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Communication
Algorithm for multimodal medication therapy in patients with complex regional pain syndrome
Min Cheol Chang, Donghwi Park
J Yeungnam Med Sci. 2023;40(Suppl):S125-S128.   Published online July 12, 2023
DOI: https://doi.org/10.12701/jyms.2023.00360
  • 1,113 View
  • 86 Download
  • 2 Crossref
AbstractAbstract PDF
Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Citations

Citations to this article as recorded by  
  • Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
    Al'bert R. Bulatov, Tatyana A. Kolesnik, Александра A. Boykova, Igor' V. Litvinenko, Nikolay V. Tsygan
    Russian Military Medical Academy Reports.2023; 42(4): 413.     CrossRef
  • Experience from a single-center study on multimodal medication therapy for patients with complex regional pain syndrome
    Donghwi Park, Jin-Woo Choi, Min Cheol Chang
    Journal of Back and Musculoskeletal Rehabilitation.2023; : 1.     CrossRef
Review article
Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review
Jinseok Yeo
J Yeungnam Med Sci. 2024;41(1):22-29.   Published online June 30, 2023
DOI: https://doi.org/10.12701/jyms.2023.00367
  • 3,943 View
  • 185 Download
AbstractAbstract PDF
Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.
Communication
Some suggestions for pain physicians working in real-world clinical settings
Jung Hwan Lee, Min Cheol Chang
J Yeungnam Med Sci. 2023;40(Suppl):S123-S124.   Published online May 23, 2023
DOI: https://doi.org/10.12701/jyms.2023.00255
  • 651 View
  • 32 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Musculoskeletal pain is a common reason for patients visiting hospitals or clinics. Various therapeutic tools including oral medications, physical modalities, and procedures have been used to alleviate musculoskeletal pain. Numerous clinical trials have been conducted to demonstrate the therapeutic effect of each treatment and compare the efficacy of different protocols. These trials were conducted under controlled conditions with specific endpoints and timeframes, and the individual constraints of each patient were not considered. We believe that the findings of such studies may not accurately reflect clinical reality in real-world settings. In this article, we propose treatment principles for patients in pain clinics. We propose two principles for pain treatment: first, “Healing, in the end, is not healing.” and second, “The patient’s job is not a patient.” The main role of pain physicians is to quickly and actively reduce pain and help patients focus on their work and lives.

Citations

Citations to this article as recorded by  
  • Protocol for lower back pain management: Insights from the French healthcare system
    Lea Evangeline Boyer, Mathieu Boudier-Revéret, Min Cheol Chang
    World Journal of Clinical Cases.2024; 12(11): 1875.     CrossRef
  • Effectiveness of transcranial alternating current stimulation for controlling chronic pain: a systematic review
    Min Cheol Chang, Marie-Michèle Briand, Mathieu Boudier-Revéret, Seoyon Yang
    Frontiers in Neurology.2023;[Epub]     CrossRef
Original article
Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study
Yoo Jung Park, Sujung Chu, Eunju Yu, Jin Deok Joo
J Yeungnam Med Sci. 2023;40(2):172-178.   Published online September 23, 2022
DOI: https://doi.org/10.12701/jyms.2022.00500
  • 2,014 View
  • 91 Download
AbstractAbstract PDF
Background
Laparoscopic cholecystectomy (LC) is a noninvasive surgery, but postoperative pain is a major problem. Studies have indicated that erector spinae plane block (ESPB) has an analgesic effect after LC. We aimed to compare the efficacy of different ESPB anesthetic concentrations in pain control in patients with LC.
Methods
This retrospective study included patients aged 20 to 75 years scheduled for LC with the American Society of Anesthesiologists physical status classification I or II. ESPB was administered using 0.375% bupivacaine in group 1 and 0.25% in group 2. Both groups received general anesthesia. Postoperative tramadol consumption and pain scores were compared and intraoperative and postoperative fentanyl requirements in the postanesthesia care unit (PACU) were measured.
Results
Eighty-five patients were included in this analysis. Tramadol consumption in the first 12 hours, second 12 hours, and total 24 hours was similar between groups (p>0.05). The differences between postoperative numeric rating scale (NRS) scores at rest did not differ significantly. The postoperative NRS scores upon bodily movement were not statistically different between the two groups, except at 12 hours. The mean intraoperative and postoperative fentanyl requirements in the PACU were similar. The difference in the requirement for rescue analgesics was not statistically significant (p=0.788).
Conclusion
Ultrasound-guided ESPB performed with different bupivacaine concentrations was effective in both groups for LC analgesia, with similar opioid consumption. A lower concentration of local anesthetic can be helpful for the safety of regional anesthesia and is recommended for the analgesic effect of ESPB in LC.
Resident fellow section: Teaching images
A 40-year-old man with neuropathic pain in the entire left foot
Jae Hwa Bae, Mathieu Boudier-Revéret, Min Cheol Chang
J Yeungnam Med Sci. 2023;40(2):223-224.   Published online August 30, 2022
DOI: https://doi.org/10.12701/jyms.2022.00486
  • 1,266 View
  • 59 Download
PDF
Case report
Crowned dens syndrome as a rare cause of anterior neck pain after transurethral resection of the prostate: a case report
Myeong Geun Jeong, Bum Soon Park, Eun-Seok Son, Jang Hyuk Cho
J Yeungnam Med Sci. 2023;40(3):289-292.   Published online August 5, 2022
DOI: https://doi.org/10.12701/jyms.2022.00388
  • 1,715 View
  • 80 Download
AbstractAbstract PDF
We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.
Review articles
Pain in amyotrophic lateral sclerosis: a narrative review
Soyoung Kwak
J Yeungnam Med Sci. 2022;39(3):181-189.   Published online June 8, 2022
DOI: https://doi.org/10.12701/jyms.2022.00332
  • 4,343 View
  • 121 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

Citations

Citations to this article as recorded by  
  • Health-related quality of life across disease stages in patients with amyotrophic lateral sclerosis: results from a real-world survey
    Katie Stenson, T. E. Fecteau, L. O’Callaghan, P. Bryden, J. Mellor, J. Wright, L. Earl, O. Thomas, H. Iqbal, S. Barlow, S. Parvanta
    Journal of Neurology.2024; 271(5): 2390.     CrossRef
  • Amyotrophic Lateral Sclerosis and Pain: A Narrative Review from Pain Assessment to Therapy
    Vincenzo Pota, Pasquale Sansone, Sara De Sarno, Caterina Aurilio, Francesco Coppolino, Manlio Barbarisi, Francesco Barbato, Marco Fiore, Gianluigi Cosenza, Maria Beatrice Passavanti, Maria Caterina Pace, Enzo Emanuele
    Behavioural Neurology.2024; 2024: 1.     CrossRef
  • Likely Pathogenic Variants of Cav1.3 and Nav1.1 Encoding Genes in Amyotrophic Lateral Sclerosis Could Elucidate the Dysregulated Pain Pathways
    Zsófia Flóra Nagy, Balázs Sonkodi, Margit Pál, Péter Klivényi, Márta Széll
    Biomedicines.2023; 11(3): 933.     CrossRef
  • Palliative Care in Amyotrophic Lateral Sclerosis
    Sebastiano Mercadante, Lou'i Al-Husinat
    Journal of Pain and Symptom Management.2023; 66(4): e485.     CrossRef
  • The blind spot and challenges in pain management
    Min Cheol Chang
    Journal of Yeungnam Medical Science.2022; 39(3): 179.     CrossRef
  • Synucleinopathy in Amyotrophic Lateral Sclerosis: A Potential Avenue for Antisense Therapeutics?
    Bradley Roberts, Frances Theunissen, Francis L. Mastaglia, P. Anthony Akkari, Loren L. Flynn
    International Journal of Molecular Sciences.2022; 23(16): 9364.     CrossRef
  • Herbal medicine and acupuncture relieved progressive bulbar palsy for more than 3 years: A case report
    Siyang Peng, Weiqian Chang, Yukun Tian, Yajing Yang, Shaohong Li, Jinxia Ni, Wenzeng Zhu
    Medicine.2022; 101(45): e31446.     CrossRef
The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review
Aung Chan Thu
J Yeungnam Med Sci. 2022;39(3):206-215.   Published online June 8, 2022
DOI: https://doi.org/10.12701/jyms.2022.00290
  • 4,060 View
  • 119 Download
  • 5 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

Citations

Citations to this article as recorded by  
  • Restraint stress-associated gastrointestinal injury and implications from the Evans blue-fed restraint stress mouse model
    Der-Shan Sun, Te-Sheng Lien, Hsin-Hou Chang
    Tzu Chi Medical Journal.2024; 36(1): 23.     CrossRef
  • Injections of Platelet-Rich Plasma: An Emerging Novel Biological Cure for Low Back Pain?
    Adarsh Jayasoorya , Nitin Samal, Gajanan Pisulkar, Kaustav Datta, Kevin Kawde
    Cureus.2024;[Epub]     CrossRef
  • Platelet-Rich Plasma in the Management of Temporomandibular Joint Pain in Young Adults With Temporomandibular Disorder
    Santosh Kumar Mathpati, Gourav Jain, Vijay Mishra, Atul K Singh, Rahul Mishra, Bipin K Yadav
    Cureus.2024;[Epub]     CrossRef
  • Potentials and impact of platelet-rich plasma (PRP) on the regenerative properties of muscle tissue
    V. H. Dzhyvak, I. M. Klishch, O. I. Khlibovska, S. S. Levenets
    Biopolymers and Cell.2024; 40(1): 3.     CrossRef
  • Injectable Lyophilized Chitosan-Thrombin-Platelet-Rich Plasma (CS-FIIa-PRP) Implant to Promote Tissue Regeneration: In Vitro and Ex Vivo Solidification Properties
    Fiona Milano, Anik Chevrier, Gregory De Crescenzo, Marc Lavertu
    Polymers.2023; 15(13): 2919.     CrossRef
  • Systematic Review of Platelet-Rich Plasma for Low Back Pain
    Edilson Silva Machado, Fabiano Pasqualotto Soares, Ernani Vianna de Abreu, Taís Amara da Costa de Souza, Robert Meves, Hans Grohs, Mary A. Ambach, Annu Navani, Renato Bevillaqua de Castro, Daniel Humberto Pozza, José Manuel Peixoto Caldas
    Biomedicines.2023; 11(9): 2404.     CrossRef
  • Potential Mechanism of Platelet-rich Plasma Treatment on Testicular Problems Related to Diabetes Mellitus
    Rista Dwi Hermilasari, Dicky Moch Rizal, Yohanes Widodo Wirohadidjojo
    Prague Medical Report.2023; 124(4): 344.     CrossRef
  • The blind spot and challenges in pain management
    Min Cheol Chang
    Journal of Yeungnam Medical Science.2022; 39(3): 179.     CrossRef
Case report
Prolonged oral sildenafil use-induced Mondor disease: a case report
Han Sol Chung, You Ho Mun
J Yeungnam Med Sci. 2022;39(3):262-265.   Published online May 24, 2022
DOI: https://doi.org/10.12701/jyms.2022.00220
  • 3,444 View
  • 90 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration caused by superficial dorsal penile vein thrombosis. We report a case of penile MD that was suspected to be related to prolonged oral sildenafil use. A 46-year-old man visited our emergency department with sustained penile pain and swelling that began 7 hours after sexual intercourse. He had used oral sildenafil intermittently for 11 years and engaged in sexual intercourse the previous night after taking sildenafil. Examination revealed no evidence of intercourse-related trauma to the genital area or an increase in penile skin temperature. However, penile swelling and tenderness over the protruding dorsal penile vein were noted. A color Doppler ultrasound examination was performed immediately, which showed hyperechoic thrombosis in the right superficial dorsal penile vein that was dilated, with soft tissue swelling and no detectable flow signal in the thrombotic lesion. The patient was diagnosed as having penile MD. The patient was treated conservatively. Some reports have indicated the involvement of sildenafil in thrombogenesis. Physicians should be aware that prolonged oral sildenafil use may be associated with penile MD.

Citations

Citations to this article as recorded by  
  • A case with Penile Mondor’s disease
    Hülya Cenk, Gülbahar Saraç, İrem Mantar Yanatma
    TURKDERM.2023; : 151.     CrossRef
Review articles
Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review
Donghwi Park, Min Cheol Chang
J Yeungnam Med Sci. 2022;39(3):190-199.   Published online April 26, 2022
DOI: https://doi.org/10.12701/jyms.2022.00192
  • 4,067 View
  • 162 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Citations

Citations to this article as recorded by  
  • The blind spot and challenges in pain management
    Min Cheol Chang
    Journal of Yeungnam Medical Science.2022; 39(3): 179.     CrossRef
The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review
Donghwi Park, Min Cheol Chang
J Yeungnam Med Sci. 2022;39(3):200-205.   Published online April 7, 2022
DOI: https://doi.org/10.12701/jyms.2022.00101
  • 4,175 View
  • 133 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • A narrative review of pulsed radiofrequency for the treatment of carpal tunnel syndrome
    Himanshu Gupta, Colm Vance, Vishal Bansal, Ahilraj Siva
    Pain Practice.2024; 24(2): 374.     CrossRef
  • Pulsed Radiofrequency for Auriculotemporal Neuralgia: A Case Report
    Yan Tereshko, Enrico Belgrado, Christian Lettieri, Simone Dal Bello, Giovanni Merlino, Gian Luigi Gigli, Mariarosaria Valente
    Neurology International.2024; 16(2): 349.     CrossRef
  • Transforaminal pulsed radiofrequency and epidural steroid injection on chronic lumbar radiculopathy: A prospective observational study from a tertiary care hospital in Vietnam
    Viet-Thang Le, Phuoc Trong Do, Vu Duc Nguyen, Luan Trung Nguyen Dao, Ipek Saadet Edipoglu
    PLOS ONE.2024; 19(4): e0292042.     CrossRef
  • Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain
    Shao‐jun Li, Dan Feng
    CNS Neuroscience & Therapeutics.2023; 29(7): 1881.     CrossRef
  • Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain
    Jiri Jandura, Milan Vajda, Roman Kostysyn, Jiri Vanasek, Eva Cermakova, Jan Zizka, Pavel Ryska
    Journal of Personalized Medicine.2023; 13(7): 1054.     CrossRef
  • Spinal Injections: A Narrative Review from a Surgeon’s Perspective
    Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
    Healthcare.2023; 11(16): 2355.     CrossRef
  • Pulsed Radiofrequency 2 Hz Preserves the Dorsal Root Ganglion Neuron Physiological Ca2+ Influx, Cytosolic ATP Level, Δψm, and pERK Compared to 4 Hz: An Insight on the Safety of Pulsed Radiofrequency in Pain Management
    Ristiawan Muji Laksono, Taufiq Agus Siswagama, Fa'urinda Riam Prabu Nery, Walter van der Weegen, Willy Halim
    Journal of Pain Research.2023; Volume 16: 3643.     CrossRef
  • Summary of the 48th KORSIS Symposium in 2023
    Min Cheol Chang
    International journal of Pain.2023; 14(2): 96.     CrossRef
  • The blind spot and challenges in pain management
    Min Cheol Chang
    Journal of Yeungnam Medical Science.2022; 39(3): 179.     CrossRef
  • Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study
    Min Cheol Chang, Donghwi Park, Yoo Jin Choo
    Journal of Pain Research.2022; Volume 15: 4065.     CrossRef
Case report
Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure: a case report
Mathieu Boudier-Revéret, Min Cheol Chang
Yeungnam Univ J Med. 2021;38(4):371-373.   Published online April 5, 2021
DOI: https://doi.org/10.12701/yujm.2021.00948
  • 4,884 View
  • 201 Download
AbstractAbstract PDFSupplementary Material
Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.
Review articles
Updates on the treatment of adhesive capsulitis with hydraulic distension
Jang Hyuk Cho
Yeungnam Univ J Med. 2021;38(1):19-26.   Published online August 31, 2020
DOI: https://doi.org/10.12701/yujm.2020.00535
  • 8,953 View
  • 229 Download
  • 10 Crossref
AbstractAbstract PDF
Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

Citations

Citations to this article as recorded by  
  • Rotator Interval vs Posterior Approach Ultrasound-guided Corticosteroid Injections in Primary Frozen Shoulder: A Meta-analysis of Randomized Controlled Trials
    Francisco Javier Arrambide-Garza, Juventino Tadeo Guerrero-Zertuche, Neri Alejandro Alvarez-Villalobos, Alejandro Quiroga-Garza, Abraham Espinosa-Uribe, Felix Vilchez-Cavazos, Yolanda Salinas-Alvarez, Juan Antonio Rivera-Perez, Rodrigo Enrique Elizondo-Om
    Archives of Physical Medicine and Rehabilitation.2024; 105(4): 760.     CrossRef
  • A prospective, randomized, blinded study on the efficacy of using corticosteroids in hydrodilatation as a treatment for adhesive capsulitis of the shoulder
    Joan Tomàs Gebellí-Jové, Antonio Buñuel-Viñau, Marta Canela-Capdevila, Jordi Camps, Fàtima Sabench, Petrea Iftimie-Iftimie
    Shoulder & Elbow.2024;[Epub]     CrossRef
  • Frozen Shoulder: Diagnosis and Management
    Sean R. Wise, Paul Seales, Alex P. Houser, Chase B. Weber
    Current Sports Medicine Reports.2023; 22(9): 307.     CrossRef
  • Ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of frozen shoulder
    Huajun Xu, Yingchun Zhang, Caishan Wang
    Journal of Back and Musculoskeletal Rehabilitation.2022; 35(5): 1153.     CrossRef
  • Impact of capsular preservation on patient-reported outcomes and complication rates in total hip arthroplasty using the direct anterior approach
    Vincent A. Stadelmann, Hannes A. Rüdiger, Selina Nauer, Michael Leunig
    The Bone & Joint Journal.2022; 104-B(7): 826.     CrossRef
  • Management of Patients with Adhesive Capsulitis via Ultrasound-Guided Hydrodilatation without Concomitant Intra-Articular Lidocaine Infusion: A Single-Center Experience
    Yung-Chieh Chen, Shu-Huei Shen, Hong-Jen Chiou, Yung-Liang Wan
    Life.2022; 12(9): 1293.     CrossRef
  • Role of Platelet-Rich Plasma in the Treatment of Adhesive Capsulitis: A Prospective Cohort Study
    Syed Imran Haider, Muhammad Zarak Awais, Muhammad Tahir Iqbal
    Cureus.2022;[Epub]     CrossRef
  • Musculoskeletal complications in patients with diabetes mellitus
    Jong Han Choi, Hae-Rim Kim, Kee-Ho Song
    The Korean Journal of Internal Medicine.2022; 37(6): 1099.     CrossRef
  • Comparison of the spread pattern of medial-to-lateral and lateral-to-medial rotator interval injections: A cadaveric study
    Benjamin J. Kozlowski, John Tran, Philip W.H. Peng, Anne M.R. Agur, Nimish Mittal
    Interventional Pain Medicine.2022; 1(4): 100164.     CrossRef
  • Updates on Intra-articular Corticosteroid Injection for the Treatment of Adhesive Capsulitis
    Ju Heon Oh, In Ho Jung, Eun Woo Park, Jang Hyuk Cho
    Keimyung Medical Journal.2022; 41(2): 51.     CrossRef
Effectiveness of orthoses for treatment in patients with spinal pain
Yoo Jin Choo, Min Cheol Chang
Yeungnam Univ J Med. 2020;37(2):84-89.   Published online March 24, 2020
DOI: https://doi.org/10.12701/yujm.2020.00150
  • 8,078 View
  • 169 Download
  • 11 Crossref
AbstractAbstract PDF
Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients’ lifestyle.

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Original article
Correlation between anterior thigh pain and morphometric mismatch of femoral stem
Haksun Chung, So Hak Chung
Yeungnam Univ J Med. 2020;37(1):40-46.   Published online September 16, 2019
DOI: https://doi.org/10.12701/yujm.2019.00325
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AbstractAbstract PDF
Background
Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint.
Methods
The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain.
Results
Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain.
Conclusion
Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

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JYMS : Journal of Yeungnam Medical Science