• Title/Summary/Keyword: Pain-level

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Low Level Laser Therapy for Two Patients with Herniated Nucleus Pulposus (척추 추간판 탈출증의 저출력 레이저에 의한 치험 2예)

  • Kim, Young-Choo;Kim, Hae-Gyu;Baik, Seong-Wan;Kim, Inn-Se;Jung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.4 no.1
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    • pp.51-55
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    • 1991
  • There is a variety of therapeutic modality for herniated nucleus pulposus. Recently the low level laser has come into use for treatment for it. We treated two patients suffered from herniated nucleus pulposus of the central type of $L_{3,4}$ level, with He-Ne, $CO_2$ and Ga Al As laser simultaneously daily under hospitalization. In order to determine the efficacy of treatment, we used the "visual analogue scale" and its improvement rate. The results were as follows; Case I complained of gait disturbance, and hypoesthesia on the lateral side of the left lower leg, as and as low back pain. At the 15th day after treatment, VAS improvement rate was 40%, and the gait disturbance and hypoesthesia were markedly improved. 35th days after tratement, VAS improvement rate was 80%. Case II complained only of low back pain. At the 15th day after treatment, the VAS improvement rate was 68%, and at 20 days after treatment it was 84%. We sugsest that, using the low level laser for treatment of herniated nucleus pulposus increased the cartilage entrophism, and inhibitory effects of the inflammatory materials such as acid glycosaminoglycan by its anti-inflammatory and analgesic effects.

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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 (만성 요통 환자와 요통이 없는 건강한 대상자의 척추 뼈분절의 압통 역치 수준 비교와 만성 요통 환자에 통증 수준, 기능장애 및 심리사회적 수준 간에 상관성)

  • Jin-yeong Yoo;Suhn-yeop Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.29 no.3
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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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Practical statistics in pain research

  • Kim, Tae Kyun
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.243-249
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    • 2017
  • Pain is subjective, while statistics related to pain research are objective. This review was written to help researchers involved in pain research make statistical decisions. The main issues are related with the level of scales that are often used in pain research, the choice of statistical methods between parametric or nonparametric statistics, and problems which arise from repeated measurements. In the field of pain research, parametric statistics used to be applied in an erroneous way. This is closely related with the scales of data and repeated measurements. The level of scales includes nominal, ordinal, interval, and ratio scales. The level of scales affects the choice of statistics between parametric or non-parametric methods. In the field of pain research, the most frequently used pain assessment scale is the ordinal scale, which would include the visual analogue scale (VAS). There used to be another view, however, which considered the VAS to be an interval or ratio scale, so that the usage of parametric statistics would be accepted practically in some cases. Repeated measurements of the same subjects always complicates statistics. It means that measurements inevitably have correlations between each other, and would preclude the application of one-way ANOVA in which independence between the measurements is necessary. Repeated measures of ANOVA (RMANOVA), however, would permit the comparison between the correlated measurements as long as the condition of sphericity assumption is satisfied. Conclusively, parametric statistical methods should be used only when the assumptions of parametric statistics, such as normality and sphericity, are established.

A Descriptive Study on Pain of Elderly (노인의 동통에 관한 조사연구)

  • 김주희;양경희;이현주
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.878-888
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    • 1996
  • The main purpose of this study was getting related to the pain charactristic data of elderly. It contains past and present health status, daily living activity level, pain frequency, causes, pain area, pain intensity, pain worse causes, and pain releave causes, pain management methods. The subject were 79 elderly whose age were over 65 years old. They were lived in their home environment. Half of them were resident of middle range city at province and the others were Seoul city. The data was collected from Dec. 1st. 1995 to Jan. 30th. 1996. Interviews were held with semi-structured questionaire after pilot study by researchers. Pain measurement tool were used graphic rating scale and Abstract of Korean Pain Language Scale. To analize the subject's general characteristics, past and present health status, daily living activity level, characteristics about pain, pain management methods statistical SPSS for win frequency were employed. The findings were as follows ; 1. There were 33(41.8%) male and 46(58.2%) female Below 69 year old were 20(25.3%), 70-79 year old were 42(53.2%), over 80 year old were 17(21.5%), mean age was 74(from 65 to 89). 2. Buddhist were 24(30.4%), Christian were 29(36. 7%), the other religious status or non religians were 26 (32.9%). 3. Past good health status were 63(79.7%), not so good status were 6(7.6%). Present good health status were 19(24.1%), moderated health status were 6(7.6%), not so good status were 14(17.7%). 4. Daily living activity limitation were 39(49.4%), nonlimitation of activity were 5(6.3%). 5. Walking limitation were 3(3.8%), nonlimitation walking were 52(65,8%). 6. Insomnia was 23(29.1%), no difficult were 38(48.1%). 7. Chronic pain complaints were 64(81%), diseases causes of pain were 25(31.6%), bad health behavior causes of pain were 27(34.2%). 8. Most pain area were back 30(29.4%), leg 17(16.7%), knee 16(15.7%), arm 13(12.7%), teeth, chest and head were each 5(4.9%), loin, trunk were each 4(3.9%), the other areas were 3(3%). 9. Pain intensity was 3.49(mean) by Korean Language Scale, 6.59(mean) by graphic rating scale. Sensitive pain was 3.5(47.9%), affective pain was 3(20.8%) It was high pain level and sensitive pain. 10. Most pain worse causes moving was 35(44.3%), pain relieving causes rest was 29(36.7%), 11. Pain management method were medication 40(42.1%), physiotherapy 23(24.2%), hospital 12(12.6%), the others 7(7.4%), none 13(13.7%). The conclusion ; Present health status of eldery was not so good. Almost half of them have some diseases. Most common diseases of eldery were arthristis, respitatory and heart problems. Foully nine percent of elderly had limitation of daily living activities. Eighty one percent of eldely had chronic pain. Most of them was back pain (30%). Pain intensity was high(score over 3.5). The worsening pain causes was moving and releiving causes was rest. Pain management method were pain medication, physiotherapy. Therefore, Nursing care plan for the elderly have to focus on pain because majority of elderly have chronic high level of pain related to the arthritis.

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Effect of vibratory stimulation on pain during local anesthesia injections: a clinical trial

  • Ghorbanzadeh, Sajedeh;Alimadadi, Hoda;Zargar, Nazanin;Dianat, Omid
    • Restorative Dentistry and Endodontics
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    • v.44 no.4
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    • pp.40.1-40.10
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    • 2019
  • Objectives: This study aimed to assess the effect of DentalVibe on the level of pain experienced during anesthetic injections using 2 different techniques. Materials and Methods: This randomized crossover clinical trial evaluated 60 patients who required 2-session endodontic treatment. Labial infiltration (LI) anesthesia was administered in the anterior maxilla of 30 patients, while inferior alveolar nerve block (IANB) was performed in the remaining 30 patients. 1.8 mL of 2% lidocaine was injected at a rate of 1 mL/min using a 27-gauge needle. DentalVibe was randomly assigned to either the first or second injection session. A visual analog scale was used to determine participants' pain level during needle insertion and the anesthetic injection. The paired t-test was applied to assess the efficacy of DentalVibe for pain reduction. Results: In LI anesthesia, the pain level was 12.0 ± 15.5 and 38.1 ± 21.0 during needle insertion and 19.1 ± 16.1 and 48.9 ± 24.6 during the anesthetic injection using DentalVibe and the conventional method, respectively. In IANB, the pain level was 14.1 ± 15.9 and 35.1 ± 20.8 during needle insertion and 17.3 ± 14.2 and 39.5 ± 20.8 during the anesthetic injection using DentalVibe and the conventional method, respectively. DentalVibe significantly decreased the level of pain experienced during needle insertion and the anesthetic injection in anterior LI and mandibular IANB anesthesia. Conclusions: The results suggest that DentalVibe can be used to reduce the level of pain experienced by adult patients during needle insertion and anesthetic injection.

A Study on Pain Characteristics in Parts of the Hand among Estheticians (피부미용사의 손 부위 통증에 관한 연구)

  • Kim, Jeong Hwa;Phee, Young Gyu;Lee, Sa-Woo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.2
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    • pp.220-228
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    • 2015
  • Objectives: The purpose of this study was to investigate estheticians' self-reported pain symptoms and pain levels according to the parts of the hand. Methods: Data were collected through a questionnaire survey among 116 estheticians from 31 skin care centers and spas. Information about general characteristics, job characteristics and work characteristics were based on data from the self-administered questionnaire. To determine the self-reported pain symptoms and pain levels according to the parts of the hand, a Cornell Musculoskeletal Discomfort Questionnaire was used. Results: The subjects had the greatest self-reported pain symptoms in the thumb(Right: 53.4%, Left: 46.6%) and felt the highest level of pain in the wrist(Right: 4.87 points, Left: 4.71 points). Physical burdens and age had statistically significant effects on the pain level in the right hand, while physical burdens and the manager rather than the director had statistically significant effects on the pain level in the left hand. Conclusions: Since the thumb and wrist have the greatest subjective pain symptoms in the hand, the use of proper tools is recommended in order to reduce the usage of the thumbs during massage, as is regular stretching to protect the wrists.

Clinical Effectiveness of Ultrasound-guided Costotransverse Joint Injection in Thoracic Back Pain Patients

  • Yoon, Kyung Bong;Kim, Shin Hyung;Park, Sang Jun;Moon, Ji Ae;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.29 no.3
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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.

Microdecompression for Extraforaminal L5-S1 Disc Herniation; The Significance of Concomitant Foraminal Disc Herniation for Postoperative Leg Pain

  • Lee, Dong-Yeob;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.19-25
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    • 2008
  • Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.

The Effect of Lower Trapezius Strengthening Exercises on Pain, Disability, Cervical Range of Motion and Strength of Lower Trapezius in Patients With Unilateral Neck Pain : A Controlled Randomized Trial (하승모근 강화운동이 편측 경부통 환자의 통증, 기능장애, 경부 관절가동범위, 하승모근 근력에 미치는 영향 : 무작위 할당 대조군 실험)

  • Kim, Ki-Yong;Kim, Suhn-Yeop
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.58-68
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    • 2015
  • This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, $n_1=20$) that received strength training of the lower trapezius muscles or a control group (CG, $n_2=20$) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

The Pain Behavior of Patients with Joint Pain (관절통환자의 통증정도와 통증연관 행위에 관한 연구)

  • 이은옥;한윤복;김순자;이선옥;김달숙;김조자;김광주;김주희;박점희
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.197-210
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    • 1988
  • The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r=.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

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