• 제목/요약/키워드: shoulder pain shoulder-arm pain

검색결과 150건 처리시간 0.031초

만성 불응성 외 상과염에서 시행한 관절경적 단 요 수근 신건 유리술 (Arthroscopic Release of the Extensor Carpi Radialis Brevis Tendon for Chronic Recalcitrant Lateral Epicondylitis)

  • 구정회;황태혁;이정수;조형래;김정우
    • 대한관절경학회지
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    • 제16권2호
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    • pp.140-146
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    • 2012
  • 목적: 보존적 치료에 반응하지 않는 만성 불응성 주관절 외 상과염에 대한 관절경적 단 요 수근 신건 유리술의 임상적 결과를 알아보고 예후에 영향을 주는 인자를 분석하고자 한다. 대상 및 방법: 주관절 외 상과염으로 관절경적 단 요 수근 신건 유리술을 시행 받은 환자 24명을 후향적으로 분석하여 술 후 환자 자신의 평가, visual analog scale (VAS) 점수, Quick-disabilities of the arm, shoulder and hand (DASH) 점수와 결과에 영향을 줄 수 있는 술 전 인자를 평가하였다. 결과: 21예(88%)에서 술 후 결과에 만족 하였고 평균 VAS 점수와 Quick-DASH 점수는 최종 추시 상 의미 있는 호전을 보였다. 나이, 성별, 우세수 여부, 증상 이환 기간, 관절낭 파열이나 석회 침착유무는 임상적 결과와 상당한 인과 관계가 없었다. 술 전 자기 공명 영상 T2강조 영상 상 단 요 수근 신건 기시부에 고강도 신호부가 없는 4예 중 3예에서 보다 높은 Quick-DASH 점수를 보였다. 결론: 보존적 치료에 반응하지 않는 만성 불응성 주관절 외 상과염에 대한 관절경적 단 요 수근 신건 유리술은 유용한 치료법 중 하나이며 술 전 자기공명영상 T2강조 영상에서 고강도 신호부가 없는 경우는 술 후 불량한 결과를 유발할 수 있으므로 수술 적응 시 고려해야 할 요소로 사료된다.

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한선 및 피부절제술을 이용한 액취증 수술 후 발생한 Axillary Web Syndrome의 치험례 (A Clinical Case of Axillary Web Syndrome after Glandular Tissue and Skin Removal for Axillary Osmidrosis)

  • 최민석;김우섭;김한구;배태희
    • Archives of Plastic Surgery
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    • 제37권3호
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    • pp.301-303
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    • 2010
  • Purpose: The axillary web syndrome (AWS) is a selflimiting cause of morbidity in the early postoperative period after axillary surgery. This article presents a rare complication developed after surgical treatment for axillary osmidrosis. Methods: A 55-year-old male patient underwent surgical excision of skin and glandular tissue for axillary osmidrosis. Three weeks after the surgery, he visited our department due to a visible web of left axillary skin overlying palpable cord extends into the medial ipsilateral arm. There was a taut and tender cord of tissue under the skin and shoulder abduction was limited to less than 90 degrees. He was diagnosed with AWS and treated with conservative management. Results: Four months later, AWS resolved completely without any treatment and patient was free of pain or motion restriction. Conculsion: Axillary web syndrome has been described as frequent complication after axillary lymph node dissection or sentinel node biopsy, but not after surgical treatment of axillary osmidrosis. Surgeons must be aware of the risk of axillary web syndrome after treatment of axillary osmidrosis.

Prevalence of MSDs and Postural Risk Assessment in Floor Mopping Activity Through Subjective and Objective Measures

  • Naik, Gouri;Khan, Mohammed Rajik
    • Safety and Health at Work
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    • 제11권1호
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    • pp.80-87
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    • 2020
  • Background: Residential and commercial cleaning is a part of our daily routine to maintain sanitation around the environment. Health care of professionals involved in such cleaning activities has become a major concern all over the world. The present study investigates the risk of musculoskeletal disorders in professional cleaners involved in floor mopping tasks. Methods: A cross-sectional study was performed on 132 mopping professionals using a modified Nordic questionnaire. The Pearson correlation test was implemented to study the association of perceived pain with work experience. The muscle strain and postural risk were evaluated by means of three-channel electromyography and real-time motion capture respectively of 15 professionals during floor mopping. Results: Regarding musculoskeletal injuries, risk was reported majorly in the right hand, lower back, left wrist, right shoulder, left biceps, and right wrist of the workers. Work experience had a low negative association with MSDs in the left wrist, right wrist, right elbow, lower back, and right lower arm (p < 0.01). Surface EMG showed occurrence of higher muscle activity in upper trapezius and biceps brachii (BB) muscles of the dominant hand and flexor carpi radialis and BB muscles of the nondominant hand positioned at the upper and lower portion of the mop rod, respectively. Conclusion: Ergonomic mediations should be executed to lessen the observed risk of musculoskeletal injuries in this professional group of workers.

흉곽출구증후군 환자에 대한 한의학적 통합치료 증례보고 1례 (A Case Report of Thoracic Outlet Syndrome Improved by Integrated Korean Medical Treatment)

  • 이동근;이욱재;이주희;이상현;이정훈;정민성;김재홍
    • Journal of Acupuncture Research
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    • 제31권2호
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    • pp.173-182
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    • 2014
  • Objectives : There are few reports on treatment of thoracic outlet syndrome in the field of traditional Korean medicine. The aim of this study is to report a case of a 29-year-old male patient diagnosed with thoracic outlet syndrome, whose symptoms were relieved after 3-week integrated Korean medical treatment. Methods : A patient diagnosed with thoracic outlet syndrome was admitted into the Korean medicine hospital. The patient had left shoulder pain and left arm numbness. The pain was worse if it had become cold. The patient was treated using Sa-am acupuncture(Daejangseunggyeok), sweet bee venom acupuncture, herbal medicine and other treatment including physical therapy from September 7th to 27th of 2012. Improvement of the patient's symptoms was evaluated by verbal numerical rating scale(VNRS), skin surface temperature difference between the left and right symmetric part of digital infrared thermographic image(DITI). Results : After 3-weeks of treatment, VNRS decreased and skin surface temperature difference between the left and right symmetric part of DITI showed moderate improvement. Conclusions : The results suggest that integrated Korean medical treatment may affect to reduce the symptoms of thoracic outlet syndrome. Further study is needed to evaluate the importance of this report.

Scolopendra Pharmacopuncture Combined with Electroacupuncture for the Treatment of Ganglion Cysts: A Retrospective Study

  • Choe, Seon;Jerng, Ui Min;Park, Jeong Hwan;Kim, Sungha;Kim, Sungchul;Lee, Jinbok;Lee, Jun-Hwan;Shin, Minseop
    • 대한약침학회지
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    • 제23권4호
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    • pp.247-251
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    • 2020
  • Objectives: Ganglion cysts require a sustainable treatment that suppresses their frequent recurrence. This study aimed to explore the clinical effects of Scolopendra pharmacopuncture (SP) and electroacupuncture on ganglion cysts. Methods: We retrospectively reviewed the patient records and follow-up reports for 20 patients with wrist ganglion cysts who received SP and electroacupuncture from April 2016 to March 2017. The cyst diameter, recurrence, visual analog scale (VAS) scores for pain, the Korean version of the disabilities of arm, shoulder, and hand (K-DASH) score, and the Korean version of the patient-rated wrist evaluation (K-PRWE) score before and after treatment were noted. Results: After treatment, the cyst diameter decreased significantly from 13.61 ± 6.41 mm to 5.15 ± 6.18 mm (p < 0.001), and VAS score for pain decreased from 1.31 ± 1.77 to 0.41 ± 0.33 (p = 0.021). Further, the K-DASH score decreased significantly from 8.97 ± 12.66 to 2.21 ± 7.39 (p = 0.016), and score for the function subscale of K-PRWE decreased from 11.37 ± 4.48 to 9.1 ± 3.67 (p = 0.046). No recurrences were reported from the followed-up patients. Any complication related to SP or electroacupuncture was not observed, except mild rash, itching, and swelling at the injection site in four patients. Conclusion: Combination of SP and electroacupuncture may be effective in treating ganglion cysts; further prospective studies with large population are needed to clarify the effect of SP and electroacupuncture.

1997-2000 관절염 자조관리 과정의 효과 분석 연구 (The Effect of Self-help Health Promotion Program for Arthritis Patients from Year 1997 to 2000)

  • 이은옥;서문자;김금순;강현숙;한상숙;임난영;송경애;김종임;이경숙;이인옥
    • 근관절건강학회지
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    • 제9권1호
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    • pp.5-17
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    • 2002
  • The purpose of this one group pre and post test study was to evaluate the effect of self-help programs(SHP) which has been conducted from 1997 to 2000. The SHP was held by Korean Rheumatology Health Professionals Society(KRHP) once a week for 6 weeks for chronic arthritis patients in Korea. Eight hundred fifty five subjects completed the program at 43 sites. The effect of SHP were evaluated by flexibility, pain, activities of daily living(ADL), fatigue, depression and self-efficacy. After SHP, followings were found: 1. Participants' characteristics of SHP were most common in living in Seoul, women, sixties, high school graduates, house wifes, osteoarthritis, completed in 1999. 2. The flexibility of arm, knee, ankle joint were significantly increased, but the flexibility of the shoulder was not changed. 3. Level of pain was decreased significantly from 5.21 to 3.99, and the number of painful joints were decreased from 4.96 to 4.18 significantly. 4. The score of ADL was increased from 53.74 to 54.97 significantly. 5. The score of depression and self-efficacy was not changed. In conclusion, SHP was clearly proved to be an effective nursing intervention to Increase the flexibility of arm, knee, ankle joint and enhanced ADL. Also SHP decreased pain and fatigue. More research is needed to determine the role of self-efficacy and depression in the SHP, use of a randomized design and longer follow up period to understand more about the effects of the program.

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인체에서 기혈(氣穴) 순환 회복을 위한 기혈테라피의 효과 탐색 (Exploring the Effect of Qihyul-therapy for Recovery of Qi Circulation in Body)

  • 김용필;이형환
    • 한국자연치유학회지
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    • 제8권2호
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    • pp.63-70
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    • 2019
  • 목적: 본 연구의 목적은 둔부근육의 협착, 틀어진 체형, 어깨 통증이 있는 기혈순환이 나쁜 대상자들을 상대로 기혈테라피의 효과를 탐색하는 것이었다. 방법: 기혈테라피와 교정 기혈운동을 사용 하였다. 결과: 기혈테라피를 시술하기 전에 둔부 근육이 거의 움직이지 않았지만, 시술한 후에는 근육의 탄력이 회복되었고 회색으로 경화되었든 피부의 색상도 밝아지었고 항문 괄약근에도 힘이 생기었다. 대상자의 체형이 우측으로 -7°가량 틀어지면서 우측 팔이 좌측팔에 비해서 약 6 cm정도 길었었으나, 체형교정 후에는 우측 팔의 길이가 약 5 cm 정도 줄어들었고, 틀어졌던 체형이 거의 평형을 이루었다. 목 및 어깨교정 후에는 쇄골과 목의 간격이 7 cm로 간격이 넓어졌고, 승모근을 풀어준 후에는 10 cm로 넓어졌으며, 어깨통증이 많이 완화 되었다. 골반교정 후 둔부통증이 완화되었고, 고관절의 위치가 바르게 돌아왔다. 좌측으로 45°각도 틀어졌던 우측다리가 바르게 교정이 되었으며, 4 cm 정도 길었던 우측 다리의 길이도 좌우가 같아졌다. 둔부통증 및 무릎통증도 완화되었다. 골반교정 기혈운동 후에 대상자 1의 고관절의 위치가 바로 잡히어 좌측으로 45°각도 틀어졌던 우측다리가 바르게 교정이 되었고, 4 cm 정도 길었던 우측 다리의 길이도 좌우가 거의 같아졌다. 대상자2는 교정 전에는 무릎이 붙지가 않았고, 오른쪽 무릎이 왼쪽에 비해서 위로 5 cm 정도 올라갔었으며, 발목이 좌측에 비해서 30° 각도로 굽어져 있었는데, 교정 후에는 두 다리의 무릎이 안정되게 붙일 수 있게 되었고, 무릎의 높이도 같아 졌으며, 발목꺾임이 각도도 정상으로 교정이 되었다. 결론: 꾸준하게 기혈테라피와 척추교정 및 골반교정 기혈운동을 한다면 틀어졌던 체형도 바르게 회복되고, 아픈 통증도 완화되어 관련 질환들을 예방 및 치유하는데 효과가 있다고 본다.

유방암 치료 후 신체 재활을 위한 비약물적 중재의 연구 동향 : 주제범위 문헌고찰 (Research Trends in Non-Pharmacological Interventions for Physical Rehabilitation after Breast Cancer Treatment: A scoping review)

  • 이정우;서태화
    • 대한통합의학회지
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    • 제12권3호
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    • pp.101-120
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    • 2024
  • Purpose : This study aimed to carry out a scoping review to investigate the research trends in non-pharmacological interventions for physical rehabilitation following breast cancer treatment. Methods : A scoping review was conducted according to the five steps outlined by Arksey and O'Malley and PRISMA-ScR. We searched three domestic databases (ScienceOn, Riss, KCI) and two international databases (PubMed, Cochrane Central) between January 2014 and April 2024. The keywords used were 'breast cancer surgery', 'breast cancer treatment', 'breast cancer lymphedema', 'intervention', 'management', 'therapy', 'disorder', and 'dysfunction'. Results : In terms of publication, the number of studies in the past five years has increased compared to the previous five years, with most studies focusing on patients aged 41 to 60 and who underwent surgical treatment for breast cancer. A total of 43 different types of non-pharmacological interventions were applied: 21 single interventions and 22 combination interventions. Among the intervention methods, complete decongestive treatment (CDT), resistance training, and manual lymphatic drainage were the most frequently utilized. The most common duration of intervention turned out to be 4~5 weeks and more than 8 weeks, with frequencies of 2~3 sessions per week and more than 4 sessions per week. The most frequently used dependent variables included range of motion (ROM) and disabilities of the arm, shoulder and hand (DASH) for the function and disorder of the upper limb category; arm circumference or volume and bio-impedance for the lymphedema category; visual analogue scale (VAS) and numerical rating scale (NRS) for the pain category; and the European organization for research and treatment of cancer quality of life questionnaire breast cancer module (EORTC QLQ) and functional assessment of cancer therapy-breast (FACT-B) for the quality of life category. Conclusion : The findings of this scoping review provide valuable mapping data for non-pharmacological interventions for physical rehabilitation following breast cancer treatment. We recommend further research, particularly systematic reviews and meta-analyses, to build upon these findings.

Late-term effects of hypofractionated chest wall and regional nodal radiotherapy with two-dimensional technique in patients with breast cancer

  • Yadav, Budhi Singh;Bansal, Anshuma;Kuttikat, Philip George;Das, Deepak;Gupta, Ankita;Dahiya, Divya
    • Radiation Oncology Journal
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    • 제38권2호
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    • pp.109-118
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    • 2020
  • Purpose: Hypofractionated radiotherapy (RT) is becoming a new standard in postoperative treatment of patients with early stage breast cancer after breast conservation surgery. However, data on hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI) is lacking. In this retrospective study, we report late-term effects of 3 weeks post-mastectomy hypofractionated local and RNI with two-dimensional (2D) technique in patients with stage II and III breast cancer. Methods: Between January 1990 and December 2007, 1,770 women with breast cancer who were given radical treatment with mastectomy, systemic therapy and RT at least 10 years ago were included. RT dose was 35 Gy/15 fractions/3 weeks to chest wall by two tangential fields and 40 Gy in same fractions to supraclavicular fossa (SCF) and internal mammary nodes (IMNs). SCF and IMNs dose was prescribed at dmax and 3 cm depth, respectively. Chemotherapy and hormonal therapy was given in 64% and 74% patients, respectively. Late-term toxicities were assessed with the Radiation Therapy Oncology Group (RTOG) scores and LENT-SOMA scales (the Late Effects Normal Tissue Task Force-Subjective, Objective, Management, Analytic scales). Results: Mean age was 48 years (range, 19 to 75 years). Median follow-up was 12 years (range, 10 to 27 years). Moderate/marked arm/shoulder pain was reported by 254 (14.3%) patients. Moderate/marked shoulder stiffness was reported by 219 (12.3%) patients. Moderate/marked arm edema was seen in 131 (7.4%) patients. Brachial plexopathy was not seen in any patient. Rib fractures were noted in 6 (0.3%) patients. Late cardiac and lung toxicity was seen in 29 (1.6%) and 23 (1.3%) patients, respectively. Second malignancy developed in 105 (5.9%) patients. Conclusion: RNI with 40 Gy/15 fractions/3 weeks hypofractionation with 2D technique seems safe and comparable to historical data of conventional fractionation (ClinicalTrial.gov Registration No. NCT04175821).

아전 근막절제술을 이용한 듀피트렌 구축의 치료 결과 (Clinical Results of Subtotal Fasciectomy for Treatment of Dupuytren Contracture)

  • 이윤민;송석환;김용우;최재훈
    • 대한정형외과학회지
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    • 제54권4호
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    • pp.353-360
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    • 2019
  • 목적: 듀피트렌 구축의 이상적인 치료 방법은 재발률을 줄이고 합병증이 적게 발생하게 하는 것이다. 본 연구의 목적은 낮은 재발 및 합병증 발생을 위해 아전 근막절제술을 시행하여 치료한 듀피트렌 구축 환자의 결과를 보고하고자 함이다. 대상 및 방법: 2007년부터 2017년 3월까지 아전 근막절제술을 시행한 45명의 환자를 후향적으로 연구하였다. 아전 근막절제술은 구축된 결절과 끈과 함께 주변에 정상 근막을 포함하여 절제하는 수술 방법이다. 평균 추시 기간은 45.9개월이었으며, 92개의 수지가 이환되었다. 선행 인자 및 이환된 관절을 조사하였으며, 수술 전 후 관절 구축의 정도를 측정하였다. 임상 결과를 확인하기 위해 quick disabilities of the arm, shoulder, and hand (quick DASH) score를 사용하였다. 수술 후 피부 결손 및 상처 관련 문제, 신경손상, 혈종, 복합 부위 통증 증후군과 같은 합병증을 조사하였다. 결과: 수술 전 관절 구축은 근위지관절 평균 43.2°, 중수지관절 평균 32.9°였고, 수술 후 9예에서 평균 9.7° (범위, 5°-20°)의 잔여 구축이 남았으며, 전체 수지에 비교했을 때 평균 2.3°의 구축이 발생하였다. 수술 후 12개월 quick DASH score는 평균 12.4점이었고, 전체 합병증 발생률은 26.6%였다. 결론: 듀피트렌 구축에서 아전 근막절제술은 비관혈적 치료에 비해 현저히 낮은 재발률을 보이고, 타 수술치료에 비해 합병증 발생이 적은 효과적인 치료 방법이다.