Personality characteristics of third decade female TMD patients was studied by means of SCL-90-R test. 112 TMD patients and 96 dental controls were subjected at the department of Oral medicine, Kyungpook National University Hospital. All the patients were divided into 3 groups according to their pain profile namely, MPDS, ID with Pain and ID with out Pain, and dental controls were divided into 2 groups manely, Dental Controls with Pain and Dental Controls without Pain for comparison. The obtained results were as follows : 1. Mean T-scores of SCL-90-R primary scales and global indexes in the patient and control group were within normal range. 2. When compared between groups with pain, MPDS group were significantly higher in scales of SOM, 0-C, I-S, HOS and PHOB than ID with Pain group and in scales of SOM, I-S. DEP, HOS and PHOM than Dental Controls with Pain group. 3. When compared with ID and Control groups in same pain condition, there were no significant differences between ID without pain and Dental Controls without Pain group. 4. When compared between groups with pain and groups without pain, there were significant differences in scales of SOM and O-C between Dental Controls with Pain and Dental controls without Pain group.
Central pain is defined as pain associated with lesions of the central nervous system, and is among the most intractable of chronic pain syndromes. A 47 year-old-female, who had right arm and shoulder pain, was diagnosed with syringomyelia of the Arnold Chiari malformation type I and received foramen magnum decompression and a syringo-subarachnoid shunt. After the operation, the evoked pain was improved, but she complained of a continuous burning pain, coupled with cold and tactile allodynia. This symptom failed to fully subside on administration of oral medicine; therefore, brachial plexus block was performed, which relieved her pain transiently. Through repeated trials, a gradual decrease in the pain intensity and frequency was found. However, the way in which brachial plexus block improves spinal central pain is not completely known.
The analgesic effects of epidural morphine were evaluated on various types of cancer-related pain in forty-eight adult patients. Epidural morphine injections were given via an epidural catheter introduced to an epidural level corresponding to the pain area. Pain relief was classified as excellent, fair, or poor by subjective scoring and by the subsequent need for systemic analgesics. Thirty-two patients of all the patients became pain-free. In sixteen patients, pain relief was complete only for one or two of various types of pain with a certain dose of epidural morphine, The best result was obtained when the pain was continuous and originated from deep somatic structures. Based on the results, the ranking order of different types of cancer pain with regard to their susceptibility to epidural morphine was as follows: 1) Continuous somatic pain 2) Continuous visceral pain 3) Intermittent somatic pain 4) Intermittent visceral pain The differential effects of epidural morphine on cancer-related pain may suggest that various types of noxious stimuli involve different kinds of opioid receptors which differ in affinity to morphine, and that there are some pain-mediating systems which function independently of opioid mechanisms.
Purpose: The purpose of this study was to explore the effects of the 8-weeks back pain management program (consisted of exercise and education for back pain) in patients with chronic low back pain. Methods: A total of 20 subjects who visited the pain clinic in a university hospital were randomly assigned either to a experimental or a control group. Ten subjects in the experimental group carried out the back pain management program for 8 weeks, and 10 in the control group did not. Results: After the back pain management program, back pain and disability were significantly reduced, and back pain management behavior and back muscle strength were significantly increased in the experimental group. However, radiating pain and flexibility were not significantly changed after the back pain management program. Conclusion: Findings of this study indicated that the 8-weeks back pain management program had favorable effects on back pain, degree of disability, back pain management behavior, and back muscle strength in patients with chronic low back pain. Future research needs to examine the optimal intensity and frequency of back muscle strengthen exercise, and the lasting effects of education for back pain.
Purpose: The aim of the study was to investigate neck posture, range of motion, muscle endurance and self-report of pain and disability in smartphone users. Methods: Seventy-eight university student volunteers, aged between 18 and 30 years (mean age 23.2), were assessed for: a head-neck posture by measuring cranial vertical angle, neck range of motions using cervical range of motion device, and a deep neck flexor endurance using a stabilizer. Finally, subjects were asked about their neck pain and completed disability questionnaires, ie, Short Form McGill Pain Questionnaire, Neck Disability Index, and World Health Organization Disability Assessment Schedule 2.0. Results: Thirty-eight subjects experienced recurrent neck pain with/without upper limb pain (neck pain group) and 40 reported no current neck pain with/without upper limb pain (no neck pain group). Differences were found between groups on pain and disability questionnaires. Subjects with neck pain had significantly higher disability scores than those of no neck pain group. However, there were no differences observed between groups in a head-neck posture, neck range of motions, and deep neck muscle endurance time. The smartphone usage time was negatively correlated with neck pain intensity and disability score whereas it had positive relationship with flexibility and posture. Conclusion: Group differences were observed as lower capacity not only for neck specific daily activities but for general functioning in daily routine when the neck pain and no neck pain groups were compared. Therefore, functioning in daily activities should be investigated as prevention for further developing neck pain in smartphone users.
Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.
Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients' medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.
Background : Validity of WHO guideline of cancer pain management has been proven and many trials have been done to derive solutions for inadequate cancer pain management. We assessed the severity of pain of terminal cancer patients in a few different ways and patients' characteristics influencing inadequate pain management. Methods : This study was based on 100 adult oncological patients who were confirmed as terminal stage in our institution from 3/1998 to 11/1998. Medical records were reviewed and individual patients were interviewed to obtain demographic information and medical characteristics such as: daily activity performance, metastasis, and drug-adjusted pain severity. Adequacy of prescribed analgesics in accordance with WHO guidelines of pain management and patients' characteristics influencing adequacy of pain management were assessed. Results : Among those cancer patients diagnosed as terminal stage, 85% complained of pain, and 68% of those patients reported pain above moderate severity. 38% of those patients received inadequate pain management resulting in greater severity of pain; the less adequate pain relief was(p<0.01). Sex, age, primary cancer site metastasis, symptoms such as depression and anxiety, and daily activity performance were not significantly related. Conclusions : Despite WHO guidelines for pain management, majority of the terminal cancer patients received inadequate pain management. There is a necessity for education on proper pain evaluation and strict implimentation for WHO guidelines of pain management.
Purpose : The purpose of present study was to improve communication of pain expressing terms and pain intensity between patient and physical therapist, and initiated to objectify a measurement of subjective pain. Methods : Data were delivered to 249 people by a self-completion questionnaire, and analyzed 160 copies except for 87 mark error of the collected 247 questionnaires. The questionnaire included a question on 55 terms used to describe pain, the type of the pain, and pain intensity using VAS (visual analogue scale). Results : The results were as follows; 'Tight' was the most frequently being expressed term of muscular pain, subsequently to 'knot' and 'dull'. 'Tear' was the term representing the most strong pain of muscular pain, subsequently to 'rupture' and 'squeeze'. 'Stinging' was the most frequently being expressed term of neurologic pain, subsequently to 'get shocked' and 'wriggle'. 'Burn' was the term representing the most strong pain of neurologic pain, subsequently to 'sear' and 'get shocked'. 'Creak' was the most frequently being expressed term of joint pain, subsequently to 'peel' and 'out of joint'. 'Break' was the term representing the most strong pain of joint pain, subsequently to 'peel' and 'crack'. Conclusion : The objectification of pain terms will be used to help physical therapist to check the patient's pain.
Background: Complex regional pain syndrome (CRPS) is still difficult to diagnose in the field of chronic pain management. CRPS is diagnosed by purely clinical criteria based on the characteristic signs and symptoms, which have to be differentiated from similar pain conditions like posttraumatic neuropathic pain. Until now, there has been a lack of objective diagnostic tools to confirm the diagnosis of CRPS. The aim of this study was to evaluate the usefulness of a three phase bone scan (TBS) for making the diagnosis of CRPS. Methods: A total of 121 patients who had been diagnosed with CRPS were evaluated. All the patients were examined by performing a TBS as a part of the diagnostic work-up. A diffuse increased tracer uptake on the delayed image (phase III) was defined as a positive finding for CRPS. Results: Forty-one patients (33.9%) out of 121 showed the positive results on the TBS. The patients with a duration of pain of less than 24 months had a significantly higher positive result (43.4%) on the TBS than did the patients with duration of pain longer than 24 months (12.1%). Conclusions: A TBS could give a better objective result for diagnosing CRPS for patients with a shorter duration of pain and a TBS gives little information for the diagnosis of CRPS in patients with a duration of pain longer than 24 months.
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