• Title/Summary/Keyword: pain relief

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Comparing neuromodulation modalities involving the suprascapular nerve in chronic refractory shoulder pain: retrospective case series and literature review

  • Dey, Saugat
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.36-41
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    • 2021
  • Chronic shoulder pain not relieved by either conservative or surgical management is referred to as chronic refractory shoulder pain. This is a retrospective case series where chronic refractory shoulder pain patients were treated either with peripheral nerve stimulation (PNS) or with pulsed radiofrequency (p-RF) therapy to the suprascapular nerve. Both patients receiving PNS reported 100% pain relief for the first month. At the 3- and 6-month follow-ups, one patient continued to experience 100% relief while the other reported 90% relief. One patient undergoing p-RF experienced about 90% pain relief at both 1- and 3-month intervals and 0% relief at the 6-month interval. The other patient with p-RF experienced 33% relief at 1-month and 0% relief thereafter. No patient reported any complications. The results of previous randomized controlled trials evaluating the efficacy of p-RF administered to the suprascapular nerve were mixed, and there is a lack of published studies on PNS effects. Neuromodulation of the suprascapular nerve can be effective for chronic refractory shoulder pain patients. Larger scale randomized controlled trials comparing PNS and p-RF are needed to better understand their respective therapeutic capacity.

Pain Relief and Satisfaction by Hydrotherapy among Urban Elderly (일부 노인들의 수치료에 의한 통증경감과 만족도 조사)

  • Lee, In-Hak;Youn, Jung-In;Moon, Seng-Ki
    • The Journal of Korean Physical Therapy
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    • v.14 no.3
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    • pp.273-296
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    • 2002
  • This study was conducted to investigate the pain relief score and the degree of satisfaction among elderly people. This study has done from July 11th, 2001 to August 31st, 2001 at Hydrotherapy Facility in the College of Bogun(Taejon Health Sciences College) located in Taejeon, Korea. Eighty-eight patients were participated to the questionnaire. The results were as follow. 1. The mean value of the pain relief score in the female group was higher than the mean value of the pain relief score in the male group(p<0.05). The mean value of the pain relief score in the group having religion was higher than the group not having religion(p<0.05). The pain relief score was not significantly different in age, presence of spouse, the way of housing, and academic background. The degree of satisfaction was not significantly different in sex, age, presence of spouse, the way of housing, religion, and academic background. 2. The pain relief score and the degree of satisfaction were not significantly different in the presence of comorbidity, going with the hydrotherapy, and the moment of diagnosis. 3. According to the ADL, the mean value of the pain relief score in the Independent was higher than the mean value in maximal assistance and minimal assistance(p<0.05). Independent, maximal assistance and minimal assistance were not significantly different in the degree of satisfaction (p<0.05). 4. The pain relief score and the degree of satisfaction were not significantly different in the legion of pain.

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Clinical Study of Acute and Chronic Pain by the Application of Magnetic Resonance Analyser $I_{TM}$ (자기공명분석기를 이용한 통증관리)

  • Park, Wook;Jin, Hee-Cheol;Cho, Myun-Hyun;Yoon, Suk-Jun;Lee, Jin-Seung;Lee, Jeong-Seok;Choi, Surk-Hwan;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.192-198
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    • 1993
  • In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

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Relief Effects by Post - Isometric Relaxation for Myofascial Pain Syndrome (근막동통 증후군에 대한 PIR의 치료효과)

  • Park, Ji-Whan;Kim, Bong-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.3 no.1
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    • pp.7-15
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    • 1997
  • The purpose of this study was to exame the pain relief effects of myofascial pain syndrome patient by Post-Isometric Relaxation. From July, 1996 to January, 1997, PIR was applied to myofascial pain syndrome associated with musculoskelatal lesions and was examed on 17 muscles in 98 patients at Sun General Hospital, Taejon city. The results of this study were as follows ; 1. Immediate pain relief group was 58(59%). 2. Only tenderness relief group was 24(25%). 3. No effect group was 16(16%). These results could be confirmed that the increased tension of the affected muscles with the resulting pain relieved by restoring the full stretch length of the muscle by PIR.

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Relief Effects by Post-Isometric Relaxation for Myofascial Pain Syndrome (근막동통 증후군에 대한 PIR의 치료효과)

  • Park, Ji-Whan;Kim, Bong-Soo
    • Journal of Korean Physical Therapy Science
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    • v.4 no.1
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    • pp.255-263
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    • 1997
  • The purpose of this study was to examed the pain relief effects of myofascial pain syndrome patient by post-isometric relaxation. From July, 1996 to January, 1997, PIR was applied to myofascial pain syndrome associated with musculoskelatal lesions and was examed on 17 muscles in 98 patients at Sun General Hospital, Taejon city. The results of this study were as follows ; 1. Immediate pain relief group was 58(59%). 2. Only tenderness relief group was 24(25%). 3. No effect group was 16(16%). These results could be confirmed that the increased tension of the affected muscles with the resulting pain relieved by restoring the full stretch length of the muscle by PIR.

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Ultrasound-Assisted Mental Nerve Block and Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: Three Case Studies

  • Park, Hae Gyun;Park, Pyung Gul;Kim, Won Joong;Park, Yong Hee;Kang, Hyun;Baek, Chong Wha;Jung, Yong Hun;Woo, Young Cheol;Koo, Gill Hoi;Shin, Hwa Yong
    • The Korean Journal of Pain
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    • v.27 no.1
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    • pp.81-85
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    • 2014
  • Postherpetic neuralgia (PHN) is one of the most difficult pain syndromes to treat. Invasive treatments may be considered when patients fail to obtain adequate pain relief from noninvasive treatment approaches. Here, we present three cases of PHN in the mandibular branch treated with ultrasound-assisted mental nerve block and pulsed radiofrequency treatment. None of the patients had adequate pain relief from the medical therapy, so we performed the mental nerve block on the affected side under ultrasound assistance. Two patients showed satisfactory pain relief continuously over 12 months without any further interventions, whereas one patient only had short-term pain relief. For the patient had short-term pain relief we performed pulsed radiofrequency treatment (PRFT) on the left mental nerve under ultrasound assistance. After PRFT, the patient had adequate pain relief for 6 months and there was no need for further management.

An Analysis of the Outcome of Transforaminal Epidural Steroid Injections in Patients with Spinal Stenosis or Herniated Intervertebral Discs (요척주관 협착증 혹은 추간판 탈출증 환자에서 실시한 경추간공 경막외 스테로이드 주입의 결과에 관한 분석)

  • Hong, Ji Hee;Lee, Yong Chul;Lee, Han Min;Kang, Chul Hyung
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.38-43
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    • 2008
  • Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.

Pain Relief and Associated Factors after a Kyphoplasty for Treating an Osteoporotic Vertebral Compression Fracture (골다공증성 척추 압박 골절에서 풍선 척추 성형술 후 통증의 호전 및 관련 요인에 대한 분석)

  • Koh, Young Do;Kim, Dong Jin
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.186-191
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    • 2014
  • Purpose: The objectives of this study were to assess pain relief according to the time after kyphoplasty and to evaluate the factors affecting pain relief after kyphoplasty in the treatment of a single-level osteoporotic vertebral compression fracture. Methods: A retrospective review of 34 kyphoplasties for single-level osteoporotic vertebral compression fractures was performed. Pain relief was assessed by using the visual analogue scale (VAS) at preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Associated factors, including age, sex, pain duration, bone mineral density, and cement leakage, were evaluated using the patients' medical records. Statistical analyses were conducted using the paired t-test to assess pain relief and using the independent t-test and Pearson's correlation coefficient to evaluate the relationship between those factors and pain relief. Results: Preoperatively, the mean VAS score was 7.06. Postoperatively, it declined to 3.66 (p=0.001), 2.81 (p=0.001) and 2.24 (p=0.001) at 6 weeks, 3 months and 6 months, respectively. Also, statistically significant pain relief was observed during the periods from 6 weeks to 3 months (p=0.001) and from 3 months to 6 months (p=0.001). However, reduction of the VAS score showed no significant correlation with age, sex, pain duration, bone mineral density, or cement leakage (p>0.05). Conclusion: Our study suggests that a kyphoplasty may be effective in osteoporotic vertebral compression fracture patients with acute pain and that after the kyphoplasty, pain is reduced remarkably for 6 weeks and then continuously for 6 months.

Analysis of Factors Associated with the Therapeutic Duration of Transforaminal Epidural Steroid Injection in Lumbar Spinal Stenosis Patients (요척주관 협착증 환자에서 경추간공 경막외 스테로이드 주입 후 통증 완화 기간과 관련된 요인의 분석)

  • Hong, Ji Hee;Lee, Yong Chul;Kim, Jin Mo;Han, Sung Ho;Park, Eun Jee
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.136-142
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    • 2008
  • Background: A transforaminal epidural steroid injection (TFESI) is one of the methods for the conservative treatment of the lumbar spinal stenosis. As efforts to prolong the therapeutic duration and to predict the outcome of TFESI are very important, we analyzed factors considered to be associated with the therapeutic duration of a TFESI. Methods: Between August 2006 and March 2007, 69 patients (Group A: patients with no pain relief, Group B: patients with pain relief of less than 6 months, Group C: patients with pain relief of more than 6 months) who failed to the medical treatment were included to undertake a fluoroscopic-guided TFESI. Prior to treatment, the VAS (visual analogue scale), ODI (Oswestry disability index), BDI (Beck depression inventory), and BAI (Beck anxiety inventory) scores were determined to evaluate the degree of pain, disability, and psychological status. The VAS and ODI scores were used to assess the degree of pain relief. To identify the total duration of pain relief, regular outpatient visits for six months were conducted, and for the patients who were not able to visit the outpatient clinic regularly, outcome was assessed by telephone interviews after six months. Results: The dural sac cross-sectional area (DSCSA), ODI, pain duration, BDI, BAI, and age showed similar distribution for patients in the A, B, and C groups. Conclusions: The DSCSA, ODI, pain duration, BDI, BAI, and age were not associated with the therapeutic duration of TFESI in lumbar spinal stenosis patients.

Lumbar Facet Joint Injection in Low Back Pain and Sciatica Caused by Lumbar Facet Joint Arthropathy (후관절 관절증으로 인한 요통 및 좌골신경통에 대한 후관절강내 차단)

  • Ban, Jong-Seok;Go, Jeon-Seock;Min, Byng-Woo
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.174-180
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    • 1989
  • An intra-articular lumbar facet joint block with a local anesthetic and asteroid is a reliable method of diagnosis and therapy for low back pain and/or sciatica caused by lumbar facet arthropathy under fluoroscopy. We injected 40 mg of methylperdnisolone acetate and 1 ml of 0.5% bupivacaine into each lumbar facet joint to 14 patients. The results are as follows: 1) Excellent pain relief in 2 patients (14.29%) 2) Good pain relief in 6 patients (42.85%) 3) Fair pain relief in 4 patients (28.57%) 4) Non effective pain relief in 2 patients (14.29%).

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