• 제목/요약/키워드: Central pain

검색결과 495건 처리시간 0.028초

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.

만성 요통 환자와 요통이 없는 건강한 대상자의 척추 뼈분절의 압통 역치 수준 비교와 만성 요통 환자에 통증 수준, 기능장애 및 심리사회적 수준 간에 상관성 (Comparison of the Pressure Pain Thresholds the Vertebral Segments Between Patients with Chronic Lower Back Pain and Healthy Individuals, and Correlation Between Pain, Dysfunction, and Psychological Status in Patients with Chronic Lower Back Pain)

  • 유진영;김선엽
    • 대한정형도수물리치료학회지
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    • 제29권3호
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    • pp.73-84
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    • 2023
  • Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.

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IMS(Intramuscular Stimulation Therapy)의 이론적 배경과 임상적 운용에 대한 고찰 (An Introduction of IMS(Intramuscular Stimulation Therapy) with Theoretcial Basis and Clinical Applications)

  • 권기록;곡경승;김성욱
    • 대한약침학회지
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    • 제6권2호
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    • pp.159-164
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    • 2003
  • Results : 1. The most important concept of IMS is chronic pain illness that may develop into hypersensitivity of the nerves, i.e., neuropathy. 2. Muscle shortening may be triggered by stress, including emotional, physical, external, and internal factors. 3. Muscle shortening increases mechanical tension on the muscles as well as inducing abrasion of the tissues by stretching ligament, tendon, cartilage, bone, and etc. 4. Pain from neuropathy is normally manifested on musculoskeletal system and spasm or shortening play as the central axis of this pain. 5. Neuropathy often appears at the nerve root level and the most important decisive factor of radiculopathy is muscle shortening. 6. Spondylosis is the most common cause of radiculopathy. 7. The most significant treatment principle of IMS is to relieve muscle shortening and remove stimulating determinant from the vertebrae. 8. Dry needling is quite effective for treating various pain caused by muscle shortening.

등마사지가 위암 수술 환자의 통증 정도, 상태불안 및 수면의 질에 미치는 효과 (The Effect of Back Massage on Degree of Pain, State Anxiety and Quality of Sleep of Postoperative Patients with Gastrectomy)

  • 한미숙;이강이
    • 종양간호연구
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    • 제12권1호
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    • pp.69-76
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    • 2012
  • Purpose: Most of postoperative patients experience pain, state anxiety and sleep disturbance. These problems negatively influence the recovery of postoperative patients. So alleviating these problems has been one of the nurses' central roles. The purpose of this study was to examine the effects of back massage on pain, state anxiety and quality of sleep of postoperative gastrectomy patients. Methods: A non-synchronized non-equivalent control group pre and post-test design was used. The research instruments used in this study were the Numerical Rating Scale (NRS) for pain, the State-Anxiety Inventory (STAI) for anxiety and the Verran and Synder-Halpern scale for quality of sleep. The subjects were patients admitted to a university hospital located in D city. Twenty-nine patients in the experimental group had a 10 minute manual back massage stimulation for 5 days from the 1st day to the 5th day after their operation, and 25 patients in the control group did not. Results: The degree of pain was significantly reduced according to post operation day and quality of sleep was significantly increased. However state anxiety was not significantly reduced. Conclusion: Back massage is a partially effective nursing intervention for postoperative patients with gastrectomy who experience pain and sleep disturbance.

Analgesic Effects of Transcranial Direct Current Stimulation on Central Neuropathic Pain in Spinal Cord Contusive Rat Model

  • Kim, Kyung-Yoon;Sim, Ki-Chol;Kim, Hyun-Seung;Choi, Wan-Suk;Kim, Gi-Do
    • International Journal of Contents
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    • 제8권1호
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    • pp.74-81
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    • 2012
  • The aim is to investigate the analgesic effect of transcranial direct current stimulation(tDCS) on central neuropathic pain(CNP) in spinal cord contusive rat model. Twenty Sprague-Dawley rats($250{\pm}50$ g, male) were used. Thoracic spinal cord(T10) was contused using New York University(NYU) spinal cord impactor. The animals were randomly assigned to two groups; GroupI: Non-treatment after SCI induction(n=10), GroupII: application of tDCS(0.1 mA, 20 min/time, 2 times/day, 5 days/6week) after SCI induction(n=10). Assess the effect of tDCS using the Basso Beattie Bresnahan(BBB) locomotor rating scales, Touch $test^{TM}$ sensory evaluator(TTSE), Plantar test$^{\circledR}$after contusion at the $2^{nd}$, $3^{rd}$, $4^{th}$, $5^{th}$, $6^{th}$ week and the immunohistochemistric response of c-fos in the thalamus, cerebral cortex after contusion at the $3^{rd}$, $6^{th}$ week after SCI. The scores of BBB scales were significantly different from $3^{rd}$week. TTSE were different significantly over time, but there were no differences at each evaluation times on between-measure time effects. Plantar test were different significantly over time and there were difference at the $4^{th}$, $6^{th}$ week after SCI on between-measure time effects. Also, immunohistochemistric response of c-fos was reduced significantly from $3^{rd}$, $6^{th}$ week after SCI in tDCS group compared with control group in thalamus and cortex. These results identified that tDCS of non-invasive therapeutic method may have beneficial analgesic effect on CNP after SCI with behavioral test and immunohistochemical test.

간접구 중심의 한의복합치료로 전대뇌동맥 및 중대뇌동맥 경색 환자의 중추성 통증과 하지마비에 개선을 보인 증례보고 1례 (A Case Report of Central Post-stroke Pain and Hemiparesis due to Anterior Cerebral Artery and Middle Cerebral Artery Infarction That Improved Following Treatment with Korean Medicine, Including Moxibustion)

  • 전성현;김다담;김유빈;박한송
    • 대한한방내과학회지
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    • 제45권2호
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    • pp.246-258
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    • 2024
  • This case report describes a patient diagnosed with central post-stroke pain (CPSP) and hemiparesis due to anterior cerebral artery and middle cerebral artery infarction. The patient was treated with Korean medicines, including moxibustion, acupuncture, electroacupuncture, herbal medicine, Western medicine, and rehabilitation therapy for 67 days. CPSP improved based on scores on the Numeric Rating Scale (NRS) (from 8 to 0), paresthesia NRS (7 to 0), Manual Muscle Test (4/1 to 4+/4-),4+/4-), Korean version of the modified Barthel Index (24 to 73), National Institute of Health's Stroke Scale (7 to 0), Global Deterioration Scale (1 to 1), and Korean version of the Mini-Mental State Examination (27 to 29). No seizures, shocks, recurrent ischemic stroke, and liver dysfunction were recorded during the treatment. A moxibustion-induced burn healed within 7 days. This case suggests that moxibustion, combined with other treatments, has the potential to improve CPSP, without severe side effects.

The effects of regular exercise on capsaicin-induced pulpal pain and pain-induced changes in passive avoidance learning and memory in rats

  • Raoof, Maryam;Shakoori, Afshin;Kooshki, Razieh;Abbasnejad, Mehdi;Amanpour, Sara
    • The Korean Journal of Pain
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    • 제30권4호
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    • pp.258-264
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    • 2017
  • Background: Pulpal pain is one of the most common and severe orofacial pain conditions with considerable adverse effects on physiological processes including learning and memory. Regular exercise is known to be effective on cognitive function as well as pain processing in the central nervous system. Here, the possible effects of regular exercise on pulpal pain response as well as pain-induced changes in learning and memory efficiency in rats were investigated. Methods: Twenty-four male Wistar rats were randomly assigned to the control, capsaicin, exercise, and exercise plus capsaicin groups. Rats in exercise groups were forced to run on a treadmill with a moderate exercise protocol for 4 weeks. Capsaicin was used to induce dental pulp pain. Passive avoidance learning and memory performance was assessed by using a shuttle box apparatus. Results: According to the results, regular exercise could decrease the time course of capsaicin-induced pulpal pain (P < 0.001). Moreover, in capsaicin-treated rats, passive avoidance acquisition was impaired as compared to the control (P < 0.05) and exercise (P < 0.001) groups. Additionally, regular exercise before capsaicin injection could attenuate capsaicin-induced memory impairments (P < 0.05). Conclusions: Taken together, the present data showed that regular exercise has inhibitory effects on capsaicin-induced pulpal pain as well as pain-induced cognitive dysfunction in rats.

통증위치에 따른 자세 치우침의 차이비교 (Changes in Postural Deviation Caused by the Pain Area)

  • 방상분;정호발
    • 대한물리치료과학회지
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    • 제9권3호
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    • pp.97-106
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    • 2002
  • Purpose. This study was tried to compare the effect of the change in postural deviation caused by the pain side Subjects and Methods. Inpatients and outpatients (n=71) were selected from I hospital who have a musculoskeletal low back pain and shoulder pain without any history of the central nervous system (CNS) lesions, orthopaedic problems of the both lower extremities, or the vestibular and the visual default. For the control group, normal and healthy subjects (n=30) were selected without any history of weight bearing disorders. the weight bearing was rated by the computerized force plate. Results. 1) Postural deviation was not significant difference between patients and control group(p<0.01). But postural deviation in patients was more pronounced than control group. 2) There was significant difference of postural deviation between in patients according to the pain side(p<0.01). When the pain side was on the left side, postural deviation tended to the right. When the pain side was on the right side and vertebral body, postural deviation tended to the left. 3) There was no significant difference of postural deviation between regional pain in shoulder and regional pain in low back(p<0.01). Discussions and Conclusion. As a result, the pain, for sure, affected the good posture and its keeping process directly or/and indirectly. Therefore, as the postural deviation increases, the additional energy consumption increased by the works of the muscles to keep the good posture. Preponderated postural deviation, furthermore, could load too much to the musculoskeletal system, leading to increase the pain. The postural deviation, a result of the pain, can cause a secondary deformity of the distal area as a compensatory reaction, and this compensation actually become a cause of the musculoskeletal symptom back in a cycle. Therefore, the appropriate treatment of the musculoskeletal problem and the education of the posture correction should be given to decrease the pain, preventing the secondary deformities, and increasing muscle energy efficiency of the posture remaining muscles.

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얼굴 통증과 가려움증을 동반한 복합부위통증증후군 환자에서 나비입천장 신경절 고주파 열응고술 -증례보고- (The Sphenopalatine Ganglion Radiofrequency Thermocoagulation on a Patient of CRPS with Facial Pain and Pruritus -A report of 2 cases-)

  • 박승재;문동언;김원영;박정주;조은정;양석우
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.228-232
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    • 2006
  • Complex regional pain syndrome (CRPS) type 1 is characterized by the presence of pain, which is severe, diffuse and associated with allodynia, and is also associated with autonomic and trophic changes. The sensitization phenomena of CRPS also cause allodynia and itching, as well as pain. These symptoms are the issues associated with the treatment of CRPS. Under normal conditions, an antagonistic interaction exists between the pain and itching, but the patterns of peripheral and central sensitization phenomena for the pain and itching are very similar. The chronic pain and chronic itch have similar characteristics in their developmental and therapeutical principles. Herein, our experience of 2 cases of CRPS, which showed improvement of these facial symptoms after sphenopalatine ganglion radiofrequency thermocoagulation, but were not controlled by spinal cord stimulation or other conservative treatments, is reported.

The Attenuation of Pain Behavior and Serum COX-2 Concentration by Curcumin in a Rat Model of Neuropathic Pain

  • Zanjani, Taraneh Moini;Ameli, Haleh;Labibi, Farzaneh;Sedaghat, Katayoun;Sabetkasaei, Masoumeh
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.246-252
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    • 2014
  • Background: Neuropathic pain is generally defined as a chronic pain state resulting from peripheral and/or central nerve injury. There is a lack of effective treatment for neuropathic pain, which may possibly be related to poor understanding of pathological mechanisms at the molecular level. Curcumin, a therapeutic herbal extract, has shown to be effectively capable of reducing chronic pain induced by peripheral administration of inflammatory agents such as formalin. In this study, we aimed to show the effect of curcumin on pain behavior and serum COX-2 level in a Chronic Constriction Injury (CCI) model of neuropathic pain. Methods: Wistar male rats (150-200 g, n = 8) were divided into three groups: CCI vehicle-treated, sham-operated, and CCI drug-treated group. Curcumin (12.5, 25, 50 mg/kg, IP) was injected 24 h before surgery and continued daily for 7 days post-surgery. Behavioral tests were performed once before and following the days 1, 3, 5, 7 after surgery. The serum COX-2 level was measured on day 7 after the surgery. Results: Curcumin (50 mg/kg) decreased mechanical and cold allodynia (P < 0.001) and produced a decline in serum COX-2 level (P < 0.001). Conclusions: A considerable decline in pain behavior and serum COX-2 levels was seen in rat following administration of curcumin in CCI model of neuropathic pain. High concentration of Curcumin was able to reduce the chronic neuropathic pain induced by CCI model and the serum level of COX-2.