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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Descriptive data are presented for 100 patients reporting facial pain and temporomandibular dysfunction (TMD) precipitated by (1) overt facial/head trauma, (2) "whiplash" injury, and (3) "whiplash" injury with overt trauma. Analysis of the data suggests that these TMD trauma subsets are significantly different in terms of total number of pain sites, presence of concomitant neck pain, range of opening, and report of sleep disturbance and involvement in litigation. They also varied with respect to reducing and nonreducing disc displacement. However, significant differences were not observed for initial pain at presentation; muscle pressure pain threshold; McGill affective or HSCL-90 depression, anxiety, and somatization scores; prior pain duration; or time post-trauma before pain onset. These findings suggest that patients within these trauma categories share some common characteristics but may differ in important demographic, pain, and temporomandibular joint dysfunction variables.
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PMID:Symptom characteristics in TMD patients reporting blunt trauma and/or whiplash injury. 181 67

A cross-sectional evaluation of 117 people who sustained acute back injuries was undertaken within 15 days of the first report of the pain. The subjects showed no discal or neural signs and had not experienced previous episodes of back or neck pain. All subjects were given a structured interview and filled in a series of psychological evaluation instruments. Results show acute pain reactions to be comparable to those seen in chronic pain groups. The predominant emotion is one of frustration rather than anxiety or depression and considerable behavioural disruption is evident from this early point. The extent to which these data undermine the model of gradual evolution of chronic back pain problems is discussed.
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PMID:Acute back pain: a psychological analysis. 183 35

21 female patients suffering from chronic tension headache received 10 sessions of upper body massage consisting of deep tissue techniques in addition to softer techniques in the beginning. When found, trigger points were carefully and forcefully massaged. The range of cervical movements, surface ENMG on mm. frontalis and trapezius, visual analogue scale (VAS) and Finnish Pain Questionnaire (FPQ), and the incidence of neck pain during a two week period before and after the treatment, and at 3 and 6 months during the follow-up period together with Beck depression inventory were taken for evaluation and follow-up. The range of movement in all directions increased, and FPQ, VAS and the number of days with neck pain decreased significantly. There was a significant change in ENMG on the frontalis muscle whereas changes in trapezius remained insignificant. Beck inventory showed an improvement after the treatment. This study confirmed clinical and physiological effects of massage.
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PMID:The effects of massage in patients with chronic tension headache. 197 5

A 48-year-old woman with head and neck pain and upper extremity weakness demonstrated equivocal neurologic findings and otherwise essentially negative laboratory and x-ray evaluations. An interview at a case conference revealed significant depression, severe marital discord, and a poor self-image. The correlation of the onset of her physical symptoms with certain life events suggested that psychologic factors were important contributors to her disorder. Discussed here are an approach to understanding such problem patients and methods of ongoing management.
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PMID:Neurologic symptoms in a depressed woman. A medical-psychiatric case conference. 746 50

A non-selected sample of 117 common whiplash patients was examined shortly after experiencing trauma (mean = 7.4 days, SD = 4.2) and six months later with regard to neuropsychological performance and psychosocial stress. Neuropsychological examination comprised an assessment of various levels of complexity of attentional processes. Further, subjective complaints, subjective headache and neck pain intensity, utilized medication and self-ratings of well-being and cognitive impairment were recorded. In addition, patients were assessed with regard to personal history of psychosocial stress and personality traits (e.g. neuroticism, depression). At six-month examination, 81 patients subjectively were fully recovered, whereas 36 patients reported persisting symptoms. Symptomatic patients were older, showed more symptoms at baseline and a higher intensity of headache and neck pain, and had a higher subjective cognitive impairment. At both, baseline and six-month examination, no significant statistical differences between the asymptomatic and symptomatic patients were found with regard to cognitive performance. However, performance of symptomatic group in a test of divided attention was pathological at baseline. Additionally, symptomatic group showed a delayed recovery of cognitive functioning, which could be explained--at least in part--by utilized medication and the higher age. This change of cognitive equilibrium could account for these patients' cognitive problems in daily life.
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PMID:[Neuropsychological and psychosocial findings in follow-up of cervical vertebrae dislocations: a prospective clinical study]. 825 Dec 59

This study evaluated the course of psychological variables during a 2-year follow-up in patients after common whiplash of the cervical spine. From a sample of 117 non-selected patients with common whiplash (investigated on average 7.2 +/- 4.2 days after trauma) a total of 21 suffered trauma-related symptoms over 2 years following initial injury. These patients (symptomatic group) were compared with 21 age, gender and education pair-matched patients, who showed complete recovery from trauma-related symptoms during the 2-year follow-up (asymptomatic group). Both groups underwent standardised testing procedures (i.e., Freiburg Personality Inventory and Well-Being Scale) at referral, and at 3, 6 and 24 months. In the symptomatic group during follow-up no significant changes in rating of neck pain or headache were found. Significant differences between the groups and significant deviation of scores over time were found on the Well-Being and Nervousness Scales. There was a lack of significant difference between the groups on the Depression Scale, indicating a possible somatic basis for changes in psychological functioning in the investigated sample. With regard to scales of Extraversion or Neuroticism, there were neither significant differences between the groups nor significant deviation over time. These results highlight that patients' psychological problems are rather a consequence than a cause of somatic symptoms in whiplash.
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PMID:Course of psychological variables in whiplash injury--a 2-year follow-up with age, gender and education pair-matched patients. 878 6

The effectiveness of caffetin, combined analgetic drug, was estimated in treatment of acute cervicalgia and lumbar ischialgia (1 tablet 3 times daily during 10 days). Both clinical and psychological parameters were analysed. Caffetin had pronounced analgetic effect which was observed on the 2-3d day of drug application. Meanwhile there was improvement of clinical and psychological parameters, namely: relaxation of the muscles, decrease of either tension symptoms or of the levels of anxiety and depression as well as improvement of quality of life. The patients well tolerated caffetin administration without any side effects. There were no negative consequences of interaction of caffetin with other drugs (vascular, psychotropic). The conclusion was drawn about safety and effectiveness of caffetin for alleviation of acute pains in patients with myofascial, myotonic and radicular syndromes of different origin.
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PMID:[Caffetin in the treatment of neck pain and lumbago-sciatica]. 921 90

Assessing both physical and mental health is necessary in clinical settings to quantify the scope of disability and to evaluate the effectiveness of treatment programs. Changes in health-related quality of life following physical therapy treatment for many patients with orthopaedic-related diagnoses is not known. The purposes of this study were to describe changes in health-related quality of life between the initial assessment and the time of discharge from physical therapy for the most common orthopaedic diagnoses and to compare the patterns of deficit among diagnostic categories. Patient outcomes in this study were evaluated from a large database generated by the Focus on Therapeutic Outcomes (FOTO) network. Health-related and employment outcomes were described for adult patients who were classified using ICD-9-CM codes. The most common orthopaedic diagnostic categories were sacroiliac sprain, back sprain, low back pain (radiating and nonradiating), neck sprain, neck pain (radiating and nonradiating), adhesive capsulitis of the shoulder, rotator cuff injury, shoulder sprain, knee dislocation, knee sprain, and knee derangement. The primary outcome measure was a 17-item questionnaire (the MOS-17) derived from the RAND 36-Item Health Survey (SF-36) and the 12-item Short Form Health Survey (SF-12). The comparison of each cohort to population norms was made by calculating a standard score on patient data adjusted for age and gender. An effect size was calculated to measure the change in health or employment status between the initial assessment and discharge from physical therapy. For all diagnostic categories, health-related quality of life with respect to norms and employment status showed a consistent pattern of improvement at the time of discharge compared with the initial assessment. There were only small changes in physical function for neck and shoulder diagnostic categories. Nearly all of the diagnostic categories had large reductions in bodily pain. The amount of clinical change in the physical components of health-related quality of life--especially the physical function and role physical domains--differed substantially across specific diagnostic categories. The largest improvements in the physical function occurred for patients with knee dislocation and knee sprain. Patients with knee dislocation also had the largest improvement in role limitations due to physical problems. The design of this study does not permit conclusions about the efficacy of physical therapy. Further study is needed to determine if the finding of different levels of health status improvement across diagnostic categories was due to the nature of the outcome measure, the type of treatments given to each patient, or other confounding variables, like depression or preinjury functional level.
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PMID:Physical therapy and health-related outcomes for patients with common orthopaedic diagnoses. 951 68

Headache often compounds chronic neck pain following whiplash injury. To better understand post-traumatic headache, the SCL-90-R symptom checklist was used to determine the psychological profiles of patients with whiplash-associated headache and of patients with whiplash-associated neck pain without headache. The psychological profiles of these patients were compared with previously published SCL-90-R profiles of patients with post-traumatic and nontraumatic headache, and of the normal population. Patients with whiplash-associated headache were not significantly different from those with other forms of post-traumatic headache or with whiplash-associated neck pain without headache. However, when patients with whiplash-associated headache and patients with nontraumatic headache were compared to normal data, significant differences emerged. Patients with nontraumatic headache exhibited higher scores on all subscales, whereas patients with whiplash-associated headache differed from the normal sample only on somatization, obsessive-compulsive, depression and hostility subscales, and the global severity index. These differences imply that patients with whiplash-associated headache suffer psychological distress secondary to chronic pain and not from tension headache and generalized psychological distress.
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PMID:The psychological profiles of patients with whiplash-associated headache. 982 54

The aims of this study were to prospectively follow up population-based cohorts of children with widespread pain, children with neck pain and pain-free children, in order to evaluate 1-y changes in pain symptoms and to evaluate predictors for persistent widespread pain and for the change of neck pain to widespread pain. A structured pain questionnaire, the Children's Depression Inventory, and a sleep questionnaire were completed by the pre-adolescent cohorts, and clinical evaluation with tender point palpation and pain threshold measurements was carried out in both years. The Child Behavior Checklist, the Teacher's Report Form and a sociodemographic questionnaire were completed at baseline. More children in the 2 pain cohorts reported pain at follow-up than did controls (p < 0.0001). Children with persistent widespread pain had lower pain thresholds compared with those whose pain classification changed. In the neck pain group, 19 (20.4%) reported widespread pain at follow-up. Although depressive symptoms and sleep problems were associated with the change of neck pain to widespread pain, neither they nor other measured factors showed independent explanatory power in multiple logistic regression analysis. In conclusion, fluctuation of pain symptoms occurred mainly among pain cohorts. Depressive and sleep problems may have an effect on the spreading of regional neck pain to widespread pain. Pain threshold measurement and evaluation of depressive and sleep problems may be useful tools for secondary prevention of musculoskeletal pain in pre-adolescents.
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PMID:Widespread pain and neck pain in schoolchildren. A prospective one-year follow-up study. 1056 60


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