Radiofrequency lesioning is a valuable tool for third occipital headache. Relative to most neural targets, a radiofrequency lesion is very small. Reliable pre-operative diagnosis of the nociceptive source is critical, as inappropriately placed lesions will not modulate pain. Knowledge of the anatomical courses of nerves and extremely precise electrode placement are required for accurate lesioning. This report describes our experience with RF lesioning in the treatment of chronic pain in two patients who suffered from third occipital headaches. In one patient, satisfactory improvement of the pain was observed after 10 months of follow up.
Chronic Pain ; Diagnosis ; Electrodes ; Follow-Up Studies ; Headache ; Humans ; Mouth*

OBJECTIVETo evaluate the reliability of flexion-extension ratio (FER) of lumbar erector muscle in surface EMG for the diagnosis of nonspecific chronic low back pain.

METHODSAccording to diagnostic study strategies, 73 patients with chronic low back pain and 86 controls were recruited in this study, FER of lumbar erector muscle were recorded in surface EMG for all the subjects. The critical value of FER for the diagnosis of nonspecific chronic low back pain was selected according to the receiver operator characteristic curve by SPSS. Sensitivity, specificity and accuracy were calculated and analyzed as well.

RESULTSThe FER in patients group was significantly higher than that in the control group. The critical value of FER was 0.68 with sensitivity, specificity and accuracy was 78.1%, 95.3% and 87.4% respectively.

CONCLUSIONFER of lumbar erector muscle might be practically applied as an objective indicator on the diagnosis of nonspecific chronic low back pain in surface EMG.

BACKGROUND: The mechanism of fatigue in patients with fibromyalgia (FM) and CFS (CFS) has not been clarified, but recently there are opinions that chronic pain is a major factor causing chronic fatigue. We performed this study to identify major factors related to chronic fatigue. METHODS: The subjects were 37 patients aged over 18 who visited the primary care institute of a university hospital, whose major symptoms were chronic widespread pain and chronic fatigue and who were given the diagnosis of FM or CFS. The research was carried out through four weeks of symptomatic treatment. The correlation of fatigue severity with the intensity of pain, depression level and anxiety level was analyzed, and regression analysis was conducted to examine the relation between improvement of fatigue after the four weeks' treatment and changes in the intensity of pain, depression level and anxiety level. RESULTS: After the four week treatment, only the intensity of pain was significantly correlatied with fatigue severity. In addition, only change in the intensity of pain was statistically significantly correlatied with the improvement of fatigue. CONCLUSION: In patients who complained of chronic fatigue and chronic widespread pain, the improvement of fatigue after treatment was related to the reduction of pain but not emotional factors such as depression and anxiety.
Anxiety ; Chronic Pain ; Depression ; Diagnosis ; Fatigue Syndrome, Chronic ; Fatigue* ; Fibromyalgia ; Humans ; Primary Health Care

Massive pancreatic pleural effusion is a rare complication of chronic pancreatitis. It results from leakage of pancreatic secretion into the pleural space through the aortic or esophageal hiatus, either by a pancreatic duct disruption or communicating pseudocyst. The presentation of the pancreatic pleural effusion is often misleading as respiratory rather than abdominal symptoms because of predominance of pulmonary complaints. Markedly elevated amylase level of the pleural fluid is highly suggestive of the diagnosis. We experienced a case of chronic pancreatitis with massive pleural effusion in a 9-year-old female, who presented with a 6-months history of intermittent abdominal pain, and cough and chest pain for 3 days.
Abdominal Pain ; Amylases ; Chest Pain ; Child ; Cough ; Diagnosis ; Female ; Humans ; Pancreatic Ducts ; Pancreatitis, Chronic* ; Pleural Effusion*

Chronic orchialgia, whose positive signs defy routine examinations, is usually misdiagnosised as chronic prostatitis or a psychological disorder. This paper aims at introducing the definition, etiology, diagnosis and management of chronic orchialgia, as well as a reappraisal and refinement of the traditional treatment of the disease.
Chronic Disease ; Humans ; Male ; Pain ; diagnosis ; etiology ; Pain Management ; Testicular Diseases ; physiopathology

With prolonged life expectancy and economic development, most people want a good quality of life. In this regard, the pain control becomes an important part in the medical care in addition to the treatment of the disease per se. Anesthesiologists have been practicing pain medicine for decades, with the unique application of specific nerve blocks. Pain clinic is a specialized department for pain management. The main therapeutic modality practiced at pain clinics in Korea is the nerve block. Nerve block is performed by an injection of an anesthetic or destructive substance hear a nerve or nerve plexus to interrupt its function for a brief or extended period, respectively. Nerve blocks play an important role in diagnosis, prognosis, and treatment of chronic pain. Nerve block intercepts the vicious cycle of pain as well as takes off the pain. Moreover, by improving the local blood flow, it also has an indirect effect on the treatment of pain. Sympathetic nerve block is used not only for pain relief, but also for the treatment of disease mainly accompanying sympathetic hyperactive symptoms. Pain clinic manages several kinds of intractable chronic pain. The rise in the number of pain clinics increases awareness of chronic pain with a considerable impact on our society.
Autonomic Nerve Block ; Chronic Pain ; Diagnosis ; Economic Development ; Korea ; Life Expectancy ; Nerve Block ; Pain Clinics* ; Pain Management* ; Prognosis ; Quality of Life

So far the etiology of chronic prostatitis(CP), particularly chronic nonbacterial prostatitis(NBP) or chronic pelvic pain syndrome (CPPS), remains to be elucidated. According to recent epidemiologic data, the prevalence of CP ranged from 2.5% to 16% of the world population, affecting men of all ages and all ethnic origins. Since 1990s researchers of many countries have carried out largerscaled, deeper and more extensive studies than ever before on the etiology, diagnosis and treatment of the disease, with the sponsorship and coordination of such international institutions as the International Prostatitis Collaborative Network(IPCN), the Chronic Prostatitis Collaborative Research Network of the National Institute of Health (NIH-CPCRN) and so on. The main achievements of recent years include: the etiology of CP/CPPS being a complicated multi-step and multi-factor course, the establishment of the new clinical classification system, the introduction of the National Institute of Health chronic prostatitis symptom index, the new criteria of diagnosis and standardized clinical evaluation, the primary explorations of new treatment methods and medicines, etc. Further investigations suggested are the optimization of clinical classification, the screening and verification of treatment methods and medicines for CP/CPPS, etc.
Chronic Disease ; Combined Modality Therapy ; Humans ; Male ; Pelvic Pain ; diagnosis ; etiology ; therapy ; Prostatitis ; diagnosis ; etiology ; therapy

Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.
Ankle ; Ankle Fractures ; Ankle Injuries* ; Arthritis ; Chronic Pain ; Cicatrix ; Classification ; Diagnosis ; Early Diagnosis ; Ligaments ; Sports

Home nursing interventions based on nursing diagnosis were implemented to the patient who are discharged from one hospital often the treatment for chronic neuromuscular system problem, and its effects were studied. The purpose of this study was to find out the effectiveness of hospital bounced home nursing provided by hospital nurses and to categorize home nursing diagnosis and its interventions. Data from experimental group patients were collected at three different time ; at the time of discharge, two weeks after discharge and our weeks after discharge. Data from control group patients were collected twice ; the first one at the time of discharge, and the other one four weeks after discharge. For this study nursing assessment and intervention booklet developed by the research team. There were no significant decrease of the number of nursing problems and life satisfaction. But daily activity level of patients showed the signs of significant improvement at the time of four weeks after discharge. Results of this study indicates that home nursing intervention based on nursing diagnosis provided the patients with noticeable difference in health maintenance, impairment of physical mobility, potential for infection, impaired home maintenance management, health seeking behavior, chronic pain, disuse syndrome, impaired skin integrity.
Chronic Pain ; Diagnosis ; Home Nursing* ; Humans ; Nursing Assessment ; Nursing Diagnosis* ; Nursing* ; Pamphlets ; Skin

Epidural block is widely used for the diagnosis and treatment of the acute and chronic pain in pain clinic. But, it has several complications like as headache, spinal injury, epidural hematoma and infection including epidural abscess, meningitis and osteomyelitis. Among them, the simultaneous occurrence of psoas and epidural abscesses is extremely rare. We report a patient diagnosed as epidural and psoas absesses one month after lumbar epidural block and treated successfully with surgical decompression and drainage.
Chronic Pain ; Decompression, Surgical ; Diagnosis ; Drainage ; Epidural Abscess ; Headache ; Hematoma ; Humans ; Meningitis ; Osteomyelitis ; Pain Clinics ; Psoas Abscess* ; Spinal Injuries