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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Trigger points are distinct areas of focal hyperirritability which give rise to areas of refered pain in well-defined areas of the musculo-skeletal system, sometimes remote from the point itself and not related to it by anatomically definable pathways. While the vast majority of pain manifestations from trigger points are related to the musculo-skeletal system, this need not be invariably so, as has been demonstrated in two of the cases cited, where injection of trigger points in the neck relieved chronic tinnitus. In all manifestations of chronic pain it is recommended that a diligent search be made for such trigger points.
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PMID:Chronic pain syndromes and their treatment. II. Trigger points. 46 66

A patient with chronic pain due to a reflex sympathetic dystrophy in his hand and arm was successfully treated with temperature biofeedback after several months of conservative standard medical care brought little relief. Over the 18 treatment sessions the patient learned to emit a reliable handwarming response of 1 to 1.5 degrees C. Coincident with his learning, the pain in his hand and arm decreased markedly and remained absent at 1-year follow-up.
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PMID:The use of temperature biofeedback in the treatment of chronic pain due to causalgia. 47 93

Chronic pain patients (101) were assigned ratings of impairment and disability and were assessed for organic pathology and pain behavior through comprehensive testing procedures. As predicted, higher ratings of impairment and disability were significantly associated with higher levels of both physical pathology and pain behaviors. These results indicate that conditioning and pathologic processes significantly influence impairment and disability ratings. Many patients showed higher disability than impairment ratings, which suggests the possibility of gainful employment in less demanding jobs. However, the current disability system rewards sickness and dysfunction and discourages patients from resuming work.
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PMID:Chronic pain states: their relationship to impairment and disability. 49 2

The submaximum effort tourniquet technique (SETT) is becoming more widely used as part of the clinical assessment of chronic pain patients despite little information about the scaling of this technique. Ratio scaling procedures resulted in a linear function, presumed to underlie clinical application of the SETT, for only 11% of the subjects. Therefore, current clinical use of the tourniquet ratio score should be questioned. Normals also obtained significantly more negatively accelerated power functions than pain patients with no difference in tolerances. Differences in these growth curves are discussed with reference to the concept of pain endurance. Continued needs for standardized pain evaluation techniques suggest that this type of psychophysical scaling procedure may improve the precision of some clinical pain assessments.
Pain 1979 Aug
PMID:Ratio scaling of pain perception with the submaximum effort tourniquet technique. 50 52

This preliminary study was conducted to test the effectiveness of cognitive treatment of clinical pain. Chronic pain patients were trained in a self-control cognitive strategy procedure. Specifically, they were provided with a conceptualization of their pain, instructed in an awareness of their thoughts prior to and during their experience of pain, and trained in the use of several cognitive strategies to replace these thoughts and relabel their pain experience. Training was provided in a group setting to further consolidate the use of the instructions by enabling patients to roleplay the instructions to one another. Patients were also encouraged to verbally reinforce themselves each time they used the procedure. The experience of pain was measured by the McGill pain questionnaire, a behavioral checklist and staff reports. Results suggest that cognitive strategies can effectively alter the experience of clinical pain. Moreover, pain as a cognitive label for a nonspecific state of arousal is suggested.
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PMID:Reinterpretative cognitive strategies in chronic pain management. 51 71

A group of moderately to severely depressed individuals with moderate anxiety were studied to determine the frequency and nature of pain complaints and their response to doxepin. It was discovered that 100% of these subjects had chronic pain complaints, most of which paralleled the course of depression. Headache was most commonly noted. Doxepin's analgesic effects were intimately associated with its antidepressant effects. There was a highly significant relationship between improvement of depression and reduction of pain on doxepin (P less than 0.005). Conversely, patients who obtained minimal antidepressant effect also obtained minimal analgesic effect. Psychophysiologic and biochemical hypotheses of this association of pain and depression are discussed.
Pain 1979 Dec
PMID:The effectiveness of tricyclic antidepressants in the treatment of coexisting pain and depression. 53 Jul 39

Psychologic assessment and treatment of the family of the chronic pain patient has been thought to be of benefit in the outcome of pain therapy. The present study was designed to determine the presence of psychologic symptoms in the spouses of pain patients and the relationship of distress levels between the marital pair. Forty-four couples were studied. Demographic data was collected and each individual completed the SCL-90, a widely used and validated measure of psychologic symptom severity. There was a significant correlation (P = less than 0.001) on psychiatric distress scores between pain patients and their spouses particularly when pain patient distress scores were high. Distress levels tended to decrease with age and were highest among the unemployed and lowest in the retired. In addition spouses were significantly higher than nonpatient norms on most symptom subscales. These data underline the importance of conjoint assessment of the chronic pain patient and the spouse, and have implications for treatment.
Pain 1979 Dec
PMID:Pain and the marital relationship: psychiatric distress. 53 Jul 40

The present research sought to examine the importance of cognitive factors in the experience and treatment of chronic pain. An attempt was made to explore possible mediational influences by testing the effectiveness of several cognitive strategies. Experimental conditions were manipulated to examine the influence of three types of cognitive strategies: (1) reinterpreting the pain stimuli, (2) diverting one's attention from it, and (3) concentrating on the sensation itself. Dependent measures such as subjective indices of pain, behavioral observations, and an unobtrusive measure of pain behavior were obtained in an attempt to explore the experience of pain. Results demonstrated that, within a physical rehabilitation hospital setting, patients with a history of persistent pain showed a significant change in their ratings of the quality and intensity of this experience, and in their behavior, through the use of reinterpretive cognitive instructions.
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PMID:Effects of different cognitive strategies on chronic pain experience. 55 83

The present status of intrathecal neurolysis with phenol, alcohol, chlorocresol and saline in the management of chronic pain has been discussed and the results of treatment reviewed. The particular use of these techniques in the therapy of pain due to malignant conditions has been stressed.
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PMID:Intrathecal neurolysis. 58 35

A process and technique for psychiatric evaluation of chronic pain patients are discussed. It is the task of a psychiatrist to rule in or rule out a psychiatric component rather than to assume the existence of "psychogenic" pain when there is a negative medical and surgical examination. Accurate communications about any psychiatric components to the referring physician, without premature judgment on "cause" of pain, lead to themost accurate decisions about future treatment.
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PMID:Psychiatric consultation in the chronic pain patient. 59 93


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