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A Study on Back Pain, Pain Disability, and Labour Pain of Postpartum Women (산후여성의 임신중 요통, 요통장애와 분만중 통증에 관한 연구)

  • Shim, Mi-Jung
    • Women's Health Nursing
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    • v.10 no.1
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    • pp.8-14
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    • 2004
  • Purpose: The purpose of this study was to look into back pain, pain disability, labour pain, and related areas of pain experienced by postpartum women. Method: A survey about pain including a Visual Analogue Scale (VAS), Oswestry pain disability, and pain drawing was used in a descriptive research method on 98 women 2-3 days after delivery. Result: 57.1% of those surveyed reported experiencing back pain before pregnancy. 75.5% reported experiencing back pain during pregnancy. The average starting time of back pain for pregnant women was 2.9 months into pregnancy. 48.8% reported the most severe back pain in the last trimester of pregnancy, while most women complained of left and right pubic pain and lumbar area pain during pregnancy. Statistical relations were calculated and menstrual symptoms (F=5.938, p=0.004), back pain prior to pregnancy (F=4.714, p=0.000), back pain during pregnancy (F=-3.429, p=0.001), and back pain disability prior to pregnancy (F=-1.994). Conclusion: There is a relation in postpartum women's back pain between back pain prior to pregnancy and back pain during pregnancy. Pelvic examinations early in pregnancy can determine if back pain will change for the worse or relapse. Therefore, the application of a pain relieving nursing intervention is needed.

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The Effectiveness of a Three Phase Bone Scan for Making the Diagnosis of Complex Regional Pain Syndrome (복합부위통증증후군 환자에서 삼상 골스캔의 유용성 평가)

  • Kim, Nan Seol;Park, Kyeong Eon;Kim, Sae Young;Chae, Yun Jeong;Kim, Chan;Han, Kyung Ream
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.33-38
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    • 2009
  • 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.

A Study on Chronic Pain, Pain Beliefs, Pain Coping, and Fatigue in the Elderly (노인의 만성통증과 통증신념, 통증대처 및 피로에 관한 연구)

  • Chang, Hae Kyung
    • Korean Journal of Adult Nursing
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    • v.18 no.3
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    • pp.377-385
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    • 2006
  • Purpose: This study were to examine the relationship among chronic pain, pain beliefs, pain coping, and fatigue and to define the main factors influencing chronic pain in the elderly. Method: Data were collected by self-reported questionnaires from 276 Korean elderly. Data analysis was done with SPSS 10.1 for descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, and Stepwise multiple regression. Results: Chronic pain score was 5.45, which was slightly higher than the average. There were significant differences in chronic pain according to age, marital state, economic state, and duration of pain. There was a significant positive correlation between chronic pain and pain beliefs, passive pain coping, physical fatigue and mental fatigue. In addition, there was a significant negative correlation between chronic pain and active pain coping. Stepwise multiple regression analysis showed that 44% of the variance in chronic pain was significantly accounted for by passive pain coping(31%), pain beliefs(8%), physical fatigue(4%), and active pain coping(1%). Conclusion: These results suggested that pain beliefs, pain coping, and fatigue can be influencing factors on chronic pain for the elderly. Also, the findings can provide a basis for nursing intervention development to effectively manage chronic pain for the elderly.

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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.

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.

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.

Risk Factors Associated with Clinical Insomnia in Chronic Low Back Pain: A Retrospective Analysis in a University Hospital in Korea

  • Kim, Shin Hyung;Sun, Jong Min;Yoon, Kyung Bong;Moon, Joo Hwa;An, Jong Rin;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.137-143
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    • 2015
  • Background: Insomnia is becoming increasingly recognized as a clinically important symptom in patients with chronic low back pain (CLBP). In this retrospective study, we have determined risk factors associated with clinical insomnia in CLBP patients in a university hospital in Korea. Methods: Data from four-hundred and eighty one CLBP patients was analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ${\geq}15$). Patients' demographics and pain-related factors were evaluated by logistic regression analysis to identify risk factors of clinical insomnia in CLBP. Results: It was found that 43% of patients reported mild to severe insomnia after the development of back pain. In addition, 20% of patients met the criteria for clinically significant insomnia (ISI score ${\geq}15$). In a stepwise multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain and neuropathic pain components, and high level of depression were strongly associated with clinical insomnia in CLBP. Among these factors, the presence of comorbid musculoskeletal pain other than back pain was the strongest determinant, with the highest odds ratio of 8.074 (95% CI 4.250 to 15.339) for predicting clinical insomnia. Conclusions: Insomnia should be addressed as an integral part of pain management in CLBP patients with these risk factors, especially in patients suffering from CLBP with comorbid musculoskeletal pain.

Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome

  • Oh, Ji Youn;Lim, Jin Hun;Kim, Yong Seok;Kwon, Young Eun;Yu, Jae Yong;Lee, Jun Hak
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.48-52
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    • 2016
  • Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.

Referred Shoulder Pain due to Liver Abscess -A case report- (간농양의 연관통으로 밝혀진 우측 견부통 환자의 치료증례)

  • Park, Sang Hyun;Lee, Pyung Bok;Seo, Myung Sin;Lim, Yun Hee;Oh, Yong Seok
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.267-270
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    • 2005
  • Referred pain is not localized to the site of its cause, but referred to an area that may be an adjacent distant from such a site. With respect to this, there is the possibility of misdiagnosis in the treatment of referred pain patient. We experienced a case of a 31-years-old male patient complaining of right shoulder pain, which subsided after a bursa injection. The patient revisited our clinic after 3 weeks complaining not only of right shoulder pain, but also of right upper quadrant pain and fever. He was diagnosed as having a liver abscess by an imaging study.

Treatment of a Twelfth Rib Syndrome -A case report- (열두 번째 갈비뼈 증후군 환자의 치료경험 -증례보고-)

  • Choi, Jong Bum;Yoon, Kyung Bong;Kim, Won Oak;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.96-98
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    • 2009
  • Twelfth rib syndrome is thought to be due to intercostal nerve irritation by a mobile twelfth rib, and presents with upper abdominal pain, or low thoracic pain. This syndrome appears to be a fairly common entity and diagnosis is based on clinical findings. Patients with twelfth rib syndrome can be misdiagnosed when it has been overlooked. We report a case of a 34-year-old male along with a presentation of twelfth rib syndrome. One patient was transferred from urologic clinic to pain clinic due to right flank pain and admitted. The patient had direct tenderness on twelfth rib area and direct tenderness was reproducible. Pain increased when the patient flexed laterally, rotated trunk. There were no specific abnormal findings in laboratory test, electrocardiogram, and radiologic examination. After intercostal nerve block and epidural block, pain decreased and the patient was discharged.