• The Korean Journal of Pain
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• v.25 no.3
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• pp.155-160
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• 2012

Background: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit $II^{(R)}$ needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability. Methods: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study. A Diskit $II^{(R)}$ needle (15-cm length, 20-gauge needle with a 20-mm active tip) was placed centrally in the disc. PRF was applied for 15 min at a setting of $5{\times}50$ ms/s and 60 V. The pain intensity score on a 0-10 numeric rating scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) were assessed pretreatment and at 1, 3, and 6 months post-treatment. Results: The mean NRS was significantly improved from $7.2{\pm}0.6$ pretreatment to$2.5{\pm}0.9$ in the Disc PRF group, and from $7.5{\pm}1.0$ to $1.7{\pm}1.5$ in the IDET group, at the 6-month follow-up. The mean RMDQ also showed significant improvement in both the Disc PRF group and the IDET group at the 6-month follow-up. There were no significant differences in the pretreatment NRS and RMDQ scores between the groups. Conclusions: Disc PRF appears to be an alternative to IDET as a safe, minimally invasive treatment option for patients with chronic discogenic LBP.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.437-446
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• 2021

Background: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions: Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

• Journal of Acupuncture Research
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• v.29 no.2
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• pp.15-27
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• 2012

Objectives : The purpose of this study is to evaluate the effect of cotreatment with $Samgieum-gagam$, acupuncture and sweet bee venom acupuncture on post-stroke shoulder pain. Methods : The subjects in this study were 43 patients with post-stroke hemiplegic shoulder pain. These patients were randomly divided into four groups : the group treated with acupuncture, the group cotreated with acupuncture and sweet bee venom acupuncture, the group cotreated with acupuncture and $Samgieum-gagam$, the group cotreated with acupuncture, sweet bee venom acupuncture and Samgieumgagam, They were treated for 4 weeks, and the effectiveness was assessed by visual analogue scale(VAS), Fugl-Meyer motor assessment(FMMA), painless passive ROM of shoulder external rotation(PROM), Modified Ashworth sacle(MAS) and Satisfaction. Results : All groups showed significant change in VAS, FMMA and PROM. The group cotreated with acupuncture, sweet bee venom acupuncture and $Samgieum-gagam$ showed more effectiveness in VAS and FMMA than the group treated with acupuncture. There was no significant difference in MAS among groups. Conclusions : This study suggests that cotreatment with $Samgieum-gagam$, acupuncture and sweet bee venom acupuncture is more effective than acupuncture treatment only on post-stroke shoulder pain. Further study based on many other combination methods, larger population, and long term follow-up is needed to confirm this suggestion.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.2 s.7
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• pp.84-89
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• 2004

Background: Many studies on efficacy of preemptive analgesia have been processed in different ways. But the value of preemptive analgesia is still controversial. The goal of this study was to compare analgesic effect of an NSAID according to three different administration times for oral surgical pain. Patients and Methods: Using a randomized, parallel-group, single-center, and active-controlled test design, this study was conducted to healthy 80 patients undergoing a surgical removal of an impacted mandibular third molar requiring bone removal. The oral NSAID was first administered 1 hour preoperatively, or 1 hour postoperatively, or no scheduled administration in pre or postsurgery. Whenever patients felt at least moderate pain (score ${\ge}$ 5 on a 10-point scale) after surgery, they were instructed to take the same drug. Pain intensities and times to the first and second onset of postoperative pain from end of surgery were assessed for 24 hours. Results: Of the enrolled eighty subjects in this study, 25 patients were assigned to preemptive, 26 to post-treatment and 29 to no treatment group. The demographic distribution and duration of surgery in the three groups were statistically similar. The mean time to first onset of postoperative pain was significantly prolonged in post-treatment group (277.2 minutes, p < 0.05) compared to preemptive (158.4 minutes) and no treatment group (196.5 minutes). The mean time to second onset of postoperative pain was not significantly different among the three groups. No significant statistical difference was found among the mean pain intensities at the first and second onset of postoperative pain in the three groups. Conclusions: In this small selected group of subjects and limited study design, the analgesic effects of NSAID administered preoperatively were no longer effective for postoperative pain. The results in this population imply that scheduled postoperative analgesics before pain development are adequate for postoperative analgesia without preoperative administration.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.244-250
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• 1995

Many clinical and laboratory experiments have been developed to prevent or decrease post-operative pain. One of these methods is pre-operative administration of opioid. Recently there have been differing and debatable results reported of pre-operative treatment for post-operative pain management. It was our study to determine whether pre-operative epidural fentanyl prevented central facilitation or wind up of spinal cord from nociceptive afferent input through c-fibers. We evaluated the effect of epidural fentanyl 50 mcg 10 minutes before operation and 10 minutes before the end of surgery. 28 parturient women for Cesarean Section were randomly allocated to receive the epidural fentanyl either at 10 minutes before operation (Group 1, n=14) or 10 minutes before the end of surgery (Group 2, n=14). All of the 28 parturient women were anesthetized with epidural block using (22 ml of) 2% lidocaine supplemented with light general anesthesia ($N_2O$ 2 L/min-$O_2$, 2 L/min), we controlled post-operative pain with epidural PCA(patient controlled analgesia) infusion of meperidine and 0.07% bupivacaine. The action duration of epidural fentanyl from the end of surgery to the first requirement of analgesics with epidural PCA were not significantly different between the two groups. No significant differences between two groups were observed in VAS pain score at 1, 2, 3, 6, 12, 24, and 48 hours after the operation. The number of self administration of narcotics with PCA during 48 hours after surgery were the same between the two groups. The hourly infusion rates of demerol were the same. Pre-operative administration of fentanyl was not clinically effective compared to administration just before the end of surgery for postoperative pain control.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.1
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• pp.95-101
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• 2012

Objectives : This study is performed to evaluate the clinical effect of Chuna therapy on the neck pain associated with kypotic cervical curvature. Methods : This study carried out on two patients with neck pain & kyphotic cervical curvature who have received treatment in Department of Oriental Rehabilitation Medicine, Dong-seo Oriental Medical hospital from 4th April 2011 to 26th May 2012. Pre and post treatment, We evaluated the cervical angle, Jackson's angle, Jochumsen method, VAS and effective score of treatment. Results & Conclusions : Two patients who received Chuna treatment recovered cervical curvature and improved neck pain.

• Journal of Korean Academy of Nursing
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• v.15 no.3
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• pp.5-20
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• 1985

The purpose of this study was to assess the value-of post-operative treatment in terms of nursing care in the allevation of pain. More specifically, the effects of supportive touch and patient education were examined. On the date before each patient's operation, the Bevels of anxiety, depression and affiliation were examined. The post-operative treatment was adminis. tered after an initial measurement of the patient's fain, according to the experimental category for the three days following the operation. On the final day, the level of anxiety and depression were again measured. The subjects of this study were 138 patient from the general surgical and gynecological wards in H university Hospital in Seoul. The study was conducted over a three-month period from June 24, 1984 to September 18, 1984. All patients had undergone laparatomies. Various standard instruments were used to measure the pain, anxiety, depression and affiliation levels. for pain, 5 grate Simple Descriptive Scale, and the Mclachlan four-range Observational Pain Scale were employed. For anxiety and depression, respectively the Spielberger State Anxiety Inventory and Beck Depression Inventory (B.D.I.) were used. Lastly, the affiliation was determined by the Mehrabian Affiliation Scale. The outcome of the research was as follows: 1. The first hypothesis concerning the existence of lower pain levels of Experimental Group A and Experimental Group B than the pain levels of Control Croup C was not supported. 2. The second hypothesis concerning the existence if lower anxiety levels of Experimental Group A and Experimental Group B than the anxiety levels of Control Group C was supported at the level of F=3.58 (p=.03). 3. The third hypothesis concerning the existence of lower depression levels of Experimental Group A and Experimental Group B than the depression levels of Control Group C was not supported. 4. The fourth hypothesis concerning the existence of different levels of pain in accordance with the levels of affiliation in Experimental Group A was not supported. 5. A positive correlation did exist between pain and anxiety after surgery (r=.34, p=.0001). Thus, the fifth hypothesis was supported. 6. A positive correlation did exist between pain and depression following surgery(r=.36, p=.0001). Thus, the sixth hypothesis was supported. Based on the above results, it was found that supportive touch and patient education either through human sources or via tape recorder do influence the anxiety of a patient after surgery, that a Positive correlation between pain, anxiety and deparession exist, that affiliation does not alter the influence of supportive touch, and that the graph on which pain levels were depicted indicates the possibility of development even if the effects of supportive touch did not reach a meaningful level. Thus it can be concluded that patient education, regardless of its form, is essential for the patient after surgery and that supportive touch, when reasonably modified and supplemented, can be an effective method of alleviating pain.

• The Korean Journal of Pain
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• v.25 no.4
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• pp.213-220
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• 2012

Background: It has been demonstrated that the expression of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and apoptotic cell death in the dorsal root ganglion (DRG) following spinal nerve constriction injury play a role in the initiation and continuation of hyperalgesia and allodynia. The present study was designed to investigate the effects of ethyl pyruvate (EP) on mechanical and cold allodynia, TNF-${\alpha}$ expression, and apoptosis in DRG after spinal nerve ligation injury. Methods: Rats were divided into 3 groups: control, pre-EP, and post-EP. EP (50 mg/kg) was intraperitoneally injected 30 minutes before (pre-EP) or after (post-EP) surgery. Behavioral tests to determine mechanical and cold allodynia were conducted before surgery and 4 and 7 days after surgery. Seven days after surgery, TNF-${\alpha}$ protein levels in DRG were evaluated by enzyme-linked immunosorbent assay, and DRG apoptosis was determined by immunohistochemical detection of activated caspase-3. Results: Treatment with EP significantly reduced mechanical and cold allodynia following spinal nerve ligation injury. TNF-${\alpha}$ protein levels in the pre-EP ($4.7{\pm}1.2$ pg/200 ${\mu}g$; P < 0.001) and post-EP ($6.4{\pm}1.8$ pg/200 ${\mu}g$; P < 0.001) groups were 2-3 times lower than the control group ($14.4{\pm}1.2$ pg/200 ${\mu}g$). The percentages of neurons and satellite cells that co-localized with caspase-3 were also significantly lower in the pre-EP and post-EP groups than the control group. Conclusions: These results demonstrate that EP has a strong anti-allodynic effect that acts through the inhibition of TNF-${\alpha}$ expression and apoptosis in DRG after spinal nerve ligation injury.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.3
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• pp.203-213
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• 2008

Purpose : The purpose of the study was to investigate the effects of sustained natural appophyseal glides (SNAGS) on pain and lumbar stability in patients with chronic low back pain. Methods : The subjects were assigned randomly devided SNAGS group(n=18) and control group(n=18). The SNAGS group received Infrared(IR) used thermal therapy for 20minutes, Interference current therapy(ICT) used electrical therapy for 10minutes and SNAGS for 10minutes to 15minutes. The control group received IR used thermal therapy for 20minutes, ICT used electrical therapy for 10minutes and active stretching exercise for 10minutes to 15minutes. The visual analogue scale(VAS) and lumbar stability were measured at pre-treatment and post-treatment. Results : The results of this study were summarized as follows : 1. The VAS score of SNAGS group and control group was significantly within-subjects pre-test and post-test (p<.05), there was significantly difference between-subjects on each groups(p<.05). 2. The SNAGS group was significantly increased in variation of lumbar stability on $0^{\circ}$, $180^{\circ}$, $90^{\circ}$, $-90^{\circ}$, $45^{\circ}$, $-45^{\circ}$, $135^{\circ}$ and $-135^{\circ}$ within-subjects pre-test and post-test(p<.05), but The control group wasn't significantly increased in variation of lumbar stability on $0^{\circ}$, $180^{\circ}$, $90^{\circ}$, $-90^{\circ}$, $45^{\circ}$, $-45^{\circ}$, $135^{\circ}$ and $-135^{\circ}$ within-subjects pre-test and post-test(p>.05). There was significantly difference between-subjects on each groups(p<.05). Conclusion : In conclusion, SNAGS found that effective to decrease of pain and increase of lumbar stability. Therefore, the results of this study suggests that SNAGS is beneficial treatment for chronic low back pain.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.1
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• pp.1-8
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• 2004

This study was conducted to assess the effect of transcutaneous electrical nerve stimulation(TENS) and interferential current(IFC) in the patients with myofascial pain syndrome(MPS) on upper trapezius. Twenty patients with MPS on upper trapezius was assigned randomly to TENS group(n=10), IFC group(n=10). In TENS group, TENS was applied to the trigger point. In IFC group, IFC was applied to the trigger point. Duration of treatment was 2 weeks. Effects were assessed before treatment, post treatment by visual analogue scale(VAS), and pain rating score(PRS). Significant change of VAS was noticed in TENS group and IFC group. Significant change of PRS was noticed in TENS group and IFC group. IFC groups were significantly higher than TENS group that of the VAS and PRS. These result showed that IFC is effective treatment method for pain control in patients with MPS.