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  • Editorial | 2023-12-31

  • Review Article | 2023-12-31


    Osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide. Animal models are required to improve our understanding of the underlying pain mechanisms associated with OA and to evaluate potential therapeutics. In this review, discuss the variety of animal models used in OA research, with a focus on their relevance to human OA and the pain behavioral methods. We discuss commonly used pain behavioral assays, the technical nuances, advantages, and limitations. Moreover, we discuss how these models and methods translate into the clinic by emphasizing any interventions or findings that have guided clinical trials or drug development. Although animal models provide invaluable insight, they still have challenges and controversies, particularly with respect to their true representation of human OA pain as well as ethical considerations. We highlight the need for refining and standardizing pain assessment techniques in animal models and address emerging technologies that promise greater translational significance. This review provides insight into the role of animal models in advancing our understanding of OA pain and paves the way for future research in this field.

  • Original Article | 2023-12-31


    Background: The purpose of this experimental study was to confirm whether the overall disease severity of Parkinson’s disease (PD), gait function, balance, and pain could be improved through the application of the lumbar muscle myofascial release technique (LMTT).
    Methods: LMTT treatments were administered to 12 patients with PD and chronic pain and evaluated pre-and post-intervention. The LMTT device was designed to provide acupressure to the operational portion, to which the bogie method was applied. To increase the therapeutic effect, aluminum, with high thermal conductivity, was used to apply heat up to 70°C and acupressure simultaneously. A heating wire was also attached. The Timed Up and Go (TUG), 10 m gait speed, 6-min walk test, Berg Balance Scale (BBS), Functional Ambulatory Category (FAC), Visual Analog Scale (VAS), fear of falling, Oswestry Disability Index, and Geriatric Depression Scale Short-Form (GDSSS) were evaluated.
    Results: The VAS score showed a significant decrease immediately after five treatments (4.46 points) and 10 treatments (3.00 points) compared to the pre-intervention evaluation (6.54 points). We found that this decrease was maintained after a 2 week follow-up (P < .001). Significant improvements were also confirmed in the TUG (P < .001), 10 m gait speed (P = .001), 6 min walk test (P = .001), and BBS (P = .001).
    Conclusions: By applying LMTT, a significant reduction in pain was confirmed in patients with PD who experience chronic back pain.

  • Original Article | 2023-12-31

    Aamirraza Mansuri1, Vivek Kumar Agarwal2, Sanjay B Patel2, Sohin K Zalavadiya2, Ketan R Patel2, Kanaiyalal D Prajapati2

    Int J Pain 2023; 14(2): 59-67


    Background: The currently available topical diclofenac products do not provide effective penetration of diclofenac across the layers of skin. Troikaa Pharmaceuticals Ltd, has developed Dynapar QPS Plus, a novel, topical formulation of diclofenac and compared its skin penetration with Diclofenac Aerosol Spray.
    Methods: In this randomized, two way crossover study, healthy human subjects (n = 8) received single dose of either 2 ml of Dynapar QPS Plus or approximately 4 gm of marketed Diclofenac Aerosol Spray. The blood samples were drawn at pre dose and up to 24 hours post dose. The plasma concentrations of Diclofenac was measured using validated LC-MS/MS bioanalytical method.
    Results: The mean Cmax after administration of Dynapar QPS Plus and Diclofenac Aerosol Spray were 102.945 ± 66.0109 and 15.885 ± 14.7750 ng/ml, respectively. Median Tmax for Dynapar QPS Plus was earlier compared to Diclofenac Aerosol Spray (7 hrs vs. 19 hrs). The mean AUC0-t after administration of Dynapar QPS Plus was significantly higher as compared to Diclofenac Aerosol Spray (AUC0-t: 855.289 ± 494.0262 vs. 149.707 ± 116.6317). Both the products were well tolerated and no adverse event occurred during the study.
    Conclusions: The results of this study showed that Dynapar QPS Plus is safe and provides faster and more than six times higher skin penetration of diclofenac in comparison to marketed Diclofenac Aerosol Spray. Due to faster and higher penetration of diclofenac, from Dynapar QPS Plus it is best suitable option to treat pain and inflammation related to acute as well chronic musculoskeletal disorders.

  • Original Article | 2023-12-31


    Background: This study aims to find out which clinical and radiologic factors affect how well intradiscal steroid injections (ISI) work for patients with discogenic lower back pain (DLBP).
    Methods: We looked back at the clinical records and radiologic images of 60 patients with DLBP, confirmed using a provocation discography. They all received ISI between May 2011 and December 2014 at a single clinic. We evaluated the degeneration grade of the discs, whether they showed a high intensity zone (HIZ), and Modic changes in the adjacent vertebral bodies. Clinical outcome was assessed by visual analogue scale (VAS).
    Results: Six months post ISI, patients with pain duration < 6 months (P = 0.02), type I Modic change (P = 0.048), and the presence of HIZ (P = 0.046) exhibited significantly greater reductions in the VAS. Multivariate logistic regression analysis highlighted three factors linked to successful outcomes after ISI: pain duration < 6 months (OR = 8.695, P = 0.007), type 1 Modic change (OR = 3.382, P = 0.021), and the presence of HIZ (OR = 4.902, P = 0.015).
    Conclusions: We found three important factors through statistics: pain for < 6 months, Type I Modic changes, and the presence of a HIZ. By carefully choosing patients with these characteristics, considering the risks of treatment, and factors predicting outcomes, we can anticipate better results in treating DLBP.

  • Case Report | 2023-12-31

    Ju Hyung Lee1, Seonghyeok Park2, Min Soo Jang2, Soo Kyung Lee2, Yi Hwa Choi2

    Int J Pain 2023; 14(2): 79-84


    Spontaneous intracranial hypotension (SIH) is caused by cerebrospinal fluid leakage and subsequent hypovolemia in the spinal subarachnoid membrane or, rarely, the intracranial space. Subdural fluid collection is a rare complication of SIH caused by the persistence of negative pressure. This report describes a case of SIH with subdural fluid collection in a patient who underwent surgical hematoma evacuation before an epidural blood patch (EBP). A 60-year-old man and 43-year-old man were initially diagnosed with SIH secondary to an orthostatic headache that became exacerbated. Brain computed tomography revealed subdural hemorrhage (SDH). Because their condition deteriorated gradually, they underwent burrhole trephination to evacuate the SDH. An epidural blood patch was applied to treat the remaining symptoms of SIH after evacuation. During the next 3 days, headache completely resolved with satisfactory results. We report this case of SIH with SDH resulting in surgical hematoma evacuation before EBP that successfully resolved.

  • Case Report | 2023-12-31

    Jungil Bae1,2, Heo Gang1, Hangaram Kim2, Hyung Sang Row1, Yongjae Yoo1

    Int J Pain 2023; 14(2): 85-89


    Bertolotti's syndrome (BS) is a condition that causes lower back pain due to the presence of a lumbosacral transitional vertebra (LSTV). A spectrum of therapeutic modalities, ranging from conservative management to surgical intervention, has been endeavored in its management. It has been reported that LSTV may subsequently lead to conditions such as scoliosis, facet joint arthritis, strains of the quadratus lumborum and iliopsoas muscles, and herniated discs. Moreover, BS commonly manifests with lower back pain; however, it is rarely associated with radiation-induced leg pain. In this case report, we aimed to investigate the effectiveness of pulsed radiofrequency treatment in patients who underwent diagnostic nerve blocks for radicular pain suspected to be induced by BS and demonstrated temporary pain relief.

  • Case Report | 2023-12-31

    Taejun Hwang1, Sang Joon Park2, Jungsoo Kim2, Yongjae Yoo2, Jee Youn Moon2,3

    Int J Pain 2023; 14(2): 90-95


    Granular cell tumors (GCTs) are uncommon soft tissue tumors usually originating from the nerve sheath, affecting any body part but rarely the spinal region. Only 2% of GCTs are malignant, which is associated with a very poor prognosis. They occur most frequently in middle-aged females. Clinical symptoms of GCTs from the spine origin depend on their location. Radical resection is the treatment of choice for GCTs, followed by radiotherapy and chemotherapy if it turns out malignancy or complete resection is impossible. Herewith, we report a case of malignant GCTs of the upper thoracic spine with pleural metastasis. Although the initial upper extremity MRI showed a small thoracic paravertebral mass, it was missed, resulting in a delayed diagnosis of malignancy. From the case, we can learn that vigilant suspicion to rule out any malignancy is essential if aggravation of symptoms is observed even under active pain management.

  • Summary of Our Symposium | 2023-12-31


    The 48th Korean Pain Intervention Society (KORSIS) Symposium was held on October 29, 2023, between 9 a.m. and 4 p.m., at Samjung Hotel in Seoul, South Korea. The symposium focused on potential management strategies for patients of the pain clinic, who have pain control challenges. In particular, the therapeutic evidence for extracorporeal shockwave therapy (ESWT), which has been popular among pain clinics in recent times, was examined. The symposium presented the following sessions. 1) Functional medicine applicable to the pain clinic. 2) Available procedures when the epidural steroid injection is ineffective. 3) The evidence for using ESWT in regeneration in the pain clinic. 4) The prescription know-how: A case series.

  • Editorial | 2023-06-30

  • Review Article | 2023-06-30

    Min Cheol Chang1, Donghwi Park2, Yoo Jin Choo1

    Int J Pain 2023; 14(1): 3-11


    Carpal tunnel syndrome (CTS) is a common neurological disorder of the upper extremities that causes pain and numbness in the wrist or fingers. The primary treatment for CTS is conservative and includes the use of splints, injections, and ultrasound therapy. Surgical intervention is required if conservative treatment is ineffective and pain persists. When CTS occurs, the most basic treatment method is to reduce the frequency of wrist use in order to reduce the pressure on the carpal tunnel. Orthoses can be a useful therapeutic option for reducing pressure in the carpal tunnel. This study reviewed the effectiveness of orthoses in the management of CTS.

  • Original Article | 2023-06-30


    Background: Anterior cutaneous nerve entrapment syndrome (ACNES) is an often overlooked and under diagnosed medical condition characterized by abdominal wall pain. The cause is supposedly an entrapment of one of the cutaneous branches of the intercostal nerves in the abdominal fascia. Treatment options are restricted to pain killers, infiltration with local anaesthetics and operative neurectomy. The use of a percutaneously inserted peripheral block catheter could be a useful minimal invasive treatment strategy for patients suffering from ACNES if medication and infiltration are unsuccessful.
    Methods: We report our first series of ten patients suffering from ACNES, who were treated with an ultrasound guided, percutaneously inserted peripheral block in the retro-rectus space at the level where the corresponding intercostal nerve was anticipated The procedure was performed in an outpatient setting.
    Results: Following the insertion of a percutaneous retrorectus catheter and three days of local anaesthetic infiltration, a significant proportion of these patients reported a reduction in pain. Six out of ten patients derived sufficient benefit from this treatment 14 days and six months after catheter placement, thus eliminating the need for operative treatment.
    Conclusions: Percutaneous inserted, ultrasound guided catheter placement seems to result in adequate short-term and long-term pain reduction in a significant proportion of patients suffering from ACNES. Up until now, surgery seemed the only viable treatment for patients suffering from ACNES who did not respond to conservative treatment. Using this minimal invasive percutaneous technique, over 50% of patients might be offered a definitive treatment, thus preventing surgical treatment.

  • Case Report | 2023-06-30


    Postherpetic neuralgia (PHN) is the most common but challenging complication of herpes zoster due to long-lasting intractable neuropathic pain. Routine pharmacologic treatments of PHN include anticonvulsants (e.g., gabapentin, pregabalin), antidepressants (e.g., amitriptyline), opioids (e.g., oxycodone, morphine). However, those medications have limitations due to side effects inclusive of peripheral edema, nausea, vomiting and somnolence, or insufficient analgesic effect. Mirogablin, a novel voltage-gated calcium channel (VGCC) selective α2δ ligand, has been recently approved as a drug to treat peripheral neuropathic pain. In this case report, we represent a 77-year-old patient with intractable PHN who achieved successful pain relief with intake of mirogabalin with less side effects.

  • Case Report | 2023-06-30


    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.

  • Summary of Our Symposium | 2023-06-30

    Min Cheol Chang1, Dong Ah Shin2, Gi-Wook Kim3, Sang-Hyuk Park4, Jung Hwan Lee5, Yun Woo Cho6, Pyung Goo Cho7, Gyu Yeul Ji8, Nack Hwan Kim9, Donghwi Park10, The Korean Pain Interventional Society (KORSIS)

    Int J Pain 2023; 14(1): 28-32


    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.

  • Letter to the Editor | 2023-06-30

  • Letter to the Editor | 2023-06-30

The Korean Association for the Study of Pain

Vol.14 No.2
December 2023

pISSN 2233-4793
eISSN 2233-4807

Frequency: Semi-Annual

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Editorial Office

Aims and Scope

International Journal of Pain (IJP) is the joint official scientific English-language journal of the Korean Association for the Study of Pain and the Korean Pain Intervention Society. IJP is a multidisciplinary journal that publishes papers of the high quality and significance in the whole range of pain research. The mission of the journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research. In addition to primary research, International Journal of Pain publishes reviews, original articles, case reports, letters to the editor, and editorials. International Journal of Pain is published semiannually on the last day of June and December.

Editorial Office