Paravertebral Block for Pain Control in Costovertebral Arthropathy: A Case Report

Ki Wook Kim,Hyo Ju Kim,Hun Jang,Sang Jun Park 대한통증연구학회 2020 International Journal of Pain Vol.11 No.2

Costovertebral arthropathy is associated with various musculoskeletal, visceral, and rheumatic diseases, making a timely diagnosis and effective treatment challenging. A 73-year-old man with complaints of stiffness and aching that had increased since its onset three years ago presented with both anterior chest wall and upper back pain. The initial X-ray of the cervical spine and rib cage showed nonspecific findings, as did cervical spine MRI. Computed tomography of the chest for further evaluation of upper back pain revealed costovertebral joint hypertrophy, indicating arthropathy at the right T6 level. The patient had been taking several oral medications, which were not sufficient for pain relief. We performed C-arm-guided cervical and thoracic medial branch block and trigger point injection into the rhomboid muscle, but these treatments were ineffective. Finally, an ultrasound-guided paravertebral block was successfully performed at the T6 level on the right side. The thoracic paravertebral block may be considered a therapeutic option for patients with costovertebral arthropathy

The 47th Korean Pain Interventional Society Symposium: April 16, 2023

Min Cheol Chang,Dong Ah Shin,Gi-Wook Kim,Sang-Hyuk Park,Jung Hwan Lee,Yun Woo Cho,Pyung Goo Cho,Gyu Yeul Ji,Nack Hwan Kim,Donghwi Park,The Korean Pain Interventional Society (KORSIS) 대한통증연구학회 2023 International Journal of Pain Vol.14 No.1

The Korean Pain Interventional Society (KORSIS) was established in 2004 to foster pain interventionalists through research, education, and imaging guidance on interventions in relation to pain originating from the spine and peripheral neuromuscular structures. The 47th symposium was held at Samjung Hotel, Seoul, Korea, from 09:00 to 16:00 on Sunday, April 16, 2023. The symposium addressed headaches and facial pain treatment that patients frequently complain of in clinical practice but which are challenging to treat. It also addressed the diagnosis of peripheral neuropathy, including cubital tunnel syndrome, injection procedure methods for treatment of peripheral neuropathy, imaging study findings of the ankle joint, and the experiences and pain treatment techniques of clinicians experienced in pain management. It is hoped that the attendees at this symposium will apply what they have learned in clinical practice to enhance patient treatment.

Difficulty of Right Shoulder Abduction Secondary to Dorsal Scapular Neuropathy: A Case Report

Jung Hwan Lee 대한통증연구학회 2023 International Journal of Pain Vol.14 No.1

A 23-year-old male patient visited with chief complaint of difficulty in right arm elevation. Passive range of motion of right shoulder was not limited and no neurologic deficits of right upper extremity were observed. Winged scapular was observed in right side but he denied pain or discomfort on shoulder and interscapular area. Electrodiagnostic study revealed decreased action potential on motor nerve conduction study of right dorsal scapular nerve and abnormal spontaneous activity on needle electromyography of right levator scapulae and rhomboids. Even if a patient does not complain of shoulder or interscapular pain, the possibility of DSNP should be considered in a case of difficulty in arm elevation. The patient should be assessed with careful examination, radiological and electrodiagnostic studies, which may be helpful for making exact diagnosis that may eventually lead to appropriate treatment plan.

Decompression of Inferior Rectal Nerve in Refractory Perianal Pain Caused by Pudendal Nerve Entrapment: A Case Report

Byung-chul Son,Chang-ik Lee 대한통증연구학회 2021 International Journal of Pain Vol.12 No.2

Pudendal neuralgia is a painful neuropathy involving the pudendal nerve. The pudendal nerve comprises sensory and motor fibers supplying the anal, perineal, and genital regions. It branches off into the inferior rectal and perineal branches, and the dorsal nerve of the penis or clitoris. Therefore, the pain associated with pudendal neuralgia is localized to the vulva, vagina, clitoris, perineum, and rectum in females and to the glans penis, scrotum, perineum, and rectum in males. Isolated perianal pain may manifest as a symptom of pudendal neuralgia caused by pudendal nerve entrapment, but the comprehensive clinical features and treatment have yet to be reported. A 67-year-old female patient presented with a two-year history of persistent stabbing and tingling pain involving her left perianal area. The pain was triggered by a blunt trauma to the buttock and was especially severe in the seated position. Transgluteal surgery confirmed the location of pudendal nerve superior to the sacrotuberous ligament in the form of inferior rectal and perineal and dorsal nerves, and along the pudendal canal. This case demonstrates the importance of accurate anatomical knowledge of the pudendal nerve and its branches in surgical decompression of pudendal nerve entrapment.

Herpes Zoster as a Sequelae of Various Kinds of COVID-19 Vaccination: A Case Series

Ji Hun Park,Ji Hye Lee,Ji Youn Oh,Hyun Joo Heo,Da Wa Jung,Hyung Gu Cho 대한통증연구학회 2021 International Journal of Pain Vol.12 No.2

Coronavirus disease 2019 (COVID-19) vaccination is associated with various complications. Herpes zoster (HZ), a reactivation of varicella zoster virus, occurred in four patients after COVID-19 vaccination. Two cases occurred after the Oxford/AstraZeneca vaccine and two cases after the SARS-CoV-2 messenger ribonucleic acid (mRNA) vaccine (Pfizer-BNT162b2 mRNA and Moderna mRNA-1273) COVID-19 mRNA vaccine. This case series suggests that COVID-19 vaccination is associated with HZ.

Superior Cluneal Nerve Entrapment as Uncommon Cause of Buttock Pain

Jeeyoung Jun,Jinyoung Oh,Dahee Park 대한통증연구학회 2021 International Journal of Pain Vol.12 No.1

The superior cluneal nerve is a pure sensory cutaneous nerve and dominates sensation in the low back and buttock area. Entrapment of superior cluneal nerve around the iliac crest, superior cluneal neuropathy, is one of the etiology of low back pain or buttock pain, but diagnosis and treatment are still challenging. Here, we report a case that the buttock pain from cluneal nerve entrapment was diagnosed and treated by percutaneous interventions. Our patient, in this case, complained of chronic buttock pain that lasted for 6 months, and there was no response to the epidural block, medial branch block, and sacroiliac joint block, but the pain was relieved through the superior cluneal nerve block, and it was diagnosed as superior cluneal nerve entrapment neuropathy. The pain could be treated through nerve block and pulsed radiofrequency therapy. Buttock pain can be induced in many diseases, and accurate diagnosis cannot be made only by imaging studies and physical examination. Two or more diseases can simultaneously cause similar symptoms. Although superior cluneal nerve entrapment causes severe buttock pain, among several causes, it is difficult to diagnose superior cluneal nerve entrapment as the cause first. It is suggested that superior cluneal entrapment neuropathy could be considered as one of the causes in patients with buttock pain.

Chronic Testicular Pain Related to Sacroiliac Joint Dysfunction: A Case Report

Youseok Shin,Won-joong Kim,Hahck Soo Park 대한통증연구학회 2021 International Journal of Pain Vol.12 No.1

Sacroiliac joint (SIJ) dysfunction is usually caused by abnormality of multiple structures around SIJ. Referral of SIJ pain has been described as located in the lower lumbar spine, buttock, groin, medial, lateral, and posterior thigh and sometimes in the calf, but rare in testis. Here, we report a case of a 71-year-old man with testicular pain for 3 months. Examination by an urologist had not revealed an abnormality of testis or scrotum. We performed the SIJ block, and pain relief have been shown.

Medial Antebrachial Cutaneous Neuropathy Caused by Venipuncture

Hak Young Rhee,Yu Yong Shin,Dong Ha Kim 대한통증연구학회 2021 International Journal of Pain Vol.12 No.1

We report a case of medial antebrachial cutaneous neuropathy caused by venipuncture in the antecubital fossa of the arm as seen in the electrophysiological findings. A 53-year-old woman, who presented with an acute development of pain in the left forearm corresponding to the area of the medial antebrachial cutaneous nerve (MACN) territory after venipuncture for routine blood sampling, was admitted to our hospital. Nerve conduction studies performed 21 days after the symptom onset demonstrated decreased amplitude in sensory nerve action potential of the left MACN compared with that of the right side.

Intrathecal Morphine Pump Insertion by Laminectomy for Cancer Pain Management: A Case Report

Young Jae Park,Chahnmee Hur,Chang-Soon Lee,Hyoungmin Kim,Yongjae Yoo 대한통증연구학회 2021 International Journal of Pain Vol.12 No.1

Pain is one of the most distressing symptoms for patients with cancer and a significant factor underlying an impairment in the quality of life. Intrathecal opioid administration has been widely used in patients with severe cancer pain that cannot be managed using conventional modalities. However, in some cases, percutaneous catheter insertion into the intrathecal space could be challenging owing to the tumor or a previous surgery. We report the case of a 21-year-old woman with chondrosarcoma of the lumbar spine and severe bilateral lower extremity pain. Although the opioid treatment was effective for pain management, the patient experienced adverse effects related to high opioid dosage. We implanted an intrathecal morphine pump by laminectomy as the patient had dura insufficiency caused by a previous surgery. This report suggests that an intrathecal morphine pump can be considered for pain control in patients with spinal tumors or those who have undergone spinal surgery.

Conference Summary of the 2022 Fall Conference of the Korean Pain Research Society

Donghwi Park,Sang-heon Lee,Hue Jung Park,Nackhwan Kim,Jin-Young Oh,Min Cheol Chang 대한통증연구학회 2022 International Journal of Pain Vol.13 No.2

On October 30, 2022, the 2022 Fall conference of the Korean Pain Research Society (KPRS), the Korean branch of the International Association of the Study of Pain (IASP), is a pivotal academic society that promotes research, exchange, and collaboration in all foundational disciplines and clinical fields related to pain (e.g., anesthesiology, neurosurgery, neurology, orthopedic surgery, rehabilitation medicine, mental health, and dentistry) and aims to attain the goals of the IASP, namely pain treatment and a multidisciplinary research approach. In this review, we summarized the programs of the 2022 Fall conference of the KPRS.