• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.13 no.1
• /
• pp.86-95
• /
• 2006

Purpose: This study was done to investigate the relationship among the variables, chronic pain, pain coping, fatigue, self-esteem, and depression in elders. Method: Data were collected by self-reported questionnaires from 270 older adults. Data analysis was done with SPSS 10.1 for descriptive statistics and a PC LISREL program for covariance structural analysis. Results: According to modified model, chronic pain was found to have a significant direct and total effect on pain coping. Chronic pain and pain coping were found to have a significant direct and total effect on fatigue. Chronic pain, pain coping and fatigue were found to have a significant direct and total effect on self-esteem. Chronic pain, pain coping, and self-esteem were found to have a significant direct effect on depression. Conclusion: This modified model is considered appropriate for explaining the relationship among chronic pain, pain coping, fatigue, self-esteem, and depression in elders. Also, the findings support the development of an intervention strategy to relieve chronic pain in elders.

• Journal of Korean Academy of Nursing
• /
• v.33 no.1
• /
• pp.26-33
• /
• 2003

Purpose: The purpose of this study was to investigate the relationships among variables of somatic attribution, chronic pain, depression and chronic fatigue in the elderly. Methods: Empirical data for testing hypothetical models was collected from 311 people over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explained causal relationship of variables. Result: According to Accepted model, the relation of variables is that the somatic attribution is the influencing variable to chronic pain and depression and chronic pain and depression is the influencing variable to chronic fatigue. Conclusion: The findings of this study give useful information to construct intervention program relating chronic pain, depression and chronic fatigue for the elderly.

• Physical Therapy Rehabilitation Science
• /
• v.12 no.2
• /
• pp.177-184
• /
• 2023

Objective: Manual therapy is a commonly utilized approach in managing chronic pain, but its specific impact on pain catastrophizing remains uncertain. The objective of this systematic review and meta-analysis was to examine the effects of manual therapy on pain catastrophizing in individuals with chronic pain. Design: A systematic review and meta-analysis Methods: A comprehensive search was conducted in electronic databases to identify relevant studies published from 2014 onwards. Studies that evaluated the impact of manual therapy on pain catastrophizing in individuals with chronic pain were incorporated. The risk of bias in the selected studies was evaluated using the Cochrane tool for risk of bias in qualitative analysis. For the quantitative analysis, RevMan 5.4 software was utilized, employing a random-effects model as the analysis model. The effect measure used in the analysis was the standardized mean difference (SMD). Results: In total, 26 studies were collected, and following the screening process, three of them were incorporated into the final analysis. The included studies involved a total of 153 patients with chronic pain. The interventions comprised various manual therapy techniques targeting different areas of the body. Pain catastrophizing and pain intensity were the primary outcomes of interest. The meta-analysis revealed a significant reduction in pain catastrophizing scores following manual therapy intervention compared to control conditions (SMD = -0.91, 95% CI: -1.25 to -0.58). However, heterogeneity between the studies was observed. Conclusions: Despite the limited quantity and heterogeneity of studies, it has been demonstrated that manual therapy intervention is effective in reducing pain catastrophizing in individuals with chronic pain.

• Journal of Korean Society of Industrial and Systems Engineering
• /
• v.44 no.4
• /
• pp.23-31
• /
• 2021

Treatment and management of chronic low back pain (CLBP) should be tailored to the patient's individual context. However, there are limited resources available in which to find and manage the causes and mechanisms for each patient. In this study, we designed and developed a personalized context awareness system that uses machine learning techniques to understand the relationship between a patient's lower back pain and the surrounding environment. A pilot study was conducted to verify the context awareness model. The performance of the lower back pain prediction model was successful enough to be practically usable. It was possible to use the information from the model to understand how the variables influence the occurrence of lower back pain.

• The Korean Journal of Pain
• /
• v.27 no.3
• /
• pp.246-252
• /
• 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.

• The Journal of Korean Medicine
• /
• v.25 no.3
• /
• pp.67-77
• /
• 2004

Objectives : Many studies have reported that acupuncture analgesia was mediated through the activation of peripheral and central opioid receptors. However, there has been little electrophysiological study on the adrenergic mechanism of acupuncture analgesia in chronic inflammatory and neuropathic pain. The present study was undertaken to elucidate the role of adrenoceptors in the production of acupuncture analgesia in the chronic pain model. Methods : In the rat with chronic inflammation and nerve injury, dorsal horn cell (DHC) responses to afferent C fiber stimulation were used as a pain index and changes in electroacupuncture (EA) analgesia were recorded before and after intravenous administration of selective adrenoceptor antagonists. EA stimulations (2Hz, 0.5msec, 3mA) were applied to the contralateral Zusanli point for 30 min. Results : EA stimulation induced long-lasting inhibition of DHC responses in the rat with chronic inflammation and nerve injury. In both models of inflammation and neuropathic pain, α-adrenoceptor antagonist (phentolamine) significantly attenuated an inhibitory effect of EA on DHC responses. Selective α2-adrenoceptor antagonist (yohimbine) also had a similar suppressive action on DHC responses to that of phentolamine. However, β-adrenoceptor antagonist (propranolol) did not have any inhibitory effect on DHC responses in either model of chronic pain. Conclusions : These experimental findings suggest that in rats with chronic pain, EA stimulation with low frequency and high intensity produced an analgesic effect which was mediated through an activation of α2-adrenoceptors.

• The Korean Journal of Pain
• /
• v.24 no.1
• /
• pp.13-21
• /
• 2011

Background: This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance. Methods: Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea. Results: The results indicated that pain intensity, hyperarousal, and pain avoidance had significant direct effects on daily functioning. Also, pain intensity showed significant indirect effects on daily functioning through hyperarousal and pain avoidance; and hyperarousal through pain avoidance. Conclusions: Results suggest a direct contribution of high levels of pain, hyperarousal symptoms of PTSD, and pain avoidance behaviors to reduced daily functioning. Also, elevated pain as reminders of the trauma may trigger high levels of hyperarousal symptoms of PTSD. Subsequently, avoidant coping strategies may be used to minimize pain so that the trauma would not be re-experienced, thus inhibiting the activation of hyperarousal symptoms of PTSD. However, prolonged use of such strategies may contribute to decline in daily functioning.

• The Korean Journal of Pain
• /
• v.21 no.2
• /
• pp.112-118
• /
• 2008

Background: This study was conducted to quantitatively analyze proteins associated with the calcitonin gene-related peptide (CGRP) in cerebrospinal fluid (CSF) that was obtained from a rat model of chronic neuropathic pain following administration of intrathecal $CGRP_{8-37}$. Methods: Male Sprague-Dawley rats (100-150 g, 5-6 wks) were divided into two groups, sham controls and neuropathic pain models. At the time of operation for neuropathic pain model, an intrathecal catheter was threaded through the intrathecal space. At 1 or 2 wks after the operation (maximum pain state), a test dose of 1, 5, 10, or 50 nM of $CGRP_{8-37}$ was injected into the intrathecal catheter and the CSF was then aspirated. Conventional proteomics to evaluate the CSF were then performed using high resolution 2-D, gel electrophoresis followed by computational image analysis and protein identification by mass spectrometry. Results: Treatment with $CGRP_{8-37}$ effectively alleviated mechanical allodynia in a dose dependent manner. The most effective response was obtained when a dose of 50 nM was administered, but significant differences were obtained following administration of only 5 nM $CGRP_{8-37}$. Furthermore, the results of the proteomic analysis were consistent with the experimental results. Specially we detected 30 differentially expressed spots in 7 images when 2-D gel electrophoresis was conducted. The intensity of 6 of these spots (spot number: 20 and 26-30) was found decrease the $CGRP_{8-37}$ dose increased; therefore, these spots were evaluated by mass spectrometry. This analysis identified 2 different proteins, CGRP (spot numbers: 26-30) and neurotensin-related peptide (spot number: 20). Conclusions: The results of this study suggest that CGRP plays a role in chronic central neuropathic pain and is a major target of chronic neuropathic pain management.

• The Journal of Korean Medicine
• /
• v.26 no.3 s.63
• /
• pp.239-248
• /
• 2005

Objectives : Electroacupuncture (EA)-induced analgesia has been known to be mediated through the activation of opioid, noradrenergic and serotonergic receptors. However, little study on serotonergic mechanism has been performed in an animal model of chronic pain. The present study was designed to elucidate the type of serotonergic receptors responsible for EA analgesia in the chronic pain model. Methods : In rats with complete Freund's: adjuvant-induced inflammation and spinal nerve injury, spinal wide dynamic range (WDR) cell responses to graded electrical stimulation of afferent C fiber were recorded before and after spinal application of selective 5-hydroxytryptamine (5-HT) receptor antagonists. EA stimulation (2Hz, 0.5msec, 3mA) was applied to the contralateral Zusanli point for 30 min. Results : In both models of chronic pain, WDR cell responses were greatly inhibited after EA stimulation. EA-induced inhibition of WDR celt responses was significantly attenuated by spinal application of non-selective 5-HT receptor antagonist, dihydroergocristine Of 5-HT receptor antagonists tested, 5-HT1A (WAY 100635) and 5-HT2 (LY53857) receptor antagonists strongly reduced an ability of EA stimulation to inhibit WDR cell responses. However, 5-HT1B (GR55562) and 5-HT3 (LY278584) receptor antagonists also had weak but significant blocking action on EA-induced inhibitory effect on chronic pain. Conclusions : Dorsal hem cell responses, afferent C fiber stimulation, chronic pain, electroacupuncture, serotonergic receptors.

• The Korean Journal of Pain
• /
• v.36 no.2
• /
• pp.149-162
• /
• 2023

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.