A 29-year-old man was brought to our hospital after his left hand was caught in the roller. The first finger was fractured at the distal phalanx, and the second to fifth fingers were resected at the metacarpophalangeal joints due to severe contusion. Operation was performed and covered with a femoral free skin valve. The patient was referred to our department due to poor pain control. After medication adjustment and a stellate ganglion block, pain control was poor, so the patient underwent pulsed radiofrequency of the median nerve. The pain range was reduced, but strong pain remained in the ulnar side of the first finger. Considering the involvement of the ulnar nerve, ulnar nerve block was performed. Ulnar nerve block was effective, so the patient underwent pulsed radiofrequency of the ulnar nerve, and the pain was relieved. It was considered important performing a test block, taking into consideration the distribution and diversity of the nerve.

Functional somatic symptoms are pain syndromes defined as “symptom complaints, distress, and disability greater than the degree of identifiable tissue damage”. We experienced two cases in which functional somatic symptoms appeared after vaccination with COVID-19 vaccines. The first case met the criteria for complex regional pain syndrome. Although the mechanism of the onset of functional physical symptoms caused by vaccination has not yet been fully elucidated, these two cases are believed to have developed functional physical symptoms due to a combination of psychological factors such as side effects of fever and pain, immobility due to side effects, anxiety and depression, which were never experienced. In addition to pain, these two cases had strong anxiety, which made social life difficult. The multidisciplinary treatment and social reintegration adjusted according to each patient's condition led to patient recovery.

We report the case of a 76-year-old man who developed intermittent claudication resulting in pain below the foot when walking. Although the pain was alleviated by opioid administration, it worsened over time. Peripheral arterial disease and lumbar spinal canal stenosis were excluded as possible causes of intermittent claudication. The presence of a positive Tinel's sign over the tarsal tunnel led to a clinical diagnosis of tarsal tunnel syndrome. Opioids and duloxetine did not improve intermittent claudication. Transition from opioids to the tetracyclic antidepressant, mianserin, improved intermittent claudication. Thus, our case suggests that intermittent claudication can be improved by transition from opioid to mianserin therapy.