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

In the awake restrained rat the intrathecal administration of substance P or the partial substance P homologue eledoisin-related peptide (ERP) reduced reaction time to a noxious radiant heat stimulus and, at high doses, produced additional behavioural responses suggesting that the animals had reacted to what they perceived as a painful stimulus. The reduction in tail-flick latency was observed as early as 30 sec following peptide administration peaked at 1 min and persisted for 5-10 min, after which an overshoot of the response (i.e., an increase in reaction time) was observed. The responses varied in their magnitude with the amount of peptide given, substance P being approximately 4 times more potent on a molar basis than ERP. Intrathecal administration of an equal volume of vehicle (artificial cerebrospinal fluid) had no effect on tail-flick latency and failed to produce any of the other behavioural changes. The following interpretations are made. The decrease in tail-flick latency suggests that pain threshold was decreased, and the dramatic behavioural effects seen at high doses suggest that an excess of substance P in the spinal cord is capable of producing a painful sensation. The rapid onset of the response suggests rapid penetration of substance P and ERP to the appropriate receptors, and the rapid decay of the response suggests rapid removal. Taken together, these results are consistent with the earlier suggestion that substance P plays a role as an excitatory agent in sensory pathways subserving pain. It is proposed that some conditions of chronic pain in man may therefore be due to an overabundant amount of substance P. This is complementary to a second proposal that other cases of chronic pain may be due to a supersensitivity of substance P receptors. The former is more likely to be associated with organic disorders, the latter with nerve damage, e.g. with causalgia, the neuralgias and perhaps some cases of phantom limb pain.
Pain 1982 Oct
PMID:Substance P reduces tail-flick latency: implications for chronic pain syndromes. 618 63

The authors report the results of DREZ thermocoagulation in 35 patients since March 1980. This technique was applied not only in patients with deafferentation pain after brachial plexus avulsion, but also for postamputation phantom limb pain and pain caused by injury to the spine and spinal cord, by peripheral nerve lesions, and by multiple sclerosis. Independent of etiology, the duration of the pain syndrome, and the quality and projection of the pain, the overall results have been satisfactory and long-lasting.
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PMID:Thermocoagulation of the dorsal root entry zone for the treatment of intractable pain. 651 71

Phantom limb pain following amputation is a well known but comparatively rare phenomenon. Spinal anaesthesia in amputees may cause reappearance of phantom pain in previously pain-free patients despite complete sensory analgesia. Two such cases are described.
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PMID:Phantom limb pain during spinal anaesthesia. Recurrence in amputees. 662 38

The incidence and clinical picture of non-painful and painful phantom limb sensations as well as stump pain was studied in 58 patients 8 days and 6 months after limb amputation. The incidence of non-painful phantom limb, phantom pain and stump pain 8 days after surgery was 84, 72 and 57%, respectively. Six months after amputation the corresponding figures were 90, 67 and 22%, respectively. Kinaesthetic sensations (feeling of length, volume or other spatial sensation of the affected limb) were present in 85% of the patients with phantom limb both immediately after surgery and 6 months later. However, 30% noticed a clear shortening of the phantom during the follow-up period; this was usually among patients with no phantom pain. Phantom pain was significantly more frequent in patients with pain in the limb the day before amputation than in those without preoperative limb pain. Of the 67% having some phantom pain at the latest interview 50% reported that pains were decreasing. Four patients (8%), however, reported that phantom pains were worse 6 months after amputation than originally. During the follow-up period the localization of phantom pains shifted from a proximal and distal distribution to a more distal localization. While knifelike, sticking phantom pains were most common immediately after surgery, squeezing or burning types of phantom pain were usually reported later in the course. Possible mechanisms for the present findings either in periphery, spinal cord or in the brain are discussed.
Pain 1983 Nov
PMID:Phantom limb, phantom pain and stump pain in amputees during the first 6 months following limb amputation. 665 85

Centro-median thalamotomy was performed on 18 patients with central pain caused by cerebrovascular disease. Fourteen were males and four were females. Clinical diagnoses were thalamic pain in 17 cases including cheiro-orale syndrome in one case and phantom limb pain in one case. CT scans were performed on six recent cases. Four cases had a small low density sera in the thalamus. The other two cases had no remarkable findings. The target was 7.5-11.0 nm posterior to the middle point of the intercommissural line, 1.0 mm below-2.0 mm above that line and 5.5-10.0 mm from the midline. Unilateral lesion was made on 15 cases. Postoperatively, five cases had almost completely relief of pain and four cases had partial improvement. The duration of pain relief was, however, less than two months in four cases, and between three and seven months in four cases. One case had a pain free period for seven months. But, then, severe dysesthesia appeared. Six cases had no pain relief by unilateral lesion. Two cases had no pain relief by bilateral lesions. In the remaining case, unilateral lesion was effective for six months. Then lesion of opposite side was made, but the result was unsatisfactory. The durations from the onset of apoplectic attack to the occurrence of pain were between four months and three years in ten effective cases, and within three months in six among eight failed cases. Many surgical and medical treatments have been attempted for central pain. However, ideal method is still not appeared. Centro-median thalamotomy was effective for 56% of the patients with central pain. But in most of the cases, the duration of pain relief is about a half year at the longest. And may be, this is the limit of effectiveness of centro-median thalamotomy for central pain.
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PMID:[Centro-median thalamotomy for central pain following stroke --its effectiveness and limits]. 675 Apr 32

Since its inception in June 1979, over 500 patients have been treated at the King/Drew Pain Center in Los Angeles. Based upon the treatment and observations of this patient group, this paper describes the psychologic aspects in patients suffering from chronic abdominal pain, low back pain, phantom limb pain, chest pain, and arthritic pain.
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PMID:Psychological aspects of chronic pain. 686 16

The pain of the phantom limb remains a diagnostic and therapeutic challenge. A case is reported in which a paraplegic patient with full sensory ablation below T11 experienced phantom limb pain only after actual amputation of one of his legs. This suggests that the cause in this case could only be central in origin. Visual appreciation seems to be an important step in this process.
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PMID:Phantom pain following limb amputation in a paraplegic. A case report. 687 96

A case of a 36-year-old man, with a history of traumatic amputation below the elbow on the left side, resulting in intractable phantom limb pain, is described. The patient failed to respond to a variety of medications including several analgesics, tranquilizers, and a beta-blocker. Other extended series of conventional treatment modalities, which included stellate ganglion and peripheral nerve blocks and neuromal excision with the anterior transposition of the ulnar nerve, did not relieve the pain. Acupuncture was then attempted with the subjective relief of phantom limb pain and the objective result that the patient could wear a prosthesis.
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PMID:Acupuncture in phantom limb pain. 697 7

A survey of phantom limb pain treatment methods currently used by Veterans Administration hospitals, medical schools, pain clinics, and pain specialists in the United States was carried out to determine which treatments are in use, their success rates as estimated by their users, and experience with unsuccessful treatment methods used by patients prior to referral to the respondent. The combined results of a recent literature search and this survey identified 68 treatment methods of which 50 were commented upon by the survey respondents as being in current use. Only a few treatment methods were even moderately successful when subjected to the criterion of low failure rates after one year. Non-surgical treatment methods were far more successful than surgical ones. A possible treatment regime based on optimizing moderately successful methods is proposed for further study.
Pain 1980 Feb
PMID:A survey of current phantom limb pain treatment in the United States. 698 65

Intraneural microelectrode recordings were made from the nerve supplying the phantom area in two patients suffering from phantom limb pain. Spontaneous activity was prominent in both cutaneous and muscle fascicle of the nerves. Tapping the neuromata which accentuated the phantom limb pain, induced afferent discharges with both short and long latencies, the latter from fibres with a conduction velocity of only 0.5 m/sec. Blocking the neuromata with lidocaine completely abolished the tap-induced afferent discharges and the tap-induced accentuation of the phantom pain. The spontaneous pain was, however, unchanged, as was the spontaneous activity recorded.
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PMID:Microelectrode recordings from transected nerves in amputees with phantom limb pain. 732 53


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