020
  • Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 57 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Surgeons score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection. Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics. Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.

겨드랑이막증후군을 가진 유방암 환자들의 도수림프배출법과 고주파 투열치료가 통증, 부피, 기능 및 삶의 질에 미치는 효과 : 사례군 연구 (Effects of Manual Lymphatic Drainage and High Frequency Diathermy on Pain, Volume, Function of Upper Extremity and Quality of Life in Breast Cancer Patients with Axillary Web Syndrome : a Study of Five Case Reports)

  • 안수연;신원섭
    • 대한통합의학회지
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    • 제9권4호
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    • pp.19-28
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    • 2021
  • Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.