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

The effect of single and repetitive electrical stimulation of the dorsal columns on cells in laminae IV and V of the ipsilateral dorsal horn at S1 was examined in spinalized cats. About two-thirds of the cells responded to thermal nociceptive cutaneous stimulation and of these most responded also to low threshold mechanical stimulation. The other one-third of the cells were innervated by mechanoreceptors including type I or Haarscheiben. A single shock to the dorsal columns typically caused short latency activation of the cells, followed by inhibition lasting about 100 msec. Several minutes of repetitive dorsal column stimulation (DCS) at 3 Hz or 50 Hz had no prolonged effect on about two-thirds of the cells. The rest of the cells were less responsive for up to 30 min after the cessation of 50 Hz. Assuming that the studied interneurons have a pain-mediating function, the results indicate that some cumulative and poststimulatory DCS suppression of pain may be ascribed to spinal mechanisms. The more effective and longer lasting suppression produced by DCS in pain patients would, however, be dependent on other types of interneurons, on suprasegmental loops and/or on effects on pathophysiological mechanisms which may be operative in the chronic pain state. The lack of cumulative inhibition in most of the cells in this study is compatible with the previous observation of a retained perception of acute pain during DCS in man.
Pain 1977 Dec
PMID:The effect of dorsal column stimulation on the nociceptive response of dorsal horn cells and its relevance for pain suppression. 60 May 39

A treatment program for chronic pain is reported which focuses on modification of patient pain behavior. After an outpatient pain clinic screening by a multidisciplinary team, the patient with chronic pain (duration of 6 months or longer) is admitted for a 7--8 week inpatient program followed by a 4-week outpatient period. The first week of the inpatient program is used for evaluation of pain behaviors, recording use of pain medications, activity levels, and tolerance for special conditioning exercises. The program is aimed at extinguishing pain behaviors and use of pain medications, increasing activity level, reinforcing well behaviors, and returning patients to full active lives, normal for their sex and age. Of the 34 patients completing the program and returning to full active normal lives, 74% (25) have maintained this attained goal at the time of follow-up from 6 months to 7 years later.
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PMID:Behavior modification of chronic pain: a treatment program by a multidisciplinary team. 60

The pain treatment program described in this paper teaches chronic pain patients and their families to manage pain in a constructive manner, increasing activity, eliminating pain medications, and reducing use of the health care system. The social worker carries a crucial role in this behavior modification program: working with the patient, family, and rehabilitation team in evaluation for the program, in treatment of the patient and family, and in the transition from hospital to home and the community. Chronic pain is a costly disability, economically and socially. For many patients traditional medical and surgical approaches have failed to bring relief. By attending to and treating the total family system, at least 75% of the patients treated are enabled to lead normally active lives again.
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PMID:The social worker's role in a behavioral management approach to chronic pain. 61 63

Patients with chronic pain may become dissatisfied because of their lack of improvement. Thirteen such patients, encountered in a pain-management program, registered formal complaints of their dissatisfaction. From their histories they were found to be the most chronic and treatment-refractory patients encountered, with problems of medication dependency, accident proneness, and dissatisfaction with previous treatment efforts. During hospitalization they opposed psychologic approaches, further manifested their dependency on medication, and some of them had circumscribed delusions. The pain-management program was difficult to apply to these patients; and further, they resisted other recommendations for treatment and even resisted discharge in in some instances. Further psychiatric screening is necessary to avoid the complications presented by this type of patient.
Pain 1978 Apr
PMID:The dissatisfied patient with chronic pain. 64 1

Traditional means of treating chronic pain have been unsuccessful in a discouraging number of cases. Pain centers have appeared within the last few years, offering a more comprehensive view of the whole pain problem. Pain centers address pain as a multifaceted event with social, economic, physiological, and psychological representations. In addition, the pain center constructs an atmosphere that provides every opportunity for reduction of pain, while minimizing those factors that tend to encourage its expression. Such a venture calls for a multidisciplinary approach; it further demands a rather sophisticated grasp of numerous factors which do not necessarily lend themselves to discussion with a single vocabulary. This paper will attempt to describe a number of conceptual models of chronic pain and to demonstrate how each of these models is addressed therapeutically in a multidisciplinary pain center millieu.
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PMID:A therapeutic milieu for chronic pain patients. 65 56

The diagnosis of chronic pain cases is now an important problem for psychiatrists and many authors have presented strong evidence for the influence of psychological factors in chronic pain conditions. The author is reporting his experience with 75 consecutive out-patient consultations. Many of the patients were foreign-born and had significant language difficulties. The main diagnostic technique described is the use of sodium amytal given intravenously over a 45 minute-period while the patient is examined physically and psychologically; his responses noted during light, midrange and deeper levels of sodium amytal sedation. Most patients fell comfortably into one of the following diagnostic groups: psychogenic regional pain, organic pain, mixed group (organic plus psychogenic regional pain), and malingering. The author suggests that sodium amytal helps to overcome language barriers, reduces the time required for proper assessment and allows the patient and the examiner to appreciate more precisely, the level of pain and the limits of physical performance as well as permitting an effective exploration of important psychodynamic issues.
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PMID:Sodium amytal in the diagnosis of chronic pain. 66 79

Many tumors, especially when metastasizing, produce a variety of symptoms. Two frequent sets of complications due to metastasizing cancer (mainly to the bones), i.e. vertebral metastases and chronic pain, are reviewed. In the case of vertebral metastases, the fitting of an orthopedic corset should--and as a rule can--be avoided. Treatment of this complication is by systemic therapy and/or radiotherapy. Symptoms or signs of medullary compression are indications for emergency treatment by the radiotherapist or the neurosurgeon. In the case of chronic pain, regular oral intake of the Brompton mixture is an alternative to injections of analgesics in that it prevents rather than alleviates pain and is only slightly addiction-forming.
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PMID:[Therapy of complications due to neoplasm metastases]. 68 96

A series of 37 patients with chronic pain was investigated with regard to neurologic and psychiatric variables. Twenty of the patients were classified as having mainly organic (= somatogenic) pain syndromes while 17 patients were rather suffering from psychogenic pain syndromes. Samples of lumbar cerebrospinal fluid (CSF) were obtained from the patients and analyzed for the presence of opiate receptor-active material, here called endorphins. Patients classified as having mainly organic pain syndromes were found to have significantly lower endorphin levels than patients with predominantly psychogenic pain syndromes. In the total group of patients as well as in the two subgroups, there was a significant correlation between CSF endorphin levels and the depth of depressive symptomatology as reported by the patients. On the other hand, there was no correlation between CSF endorphin levels and extent of anxiety or motor retardation. It is concluded that CSF endorphins reflect central processes involved in chronic pain syndromes.
Pain 1978 Aug
PMID:Endorphins in chronic pain. I. Differences in CSF endorphin levels between organic and psychogenic pain syndromes. 69 70

Previous work has suggested that patients with organic lesions causing pain may show as much emotional disturbance as patients with pain but without lesions. This study examined 141 chronic pain patients for their life experience, both currently and premorbidly, in terms of upbringing, neurotic traits and personality disturbance. Patients with an organic cause for pain reported significantly less family disturbance in childhood, less premorbid personality problems and less neurotic traits than patients who did not have any organic cause for their pain. The data provide support for the view that a significant proportion of the emotional disturbance associated with chronic pain is a secondary effect. Adjectives used to describe pain and factors causing exacerbation and relief of pain, although overlapping, also differed in the two groups.
Pain 1978 Aug
PMID:Emotional adjustment and chronic pain. 69 71

The evaluation of chronic pain after hip arthroplasty has always been a difficult problem and recently scintigraphy has been recommended as a suitable method of examination for this purpose. On the basis of radiographic and laboratory studies, scintigraphy, allergy tests, cultures and histological examinations, in 16 patients with chronic pain in the hip after arthroplasty, it is concluded that radiography and scintigraphy together give valuable information about the cause of pain, especially if the prosthesis is infected. Fenestration of the femoral cortex may verify the diagnosis before replacement of the prosthesis.
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PMID:Evaluation of painful hip arthroplasty. 69 79


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