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

The purpose of this study was to examine the effects of brief, intense transcutaneous electrical stimulations at trigger points or acupuncture points on severe clinical pain. The McGill Pain Questionnaire was used to measure the change in pain quality and intensity produced by stimulation. The data indicate that the procedure provides a powerful method for the control of some forms of severe pathological pain. The average pain decrease during stimulation sessions was 75% for pain due to peripheral nerve injury, 66% for phantom limb pain, 62% for shoulder-arm pain, and 60% for low-back pain. The duration of relief frequently outlasted the period of stimulation by several hours, occasionally for days or weeks. Different patterns of the amount and duration of pain relief were observed. Daily stimulation carried out at home by the patient sometimes provided gradually increasing relief over periods of weeks or months. Control experiments, which included two forms of placebo stimulation, showed that brief, intense electrical stimulation is significantly more effective than placebo contributions. Possible neural mechanisms that underlie these patterns of pain relief by brief, intense stimulation are discussed.
Pain 1975 Dec
PMID:Prolonged relief of pain by brief, intense transcutaneous somatic stimulation. 14 44

Evoked electrical potentials were recorded via intracerebral electrodes in a patient with stump and phantom limb pain who had a previously implanted dorsal column stimulator. When pain was elicited by peripheral stimulation it was found that positive deflections appeared in the ventrolateral nucleus of the thalamus at time latencies corresponding to the propagation velocities of A delta- and C-fibres. Dorsal column stimulation completely eliminated the C-fibres. Dorsal column stimulation completely eliminated the C-fibre deflection and partially eliminated the A delta-fibre deflection.
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PMID:Effect of dorsal column stimulation on pain-induced intracerebral impulse patterns. 31 85

Sixteen phantom limb pain patients were treated with a combination of (1) progressive muscle relaxation exercise, (2) feedback of stump and forehead muscle tension, and (3) reassurance about normal phantom sensations and the relationship between anxiety and pain. Fourteen of the patients had chronic pain (average of 12 years) and two were recent amputees (5- and 1-week). At the end of treatment, 8 of the chronic patients showed virtually complete relief from pain, 4 showed significant decreases to a point at which they no longer desired treatment and 2 showed no significant change. Both recent amputees showed complete relief from pain. These changes have been sustained for follow-up period of 6 months to 3 years. The 2 unsuccessful patients did not learn to relax and had strong psychological needs for their pain.
Pain 1979 Feb
PMID:Treatment of phantom limb pain with muscular relaxation training to disrupt the pain--anxiety--tension cycle. 37 Jul 38

This paper reports and illustrates in figurine style results obtained by electrical stimulation of the cortex in 20 patients and by recording of cortical evoked potentials (EPs) in 13 of these patients, whose surgery required wide exposure of the Rolandic or paracentral regions of the cortex. This study is unique in that cutaneous receptive fields related to specific cortical sites were defined by mechanical stimulation, as is done in animals, in contrast to electrical stimulation of peripheral nerves at fixed sites, as in scalp EP recordings. Observations were made on pre- and postcentral gyri, on the second somatic sensory-motor area, on the supplementary motor area, and on the supplementary sensory area. In two patients with phantom limb pain, the pain was elicited in one on stimulation of the postcentral arm area, and in the other on stimulation of the supplementary sensory leg area. Surgical removal of these areas had the immediate effect of abolishing the phantoms and the pain. Long-term follow-up review was not possible. In one patient with severe Parkinson's disease, stimulating currents subthreshold for the elicitation of movement resulted in disappearance of tremor and rigidity for short periods after stimulation of the precentral gyrus. The possible patterns of organization of the human pre- and postcentral areas are considered and compared with those of the chimpanzee and other primates. In patients in whom data from pre- and postcentral gyri were adequate, it appeared that the precentral face-arm boundary is situated 1 to 2 cm higher than the corresponding postcentral boundary.
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PMID:Localization in somatic sensory and motor areas of human cerebral cortex as determined by direct recording of evoked potentials and electrical stimulation. 47 34

Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical excision has proved necessary in some patients. Mechanical stimulation by stump tapping, prosthetic application, or electrical transcutaneous stimulation also may be useful. Sympathetic nerve block is occasionally very rewarding. Most patients need some form of psychological therapy. Rarely is cordotomy or higher central nervous system surgery required. There is no single best mode of therapy for phantom limb pain, nor can patients be guaranteed a permanent cure.
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PMID:The care of patients with phantom limb pain in a pain clinic. 56 90

Seventy-three soldiers who had traumatic amputations were examined from 1 to 6 months after limb loss. All experienced phantom limb sensations and 67 percent experienced phantom limb pains, usually transient. Stump pain occurred in 43 percent and was associated with phantom pain in 54 percent of these. Of the 23 percent of the entire group who had evident stump pathology, 33 percent had phantom pains only, 20 percent had stump pains only, 40 percent had both, and 7 percent were pain-free. All stump ends exhibited an area of hyperpathia with hypoesthesia. Phantom pain probably results from peripheral or spinal cord mechanisms, or both, rather then from more rostral mechanisms.
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PMID:Phantom limbs and related phenomena in recent traumatic amputations. 56 74

Fantasies concerning an amputated limb can contribute to the occurrence of persistent phantom limb pain. We report a case in which burning pain perceived as located in the amputated lower extremities was related to the patient's feelings about incineration of the removed limbs against her wishes. Hypnotherapy involving elucidation of the fantasy and suggestion was successfully employed in this case and may be a helpful approach in other such cases. Importantly, adequate preparation of the patient for amputation, including an awareness of concerns about the disposition of the limb, may help prevent pathological limb sensations.
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PMID:A burning issue. Phantom limb pain and psychological preparation of the patient for amputation. 62 80

Twenty patients suffering from phantom limb pain were assessed for suitability for treatment by electrical stimulator implant to the peripheral nerve or the spinal cord. Twelve were so treated and seven obtained excellent and three partial relief of pain. One patient maintains excellent relief of pain by trancutaneous electrical stimulation. Factors that might influence the responsiveness of pain to electrical stimulation and the qualitative results from such treatment are discussed.
Pain 1978 Dec
PMID:Phantom limb pain treated by electrical stimulation. 74 Apr 3

Forty-six patients with chronic pain were treated with transcutaneous nerve stimulation (TNS). If there were any signs of sensory loss in the pain area, the electrodes were placed on the healthy side of the body. The effect of TNS was assessed quantitatively. After 9 months of repeated TNS, on average, the total pain score had improved by 39%. The subjective intensity of the pain, the frequency of pain and the need for analgesics had diminished by 46-47%. In those conditions in which total improvement was better than the mean (phantom limb pain, 65%; zoster neuralgia, 56%; thalamic pain, 45%), the healthy side of the body had been stimulated. In those in which the painful area had been stimulated (cancer pain, 32%; low back pain, 32%; brachialgia, 15%), the beneficial effect did not reach the mean for the whole series. This suggests that TNS of the healthy side of the body may give better long-term improvement than stimulation of the painful area. A theory of chronic pain and the mechanism of TNS is presented.
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PMID:[Placement of electrodes in transcutaneous stimulation for chronic pain]. 108 64

Follow-up examination of 17 patients with severe and lasting stump and phantom limb pain which could not be improved by analgetics and who then underwent surgical procedures at the neuroma. The results were discouraging. Only 2 patients showed a lasting improvement. Resection of the neuroma and injection of alcohol into the neuroma seem to be successful only if the preoperative history of pain is very short or if there is an isolated injury of a peripheral nerve and a subsequent single neuroma.
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PMID:[Problems of peripheral nerve surgery in amputation stump pain and phantom limbs]. 124 Jul 97


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