• Title/Summary/Keyword: Chronic pain

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The Evaluation of Permanent Impairment in Chronic Pain Patients (통증질환의 장애인정 여부에 대하여)

  • Kim, Yong-Chul
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.1-7
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    • 2007
  • Pain is one of the most common causes of disability and work loss. However, patients with chronic pain have not been regarded as impaired persons in the Republic of Korea because of a lack of objective findings in those patients and difficulties in validating their genuine suffering and quantitative evaluation of pain. Here, the difficulties in the evaluation of impairment in chronic pain patients are discussed. In addition, guidelines for rating impairment in chronic pain patients, which are under development by the Korean Academy of Medical Sciences, are introduced.

Treatment of Failed Back Surgery Syndrome with a Spinal Cord Stimulator -A report of 2 cases- (척추수술후증후군에서 척수자극술을 이용한 치료경험 -증례 보고-)

  • Park, Chan Hong;Cho, Chul Bum
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.123-126
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    • 2006
  • Spinal cord stimulation (SCS) has been used since 1967 for refractory chronic pain. SCS has recently undergone a variety of technical modifications and advances, and it has been applied in a variety of pain conditions. SCS has been most commonly applied for those patients with chronic back and leg pain and failed back surgery syndrome (FBSS). The clinical hallmark of FBSS is chronic postoperative pain. The pain pattern varies and the pain may show an axial or radicular distribution. Chronic intractable pain after FBSS is difficult to treat. This report describes our experience with treating chronic pain in two patients who suffered from FBSS with a spinal cord stimulator. A permanent spinal cord stimulator was implanted after a successful trial of stimulation with temporarily implanted electrodes. After 5 months of follow-up, the two patients had satisfactory improvement of their pain.

Study on Relations of Variables; Attributions of Somatic Symptoms, Fatigue, Chronic Pain and Depression in the Elderly (노인의 신체증상귀인, 피로, 만성통증, 우울의 관계연구)

  • 장성옥;박영주;윤지원
    • Journal of Korean Academy of Nursing
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    • v.33 no.1
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    • pp.26-33
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    • 2003
  • Purpose: The purpose of this study was to investigate the relationships among variables of somatic attribution, chronic pain, depression and chronic fatigue in the elderly. Methods: Empirical data for testing hypothetical models was collected from 311 people over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explained causal relationship of variables. Result: According to Accepted model, the relation of variables is that the somatic attribution is the influencing variable to chronic pain and depression and chronic pain and depression is the influencing variable to chronic fatigue. Conclusion: The findings of this study give useful information to construct intervention program relating chronic pain, depression and chronic fatigue for the elderly.

Neural circuit remodeling and structural plasticity in the cortex during chronic pain

  • Kim, Woojin;Kim, Sun Kwang
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.1
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    • pp.1-8
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    • 2016
  • Damage in the periphery or spinal cord induces maladaptive plastic changes along the somatosensory nervous system from the periphery to the cortex, often leading to chronic pain. Although the role of neural circuit remodeling and structural synaptic plasticity in the 'pain matrix' cortices in chronic pain has been thought as a secondary epiphenomenon to altered nociceptive signaling in the spinal cord, progress in whole brain imaging studies on human patients and animal models has suggested a possibility that plastic changes in cortical neural circuits may actively contribute to chronic pain symptoms. Furthermore, recent development in two-photon microscopy and fluorescence labeling techniques have enabled us to longitudinally trace the structural and functional changes in local circuits, single neurons and even individual synapses in the brain of living animals. These technical advances has started to reveal that cortical structural remodeling following tissue or nerve damage could rapidly occur within days, which are temporally correlated with functional plasticity of cortical circuits as well as the development and maintenance of chronic pain behavior, thereby modifying the previous concept that it takes much longer periods (e.g. months or years). In this review, we discuss the relation of neural circuit plasticity in the 'pain matrix' cortices, such as the anterior cingulate cortex, prefrontal cortex and primary somatosensory cortex, with chronic pain. We also introduce how to apply long-term in vivo two-photon imaging approaches for the study of pathophysiological mechanisms of chronic pain.

Evaluation of the Children with Chronic Abdominal Pain (소아 만성 복통의 진단적 평가 -기능성 복통과의 감별점을 중심으로-)

  • Jeong, Su Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup2
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    • pp.19-28
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    • 2008
  • Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians and medical subspecialists. Chronic abdominal pain in children is usually functional, i.e., without objective evidence of an underlying organic disorder. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia according to the Rome II criteria for pediatric functional gastrointestinal disorders. There is insufficient evidence to state that the nature of abdominal pain or the presence of associated symptoms can discriminate between functional and organic disorders. The presence of alarming symptoms or signs, such as weight loss, gastrointestinal bleeding, persistent fever, and chronic severe diarrhea, is associated with a higher prevalence of organic disease. Most children with chronic abdominal pain are unlikely to require diagnostic testing; such children often need pharmacologic and behavioral therapy.

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The Impact of Manual Therapy on Pain Catastrophizing in Chronic Pain Conditions: A Systematic Review and Meta-analysis

  • Hyunjoong Kim;Seungwon Lee
    • Physical Therapy Rehabilitation Science
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    • v.12 no.2
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    • pp.177-184
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    • 2023
  • Objective: Manual therapy is a commonly utilized approach in managing chronic pain, but its specific impact on pain catastrophizing remains uncertain. The objective of this systematic review and meta-analysis was to examine the effects of manual therapy on pain catastrophizing in individuals with chronic pain. Design: A systematic review and meta-analysis Methods: A comprehensive search was conducted in electronic databases to identify relevant studies published from 2014 onwards. Studies that evaluated the impact of manual therapy on pain catastrophizing in individuals with chronic pain were incorporated. The risk of bias in the selected studies was evaluated using the Cochrane tool for risk of bias in qualitative analysis. For the quantitative analysis, RevMan 5.4 software was utilized, employing a random-effects model as the analysis model. The effect measure used in the analysis was the standardized mean difference (SMD). Results: In total, 26 studies were collected, and following the screening process, three of them were incorporated into the final analysis. The included studies involved a total of 153 patients with chronic pain. The interventions comprised various manual therapy techniques targeting different areas of the body. Pain catastrophizing and pain intensity were the primary outcomes of interest. The meta-analysis revealed a significant reduction in pain catastrophizing scores following manual therapy intervention compared to control conditions (SMD = -0.91, 95% CI: -1.25 to -0.58). However, heterogeneity between the studies was observed. Conclusions: Despite the limited quantity and heterogeneity of studies, it has been demonstrated that manual therapy intervention is effective in reducing pain catastrophizing in individuals with chronic pain.

Altered synaptic connections and inhibitory network of the primary somatosensory cortex in chronic pain

  • Kim, Yoo Rim;Kim, Sang Jeong
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.2
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    • pp.69-75
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    • 2022
  • Chronic pain is induced by tissue or nerve damage and is accompanied by pain hypersensitivity (i.e., allodynia and hyperalgesia). Previous studies using in vivo two-photon microscopy have shown functional and structural changes in the primary somatosensory (S1) cortex at the cellular and synaptic levels in inflammatory and neuropathic chronic pain. Furthermore, alterations in local cortical circuits were revealed during the development of chronic pain. In this review, we summarize recent findings regarding functional and structural plastic changes of the S1 cortex and alteration of the S1 inhibitory network in chronic pain. Finally, we discuss potential neuromodulators driving modified cortical circuits and suggest further studies to understand the cortical mechanisms that induce pain hypersensitivity.

Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Myofascial Pain Syndrome in Chronic Back Pain Patients

  • Chen, Chee Kean;Nizar, Abd Jalil
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.100-104
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    • 2011
  • Background: Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods: This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results: The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS ($x^2$ = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. Conclusions: MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome.

A Case Report of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Treated with Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment (회음혈 봉약침 치료와 팔료혈 자침을 통한 만성전립선염/만성골반통증 증후군 치험 1례)

  • Do-yeon Park;Hyang-ran Moon;Hui-jeong Noh;Sang-yoon Jeon
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.536-543
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    • 2023
  • Objectives: The purpose of this study was to report the effectiveness of Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment in the management of chronic prostatitis/chronic pelvic pain syndrome. Methods: A patient with chronic prostatitis/chronic pelvic pain syndrome underwent Korean medical treatment, including Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment. The severity of symptoms was assessed with a daily visual analog scale (VAS) for orchialgia and lower abdominal pain. In addition, we measured the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) on the first and last days of visit. Results: The patient's symptoms were improved after treatment. The severity of orchialgia was reduced from VAS7 to VAS2, and lower abdominal pain was improved from VAS6 to VAS1. NIH-CPSI decreased from 21 to 5. Conclusion: Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment are effective in treating chronic prostatitis/chronic pelvic pain syndrome.