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Ex) Article Title, Author, Keywords

Review Article
Intramuscular Stimulation Therapy
Muscle pain can be caused by various causes and it deteriorates the patient’s function and quality of life. Intramuscular stimulation therapy, performed under the concept of myofascial pain syndrome, is an effective treatment for relieving somatic pain in skeletal muscles through muscle relaxation, improving the limited range of motion of joints, enhancing muscle strength, and improving accompanying autonomic nervous system symptoms. Dry needling, trigger point injection, and intramuscular electrical stimulation are typical methods of intramuscular stimulation, and they must be safely perfor...
Clinical Pain 2023; 22(1): 1-8
Review Article
Usefulness of Ultrasound for Carpal Tunnel Syndrome Proven in Meta-Analysis Studies
Carpal tunnel syndrome is a very common and important disease caused by entrapment of the median nerve in the carpal tunnel. With the widespread use of high-resolution ultrasound, ultrasound is being used usefully in the diagnosis of carpal tunnel syndrome. Compared to electrodiagnostic study, ultrasound examinations are easier and, above all, non-invasive. In addition, ultrasound-guided injection can be performed alone or in combination with ultrasound examination. In the case of nerve hydrodissection, which has recently been spotlighted as a treatment for carpal tunnel syndrome, it is the pr...
Clinical Pain 2023; 22(1): 9-13
Review Article
Ultrasound Findings and Procedures for Knee and Distal Femur Pathologies
Ultrasound imaging of the musculoskeletal system is widely used for diagnosis and treatment. Pathologies occurring in the knee joint and the distal femur are among the challenging areas for ultrasound diagnosis due to their complex structural nature. However, advancements in ultrasound technology have made it possible to assess and diagnose superficial structures using ultrasound. Moreover, ultrasound-guided procedures have gained significant popularity due to their advantages in terms of efficacy and safety. This paper aims to explore the ultrasound findings of commonly occurring conditions i...
Clinical Pain 2023; 22(1): 14-21
Review Article
Muscle and Tendon Injury in Thigh
Most muscle and tendon injuries in thigh occur in sports activities with high energy, for example kicking and running, related with deceleration phase, which require eccentric contraction of quadriceps and hamstring. Most common injury is hamstring strain injury (HSI) and also common injuries of anterior thigh is quadriceps strain injury. Strain injuries occur at myo-tendinous junction and surrounding muscle fibers and in most strains except complete rupture first choice of treatment is conservative treatment including RICE in acute phase and subsequent rehabilitation programs. In competitive ...
Clinical Pain 2023; 22(1): 22-28
Review Article
Exercise-Induced Pain Reduction and Its Central Mechanism in Patients with Chronic Pain
For the effective rehabilitation of chronic pain, it is necessary to know the changes in the pain networks of patients with chronic pain. There is a need for attention to changes in emotional pain networks and cognitive pain networks. In patients with chronic pain, post-exercise pain reduction is less pronounced than in those without chronic pain. In order to achieve the exercise effect, emotional problems must be considered in addition to the patient's physical changes. In addition, a detailed prior explanation is needed to raise the expectations for exercise effect, moreover, in order to con...
Clinical Pain 2023; 22(1): 29-32
Review Article
Ultrasound Guided Therapeutic Medial Branch Block for the Facet Joint Pain
The facet joints are a common source of chronic spinal pain. Blocks of the nerves supplying the facet joints are validated tools in the diagnosis and treatment for facet joint pain. These interventions are typically performed with fluoroscopic guidance. However, the target, which is the nerve, is radiolucent and cannot be identified with fluoroscopy. Recently, several ultrasound guided techniques in the domain of spinal pain have been emerging because ultrasound is useful in visualization of the inner structures, is portable, and is not associated with the radiation exposure. This paper review...
Clinical Pain 2023; 22(1): 33-37
Original Article
The Effects of Online-Based Interventions for Chronic Low Back Pain Patients: A Clinical Trial
Objective: Chronic low back pain (LBP) is a huge social burden, and optimal exercise therapies for chronic LBP patients are continuously being studied. To evaluate the effects of digital intervention on pain and disability in patients with chronic LBP, we performed a prospective cohort study. Method: From February 2020 to January 2021, 25 patients with chronic LBP were recruited. Digital intervention contains education contents and video demonstration for individually prescribed exercise. The exercise prescription was renewed every 4 weeks according to subjects’ condition and accomplishm...
Clinical Pain 2023; 22(1): 38-47
Case Report
Painful Chronic Expanding Hematoma of the Transtibial Amputation Stump
Chronic expanding hematoma (CEH) is a hematoma that increases in size, usually occurring after trauma or surgery, more than a month after initial bleeding. Thighs and upper limbs are the most common sites of CEH. Only a few cases of CEH have been reported in the amputation stump site since CEH itself is a rare disease.We experienced a case of a 59-year-old man who underwent transtibial amputation and suffered from recurrent non-infectious hematoma. For the treatment of CEH, the patient underwent an open bursectomy, followed by bony spur removal surgery. However, CEH recurred, and the pain was ...
Clinical Pain 2023; 22(1): 48-51
Case Report
Clinical Effect of Selective Neuroablative Technique Using Radiofrequency on Spasticity in a Patient with Stroke
Radiofrequency energy, such as that used in neuroablation, has been applied in various medical and surgical fields. However, no consensus exists regarding neuroablation protocols using radiofrequency. This study aimed to report the effect of a radio-frequency neuroablative technique on spastic foot management in a patient with stroke and present its safety and persistence. A 59-year-old man with hemiplegic gait by the intracerebral hemorrhage had radiofrequency ablation of the motor nerve branch supplying the medial gastrocnemius. The patient’s subjective and objective measurements of th...
Clinical Pain 2023; 22(1): 52-56
Case Report
Atypical May-Thurner Syndrome Caused by Bone Spur of the L4∼5 Lumbar Vertebrae
May–Thurner syndrome (MTS) is a condition in which the left common iliac vein is irritated by chronic pulsatile compression between the right common iliac artery and the upper iliac or lumbar spine. It mainly causes swelling and pain in the left lower extremity, venous thrombosis, and repeated deep venous thrombosis. In patients with sudden swelling and pain in the left lower extremity and suspected lower extremity thrombosis, when no other obvious cause can be found, the possibility of MTS should be considered. We experienced a rare case of an older patient with atypical MTS caused by b...
Clinical Pain 2023; 22(1): 57-60

  • Review Article 2023-06-30

    Intramuscular Stimulation Therapy

    Jinyoung Park

    Clinical Pain 2023; 22(1): 1-8

    https://doi.org/10.35827/cp.2023.22.1.1
    Abstract
    Full Text PDF Cite Share
    Muscle pain can be caused by various causes and it deteriorates the patient’s function and quality of life. Intramuscular stimulation therapy, performed under the concept of myofascial pain syndrome, is an effective treatment for relieving somatic pain in skeletal muscles through muscle relaxation, improving the limited range of motion of joints, enhancing muscle strength, and improving accompanying autonomic nervous system symptoms. Dry needling, trigger point injection, and intramuscular electrical stimulation are typical methods of intramuscular stimulation, and they must be safely performed by experienced practitioners. The mechanism, clinical use, efficacy, and precautions of intramuscular stimulation therapy will be reviewed in this article. Although additional supplementation of the academic evidence of intramuscular stimulation is still needed through experimental research, it is expected that the clinical application area can be expanded.

  • Review Article 2023-06-30

    Usefulness of Ultrasound for Carpal Tunnel Syndrome Proven in Meta-Analysis Studies

    Sang Chul Lee

    Clinical Pain 2023; 22(1): 9-13

    https://doi.org/10.35827/cp.2023.22.1.9
    Abstract
    Full Text PDF Cite Share
    Carpal tunnel syndrome is a very common and important disease caused by entrapment of the median nerve in the carpal tunnel. With the widespread use of high-resolution ultrasound, ultrasound is being used usefully in the diagnosis of carpal tunnel syndrome. Compared to electrodiagnostic study, ultrasound examinations are easier and, above all, non-invasive. In addition, ultrasound-guided injection can be performed alone or in combination with ultrasound examination. In the case of nerve hydrodissection, which has recently been spotlighted as a treatment for carpal tunnel syndrome, it is the procedure that could not be attempted before without ultrasound equipment. In this paper, through a comprehensive review of meta-analysis literatures, we look back at the value of ultrasound as a diagnostic tool for carpal tunnel syndrome and the effect of ultrasound-guided injection to get an objective perspective and gain new insights. The usefulness of ultrasound will be largely divided into applications of ultrasound-guided injection, diagnosis, and sonoelastography.

  • Review Article 2023-06-30

    Ultrasound Findings and Procedures for Knee and Distal Femur Pathologies

    Seok Kang

    Clinical Pain 2023; 22(1): 14-21

    https://doi.org/10.35827/cp.2023.22.1.14
    Abstract
    Full Text PDF Cite Share
    Ultrasound imaging of the musculoskeletal system is widely used for diagnosis and treatment. Pathologies occurring in the knee joint and the distal femur are among the challenging areas for ultrasound diagnosis due to their complex structural nature. However, advancements in ultrasound technology have made it possible to assess and diagnose superficial structures using ultrasound. Moreover, ultrasound-guided procedures have gained significant popularity due to their advantages in terms of efficacy and safety. This paper aims to explore the ultrasound findings of commonly occurring conditions in the knee joint and proximal femur and discuss ultrasound-guided interventions that can be performed in these areas for treatment.

  • Review Article 2023-06-30

    Muscle and Tendon Injury in Thigh

    Ho Jun Lee

    Clinical Pain 2023; 22(1): 22-28

    https://doi.org/10.35827/cp.2023.22.1.22
    Abstract
    Full Text PDF Cite Share
    Most muscle and tendon injuries in thigh occur in sports activities with high energy, for example kicking and running, related with deceleration phase, which require eccentric contraction of quadriceps and hamstring. Most common injury is hamstring strain injury (HSI) and also common injuries of anterior thigh is quadriceps strain injury. Strain injuries occur at myo-tendinous junction and surrounding muscle fibers and in most strains except complete rupture first choice of treatment is conservative treatment including RICE in acute phase and subsequent rehabilitation programs. In competitive sports activities such as football quadriceps contusion injury is common after heavy collision. Prognosis is dependent on the extension of muscle fiber damage and hematoma formation. Hematoma formation can develop to myositis ossificans or Morel-Lavellee lesion, which can induce pain and disability. Hamstring and quadriceps strain and tendon tear can occur in middle-aged or elderly people in community circumstances after slip down or falling, which lead to sudden lengthening and eccentric contraction of hamstring or quadriceps. Tendon tear including avulsion tear in greater tuberosity has higher proportion than strain, that is opposite in sports injuries, because middle aged or elderly people have higher possibility of tendon degeneration and tendinosis with higher risk of tendon tear. Therefore rapid and accurate diagnosis and proper treatment including rehabilitation program for hamstring and quadriceps injury is necessary in middle aged or elderly people.

  • Review Article 2023-06-30

    Exercise-Induced Pain Reduction and Its Central Mechanism in Patients with Chronic Pain

    Suk Hoon Ohn

    Clinical Pain 2023; 22(1): 29-32

    https://doi.org/10.35827/cp.2023.22.1.29
    Abstract
    Full Text PDF Cite Share
    For the effective rehabilitation of chronic pain, it is necessary to know the changes in the pain networks of patients with chronic pain. There is a need for attention to changes in emotional pain networks and cognitive pain networks. In patients with chronic pain, post-exercise pain reduction is less pronounced than in those without chronic pain. In order to achieve the exercise effect, emotional problems must be considered in addition to the patient's physical changes. In addition, a detailed prior explanation is needed to raise the expectations for exercise effect, moreover, in order to continue exercising for a safe and long period, exercise suitable for patients should be selected and low-intensity exercise protocols should be provided.

  • Review Article 2023-06-30

    Ultrasound Guided Therapeutic Medial Branch Block for the Facet Joint Pain

    Yongbum Park, Jun Hyeong Song

    Clinical Pain 2023; 22(1): 33-37

    https://doi.org/10.35827/cp.2023.22.1.33
    Abstract
    Full Text PDF Cite Share
    The facet joints are a common source of chronic spinal pain. Blocks of the nerves supplying the facet joints are validated tools in the diagnosis and treatment for facet joint pain. These interventions are typically performed with fluoroscopic guidance. However, the target, which is the nerve, is radiolucent and cannot be identified with fluoroscopy. Recently, several ultrasound guided techniques in the domain of spinal pain have been emerging because ultrasound is useful in visualization of the inner structures, is portable, and is not associated with the radiation exposure. This paper reviews a variety of techniques for ultrasound guided interventions for the medial branch block which has been reported in treating axial pain originating from the facet joint.

  • Original Article 2023-06-30

    The Effects of Online-Based Interventions for Chronic Low Back Pain Patients: A Clinical Trial

    Dong Jin Heo, Jaewon Kim, Jae Min Kim

    Clinical Pain 2023; 22(1): 38-47

    https://doi.org/10.35827/cp.2023.22.1.38
    Abstract
    Full Text PDF Cite Share
    Objective: Chronic low back pain (LBP) is a huge social burden, and optimal exercise therapies for chronic LBP patients are continuously being studied. To evaluate the effects of digital intervention on pain and disability in patients with chronic LBP, we performed a prospective cohort study. Method: From February 2020 to January 2021, 25 patients with chronic LBP were recruited. Digital intervention contains education contents and video demonstration for individually prescribed exercise. The exercise prescription was renewed every 4 weeks according to subjects’ condition and accomplishment of exercise. This intervention was performed for more than 30 weeks. The pain intensity was assessed using a numeric rating scale (NRS) while their degree of disability was assessed using the Roland-Morris Disability Questionnaire (RMDQ). The pain intensity and disability was evaluated at short term (8∼20 weeks) and long term (30 weeks). Results: As a result, pain intensity (NRS) decreased significantly over the short term and long term (p<0.05). However, pain related disability (RMDQ score) did not change significantly over the follow-up period (p=0.554). Conclusion: Our findings indicate that online-based digital intervention reduced the intensity of chronic LBP. Further research is needed to identify methods to cost-effectively and consistently manage chronic LBP.

  • Case Report 2023-06-30

    Painful Chronic Expanding Hematoma of the Transtibial Amputation Stump

    Son Mi Lee, Donghyun Shin, Jongkyu Kim

    Clinical Pain 2023; 22(1): 48-51

    https://doi.org/10.35827/cp.2023.22.1.48
    Abstract
    Full Text PDF Cite Share
    Chronic expanding hematoma (CEH) is a hematoma that increases in size, usually occurring after trauma or surgery, more than a month after initial bleeding. Thighs and upper limbs are the most common sites of CEH. Only a few cases of CEH have been reported in the amputation stump site since CEH itself is a rare disease.We experienced a case of a 59-year-old man who underwent transtibial amputation and suffered from recurrent non-infectious hematoma. For the treatment of CEH, the patient underwent an open bursectomy, followed by bony spur removal surgery. However, CEH recurred, and the pain was only managed by intermittent aspiration and compression. We report a long journey of managing painful CEH of the transtibial amputation stump.

  • Case Report 2023-06-30

    Clinical Effect of Selective Neuroablative Technique Using Radiofrequency on Spasticity in a Patient with Stroke

    Hyo Jeong Lee1, Yeon-Jae Seong2, Yoon Ghil Park3

    Clinical Pain 2023; 22(1): 52-56

    https://doi.org/10.35827/cp.2023.22.1.52
    Abstract
    Full Text PDF Cite Share
    Radiofrequency energy, such as that used in neuroablation, has been applied in various medical and surgical fields. However, no consensus exists regarding neuroablation protocols using radiofrequency. This study aimed to report the effect of a radio-frequency neuroablative technique on spastic foot management in a patient with stroke and present its safety and persistence. A 59-year-old man with hemiplegic gait by the intracerebral hemorrhage had radiofrequency ablation of the motor nerve branch supplying the medial gastrocnemius. The patient’s subjective and objective measurements of the spastic limb improved after the intervention. The effect lasted for 3 months. Radiofrequency neuroablative technique may be beneficial for treating spastic gait in patients with stroke. The above technique must be used to verify patients with spasticity, and research should be investigated to determine appropriated parameters.

  • Case Report 2023-06-30

    Atypical May-Thurner Syndrome Caused by Bone Spur of the L4∼5 Lumbar Vertebrae

    Gyoung Ho Nam, Ji Hye Hwang

    Clinical Pain 2023; 22(1): 57-60

    https://doi.org/10.35827/cp.2023.22.1.57
    Abstract
    Full Text PDF Cite Share
    May–Thurner syndrome (MTS) is a condition in which the left common iliac vein is irritated by chronic pulsatile compression between the right common iliac artery and the upper iliac or lumbar spine. It mainly causes swelling and pain in the left lower extremity, venous thrombosis, and repeated deep venous thrombosis. In patients with sudden swelling and pain in the left lower extremity and suspected lower extremity thrombosis, when no other obvious cause can be found, the possibility of MTS should be considered. We experienced a rare case of an older patient with atypical MTS caused by bone spur of the 4th and 5th lumbar vertebrae, which has been reported here along with a review of the literature.
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  • Review Article 2023-06-30

    Intramuscular Stimulation Therapy

    Jinyoung Park

    Clinical Pain 2023; 22(1): 1-8

    https://doi.org/10.35827/cp.2023.22.1.1
    Abstract
    Full Text PDF Cite Share
    Muscle pain can be caused by various causes and it deteriorates the patient’s function and quality of life. Intramuscular stimulation therapy, performed under the concept of myofascial pain syndrome, is an effective treatment for relieving somatic pain in skeletal muscles through muscle relaxation, improving the limited range of motion of joints, enhancing muscle strength, and improving accompanying autonomic nervous system symptoms. Dry needling, trigger point injection, and intramuscular electrical stimulation are typical methods of intramuscular stimulation, and they must be safely performed by experienced practitioners. The mechanism, clinical use, efficacy, and precautions of intramuscular stimulation therapy will be reviewed in this article. Although additional supplementation of the academic evidence of intramuscular stimulation is still needed through experimental research, it is expected that the clinical application area can be expanded.

  • Review Article 2023-06-30

    Usefulness of Ultrasound for Carpal Tunnel Syndrome Proven in Meta-Analysis Studies

    Sang Chul Lee

    Clinical Pain 2023; 22(1): 9-13

    https://doi.org/10.35827/cp.2023.22.1.9
    Abstract
    Full Text PDF Cite Share
    Carpal tunnel syndrome is a very common and important disease caused by entrapment of the median nerve in the carpal tunnel. With the widespread use of high-resolution ultrasound, ultrasound is being used usefully in the diagnosis of carpal tunnel syndrome. Compared to electrodiagnostic study, ultrasound examinations are easier and, above all, non-invasive. In addition, ultrasound-guided injection can be performed alone or in combination with ultrasound examination. In the case of nerve hydrodissection, which has recently been spotlighted as a treatment for carpal tunnel syndrome, it is the procedure that could not be attempted before without ultrasound equipment. In this paper, through a comprehensive review of meta-analysis literatures, we look back at the value of ultrasound as a diagnostic tool for carpal tunnel syndrome and the effect of ultrasound-guided injection to get an objective perspective and gain new insights. The usefulness of ultrasound will be largely divided into applications of ultrasound-guided injection, diagnosis, and sonoelastography.

  • Review Article 2023-06-30

    Ultrasound Findings and Procedures for Knee and Distal Femur Pathologies

    Seok Kang

    Clinical Pain 2023; 22(1): 14-21

    https://doi.org/10.35827/cp.2023.22.1.14
    Abstract
    Full Text PDF Cite Share
    Ultrasound imaging of the musculoskeletal system is widely used for diagnosis and treatment. Pathologies occurring in the knee joint and the distal femur are among the challenging areas for ultrasound diagnosis due to their complex structural nature. However, advancements in ultrasound technology have made it possible to assess and diagnose superficial structures using ultrasound. Moreover, ultrasound-guided procedures have gained significant popularity due to their advantages in terms of efficacy and safety. This paper aims to explore the ultrasound findings of commonly occurring conditions in the knee joint and proximal femur and discuss ultrasound-guided interventions that can be performed in these areas for treatment.

  • Review Article 2023-06-30

    Exercise-Induced Pain Reduction and Its Central Mechanism in Patients with Chronic Pain

    Suk Hoon Ohn

    Clinical Pain 2023; 22(1): 29-32

    https://doi.org/10.35827/cp.2023.22.1.29
    Abstract
    Full Text PDF Cite Share
    For the effective rehabilitation of chronic pain, it is necessary to know the changes in the pain networks of patients with chronic pain. There is a need for attention to changes in emotional pain networks and cognitive pain networks. In patients with chronic pain, post-exercise pain reduction is less pronounced than in those without chronic pain. In order to achieve the exercise effect, emotional problems must be considered in addition to the patient's physical changes. In addition, a detailed prior explanation is needed to raise the expectations for exercise effect, moreover, in order to continue exercising for a safe and long period, exercise suitable for patients should be selected and low-intensity exercise protocols should be provided.

  • Review Article 2023-06-30

    Ultrasound Guided Therapeutic Medial Branch Block for the Facet Joint Pain

    Yongbum Park, Jun Hyeong Song

    Clinical Pain 2023; 22(1): 33-37

    https://doi.org/10.35827/cp.2023.22.1.33
    Abstract
    Full Text PDF Cite Share
    The facet joints are a common source of chronic spinal pain. Blocks of the nerves supplying the facet joints are validated tools in the diagnosis and treatment for facet joint pain. These interventions are typically performed with fluoroscopic guidance. However, the target, which is the nerve, is radiolucent and cannot be identified with fluoroscopy. Recently, several ultrasound guided techniques in the domain of spinal pain have been emerging because ultrasound is useful in visualization of the inner structures, is portable, and is not associated with the radiation exposure. This paper reviews a variety of techniques for ultrasound guided interventions for the medial branch block which has been reported in treating axial pain originating from the facet joint.

  • Original Article 2023-06-30

    The Effects of Online-Based Interventions for Chronic Low Back Pain Patients: A Clinical Trial

    Dong Jin Heo, Jaewon Kim, Jae Min Kim

    Clinical Pain 2023; 22(1): 38-47

    https://doi.org/10.35827/cp.2023.22.1.38
    Abstract
    Full Text PDF Cite Share
    Objective: Chronic low back pain (LBP) is a huge social burden, and optimal exercise therapies for chronic LBP patients are continuously being studied. To evaluate the effects of digital intervention on pain and disability in patients with chronic LBP, we performed a prospective cohort study. Method: From February 2020 to January 2021, 25 patients with chronic LBP were recruited. Digital intervention contains education contents and video demonstration for individually prescribed exercise. The exercise prescription was renewed every 4 weeks according to subjects’ condition and accomplishment of exercise. This intervention was performed for more than 30 weeks. The pain intensity was assessed using a numeric rating scale (NRS) while their degree of disability was assessed using the Roland-Morris Disability Questionnaire (RMDQ). The pain intensity and disability was evaluated at short term (8∼20 weeks) and long term (30 weeks). Results: As a result, pain intensity (NRS) decreased significantly over the short term and long term (p<0.05). However, pain related disability (RMDQ score) did not change significantly over the follow-up period (p=0.554). Conclusion: Our findings indicate that online-based digital intervention reduced the intensity of chronic LBP. Further research is needed to identify methods to cost-effectively and consistently manage chronic LBP.

  • Case Report 2023-06-30

    Clinical Effect of Selective Neuroablative Technique Using Radiofrequency on Spasticity in a Patient with Stroke

    Hyo Jeong Lee1, Yeon-Jae Seong2, Yoon Ghil Park3

    Clinical Pain 2023; 22(1): 52-56

    https://doi.org/10.35827/cp.2023.22.1.52
    Abstract
    Full Text PDF Cite Share
    Radiofrequency energy, such as that used in neuroablation, has been applied in various medical and surgical fields. However, no consensus exists regarding neuroablation protocols using radiofrequency. This study aimed to report the effect of a radio-frequency neuroablative technique on spastic foot management in a patient with stroke and present its safety and persistence. A 59-year-old man with hemiplegic gait by the intracerebral hemorrhage had radiofrequency ablation of the motor nerve branch supplying the medial gastrocnemius. The patient’s subjective and objective measurements of the spastic limb improved after the intervention. The effect lasted for 3 months. Radiofrequency neuroablative technique may be beneficial for treating spastic gait in patients with stroke. The above technique must be used to verify patients with spasticity, and research should be investigated to determine appropriated parameters.

  • Review Article 2023-06-30

    Muscle and Tendon Injury in Thigh

    Ho Jun Lee

    Clinical Pain 2023; 22(1): 22-28

    https://doi.org/10.35827/cp.2023.22.1.22
    Abstract
    Full Text PDF Cite Share
    Most muscle and tendon injuries in thigh occur in sports activities with high energy, for example kicking and running, related with deceleration phase, which require eccentric contraction of quadriceps and hamstring. Most common injury is hamstring strain injury (HSI) and also common injuries of anterior thigh is quadriceps strain injury. Strain injuries occur at myo-tendinous junction and surrounding muscle fibers and in most strains except complete rupture first choice of treatment is conservative treatment including RICE in acute phase and subsequent rehabilitation programs. In competitive sports activities such as football quadriceps contusion injury is common after heavy collision. Prognosis is dependent on the extension of muscle fiber damage and hematoma formation. Hematoma formation can develop to myositis ossificans or Morel-Lavellee lesion, which can induce pain and disability. Hamstring and quadriceps strain and tendon tear can occur in middle-aged or elderly people in community circumstances after slip down or falling, which lead to sudden lengthening and eccentric contraction of hamstring or quadriceps. Tendon tear including avulsion tear in greater tuberosity has higher proportion than strain, that is opposite in sports injuries, because middle aged or elderly people have higher possibility of tendon degeneration and tendinosis with higher risk of tendon tear. Therefore rapid and accurate diagnosis and proper treatment including rehabilitation program for hamstring and quadriceps injury is necessary in middle aged or elderly people.

  • Case Report 2023-06-30

    Atypical May-Thurner Syndrome Caused by Bone Spur of the L4∼5 Lumbar Vertebrae

    Gyoung Ho Nam, Ji Hye Hwang

    Clinical Pain 2023; 22(1): 57-60

    https://doi.org/10.35827/cp.2023.22.1.57
    Abstract
    Full Text PDF Cite Share
    May–Thurner syndrome (MTS) is a condition in which the left common iliac vein is irritated by chronic pulsatile compression between the right common iliac artery and the upper iliac or lumbar spine. It mainly causes swelling and pain in the left lower extremity, venous thrombosis, and repeated deep venous thrombosis. In patients with sudden swelling and pain in the left lower extremity and suspected lower extremity thrombosis, when no other obvious cause can be found, the possibility of MTS should be considered. We experienced a rare case of an older patient with atypical MTS caused by bone spur of the 4th and 5th lumbar vertebrae, which has been reported here along with a review of the literature.

  • Review Article 2022-12-31

    Neuromuscular Ultrasound in Wrist and Hand

    Sun Jae Won, M.D., Ph.D.

    Clinical Pain 2022; 21(2): 51-55

    https://doi.org/10.35827/cp.2022.21.2.51
    Abstract
    Full Text PDF Cite Share
    Neuromuscular ultrasound has been used increasingly for the diagnosis and guided-intervention of various neuromuscular structures. Using neuromuscular ultrasound, clinicians can reliably evaluate various structures in wrist and hand such as the nerves, joints, tendons or ligaments. In this article, a practical guide to the basis of neuromuscular ultrasound and the diagnostic criteria are reviewed for the diseases in wrist and hand; specifically median nerve, ulnar nerve, superficial radial nerve, wrist joint, ligaments, and stenosing tenosynovitis. Neuromuscular ultrasound can improve the accuracy of the diagnosis and the quality of patient care and is becoming a standard element in clinical practice. The development of quantitative measures also appears promising in its ability to improve patient care.

  • Case Report 2023-06-30

    Painful Chronic Expanding Hematoma of the Transtibial Amputation Stump

    Son Mi Lee, Donghyun Shin, Jongkyu Kim

    Clinical Pain 2023; 22(1): 48-51

    https://doi.org/10.35827/cp.2023.22.1.48
    Abstract
    Full Text PDF Cite Share
    Chronic expanding hematoma (CEH) is a hematoma that increases in size, usually occurring after trauma or surgery, more than a month after initial bleeding. Thighs and upper limbs are the most common sites of CEH. Only a few cases of CEH have been reported in the amputation stump site since CEH itself is a rare disease.We experienced a case of a 59-year-old man who underwent transtibial amputation and suffered from recurrent non-infectious hematoma. For the treatment of CEH, the patient underwent an open bursectomy, followed by bony spur removal surgery. However, CEH recurred, and the pain was only managed by intermittent aspiration and compression. We report a long journey of managing painful CEH of the transtibial amputation stump.

  • Review Article 2022-12-31

    Musculoskeletal Ultrasound Review of the Distal Lower Extremity, Ankle, and Foot

    Sung Hyun Kim, M.D. and Donghwi Park, M.D. et al.

    Clinical Pain 2022; 21(2): 56-62

    https://doi.org/10.35827/cp.2022.21.2.56
    Abstract
    Full Text PDF Cite Share
    In actual clinical practice, injuries of the lower extremities are frequently encountered. Some diseases are diagnosed through a physical examination, but when non-specific symptoms are complained, it may be difficult to diagnose only with a physical examination. Therefore, the ultrasound examination can be used as an appropriate diagnostic tool by using the inherent advantages of the device. This review article aims to describe in detail the main features of ultrasound imaging for common injuries of the distal lower extremity, ankle, and foot.

  • Case Report 2022-12-31

    Left-Sided Poland’s Syndrome without Limb Anomalies

    Yeong-Il Na, M.D., Seungbok Lee et al.

    Clinical Pain 2022; 21(2): 129-132

    https://doi.org/10.35827/cp.2022.21.2.129
    Abstract
    Full Text PDF Cite Share
    “Poland’s syndrome” is a rare congenital disease whereby defects can accompany the chest, nipple, chest wall, and extremities on one side of the body. We diagnosed a 19-year-old male patient who presented to another hospital for a routine physical exam before enlisting in the military and was suspected of having a left brachial plexus injury. His chief complaint was the flatness of the left anterior chest wall without any significant functional inconvenience. Aplasia of the pectoralis minor and costosternal portion of the pectoralis major was observed through physical examination and computed tomography (CT). The patient was diagnosed with left-sided Poland’s syndrome without any limb abnormalities. Poland Syndrome should be highly considered in patients presenting with bilateral chest wall imbalance in the absence of with a recent traumatic history.

  • Original Articles 2022-12-31

    Digital Therapeutics for the Musculoskeletal Disorders

    Jinyoung Park, M.D. and Jung Hyun Park, M.D. et al.

    Clinical Pain 2022; 21(2): 74-79

    https://doi.org/10.35827/cp.2022.21.2.74
    Abstract
    Full Text PDF Cite Share
    Digital therapeutics (DTx) is emerging in the field of digital healthcare thanks to the development of ICT (information and communications technology), sensors, and AI (artificial intelligence) technology. A clinical trial-based design and manufacturing process is required for DTx before it can be prescribed in the medical field. The risks, and effectiveness and intended use of DTx must then be approved by regulatory authorities. The digital healthcare apps for musculoskeletal disorders, which had previously concentrated on monitoring and feedback on aerobic exercise, have lately begun to be applied to rehabilitative exercises utilizing AI technologies using convolutional neural networks. The development of DTx focusing on therapeutic rehabilitative exercise is expected in the future.

  • Review Article 2022-06-30

    Ultrasonographic Findings of Common Pathologic Conditions of the Elbow and Injections Focusing on Lateral Epicondylitis

    Kyunghoon Min, M.D., Ph.D.

    Clinical Pain 2022; 21(1): 1-6

    https://doi.org/10.35827/cp.2022.21.1.1
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    Ultrasonography is an essential imaging tool to diagnose and treat the musculoskeletal pathologies of the elbow. In this review article, ultrasound findings of common elbow pathologies were described according to the pain areas. In addition, various injections such as steroids, biologics (platelet-rich plasma and autologous whole blood), dextrose, and botulinum toxin were explained focusing on lateral epicondylitis of the elbow.

  • Original Article 2022-12-31

    Shoulder Injury Related to Vaccine Administration (SIRVA) after COVID-19 Vaccinations: Clinical and Radiological Investigation in 8 Cases of Adhesive Capsulitis

    Chae Woon Paek, M.D. and Jong Geol Do, M.D. et al.

    Clinical Pain 2022; 21(2): 100-108

    https://doi.org/10.35827/cp.2022.21.2.100
    Abstract
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    Objective: Recently, there are clinical reports of Shoulder Injury Related to Vaccine Administration (SIRVA) after COVID-19 vaccinations. Yet, radiological description and treatment response has not been delineated. The purpose of this study is to report clinical aspects of eight cases of SIRVA after COVID-19 vaccinations and to describe MRI characteristics in five of these patients.
    Method: We retrospectively identified and investigated eight patients who presented with shoulder pain and global range of motion limitation following COVID-19 vaccination between January 1st, 2022 and March 31st, 2022.
    Results: The mean age of the eight patients (five women and three men) was 56. 0 ± 5.0 years (range, 48∼63 years). Symptoms of shoulder pain and stiffness began on the day of injection in four patients, within 24 hours in two patients, and more than three days in two patients. Initial shoulder range of motion was restricted in forward elevation, abduction, and internal rotation. Three patients who received glenohumeral intra-articular injection showed improvement of NRS scores and shoulder range of motion. Five patients’ MRI were featured with hyperintense axillary capsule, axillary capsular thickness thicker than 4 mm (6.1 ± 0.4 mm, range 5.7∼6.8 mm) and rotator interval fat obliteration.
    Conclusion: Adhesive capsulitis after COVID-19 vaccine resembles idiopathic adhesive capsulitis both clinically and radiologically. Although the exact pathogenesis regarding adhesive capsulitis after COVID-19 vaccinations remains ambiguous, immune-mediated inflammatory reaction after vaccination can cause adhesive capsulitis. Appropriate anti-inflammatory treatment including intra-articular steroid injection is effective. Physicians should be mindful of this diagnosis so that such patients can be diagnosed promptly and treated properly.

  • Review Article 2022-12-31

    Ultrasound Guidance for Intra-Articular Shoulder Injections for Frozen Shoulder

    Sang Chul Lee, M.D., Ph.D.

    Clinical Pain 2022; 21(2): 70-73

    https://doi.org/10.35827/cp.2022.21.2.70
    Abstract
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    Frozen shoulder is a common shoulder disease that causes shoulder pain and limitation of shoulder motion. Intra-articular corticosteroid injection is one of the first-line treatment methods for frozen shoulder. Ultrasound guidance allows visualization of the glenohumeral joint and can improve the accuracy of the injection. Ultrasound-guided intra-articular injection can be performed via an anterior, posterior, or rotator cuff interval approach. This review article aims to summarize and discuss the most effective approach with ultrasound guided intra-articular injection for frozen shoulder. Also this review to introduce hydraulic distension with ‘pumping technique’ to obtain the maximal stretching effect on the capsule.

  • Review Article 2022-12-31

    The Effect of Digital Therapeutics for Low Back Pain

    Jaewon Kim, M.D. and Jae Min Kim, M.D. et al.

    Clinical Pain 2022; 21(2): 63-69

    https://doi.org/10.35827/cp.2022.21.2.63
    Abstract
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    Low back pain (LBP) is a common musculoskeletal disorder such that 70∼85% of people experience LBP at least once in their lifetime. With advances in Internet and mobile technology, digital intervention for LBP has emerged as a new treatment method that allows patients to actively participate in treatment at home using digital devices. Several studies on digital interventions have reported improvements in pain by up to 68%, on disability scales by up to 55%, and also in other significant areas such as quality of life and psychological well-being. In particular, mobile application-based treatment was effective, and treatment including exercise therapy had a distinct effect. Also, studies have shown that interactions between healthcare provider and patient, and immediate audiovisual feedback following analysis of the patients’ motions can enhance the therapeutic effect. Evidence-based digital care for patients with LBP is an effective method of treatment and is expected to advance further in the future.

  • Case Report 2022-06-30

    Two Schwannomas Derived from the Ulnar Nerve Confirmed by Ultrasonography

    Eun Ji Lee, M.D., Sang-Uk Lee et al.

    Clinical Pain 2022; 21(1): 41-45

    https://doi.org/10.35827/cp.2022.21.1.41
    Abstract
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    Schwannoma is a rare tumor from the peripheral nerve and is mainly found alone. Diagnosis is made by ultrasonography or magnetic resonance imaging, and magnetic resonance imaging is preferred to ultrasonography for differential diagnosis of mass. After diagnosis, treatment is performed through surgical excision. In this case, a very small-sized neuropathy-causing lesion was identified through ultrasonography with electrodiagnostic study, and the other mass in the same nerve was discovered by chance through ultrasonography. Both masses were identified as schwannoma originating from the ulnar nerve and were successfully excised. We confirmed the advantages of ultrasonography in the rare diagnosis and again showed that ultrasonography has a diagnostic value that is not inferior to magnetic resonance imaging. Also, cases of multiple schwannomas confined to the ulnar nerve are rare and have been rarely reported worldwide. Therefore, it is reported together with the previous reports.

  • Original Articles 2022-06-30

    Relationship between Anconeus Epitrochlearis and Ulnar Motor Nerve Conduction Velocity

    Dongin Lim, M.D., Minsu Seo et al.

    Clinical Pain 2022; 21(1): 32-37

    https://doi.org/10.35827/cp.2022.21.1.32
    Abstract
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    Objective: To determine the incidence of anconeus epitrochlearis (AE) muscle and evaluate the correlation between AE muscle and ulnar motor nerve conduction velocity (NCV). Method: Forty healthy volunteers (80 arms) were evaluated. Ulnar motor nerve conduction study was performed. NCVs at the forearm and across the elbow were calculated. Ultrasonography (US) was used to obtain a transverse scan view of the cubital tunnel and confirm the presence of the AE muscle. Cross-sectional areas (CSAs) of following structures were obtained: ulnar nerve (UNCSA), cubital tunnel (CTCSA), and AE (AECSA). AECSA was divided by CTCSA to obtain the AE/CT ratio. Pearson correlation coefficient (PCC) was calculated to evaluate the relationship between NCV across elbow and each variable obtained by US. Results: Sixty-three (78.75%) of eighty arms showed the presence of AE muscle. NCV had no significant correlations with sonographic variables. However, when 17 arms with a relatively low NCV value (≤ 60 m/s) were analyzed, NCV showed significant correlations with AECSA (PCC: r = −0.674, p=0.003) and AE/CT ratio (PCC: r = −0.516, p=0.034). Conclusion: When all 63 cases with AE muscle were analyzed, ulnar NCV showed no significant correlations with sonographic variables. However, when those with NCV value of 60 m/s or less were analyzed, NCV showed significant negative correlations with AECSA and AE/CT ratio.

  • Case Report 2021-12-31

    Musculocutaneous and Median Neuropathy after MiraDryⓇ Procedure for Axillary Hyperhidrosis

    Youngmin Kim, M.D., Mi-Jeong Yoon et al.

    Clinical Pain 2021; 20(2): 135-140

    https://doi.org/10.35827/cp.2021.20.2.135
    Abstract
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    MiraDry®, a microwave thermolysis device, is comparably new non-surgical agent in the field of eradication of sweat glands for treating axillary hyperhidrosis and osmidrosis. So far, altered sensation, swelling, and compensatory sweating are widely known as adverse effects of MiraDry®. Of the few reported MiraDry®-induced neuropathy cases, median and ulnar neuropathies are common. Although, one case has described radial nerve and posterior cord damage with maximized stimulation intensity, musculocutaneous nerve damage induced by MiraDry® has not been reported. Here, we report a case of a 30-year-old woman experiencing left hand weakness after receiving MiraDry® at a local dermatology clinic. Left brachial plexopathy, mainly involving the median nerve and the musculocutaneous nerve with partial axonotmesis, was confirmed by electrodiagnostic studies. Ultrasound evaluation showed corresponding results. This is the first case report of the musculocutaneous neuropathy by MiraDry®.

  • Original Article 2022-12-31

    Effects of Combined Treatment with Thermotherapy and Electrical Stimulation on Musculoskeletal Pain Disorders: A Systematic Review

    Kyeong Eun Uhm, M.D., Bo Mi Kwon et al.

    Clinical Pain 2022; 21(2): 95-99

    https://doi.org/10.35827/cp.2022.21.2.95
    Abstract
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    Objective: This review aimed to investigate the effects of combined treatment with thermotherapy and electrical stimulation simultaneously in musculoskeletal pain disorders.
    Method: A systematic review was performed using electronic databases including PubMed and Embase. Following search terms were used: (simultaneous OR synchronous OR combined) AND (thermotherapy OR “thermal therapy” OR heat OR “hot pack” OR ultrasound OR microwave OR shortwave OR cold OR cryotherapy) AND (“electrical stimulation” OR electrotherapy OR TENS OR “interferential current”). Studies on the simultaneous application of thermotherapy and electrical stimulation, comparing with single physical modalities or massage were included.
    Results: After title and abstract exclusion, four articles were selected, according to the eligibility criteria. Combined treatment did not reveal a differential effect on pain reduction when compared to a single physical modality. However, combined treatment showed superior effects on functional aspects such as range of motion (ROM) and timed up-and-go score.
    Conclusion: This review suggests that combined treatment with thermotherapy and electrical stimulation simultaneously seems to have a superior effect on ROM, balance, and gait ability, but not pain reduction, in musculoskeletal pain disorders. However, the number of included studies in this review was small and study designs were heterogeneous. Therefore, further research is needed to confirm these findings.

  • Case Report 2022-12-31

    Comprehensive Rehabilitation in Patients with Acute Respiratory Distress Syndrome due to Coronavirus Disease 2019 (COVID-19)

    Dong Wan Jin, M.D., Seong Jun Kim et al.

    Clinical Pain 2022; 21(2): 123-128

    https://doi.org/10.35827/cp.2022.21.2.123
    Abstract
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    We described a case in which symptoms and function improved through rehabilitation in a patient with coronavirus disease 2019 (COVID-2019) accompanied by acute respiratory distress syndrome (ARDS), limb weakness, and peroneal neuropathy. A 71-year-old man was diagnosed with COVID-19 and ARDS. He needed extracorporeal membrane oxygenation (ECMO) treatment in an incentive care unit (ICU). After ICU treatment, both ankle dorsiflexor weakness and foot drop were present. Common peroneal neuropathy was diagnosed and it was presumed to be due to long-term ECMO application. Comprehensive rehabilitation was performed to improve respiratory function and functional level. In addition, electrical stimulation therapy was applied to strengthen the ankle dorsiflexor. Before rehabilitation, he could not maintain a sitting position independently and required oxygen supply through tracheostomy. After 6 months rehabilitation, he was able to walk independently without oxygen. However, the ankle dorsiflexor did not improve sufficiently, so ankle foot orthosis was applied for outdoor gait.

  • Review Article 2022-12-31

    Diagnosis and Treatment of Rheumatoid Shoulder

    Gi-Young Park, M.D., Ph.D.

    Clinical Pain 2022; 21(2): 88-94

    https://doi.org/10.35827/cp.2022.21.2.88
    Abstract
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    Shoulder joint involvement is common in patients with rheumatoid arthritis (RA), and the clinical manifestations are nonspecific. Shoulder joint destruction in the patients with RA gradually occurs, resulting in decreased function. In rheumatoid shoulder, loss of cartilage and soft tissue degeneration coexists with pain and reduced range of motion. To avoid the joint destruction, early detection of inflammation in the shoulder joints is necessary. Therefore, shoulder involvement should be checked routinely and detected early. Radiograph of the rheumatoid shoulder provides essential guidance for treatment decisions. The development of glenohumeral joint space narrowing on radiograph is a turning point that indicates a risk of rapid joint destruction. Ultrasound and magnetic resonance imaging are useful for assessing the lesions and guiding the treatment strategy. The goals of treatment in rheumatoid shoulder are to relieve pain and to restore function. This is accomplished by early detection, proper medication, intervention, rehabilitation, and operation.

  • Original Article 2022-12-31

    Intramedullary Spinal Cord Hemorrhage Associated with Monoparesis after Transforaminal Cervical Epidural Steroid Injection

    Mi Rim Suh, M.D., Yongbum Park et al.

    Clinical Pain 2022; 21(2): 109-113

    https://doi.org/10.35827/cp.2022.21.2.109
    Abstract
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    Transforaminal cervical epidural steroid injection (TFCESI) is widely used as conservative treatment for cervical radiculopathy, but severe complications associated with this procedure have been reported. This report was the first case of intramedullary spinal cord hemorrhage following TFCESI. A 67-year-old woman presented with weakness and sensory disturbance in left upper extremity after TFCESI. Cervical magnetic resonance imaging revealed intramedullary spinal cord hemorrhage accompanied by myelopathy at the C2∼C5 level. The patient was administered intravenous methylprednisolone daily (1,000 mg/8 hours) for 5 days and was subsequently transferred to the Department of Rehabilitation Medicine for rehabilitation therapy. A month later, the patient’s neurological impairment partially improved. Although TFCESI is rarely associated with major complications, physicians should be cautious when performing the procedure, and remain mindful of the potentially serious complications.

  • Review Article 2022-12-31

    Diagnosis and Treatment of Post-Traumatic Headache

    Nam-Gyu Jo, M.D. and Gi-Wook Kim, M.D. et al.

    Clinical Pain 2022; 21(2): 80-87

    https://doi.org/10.35827/cp.2022.21.2.80
    Abstract
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    Headache after trauma, such as a traffic accident are the most commonly reported as post-traumatic headache (PTH), a secondary headache disorder following traumatic brain injury or whiplash injury. Post-traumatic headache has various clinical features in terms of intensity, frequency, and duration of pain. The characteristics of PTH are often similar to primary headaches such as migraines or tension-type headaches, and may be accompanied by or sequentially present, other symptoms including fatigue, difficulty concentrating, dizziness, visual and auditory symptoms, emotional disturbances, anxiety, depression, and general irritability. Therefore, the diagnosis and therapeutic approach may vary depending on the patient’s condition, so careful consideration by the clinicians is required in the medical process. We believe that this review can be valuable in the classification, diagnosis, and therapeutic approaches for headache after traffic accident.

  • Case Report 2022-12-31

    A Malignant Tumor in the Calf Muscles Misdiagnosed as a Myofascial Trigger Point

    Hyun Jeong Lee, M.D., Hyun Sung Lee et al.

    Clinical Pain 2022; 21(2): 119-122

    https://doi.org/10.35827/cp.2022.21.2.119
    Abstract
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    Tumors are rare causes of calf pain and usually present insidiously. A 69-year-old woman developed sudden severe pain and a hard palpable mass in her left calf that persisted for 6 months without a history of trauma. Although a myofascial trigger point was initially suspected, subsequent ultrasonography revealed two well-defined heterogeneous masses in the calf muscle. Magnetic resonance imaging revealed a multi-lobulated mass involving the soleus, tibialis posterior muscle, and deep peroneal neurovascular bundle, suggesting a soft tissue sarcoma. Fluorine-18-fluorodeoxyglucose positron emission tomography revealed a heterogeneous hypermetabolic lesion in the left calf, suggesting malignancy. The patient received an incisional biopsy of her left calf lesion and was diagnosed with leiomyosarcoma. The patient underwent a wide excision with partial fibulectomy of the left calf and received chemotherapy for metastasis in the left upper lobe of the lung. Although rare, soft tissue sarcoma should be considered in the differential diagnosis if calf pain and a palpable mass persist despite conservative management, and imaging studies are essential for distinguishing tumors from other causes of calf pain.

  • Original Articles 2022-06-30

    Effect of Ramp on Joint Moment of Attendants during Manual Control of Wheelchairs

    Yuho Jeon, M.S., Nackhwan Kim et al.

    Clinical Pain 2022; 21(1): 21-31

    https://doi.org/10.35827/cp.2022.21.1.21
    Abstract
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    Objective: This study aimed to predict the injury risk to attendants by simulating and analyzing the joint moment that occurs during wheelchair transportation for five different ramp ratios and five different velocities. Method: Three-dimensional musculoskeletal models and rigid structure of a standard wheelchair were developed using the AnyBody Modeling System. The ramp ratio was set to 1：6 (the steepest), 1：8, 1：10, 1：12, and 1：14 (the gentlest). The wheelchair speeds were set to 0.4, 0.5, 0.6, 0.7, and 0.8 m/s. Both the uphill and downhill movement conditions were investigated. Results: Most of the joint moments that occur in the wrist joint, elbow and shoulder while driving uphill increased or decreased proportionally to the slope and speed of the ramp. However, the external moment of the wrist occurring downhill was largely influenced by the slope, and the joint moment of the shoulder showed a dynamic pattern of change in the middle of the ramp in spite of constant driving speed. Conclusion: The influence that occurs during deceleration while wheelchair driving on a ramp is primarily on the proximal shoulder joint, and the influence of the release control in the middle of driving primarily causes loads on the distal wrist and forearm. A high risk of damage exists because the moment change value of the load on the shoulder joint is relatively large and increases with inclination. The increase in wrist abduction moment for deceleration while driving downhill also suggests the possibility of damage.

  • Case Report 2022-12-31

    The Treatment of Calcific Tendinitis of the Gluteus Medius Muscle Using Ultrasound-Guided Barbotage Technique

    Ji Hwan Kim, M.D., Wonjea Lee et al.

    Clinical Pain 2022; 21(2): 114-118

    https://doi.org/10.35827/cp.2022.21.2.114
    Abstract
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    We report the effective treatment of calcific tendinitis in the gluteus medius muscle with a single application of the barbotage technique. A 68-year-old man visited our hospital complaining of right hip pain with an intensity of 8 on a numeric rating scale. A simple radiograph of the right hip showed a calcific nodule at the insertion site of the gluteus medius tendon. The stage of the calcific lesion was inferred through the characteristics of the findings confirmed on radiographs. Ultrasonography was performed and the results were combined to determine the appropriate stage to apply the barbotage technique. He confirmed the pain relief effect after performing the intervention. After 1 month, it was confirmed that the calcific lesion was completely removed at follow-up.

  • Original Articles 2021-12-31

    Safety and Effectiveness of Intra-articular Injection on the Ipsilateral Adhesive Capsulitis after Breast Cancer Surgery

    Mi Kyung Cho, M.D., Dong Min Kim et al.

    Clinical Pain 2021; 20(2): 99-104

    https://doi.org/10.35827/cp.2021.20.2.99
    Abstract
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    Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.
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  • Case Report 2021-12-31

    Musculocutaneous and Median Neuropathy after MiraDryⓇ Procedure for Axillary Hyperhidrosis

    Youngmin Kim, M.D., Mi-Jeong Yoon et al.

    Clinical Pain 2021; 20(2): 135-140

    https://doi.org/10.35827/cp.2021.20.2.135
    Abstract
    Full Text PDF Cite Share
    Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.

  • Original Articles 2019-12-31

    Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome

    Jihyun Park, M.D., Jang Woo Lee et al.

    Clinical Pain 2019; 18(2): 70-75

    https://doi.org/10.35827/cp.2019.18.2.70
    Abstract
    Full Text PDF Cite Share
    Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.

  • Case Report 2019-12-31

    Contralateral Mirror Image Spreading in Post-Stroke Complex Regional Pain Syndrome

    Ki Hyun Byun, M.D. and Chang Ho Hwang, M.D. et al.

    Clinical Pain 2019; 18(2): 133-137

    https://doi.org/10.35827/cp.2019.18.2.133
    Abstract
    Full Text PDF Cite Share
    Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.
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Korean Association of Pain Medicine

Vol.22 No.1
June 2023

eISSN: 2765-5156

Frequency: Semi Annual

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Aims and Scope

Clinical Pain is the official journal of the Korean Association of Pain Medicine(KAPM) and Korean Association of Neuromusculoskeletal Ultrasound Society (KANMS), which publishes scientific articles regarding the characteristics, the mechanism of development, valuable diagnostic procedure, management of pain and the clinical research & education of neuromusculoskeletal ultrasonography for muscles, ligaments, joints and peripheral nerves.
This is a peer-reviewed open access journal that is published twice a year on the last day of June and December.

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