Lee, Pil Moo;So, Yun;Park, Jung Min;Park, Chul Min;Kim, Hae Kyoung;Kim, Jae Hun
The Korean Journal of Pain
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v.29
no.2
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pp.123-128
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2016
Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.
It is easy to overlook osteochondral lesions (OCLs) of the ankle in patients with chronic lower limb pain, such as complex regional pain syndrome (CRPS) or thromboangiitis obliterans (TAO, Buerger's disease). A 57-year-old woman diagnosed with type 1 CRPS, and a 58-year-old man, diagnosed with TAO, complained of tactile and cold allodynia in their lower legs. After neurolytic lumbar sympathethic ganglion block and titration of medications for neuropathic pain, each subject could walk without the aid of crutches. However, they both complained of constant pain on the left ankle during walking. Focal tenderness was noted; subsequent imaging studies revealed OCLs of her talus and his distal tibia, respectively. Immediately after percutaneous osteoplasties, the patients could walk without ankle pain. It is important to consider the presence of a hidden OCL in chronic pain patients that develop weight-bearing pain and complain of localized tenderness on the ankle.
Journal of the Korean Society of Physical Medicine
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v.6
no.3
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pp.257-266
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2011
Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.
A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.
Objectives: This study aimed to report the effectiveness and outcome on the prognosis of pregnancy of traditional Korean medicine treatment for inpatients who had a traffic accident during pregnancy. Methods: The study is conducted by analyzing the medical records of hospitalized patients in a Korean medicine hospital. Seventy-six pregnant patients who got into car accidents from March 2015 to February 2020 were included. We performed statistical analysis by using Statistical Package for the Social Sciences(SPSS) ver. 25.0. To verify the effect of traditional Korean medicine treatment for traffic accidents during pregnancy, we analyzed improvement of symptoms. Also, we analyzed the prognosis of pregnancy and signs of premature birth or miscarriage during treatment to verify the applicability of traditional Korean medicine treatment for traffic accidents during pregnancy. Results: Among the symptoms of pain, there was a statistically significant decrease in lower back pain, post neck pain, headache, pelvic pain, knee pain, lower limb pain, wrist pain, and upper limb pain. Other systemic symptoms showed statistically significant improvement in nausea, abdominal pain, dizziness, and lower limb numbness. All confirmed cases reported normal pregnancy maintenance and delivery, and no miscarriage was reported. Two cases that showed signs of premature birth or miscarriage during treatment were unrelated or unclear with traditional Korean medicine treatment. Conclusions: Traditional Korean medicine treatment is effective and applicable for pregnant women injured by traffic accidents. Further studies are needed to identify the effectiveness and safety of traditional Korean medicine treatment for the sequelae of traffic accidents during pregnancy.
Journal of Korea Entertainment Industry Association
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v.14
no.7
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pp.469-476
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2020
This study was conducted on college students with low back pain to find out how a backrest exercise program affects the pain and balance of students. Thirty-two students at K University in Gwangju City were randomly classified with backrests and without backrests group respectively. Each group conducted the program for lasted three times a week for a total of 30 minutes for four weeks. Visual Analog Scale (VAS) was measured for pain assessment before and after arbitration, and the Korean Oswestry Disability Index (KODI) was measured for functional disability assessment. TETRAX is used to measure the weight distribution index and posture stability. According to the results of the experiment, the Visual Analog Scale (VAS) and the Korean Oswestry Disability Index (KODI) and weight distribution index showed significant differences over time, but the posture stability was no significant difference. The results of this study show that the lower limb exercise program is effective in back pain, dysfunction and weight distribution index, and it is believed that the pain reduction is significant when performed by distal movement in the area of back pain, It can be applied effectively to reduce low back pain in college students who spend a lot of time sitting down.
Objective : The purpose of this case report is to offer an unprecedented target for Gyejigabuja-tang by analyzing a case in which the symptoms were improved by the herbal decoction therapy, and to accumulate a fundamental knowledge in herbal medicine therapy for urinary incontinence. Method : We studied a patient's chart with the patient's consent and displayed patient's timeline and adherence in a figure according to the CARE guideline. The progress of urination symptoms were assessed with the frequency of urination and how long the patient can stand urine. The accompanied lower limb pain was estimated with Numerical Rating Scale(NRS) Results : The patient's adherence was good during the medication period and symptoms related with urination and accompanied lower limb pain were improved with no specific side effects. NRS of the lower limb pain decreased from 7 to 2, the frequency of urination also improved from over 10 times to 6~8 times per day, and the patient can stand urine from less than 1 second to 2~3 minutes. Conclusions : Gyejigabuja-tang was effective for an urinary incontinence patient which corresponds to the provision No.20 in Shanghanlun.
Objectives : The objectives of this study were to investigate the relationship between electrical detection of ear acupuncture points and musculoskeletal pain. Methods : 18 adults who have musculoskeletal pain without trauma factorsparticipated in this study. They answered the questionnaire and their ear acupuncture points were examined with electrical detectors. We analyzed the relationship between electrical detection of ear acupuncture points and musculoskeletal pain with concordance rate and validity. Results : Total concordance rates of the head region was 68.00%(questionnaire) 32.08%(investigation), that of vertebral region was 67.86%, 59.38%, that of both upper limbs was 86.67%, 39.69%, and that of both lower limbs was 50.00%, 23.46%. The true positive rate was 0.704, the true negative rate was 0.492, the false positive rate was 0.508, and the false negative rate was 0.296 in the validity test. In the head, two concordance rates of the temporal and occipital regions were relatively higher than those of the parietal and frontal regions. In the vertebral region, two concordance rates of the cervical and lumbar regions were relatively higher than those of the thoracic and sacrum regions. In the upper limb, two concordance rates of the shoulder and shoulder joints were relatively higher than those of the others. In the lower limb, concordance rates of investigation were relatively low at all areas. The right lower limb was relatively higher than the left in concordance rates of the questionnaire. Conclusions : The results suggest that electrical detection of ear acupuncture points can be used in the diagnosis and treatment of musculoskeletal pain.
Purpose: The purpose of this study is to compare kinematics on lower limbs between stair walking with high heel and barefoot in healthy adult women. Methods: 18 healthy adult women were recruited in this study. The subjects performed stair ascent and descent with high heels and barefoot. The experiment was conducted in random order and repeated three times for each stair walking with high heels and barefoot. The movements of lower limb joints were measured and analyzed using a three-dimensional analysis system. Results: The ankle, knee, and hip flexion angles on the sagittal plane exhibited statistically significant differences between stair ascent and descent with high heels and barefoot. The pelvic forward tilt angles showed statistically significant differences only during stair ascent. The ankle inversion, hip abduction and pelvic lateral tilt angles on the frontal plane showed statistically significant differences between stair walking with high heels and barefoot. On the transverse plane, the hip rotation angles showed statistically significant differences between the high-heeled and barefoot gait during stair ascent and descent. However, the pelvic rotation angles showed no statistically significant differences. Conclusion: Therefore, wearing high-heeled shoes during stair walking in daily life is considered to influence lower limb kinematics due to the high heel, and thus poses the risks of pain, and low stability and joint damage caused by changes in the movement of lower limb joints.
Lee Gun-Hyee;Hwang Byung-Chun;Choi Jeong-Son;Kim Yang-Jung;Yun Ju-Young;Lee Geon-Mok
Journal of Physiology & Pathology in Korean Medicine
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v.19
no.5
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pp.1356-1362
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2005
The purpose of this study os to investigative the effect of Carrageenan-Induced Pain on lower limb muscle and ligament of rat. To evaluate pain mechanism in muscle and ligament, pain was induced by the injection of 2% $0.1m{\ell}$ carrageenan into the left lower limb muscle of rats after rats were anesthesized with 3% enflurane. Rats were killed on 72 hours after pain induction under the anesthesia. anterior rectus femoris muscle and its ligament were removed from rat hind limb. Morphological changes of them were peformed by the observation of light and electron microscopes. In the light microscopic findings, the muscle cells were polyheadral and situated with each other without small gap in control group. nucleus of cell was seen along the cell margin, and muscle cell groups were divided by regular narrow gap in cross section. In the pain-induced group, muscle cell groups were divided each other by the irregular gap, and some of groups formed larger than other cell groups by the fusion. Intercellular gap of most cell groups were increased compared with control groups. And also, perimysium of muscle cell groups was swollen in cross section. In control group, muscle cells contacted each other closely and each cell was divided by perimysium. The intracellular gaps were not seen between myofibrills, and also striations were well defined between muscle cells in longitudinal section. In pain-induced group, muscle cells were divided by the small intracellular gaps. And also, muscle cell showed many a short cross or longitudinal intercellular gaps in longitudinal section. In light microscopic findings of control group, tendon was composed with many tendon fibers contacted each other closely without gap. The free margin of tendon was fused, and apso the tendon fibers did not invaded between muscles. In pain-induced group, tendon was divided small groups by intertendinous gap, and also the margin of tendon divided by small groups. In the free margin, tendon invaded into muscle cells, and also fibroblasts between tendon fibers were long and lance-shaped. From these results, it is suggested that pain induction by carrageenan injured rat skeletal muscle and ligament by the morphological changes.
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