• The Korean Journal of Pain
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• 제4권2호
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• pp.122-126
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• 1991

Continuous epidural analgesia with intermittent morphine injection is a good technique for the management of intractabie cancer pain. Since epidural tunnelling was introduced for the first time to our institution in 1988, it has been widely used for the cancer pain management. Recently epidural tunnelling was introduced for the keeping an inserted catheter for a long period of time. Twenty-five patients with terminal cancer had been used an epidural tunnelling at the pain clinic of Dongsan Medical Center during the period of 3 months in 1991. Among the 25 patients, 14 were male and 11 were female, and most of them were at the ages of 6th decade. The causes of pain were from stomach cancer in 12, CBD cancer in 3, hepatoma in 2, pancreatic cancer in 2, uterine cervical cancer in 2, and miscellaneous cancer in 4 cases respectively. The outcome of treatment were excellent results in 14(56%), good in 9(36%), and moderate in 2.patients(8%). Accordingly satisfactory pain relief was achieved in 92% of the patients. It is suggested that this long-term management of intractable cancer pain by epidural bupivacaine and morphine with epidural tunnelling is satisfactory and reliable.

• 대한암한의학회지
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• 제14권1호
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• pp.37-44
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• 2009

Most of patients who have cancer still suffer from various forms of pain that significantly impact their quality of life. Cancer pain is a difficult problem for clinicians because analgesic drugs do not always procure complete relief. Acupuncture has been used as complementary treatment of cancer pain. We report a patient with colorectal cancer who suffer from cancer pain. The patient underwent chemotherapy, radiotherapy and opioid therapy. However, the patient insisted on being treated for his continuous pain with oriental medical treatment. The patient was treated with acupuncture(especially SAAM acupuncture) for 2 months, additional herbal medication was administered. After those treatments, the patient showed remarkable improvement in terms of intensity and severity of cancer pain. Further study will be needed in order to determine the long-term efficacy of acupuncture on cancer pain.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.165-167
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• 2009

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

• The Korean Journal of Pain
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• 제19권2호
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• pp.249-252
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• 2006

Postlaminectomy syndrome is characterized by persistent low back pain and radiculopathy of the legs after surgery of the spine. Pseudomeningocele is an uncommon cause of postlaminectomy syndrome; it is characterized by an extradural collection of cerebrospinal fluid (CSF) without dural covering, resulting from unrecognized dural tears at the time of lumbar surgery. In most cases, surgery to repair a pseudomeningocele is recommended. However if surgical treatment does not yield symptomatic relief, then conservative treatment should be considered. We treated a patient with a pseudomeningocele after spine surgery in which selective transforaminal epidural block produced long-term relief of symptoms. Here we describe the management of this patient.

• Journal of Korean Neurosurgical Society
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• 제38권6호
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• pp.442-444
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• 2005

Objective : There were few reports about statistically significant factor which contribute to low back pain[LBP] after microscopic discectomy. We analyzed the result of percutaneous radiofrequency neurotomy[PRN] for low back pain after microscopic discectomy in lumbar disc herniation. Methods : Forty four patients with LBP after microscopic discectomy who were treated by one level microscopic discectomy from January 2003 to March 2004 were included in this study. They were divided into two groups by the presence of preoperative LBP into preoperative back pain group [group I] and postoperative back pain group [group II]. Radiofrequency procedures were performed in the usual manner, targetting the medial branch of L4, L5 and Sl. Pain relief was estimated at 1 week, 1 month and 6 months following the procedure, using the visual analogue scale. Above 50% pain relief was defined as the positive response. Results : Positive responders were 16 patients [73%] at 1 week, 12 patients [55%] at 1 month, and 7 patients [32%] at 6 months after PRN in group I. In Group II, 18 patients, 15 patients and 13 patients responded positively after 1 week, 1 month and 6 months after PRN, respectively. Conclusion : PRN is an effective treatment for newly developed low back pain after microscopic discectomy. There was no morbidity in our series, but long-term follow up is necessary.

• 근관절건강학회지
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• 제16권1호
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• pp.36-45
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• 2009

Purpose: This study was to determine the effects of laughter therapy on stress response and pain of military patients with low back pain. Method: The subjects in the experimental group received 3-sessions of laughter therapy on 3 consecutive days. The primary outcome measures were state anxiety, depression, blood pressure, pulse rate and pain. Result: After 3 sessions of laughter therapy, the scores of state anxiety(p=.046), depression(p=.028) and pulse rate(p=.003) were significantly lower and diastolic blood pressure(p=.038) was significantly higher in the experimental group than those in the control group. The level of pain(p=.711) was not different significantly between two groups. Conclusion: Laughter therapy could be an effective strategic intervention for military patients with low back pain to reduce the level of anxiety and depression. Further studies are needed to determine long-term effects of laughter therapy and its effects on cardiovascular system and pain.

• The Korean Journal of Pain
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• 제33권4호
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• pp.359-377
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• 2020

Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain. Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were completed. A control group (n = 50) was recruited. Results: There was a significant difference between current smokers and nonsmokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP "definite/probable" neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of "definite/probable" increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score. Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.

• The Korean Journal of Pain
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• 제29권3호
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• pp.197-201
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• 2016

Because of its anatomical location and function, the costotransverse (CTRV) joint can be a source of thoracic back pain. In this retrospective observational study, we evaluated the clinical effectiveness of the CTRV joint injection in thoracic back pain patients with suspected CTRV joint problems. We enrolled 20 thoracic back pain patients with localized tenderness that was provoked by the application of pressure on the affected CTRV joints. We injected it with 0.5 ml of a ropivacaine and triamcinolone mixture at each level. The mean pre-injection pain score decreased by 37.9% ($7.2{\pm}1.5$ to $4.5{\pm}1.7$, P < 0.001) two weeks after CTRV joint injection. In addition, 70% of patients reported an excellent or good level of satisfaction. We demonstrated that an ultrasound-guided injection of the CTRV joint reduced patients' pain scores and led to a high level of satisfaction at short-term follow-ups in patients with suspected CTRV joint problems.

• Journal of Oral Medicine and Pain
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• 제42권3호
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• pp.53-61
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• 2017

Myogenous temporomandibular disorder is a collective term for pathologic conditions of the masticatory muscles, mainly characterized by pain and dysfunction associated with various pathophysiological processes. Among the subtypes of myogenous temporomandibular disorder, myofascial pain is one of the most common muscle disorders, characterized by the presence of trigger points (TrPs). Various modalities, such as ultrasound, manipulative therapy, spray-and-stretch technique, transcutaneous electrical nerve stimulation, injection/dry needling, and low-level laser therapy are used to inactivate TrPs. Needling/injection on the TrPs is one of the most common treatments for myofascial pain. Despite the evidence, there is continued controversy over defining the biological and clinical characteristics of TrPs and the efficacy of injection/dry needling. This review discusses the current concept of injection/needling to relieve TrPs.

• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.115-126
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• 2003

Although painful conditions of varying degrees of severity involving the soft tissues (i .e., muscles, tendons, ligaments, periosteum and peripheral nerves) occur frequently, their underlying pathogenesis is poorly understood. The term peripheral neuropathic pain has recently been suggested to embrace the combination of positive and negative symptoms in patients whose pain is due to pathological changes or dysfunction in peripheral nerves or nerve root. The spinal nerve root, because of its vulnerable position, is very easily prone to injury from pressure, stretch, angulation, and friction. Therefore, not a few of musculoskeletal chronic pains are result of nerve root dysfunction. Neuropathic changes due to nerve root dysfunction are primarily in soft tissue especially muscle, tendon and joint. It shows tenderness over muscle motor points and palpable muscle contracture bands and restricted Joint range. Careful palpation and physical examination is the important tool that, be abne to detect all of these phenomena.