• The Korean Journal of Pain
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• v.1 no.2
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• pp.181-187
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• 1988

Since the introduction of epidural corticosteroid injections for the management of sciatica, lumbosacral radiculopathy has become one of the most common pain problems encountered by anesthesiologists. In order to function effectively, anesthesiologists should be able to: (1) recognize those syndromes which may respond to nerve block; (2) understand the pathophysiology of the conditions being treated and (3) be familiar with alternate therapeutic pathways for patients not responding to merre block. There are many etiologic factors of low back pain and lumbosacral radiculopathy. Particularly, Nerve root compression caused by a protruding disc, a osteophyte or tumors are usually responsible for pain. Neural inflammation, therefore, is considered to play a major role in pain production. The use of local anesthetics in mixture with steroids is believed to break down neural inflammation. Steroids and local anesthetics were injected lumbar or caudal epidmal to 106 patients for the purpose of relieving low back pain and lumbosacral radiculopathy. The results are as follows: Excellent pain relieved group: 27 patients (25.5%) Good pain relieved group: 49 patients (46.1%) Fair pain relieved group: 15 patients(14.2%) Not effective group: 15 patients(14.2%).

• The Korean Journal of Pain
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• v.25 no.1
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• pp.22-27
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• 2012

Background: The common causes of lower back pain with or without leg pain includes disk disease and spinal stenosis. A definitive diagnosis is usually made by means of magnetic resonance imaging (MRI), but treatment is often difficult because the MRI findings are not consistent with the symptoms of the patient in many cases. The objective of this study was to observe the correlation between the patterns of epidurography performed in patients having lower back pain with or without leg pain and the position or severity of the pain as subjectively described by the patients. Methods: The subjects of this study were 69 outpatients with lower back pain with or without leg pain who visited our clinic and complained of predominant pain on one side. We performed caudal epidural block using an image intensifier. A mixture of the therapeutic drug and the contrast agent (10 ml) was injected to observe the contrast flow pattern. The patients who complained of predominant pain on one side were divided into the left side group and the right side group. A judgment of inconsistency was made if the contrast agent flowed to the side of the pain, while a judgment of consistency was made if the contrast agent flowed to the opposite side of the pain. The degree of the drug distribution was evaluated by counting the number of cells to which the contrast agent's flowed for evaluating the correlation between the contrasted cell and the severity of pain (one group ${\leq}$ VAS 7, the other group ${\geq}$ VAS 8) the degree of the contrast agent's contrast was evaluated by dividing and counting an image into 15 cells (the left, right, and middle sections at each level of L4, L5, S1, S2, and S3). Results: Thirty out of the 69 patients who had laterality in pain, that is, those who complained of predominant pain on one side, showed that the laterality of the pain and the contrast agent flow was consistent, while 39 patients showed that the laterality was inconsistent (P: 0.137). The evaluation of the correlation between the pain and the contrast agent flow showed that the mean number of contrasted cells was $9.0{\pm}2.2$ for the 46 patients in the group with a VAS of 7 or lower and $6.5{\pm}2.0$ for the 23 patients in the group with a VAS of 8 or higher, indicating that the former group showed a significantly greater number of contrasted cells (P < 0.001). Conclusions: This study, conducted with patients having lower back pain with or without leg pain, showed that the contrast flow pattern of caudal epidurography had a significant correlation with the severity of the pain but not with the laterality of the pain.

• Clinical Pain
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• v.18 no.2
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• pp.65-69
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• 2019

Objective: This study aims to evaluate the efficacy of high-voltage microcurrent therapy in patients with herniated lumbar disc (HLD) presenting radicular or back pain. Method: This is a retrospective study with 33 patients who are complaining pain with HLD findings on magnetic resonance image. Microcurrent therapy was applied to leg or paralumbar area. Treatment was conducted for seven minutes with 250~1000 uA intensity as high as the patients could tolerate via stimulating probe with roller type and the frequency was 60 Hz with a sine wave pulse. The visual analogue scale (VAS) was measured just before and after the treatment. Results: The degree of pain reduction (△VAS) was 1.6 points after treatment on average. The △VAS according to the diagnosis, stenosis, dermatome area, medication, pain site and caudal epidural block was not statistically significant. However, the △VAS according to the number of treatments (< 3, ≥ 3 times) showed a statistically significant difference (p=0.04). Conclusion: High-voltage microcurrent therapy may help reduce lumbar or lumbosacral radiating pain after the procedure. The effect was better when microcurrent was applied three times or more. This result suggests that the microcurrent would have cumulative effect on reducing radicular or back pain in patients with HLD.