• Title/Summary/Keyword: Pain reduction

Search Result 891, Processing Time 0.024 seconds

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
    • /
    • v.39 no.3
    • /
    • pp.200-205
    • /
    • 2022
  • Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

Radiofrequency Neurotomy for Remnant Pain after Vertebroplasty as the Treatment of Severe Compression Fracture

  • Kim, Saeng-Youp;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.2
    • /
    • pp.95-98
    • /
    • 2006
  • Objective : The aim of this study is to evaluate the feasibility, safety and effectiveness of radiofrequency neurotomy[RFN] for remnant pain after vertebroplasty for the treatment of severe compression fracture. Methods : 25 patients with remnant pain after vertebroplasty for one level severe compression fracture were treated by RFN. The severe compression fractures were defined to the vertebrae which less than 50% of their original heights have collapsed. Pain relief was evaluated at 2 weeks, 6 weeks and 3 months after the procedure using a visual analog scale[VAS]. Results : Successful outcome was determined if pain reduction exceeded 50% on the VAS at 6 weeks. Six of the 25 patients did not respond favorably to RFN [pain reduction less than 50%], and nineteen patients showed successful responses. Mean VAS score was decreased from 5.48 to 2.96 at 6 weeks. Conclusion : The radiofrequency neurotomy may be both feasible and useful treatment for the remnant pain after vertebroplasty. However long-term follow up is needed to confirm the effectiveness.

Spontaneous Vertebral Reduction during the Procedure of Kyphoplasty in a Patient with Kummell's Disease

  • Hur, Won-Seok;Choi, Sang-Sik;Lee, Mi-Kyoung;Lee, Dong-Kyu;Lee, Jae-Jin;Kim, Kyong-Jong
    • The Korean Journal of Pain
    • /
    • v.24 no.4
    • /
    • pp.231-234
    • /
    • 2011
  • Kummell's disease is a spinal disorder characterized by delayed post-traumatic collapse of a vertebral body with avascular necrosis. Although definitive treatment for Kummell's disease has not been established, it has been reported that percutaneous vertebroplasty or kyphoplasty has shown good results. However, these procedures are not recommended for severely collapsed vertebral bodies because of the risk of cement leakage or technical difficulties. Authors report a rare case of spontaneous reduction in vertebral height by the insertion of a working cannula into the vertebral body in Kummell's disease.

Thermographic Findings in Craniomandibular Disorders ; Clinical Evaluation (두개하악장애환자의 임상적 평가를 위한 컴퓨터적외선체열검사)

  • Ick-Joo Cho;Jung-Pyo Hong;Sang-Rae Lee
    • Journal of Oral Medicine and Pain
    • /
    • v.20 no.2
    • /
    • pp.477-487
    • /
    • 1995
  • The purpose of this study was to assess the thermographic differences of craniomandibular area between normal individual and patients with craniomandibular disorders and to compare the differences between clinical and thermographical assessment. The author had used 50 subjects as materials for this study, which was divided into 2 groups (first group included 15 healthy subjects and second group included 35 patients) with craiomandibular disorders; 17 subjects had normal disc-condyle relationship, 13 subjects had disc displacement with reduction and 5 subjects had disc displacement without reduction. Agema 870 thermovision(D.I.T.I.) was used to take thermographs with $0.1^{\circ}C$ difference of gradual temperature shift. The results were as follows : 1. Of 34 patients with craniofacial pain, 15(44%) subjects showed hyperthermia on the pain site in the thermography, 8(23.5%)exhibited hyperthermia on the site opposed to the pain site, and 11(32.4%) did not show any significant thermal change. One patient without craniofacial pain showed hyperthermia on the site opposed to the site of disc displacement without reductin. 2. Of 35 patients with craniofacial pain or disc displacement, 24(68.6%) subjects showed a significant thermal difference between symptomatic and asymptomatic sides of the face, but 11(31.4%) did not show any difference. 3. Of 17 patients with pain but with normal disc-condyle relationship, 8(47.1 subjects showed hyperthermia on the pain site, 4(23.5%) showed on the site opposed to the pain site, and 5(29.4%) did not show any significant thermal change. 4. Or 13 patients with pain and disc displacement with reduction, 6(46.2%) subjects showed hyperthermia on the pain site, 3(23.1%) showed on the site opposed to the pain site, and 4(30.8%) did not show any significant thermal change. 5. 15 healthy subjects did not show any thermal differences between the both sides of the face.

  • PDF

Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year

  • Tinnirello, Andrea
    • The Korean Journal of Pain
    • /
    • v.33 no.2
    • /
    • pp.183-191
    • /
    • 2020
  • Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

Basic Study on the Doin Gigong Exercise for the Reduction of Shoulder-arm Pain (견비통 완화 도인기공체조에 대한 기초적인 연구)

  • Kim Lee-Sun;Kim Gyeong-Cheol
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.20 no.1
    • /
    • pp.52-57
    • /
    • 2006
  • Gigong exercise is simple form's game for health care. Gigong exercise is the training method in mind and body, and it prevent or cure the disease by becoming larger the human's nature-healing power This syudy intends to identify the effective processing channel of the Doin Gigong Exercise for the reduction of shoulder-arm pain. The processing channel of the Doin Gigong Exercise for the reduction of shoulder-arm pain cinsist of warming, main, finishing exercise. The warming exercise start breathing and concentrate upon shoulder-arm exercise. The upper and lower sides join-hands exercise give help smoothly the Gi-circulation of human body in every direction. The finishing exercise consist of experience to Gi with the object of maintaining human comfortable condition. As mentioned above, the Doin Gigong exercise is effective intervention for the reduction of shoulder-arm pain.

The Effects of Visual and Auditory Feedback on Pain Reduce (시각과 청각되먹임이 통증감소에 미치는 영향)

  • Bae, Young-Sook;Kim, Soon-Hoe;Min, Kyung-Ok
    • Journal of Korean Physical Therapy Science
    • /
    • v.9 no.1
    • /
    • pp.1-8
    • /
    • 2002
  • This study set out to investigate what kind of effects the consistent visual stimuli and verbal and non verbal auditory stimuli have on pain alleviation, as well as to see the influence of joint application of visual and auditory stimuli at the same time on pain alleviation, according to lightness of 50lux and 200lux, ultimately providing basic data in setting up an environment in case of treating pain. The subject were comprised of 30 male and female adults with pain in the neck and back area. The subject were treated in their pain area with Transcutaneous Electrical Nerve Stimulator(TENS) 100HZ for 20 minutes in the research set where each visual, auditory, and joint visual and auditory stimuli was given. For analysis methods, Visual Analogue Scale(VAS) and McGill Pain Questionnaire were adopted to see the changes before and after treatment, and the electrocardiogram, systolic and diastolic pressure, number of heart rate and breathing frequence and endorphin were compared and analyzed using the Wilcoxon singed-rank test. And The Kreskal-walllis test was used to compare the two subgroups from each group. Wilcoxon singed-rank test and the Kreskal-walllis test was used to compare the two subgroups from each group. The results were as follows: 1. The group of 50lux and 200lux were compared given varying degrees of visual stimuli. The group of 200lux showed more reduction in pain points, average systolic and diastolic pressure and average endorphin. 2. The group of verbal and non verbal were compared given varying degrees of auditory stimuli. The group of non-verbal showed more reduction in average systolic and diastolic pressure. 3. The group of 200lux+verbal and 200lux+non verbal were compared given varying degrees of joint visual and auditory stimuli. There was found a statistical significance(p<0.05) in endorphin between the two groups, with more endorphin reduction for 200lux+non verbal group. And there was a statistically significant reduction in VAS and McGill before and after the treatment between the two groups.

  • PDF

The Effects of Character Distraction on Intravenous Injection Pain of Hospitalized Preschooler (캐릭터를 이용한 관심전환중재가 학령전기 아동의 정맥주사 시 통증과 주사공포에 미치는 효과)

  • Lim, Ok-Woo;Cho, Kyoul-Ja
    • Child Health Nursing Research
    • /
    • v.12 no.2
    • /
    • pp.215-222
    • /
    • 2006
  • Purpose: This study was done to identify the effects of the distraction generated by character stamp and stickers on reduction of intravenous injection pain. Method: This study was conducted using a quasi experimental non-equivalent control group non-synchronized design. 60 preschool children who admitted to a Pediatric Department in a C University Hospital were selected as subjects. Convenience assignment was used. The two groups were homogeneous on characteristics. Results: In the experimental group, objective pain(t=3.666, p=.001), subjective pain (t=3.415, p=.001) and perceived pain by the mother(t=2.528, p=0.014) decreased after intravenous injections than the control group. There were no statistical significant differences in pulse rate or fear between the experimental and the control group. Conclusion: These findings indicate that using character stamp and stickers could be considered as an independent nursing intervention for intravenous injection pain reduction in preschooler.

  • PDF

Effect of lidocaine on pain caused by nasal pack removal after closed reduction of nasal bone fractures

  • Sung, Ji Yoon;Kang, Kyung Dong;Kim, Min Wook;Kim, Joo Hyoung
    • Archives of Plastic Surgery
    • /
    • v.47 no.1
    • /
    • pp.15-19
    • /
    • 2020
  • Background Pain caused by nasal pack removal after closed reduction of nasal bone fractures is a common problem. This study investigated the effect of infiltrating lidocaine into nasal packs on the pain caused by pack removal after closed reduction of nasal bone fractures. Methods Seventy-five patients who underwent closed reduction of nasal bone fractures between March 2016 and March 2018 were enrolled in this prospective, randomized, single-blind study. Merocel (hydroxylated polyvinyl acetate) packs were applied bilaterally and retained for 5 days. Twenty minutes before removal, both packs were rehydrated with 6 mL of 2% lidocaine in 26 patients and with 6 mL of saline in 24 patients; the packs were not rehydrated in 25 patients. Visual analog scale (VAS) scores for pain on removal were recorded. Results The mean VAS score was 5.3±2.0 in all patients, 3.8±1.5 in the lidocaine group, 5.8±1.4 in the saline group, and 6.3±2.1 in the non-rehydrated group. There was a significant difference in the pain score between the lidocaine and saline groups (P<0.001) but not between the saline and non-rehydrated groups (P=0.186). Conclusions Infiltration of lidocaine into Merocel packs reduced the pain caused by pack removal after closed reduction of nasal bone fractures.

A Randomised, Placebo-controlled Trial of the Effects of Preoperative Pregabalin on Pain Intensity and Opioid Consumption following Lumbar Discectomy

  • Hegarty, Dominic A.;Shorten, George D.
    • The Korean Journal of Pain
    • /
    • v.24 no.1
    • /
    • pp.22-30
    • /
    • 2011
  • Background: Pregabalin has been shown to have analgesic effect in acute pain models. The primary objective was to examine the efficacy a single dose of pregabalin, would have on morphine consumption following lumbar discectomy. Methods: With ethical approval a randomized, placebo-controlled prospective trial was undertaken in 32 patients (ASA I-II, 18-65 years) with radicular low back pain for > 3 months undergoing elective lumbar discectomy. Patients received either oral pregabalin 300 mg (PG Group) or placebo (C Group) one hour before surgery. Pain intensity, the accumulative morphine consumption and adverse effects were recorded for 24 hours following surgery. Functional, psychological and quantitative sensory testing were also assessed. Results: Fourteen patients out of the 32 recruited were randomized to receive pregabalin. Morphine consumption was reduced (absolute difference of 42.3%) between groups with medium effect size. (Mann-Whitney; U =52.5, z-score= 2.84, P = 0.004, r = 0.14). This was not associated with a significant difference in the incidence of adverse effects between the two groups. The median pain intensity (VAS) on movement was not significantly different between groups. Conclusions: A single pre-operative dose of pregabalin (300 mg) did not result in a reduction in pain intensity compared to placebo in this patient cohort but the significant reduction in morphine consumption suggests that a fixed peri-operative dosing regime warrants investigation.