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

By measurement of intradiscal pressure in vitro, the hydrostatic properties of the nucleus pulposus of normal lumbar intervertebral disc was established. The stress distribution within normal discs subjected to vertical load was also explained, demonstrating the high tangential strains occurring in the posterior part of the annulus fibrosus. Intravitally performed measurements of disc pressure have demonstrated how the load on the lumbar disc varies according to the position of the subject's body. Compared to the pressure or load in the upright standing position, reclining reduces the pressure by 70%, while unsupported sitting increases the load by 40% and forward leaning and weight lifting by more than 100%. Similar relatively large augmentations of the load were observed in subjects performing various commonly used muscle-strengthening exercises. Measurement of intradiscal pressure is instrumental in explaining, from a mechanical point, the occurrence of posterior ruptures in the lumbar discs, and provides a basis for the rational treatment of patients with low-back pain in so far as these exhibit increase of pain on increased mechanical loads. For the majority of patients with low-back pain, the cause is unknown, although most evidence so far presented links the lumbar intervertebral disc to the pain syndromes. Results of recent studies have shown that both chemical and mechanical factors are probably of importance. So far we cannot successfully treat the chemical part of the disc syndrome. Since all our patients exhibit more pain when the spine is mechanically loaded, knowledge gained from intravital disc-pressure measurements provides a basis for successfully treating the mechanical part of the condition. Since none of the frequently prescribed and more spectacular remedies has ever been proved statistically superior to any of the others, it is most fair to our patients and to ourselves to use simpler, less expensive, and less dangerous programmes, such as bed-rest, administration of salicylates, and proper ergonomic advice. Based on a scientific approach, the low-back-pain school is intended to help the patient to be able to cope with these back troubles, to avoid excess therapy, and to decrease the cost both for the individual and for Society.
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PMID:Towards a better understanding of low-back pain: a review of the mechanics of the lumbar disc. 12 14

Four elements of the nervous system may be involved in the production of the lumbar intervertebral disc syndrome. These are the lumbosacral nerve roots, the spinal nerves, the dorsal rami and the sinuvertebral nerves. Each nerve is associated with a particular group of pathological conditions which may irritate the nerve and produce symptoms. The anatomy of each nerve determines which particular conditions may irritate it. Moreover, one or both of two mechanisms may be involved in symptom production. The type of nerve irritated determines which mechanism is involved. In the first mechanism, low back pain and referred lower limb symptoms are produced when afferent fibres from dorsal and ventral rami are stimulated where they pass in common through spinal nerves or nerve roots. In the second mechanism, dorsal rami or sinuvertebral nerves are stimulated. This directly produces low back pain, but referred pain is produced by reflex mechanisms in the spinal cord.
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PMID:The anatomy of the lumbar intervertebral disc syndrome. 13

The cervical discogenic (painful disc) syndrome consists of scapular pain radiating to the head, shoulder and upper arm, often associated with paraesthesiae but without neurological deficit. Analgesic discography confirms the diagnosis and more accurately locates the pain-producing disc. In this series of patients analgesic discography followed by anterior cervical fusion with or without discectomy resulted in an 81% excellent or good result. Analgesic discography is the most effective test for location of the lesion in the painful disc syndrome.
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PMID:Cervical analgesic discography. A test for diagnosis of the painful disc syndrome. 356 72

Low back pain, referred pain in the lower limbs, and spasm of the back, gluteal, and hamstring muscles are clinical features which can be induced in normal volunteers by stimulating structures which are innervated by the lumbar dorsal rami. Conversely, they can be relieved in certain patients by selective interruption of conduction along dorsal rami. These facts permit the definition of a lumbar dorsal ramus syndrome, which can be distinguished from the intervertebral disc syndrome and other forms of low back pain. The distinguishing feature is that, in lumbar dorsal ramus syndrome, all the clinical features are exclusively mediated by dorsal rami and do not arise from nerve-root compression. The pathophysiology, pathology, and treatment of this syndrome are described. Recognition of this syndrome, and its treatment with relatively minor procedures, can obviate the need for major surgery which might otherwise be undertaken.
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PMID:Lumbar dorsal ramus syndrome. 645 Aug 75

The authors measured endorphin levels in the cerebrospinal fluid (CSF) of 12 patients with chronic pain due to lumbar disc syndrome and eight patients with acute postoperative pain. These were compared with CSF endorphin levels in 20 control patients with no history of pain. Endorphins were extracted by adsorption to a synthetic resin (Amberlite XAD-2), eluted with methanol, and assayed using the electrically stimulated mouse vas deferens. Results were expressed as methionine-enkephalin (Met-E) equivalents, which was the standard in the bioassay. The CSF endorphin level was 0.42 +/- 0.07 pmol/ml (mean +/- SE) in the postoperative group, 1.44 +/- 0.2 pmol/ml in the chronic pain group, and 4.36 +/- 0.89 pmol/ml in the control group. CSF endorphin levels in the two pain groups differed significantly from both the control group and each other. These results suggest a correlation between pain levels and endorphin concentration in the CSF; however, in the acute postoperative pain group the influence of other factors such as anesthesia or surgical stress cannot be evaluated.
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PMID:Endorphin levels in cerebrospinal fluid of patients with postoperative and chronic pain. 709 14