We report a case of persistent pain in a 21-year-old male patient, which responded well to yokukansan and keishikaryukotsuboreito, after biopsy surgery performed 5 years ago. Chronic postsurgical pain (CPSP) is a condition in which pain persists even after the surgical wound has healed, significantly affecting the patient’s daily life and mental state. Our patient was diagnosed with fibrous osteodysplasia based on a biopsy of the sacral region, but his postoperative pain persisted and became chronic. The patient’s activities of daily living (ADL) significantly declined, and he was unable to maintain a normal school life. Simultaneous treatment with shigyakusan, keishibukuryogankayokuinin, tramadol hydrochloride, and acetaminophen was started, and the medication was repeatedly changed. His quality of life notably improved with yokukansan and keishikaryukotsuboreito. In recent years, there have been many reports of the use of yokukansan for chronic pain, and the results of our case suggest that the addition of the anxiolytic and analgesic effects of keishikaryukotsuboreito is effective for intractable chronic pain.

Purpose: Head and neck cancer patients receiving chemoradiation therapy often suffer from severe mucositis. Chemoradiation therapy-induced mucositis is usually accompanied by severe and intractable pain that impairs quality of life. To establish an effective method for treatment of mucositis pain, we retrospectively investigated the relationships of radiation dose with severity of mucositis and opioid consumption. We also conducted a survey on satisfaction of pain treatment. Methods: Study 1: Fourteen patients who underwent chemoradiation therapy of 70 Gy for head and neck cancer from 2005 to 2009 participated in the study. The relationship of severity of mucositis with opioid use was studied. Study 2: Seven patients who had mucositis of over grade 3 and had completed radiation therapy participated in the study. We carried out a questionnaire survey about satisfaction of each pain treatment. Results: Study 1: Increase of radiation dose significantly worsened the severity of mucositis. Opioid consumption for treating pain was significantly greater in the pharynx cancer group than in the oral cancer group. Study 2: Oral care treatment was preferred to systemic administration of analgesics including opioids. Conclusions: In the oral cancer group, oral care treatment was thought to be useful for pain treatment. Oral cancer patients needed less opioids than did pharynx cancer patients.