• Title, Summary, Keyword: Pain

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Effect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings

  • Choi, Ji Won;Lim, Hyung Woo;Lee, Jin Young;Lee, Won Il;Lee, Eun Kyung;Chang, Choo Hoon;Yang, Jae Young;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.96-102
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    • 2016
  • Background: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.

Chronic Pain Control of SCI Patients after Cervical Epidural Block -Case report on 2 cases- (경부 경막외 차단에 의한 척수손상 환자의 만성 통증 조절 -2예 보고-)

  • Lee, Ji-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.273-278
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    • 1992
  • With the medical progress that has given spinal cord injured(SCI) individuals greater longevity and better overall health, chronic pain is emerged as major challenge in treating this population. According to past reports, estimates of prevalance of severe/disabling chronic pain in SCI patients have ranged from 18% to 63%. In etiologies of chronic pain in SCI patients, psychic or psychogenic pain categories should be included and more recent data have demonstrated that the persistant pain is directly related to higher levels of psychosocial distress and impairment. Recently, neurophysiological classification of the SCI pain syndrome into three etiologic groups(a; mechanical pain, b; radicular pain, c; deafferentation pain) is more frequently adopted for the classification of chronic SCI pain syndrome. The deafferentation pain is most common of the pain syndromes associated with SCI. After cervical epidural anesthesia for the surgical intervention of decubitus ulcer on the hip of two SCI patients, there were much reduction of existing chronic deafferentation character pain.

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Pilot Study for Scale Development for Measurement of Arthritic Pain Using Pain Terms (통증어휘를 이용한 관절통 척도개발의 예비연구)

  • Lee, Eun-Ok;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.10 no.1
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    • pp.44-53
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    • 2003
  • Purpose : This study was to identify Korean terms appropriate for a new scale using pain terms to assess the pain of the arthritis patients. Method : This study was conducted by secondary analysis of two previous studies, one from Kim's data (1994) and the other from Lee and Choi's(1988). The subjects were 482 patients with arthralgia. Data were analyzed by SPSS Win 11.0, for frequencies, percentages, and means. Results : Five pain groups were sorted out from the sensory pain category, three in the affective pain category, and two in the miscellaneous pain category by selecting groups of pain terms expressed more than 50% by all subjects. Local inflammatory repeated pain terms, simple irritative pain terms, superficial pressure pain terms, traction pain terms, and peripheral nerve terms were included in the sensory pain category, fatigue-related pain terms, digestion-related terms, and suffering-related terms in the affective category, and dull pain terms and body cavity pressure pain category. Among five sample groups terms selected by more than 3 groups with more than 30% of patients were dugumhada, sikungorinda, wooksinwooksinhada, nurudusi apuda, and dangginda in the sensory pain category; nogonhage apuda, gobukhada, and jajungsurupge apuda in the affecte pain category; and buctjockgigunhada and manjimyon apuda in the miscellaneous pain category. Conclusion : Ten pain groups were tentatively selected out of 20 pain groups; 10 pain terms composed of 1 pain term from each group were selected out of 90 pain terms from thesecondarydataofarthriticpainpatients. Implications More detailed clinical studies are needed for the refinement of the scale.

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An Analysis of Various Factors Affecting Neck Pain and Dysfunction in Adults with Chronic Neck Pain Using Regression Analysis

  • Park, Seiyoun;Lee, Sangbin
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.4
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    • pp.1907-1913
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    • 2019
  • Background: The prevalence of neck pain and neck dysfunction is high in general population. However, there is little literature on the relationship and factors affecting neck pain and neck dysfunction. Objective: To investigate the correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction, and sleep quality in adults with chronic neck pain, and factors affecting neck pain and neck dysfunction. Design: Cross-sectional study Methods : The sample included 114 subjects, who had complained of chronic neck pain for more 12 weeks. We conducted a Pearson's correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction and sleep quality and a regression analysis of the related variables, thereby analyzing factors affecting neck pain and neck dysfunction. Results : In the present study, in adults with chronic neck pain, neck pain was positively correlated with the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI)-Pain score, and SPADI-Total score (p<.05). The NDI was positively correlated with neck pain, SPADI-Pain score, and SPADI-Total score, as well as with Pittsburgh Sleep Qulity Index(PSQI-K) (p<.05). Among the factors affecting neck pain, shoulder disability as assessed by the SPADI was a significantly associated with neck pain, while shoulder pain and shoulder disability determined by the SPADI were identified as significant variables among the factors affecting neck disability. Conclusion : These results indicated that as neck pain worsened, shoulder pain and neck and shoulder dysfunction also increased, which suggested that shoulder disability affected neck pain. In addition, as the neck dysfunction increased, neck pain and shoulder pain and shoulder dysfunction increased, and sleep quality deteriorated, which suggested that shoulder pain and shoulder disability affected neck disability.

High prevalence of musculoskeletal pain in individuals with severe obesity: sites, intensity, and associated factors

  • Mendonca, Carolina Rodrigues;Noll, Matias;Santos, Annelisa Silva e Alves de Carvalho;Rodrigues, Ana Paula dos Santos;Silveira, Erika Aparecida
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.245-257
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    • 2020
  • Background: Musculoskeletal pain is associated with obesity; however, information on factors associated with pain in adults with obesity and severe obesity is limited. The purpose of this study was to assess the prevalence of musculoskeletal pain by site and intensity of pain and associated factors in individuals with severe obesity (body mass index ≥ 35.0 kg/㎡). Methods: Baseline data from the DieTBra Trial study evaluating pain symptoms in nine body regions over the last seven days using the Nordic Questionnaire on Musculoskeletal Symptoms and Numerical Pain Scale. The variables analyzed using multiple Poisson regression with hierarchical analysis were: sociodemographic, lifestyle, food consumption, clinical, and anthropometric, and the outcome was moderate and intense pain. Results: In 150 participants, there was a high prevalence of ankle and foot pain (68.7%), lower back pain (62.7%), pain in the knees (53.3%) and upper back pain (52.0%), with a predominance of intense pain. Factors associated with pain according to specific sites were: type 2 diabetes with hand/wrist pain; sedentary time with hip pain; insomnia with pain in the hip and knee; edema in the lower limbs with pain in the lower back and ankles/feet; degree of obesity with ankle/foot pain; and percentage of total fat with ankle/foot pain. Conclusions: There was a high prevalence of pain and intense pain in individuals with severe obesity and an association with clinical variables, the degree of obesity, and sedentary lifestyle.

Diagnosis and treatment of abnormal dental pain

  • Fukuda, Ken-ichi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.1
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    • pp.1-8
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    • 2016
  • Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, these potential alternate causes should be considered. In this clinical review, we have presented a case of referred pain from the digastric muscle (Patient 1), of pulpectomized (Patient 2), and of pulpectomized pain (Patient 3) to illustrate referred, neuromodulatory, and neuropathic pain, respectively. The Patient 1 was advised muscle stretching and gentle massage of the trigger points, as well as pain relief using a nonsteroidal anti-inflammatory and the tricyclic antidepressant amitriptyline. The pain in Patient 2 was relieved completely by the tricyclic antidepressant amitriptyline. In Patient 3, the pain was controlled using either a continuous drip infusion of adenosine triphosphate or intravenous Mg2+ and lidocaine administered every 2 weeks. In each case of abnormal dental pain, the patient's diagnostic chart was used (Fig.2 and 3). Pain was satisfactorily relieved in all cases.

A Patient with Kikuchi's Disease: What Should Pain Clinicians Do?

  • Park, Kyeong-Eon;Kang, Se-Bin;Ok, Seong-Ho;Shin, Il-Woo;Sohn, Ju-Tae;Chung, Young-Kyun;Lee, Heon-Keun
    • The Korean Journal of Pain
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    • v.25 no.3
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    • pp.188-190
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    • 2012
  • Kikuchi's disease (KD) is an idiopathic and self-limiting necrotizing lymphadenitis that predominantly occurs in young females. It is common in Asia, and the cervical lymph nodes are commonly involved. Generally, KD has symptoms and signs of lymph node tenderness, fever, and leukocytopenia, but there are no reports on treatment for the associated myofacial pain. We herein report a young female patient who visited a pain clinic and received a trigger point injection 2 weeks before the diagnosis of KD. When young female patients with myofascial pain visit a pain clinic, doctors should be concerned about the possibility of KD, which is rare but can cause severe complications.

Study of Suffering Inference by Nurses' pain Experience (간호사의 통증경험에 따른 고통추론 연구)

  • Ryoo, Eon-Na;Park, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.14 no.2
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    • pp.174-183
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    • 2002
  • Purpose: The purpose of this study was to determine the effect of nurses' pain experience on the inference of their patients' suffering. Method: Study subjects were sampled from 184 nurses who worked in general wards in one S university hospital located at Seoul. Nurses' pain experience consists of personal pain experience and professional pain experience. The Standard Measure of Inference of Suffering (Davitz & Davitz, 1981) was used for suffering inference measure, and patients' suffering which consists of physical pain and psychological distress. Result: Suffering inference scores of nurses without personal pain experience revealed a higher value than that of nurses with personal pain experience. But these differences were not statistically significant. The higher intense pain was experienced, the higher were suffering inference scores. This physical pain inference score was statistically significant(p=.044). Of the nurses who had personal pain experience, suffering inference scores of nurses with unrelieved pain experience revealed a higher value than that of nurses with relieved pain experience. Physical pain and psychological distress inference scores were statistically significant(p=.010, p=.006). Suffering inference scores of nurses without professional pain experience(internal medicine, general surgery, orthopedic surgery) revealed a higher value than that of nurses with professional pain experience. Professional pain experience of internal medical illness was statistically significant in psychological distress of internal medical illness(p=.044), and professional pain experience of orthopedic surgical illness was statistically significant in physical pain of orthopedic surgical illness(p=.027). Conclusion: Nurses who have experienced low pain intensity or good pain relief are inclined n to underestimate patient' pain. Although nurses who care for the same patient over a long time deal skillfully with that patient, nurses are inclined to underestimate that patients' pain. Nurses need to be aware of possible biases related to pain assessment as a result of pain experience.

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Pain management and Pain knowledge of Nurses (간호사의 암환자 통증관리 및 통증지식에 관한 연구)

  • Choi, So-Young
    • Asian Oncology Nursing
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    • v.4 no.1
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    • pp.82-90
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    • 2004
  • Purpose: This study is part of questionnaire survey concerned with the views of nursing staff for cancer patients. This study was done to describe cancer pain management problem, pain management knowledge. Methods: The participants were 188 nurses at cancer ward. Data were collected from July 2003 to August 2003. Data were collected with multiple-choice items and one open-ended question, which were constructed structured questionnaire. The data were analyzed by means of SPSS statistical software and content analysis. Results: Experiences of pain education are 53.7%, pain assessment sheet not use 86%, pain management status are partial. Education need of pain management was 87.8% patients in pain were very often(23.9%) or rather often (35.1%) cancer patients. The nurses are respond to open question. Pain management problems as assessed by nurses are categorized 11 item. The health professional problems are Knowledge deficit pain management, Incontrollable pain, Doctor's busy. The patient problems afraid of narcotics for addiction, side effect, distinguishing between physical and suffering, economical problem. The scores of knowledge about pain was average 16.7 score. The pain knowledge showed significant correlation education need(r=.180, p=.013). The effective variable was need of $education({\beta}=.163)$. Conclusion: It was found that pain knowledge was middle score and pain management problem was multiple. The study highlights the need to increase pain education for health professional. Therefore, This study suggest that health professionals education should be done to improve pain management problem.

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Effects of Pain Control Education on Pain Control Barrier, Postoperative Pain and Pain Control Satisfaction in Gynecological Patients (통증조절 개별교육이 부인과 수술환자의 통증조절 방해, 수술 후 통증 및 통증조절 만족도에 미치는 효과)

  • Lee, Bok-Nam;Lee, Ga-Eon
    • Journal of Korean Academy of Nursing
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    • v.36 no.6
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    • pp.968-975
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    • 2006
  • Purpose: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. Method: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. Results: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. Conclusion: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.