• Title/Summary/Keyword: upper extremity pain

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Treatment of Nerve Root Injury during Cervical Epidural Block -A case report- (경부 경막외 블록 중 발생한 신경근 손상 치료경험 -증례 보고-)

  • Kim, Won-Hong
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.123-125
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    • 2001
  • A 50-year-old female patient developed severe right neck and upper extremity pain, hyperesthesia and allodynia during cervical epidural block. Her pain was diagnosed as neuropathic nature. She was treated with repeated stellate ganglion block (SGB) and electrical stimulation (EST). After 3 weeks of treatment, symptomatic relief was achieved, but a mild degree of hyperesthesia and motor weakness was remained. However, she refused all treatment. So treatment was stopped. In a follow-up done, 15 weeks after the nerve injury, she had recovered without complications.

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The Shoulder Pain after Stroke and the relationship with Motor Function, and Quality of Life (뇌졸중 환자의 견관절 통증과 운동 기능 및 삶의 만족도와의 관계)

  • Lee, Dong-Jin;An, Seung-Heon
    • 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.

Quadriplegia due to Epidural Abscess following Continuous Cervical Epidural Block -A case report- (지속적 경부 경막외 차단 중 발생한 경막외 농양에 의한 사지마비 -증례 보고-)

  • Lee, Hyo-Keun;Yang, Seung-Kon;Kim, Ji-Young;Chae, Hwa-Ju;Kim, Ki-Yeob;Kim, Chan
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.279-282
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    • 1996
  • A 45-year-old male received cervical continuous epidural block for posterior neck pain radiating to right upper extremity secondary to cervical herniated nucleus pulposus. Three days after epidural catheterization, fever, radicular pain and weakness of both upper extremities were developed. On admission, his temperature was $38.3^{\circ}C$ and showed progressive weakness and numbness in both upper and lower extremities. Cervical epidural abscess was suspected; MRI showed an epidural abscess from C4 to C7 level. Within 24 hours of admission, surgical decompression and drainage was effected. Culture of pus obtained at the lesion yielded Staphylococcus aureus. He was treated with intravenous antibiotics for 7 weeks resulting marked improvement of neurologic signs and symptoms.

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Treatment of Lateral Antebrachial Cutaneous Neuropathy by Biceps Tenoplasty (상완이두건 성형술을 이용한 외측 상완 표피 신경증의 치료 - 1예 보고 -)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Chung, Chae-Ik;Park, Kyung-Jun;Kang, Hyun-Suk
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.89-93
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    • 2011
  • Purpose: We want to report on one patient who presented with lateral forearm pain caused by compression neuropathy of the lateral antebrachial cutaneous nerve. Materials and Methods: A female patient was managed by operative treatment (biceps tenoplasty) after failure with conservative treatment for 6 weeks. One year later, we evaluated the clinical symptoms and biceps tendon problems such as supination weakness or rupture after the tenoplasty. Results: Her symptom completely subsided immediately at the first postoperative day and her recovery was uneventful. Supination weakness and rupture of the distal biceps tendon were not found after the operation. Conclusion: We have reported here on a case of successful management of lateral antebrachial cutaneous neuropathy by performing biceps tenoplasty, along with a review of the previously published articles.

An Analysis of Grip Strength of Heavy Industry Workers (중공업 근로자의 악력 특성 분석에 관한 연구)

  • Park, Kyunghwan;Kim, Yuchang
    • Journal of the Korean Society of Safety
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    • v.31 no.1
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    • pp.81-86
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    • 2016
  • The WMSDs are known to occur more in upper extremity than lower extremity, and such a ratio is increasing each year. The motions or repeated work requiring excessive strength beyond worker's maximum grip strength were known as a major cause of the WMSDs in upper extremity. To prevent the WMSDs in upper extremity, research on the grip strength characteristics analysis of field workers that can be used as basic data for work design and manual tool design is needed. The purpose of this study is to identify various variables affecting grip strength and is to find out the impacts of grip strength on WMSDs. This research measured the grip strength of 327 field workers at Heavy Industries, and also conducted a questionnaire survey on individual characteristics and job characteristics. As a result of analyzing grip strength, the grip strength was statistically significant (P<0.1) according to the body surface area (BSA) of the research subjects. The differences between percentile groups of grip strength were statistically significant (P<0.1) according to pain levels of hand/wrist/finger and arm/elbow. The comparison results between the average grip strength of Korean adult males and the average grip strength of the survey-targeted heavy industry workers show that the average grip strength of the heavy industry workers was higher by 9.75 kg. This study analyzed relationship between grip strength and the pain levels of hand/wrist/finger and arm/elbow, and compared the findings in this study with those of existing preceding studies. Also, this research comparatively analyzed the grip strength of Korean adult males and survey-targeted heavy industry workers. The findings of this study can be used as useful data for ergonomic work design and manual tool design to prevent WMSDs at industrial worksites, given that almost no data on the grip strength of workers in the industrial sites are found in Korea.

The study of clinical usefulness of Si-Zong-Sue-Ge(四總穴歌) (사총혈가(四總穴歌)에 관(關)한 연구(硏究))

  • Yang, Gi-Joong;Bae, Geyn-Tae;Yoon, Jong-Hwa
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.1-12
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    • 2000
  • Ge-Fu(歌賦) means prose and poetry individually, and they both have a meaning of all the rhythmical poetrical compositions making it ease for people to remember the content. All the Ge-Fus used in oriental medicine are made in Yuan(元), Mine(明)and Qing(靑)dynasty, and they have been largely used in most of all the fields of medicine such as Ben-Cao(本草), Tang-Ye(湯液), Zhen-Jiu(鍼灸), Zhen-Duan(診斷). Zhen-Jiu-Ge-Fu(鍼灸歌賦) has about 90 poetries and 10 proses and they contain the names of meridian; courses of meridian streams; accurate positions of acupuncture points; functions; effects; meanings of the name of acupuncture points; usages and effects of special points; manipulations of reinforcing and reducing method; contraindications of acupuncturing; principles of selections and orders of acupuncture points in therapy; and eight diadgoses. Zhen-Jiu-Ge-Fu is subdivided into Jing-Xue(經穴歌), Zhi-Jiu-Ge(刺灸歌), Shu-Xue-Ge(輸穴歌), Zhi-Liao-Ge(治療歌). And In Zhi-Liao-Ge, the most brief and essential Ge-Fu-Si-Zong-Sue-Ge- contains theraputic designs using far apart acpuncture points from the right painful areas in the body. In this study, the author opinionated the Si-Zong-Sue-Ge can be the prototype of the distant needling; the research on this can open the importance of Ge-Fus. On conclusion, 1. "Upper and lower Abdomen - Zu-San-Li($S_{36}$) (肚腹三里留)" means when there are problems and disorders in upper and lower abdomen, distinctively, such as gastric pain, maldigestion, flatulence, abdominal pain, constipation, diarrhea, vomiting, menstrual disorer, knee pain and tonic functioning, 족삼리 can be a right choice for distant needling point for treating. 2. "Face and Eye-He-Gu($Li_4$) (面目合谷收)" means when there are problems and disorders in facial, eye, ear, nose, throat, mouth regions, distinctively, such as facial edema, toothache, headache, sore throat, rhinorrhea, frontal headache, abdominal pain, dizziness, He-Gu can be a right choice for distant needling point for treating. 3. "Upper and lower back - Wei-Zhong($B_{40}$) (腰背委中求)" means when there are problems and disorders in upper and lower back, distinctively, such as upper back pain, lumbargo, hamstring muscle pain, popliteal region pain, lower extremity compartment syndrom, Inguinal region pain, muscle twitch, vomiting and diarrhea, hemorrhoidal bleeding, skin rash, Wei-Zhong can be a right choice for distant needling point for treating. 4. "Head and neck - Lie-Que($L_7$) (頭項審列缺)" means when there are problems and disorders in capital and nuchal area, distinctively, such as migraine, frontal headache, rhinorrhea, asthmatic dyspnea, aphasia, coughing, neck stiffness, occipital headache, upper extremity pain, Lie-Que can be a right choice for distant needling point for treating.

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Vertebral Spreading Segments of Cervical Epidural Injection: a Comparative Study with 5 ml and 10 ml of Injected Volume (경부경막외차단 시 약물의 용량에 따른 약물 분포 범위: 5 ml와 10 ml 주입량에 대한 비교 연구)

  • Lee, Sang Eun;Han, Kyung Ream;Kim, Chan;Chae, Yun Jeong;Yoo, Ji Young
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.181-186
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    • 2006
  • Background: Although cervical epidural block can be a useful therapeutic treatment for head, neck and upper extremities pain, there is no consensus regarding the volume of injection required for pain management. Herein, the spreading in the vertebral segments after a cervical epidural injection of either a 5 or 10 ml volume was studied. Methods: A total of 78 patients, suffering from head, neck and upper extremity pain, were selected. Cervical epidural blocks were performed consecutively with 5 ml (n = 42) and 10 ml (n = 36) of 0.4% mepivacaine and 222 mg I/ml iopamidol at the C7⁣-T1 levels. Both anteroposterior (AP) and lateral radiographs were obtained under fluoroscopy, and the upper and lower epidural spreading of the contrast media in relation to the vertebral level was evaluated. Results: The cervical epidural blocks were performed without complications. The rostral spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.6{\pm}1.1$ and $6.1{\pm}1.1$, respectively. The caudal spreading of the contrast media in the vertebral segments in groups 1 and 2 were $5.4{\pm}3.4$ and $7.2{\pm}3.9$, respectively. The total numbers of segments with vertebral spreading of the contrast media in both directions showed significant differences between the two groups. The numbers of patients who showed spreading of the contrast media up to C2 vertebral segment showed no significant differences between the two groups. Conclusions: 5 and 10 ml epidural injection volumes may be adequate for the spread of contrast media to the entire cervical spine. A 5 ml epidural injection volume, compared to a 10 ml volume, may be ample when considering the possibility of unnecessary caudal spreading of drugs and volume related complications in the management of head, neck and upper extremity pain.

Comparison of Glenohumeral Stabilization Exercise and Scapular Stabilization Exercise on Upper Extremity Stability, Alignment, Pain, Muscle Power and Range of Motion in Patients With Nonspecific Shoulder Pain

  • Jeon, Na-young;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.23 no.4
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    • pp.38-46
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    • 2016
  • Background: Shoulder stabilization commonly involves two components: the glenohumeral stabilization exercise (GSE) and scapular stabilization exercise (SSE). Despite the fact that the shoulder stabilization has advantageous merit, to our knowledge, only a few studies have compared the superior of the GSE and the SSE. Objects: The purpose of this study was to assess the effects of GSE in patients with nonspecific shoulder pain. Methods: Thirty subjects with nonspecific shoulder pain were randomly divided into an experimental group and control group, each with 15 patients. The experimental group used an GSE, whereas the control group did SSE. All subjects were measured in shoulder stability, scapular symmetric alignment, pain, muscle power, and range of motion before and after the intervention. Results: GSE resulted in significantly better shoulder stability (p=.046, from $8.67{\pm}7.54$ score to $13.93{\pm}9.40$) in the experimental group compared with SSE in the control group. However, no significant effects were observed for scapular symmetric alignment including the angles of inferior scapular distance (p=.829) and inferior scapular height difference (p=.735), pain (p=.113), muscle power including shoulder flexion (p=.723) and abduction (p=.897) and range of motion including shoulder flexion (p=.853) and abduction (p=.472). Conclusion: These findings suggest that GSE may be more effective in increasing the shoulder stability than the SSE in patients with nonspecific shoulder pain, probably through a centralization effect on the shoulder mechanism.

Complex Korean Medicine Treatment after Elbow Replantation Following Traumatic Amputation: A Case Report

  • Eunbyul Cho;Shin-Hyeok Park;Hyesoo Jeon;Nam Geun Cho
    • Journal of Acupuncture Research
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    • v.40 no.1
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    • pp.61-66
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    • 2023
  • Very few studies have been reported on upper extremity replantation following traumatic amputation. This case study aimed to report the progress of a patient treated with complex Korean medicine for 1 year after elbow replantation. The patient mainly complained of forearm sensory loss, muscle weakness, and hand pain after undergoing upper limb amputation and emergency replantation. He was hospitalized for approximately 50 days and then received outpatient treatment for approximately 10 months, followed by electroacupuncture, moxibustion, Chuna, herbal medicine, and transcutaneous electrical nerve stimulation. The muscle strength of the wrist joint improved to good (flexion) and fair (extension), and the forearm sensation was partially recovered approximately 10 months after the onset. To our knowledge, this is the first case report on replantation rehabilitation in Korean medicine, and it suggests that complex Korean medicine treatment might be beneficial for patients undergoing replantation after upper extremity amputation.

Surgical Treatment of Metastatic Bone Tumor in Extremity (사지에서 전이성 골종양의 수술적 치료)

  • Lee, Han-Koo;Lee, Sang-Hoon;Baek, Goo-Hyun;Lee, Chang-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.45-51
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    • 1995
  • The incidence of metastatic bony lesion has been increased recently, with the advanced therapeutic modalities of malignant tumors. The purpose of this study was to evaluate the effectiveness of surgical treatment in impending or established pathologic fractures due to metastasis in extremity. From 1981 to 1992, thirty two patients who had established or impending pathologic fractures in extremity had been treated surgically. The locations of metastasis, were lower extremity in 24 cases(femsral head and neck;5, intertrochanteric;7, subtrochanteric;8, femoral shaft;4) and upper extremity in 8 cases(proximal humerus;2, humoral shaft;6). The method of surgery was excision of tumor mass and rigid internal fixation to allow immediate mobilization, except 2 cases of amputation. The results were analysed by two criteria. The first was the grade of performance status that was made by modification of Functional Classification of New York Heart Association. The second was the degree of pain relief. The performance status was improved at least one grade in all patients and the mean improvement was 1.7 grades. The satisfactory pain relief was achieved in 81% of patients. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and they became comfortable at rest and ordinary activities. The solitary metastatic lesions showed better pain relief(92%) than multiple metastasis(75%). The curative surgery was done in 3 cases, and they showed more than 24 months of disease-free survival.

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