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

Twelve patients treated with cervical traction for complaints of cervical radicular pain subsequently developed lumbar radicular discomfort. Intermittent cervical traction therapy had been initiated at 15 pounds and increased to 30 pounds. Lumbar spine roentgenographs in four patients demonstrated a transitional lumbar vertebrae and ten patients had evidence of spinal osteoarthritis with associated degenerative changes. Abnormal electroneuromyographs were found in four patients. In two additional patients with normal electromyographs, the spinal evoked potentials were asymmetrically slowed suggesting chronic lumbar root compromise. The onset of lumbar radiculopathy after intermittent cervical traction suggests that axial tension induced in the spinal cord's dural coverings can be transmitted to lumbar nerve roots. When these structures are tethered by anatomic variants and/or associated degenerative changes, spinal root excursion may be limited, and lumbar pain may be precipitated by traction.
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PMID:Intermittent cervical traction: a progenitor of lumbar radicular pain. 153 17

This double-blind, parallel, controlled and randomized trial compares the clinical efficacy and tolerance of a new NSAID (pro-drug of piroxicam), droxicam, at the dose of 20 mg/day against that of piroxicam at the same dose. The comparison is drawn after the administration to 30 patients with spinal osteoarthritis during 8 weeks after a single-blind placebo-period run-in of 7 days. Results show that both drugs improve, with statistical significance, all parameters evaluated (pain intensity, morning stiffness, nocturnal pain, pain after getting up and after 30 min standing, difficulty in daily living, frequency of pain exacerbations and the ability to do several daily activities). No statistically significant differences were found between groups. Only one case in the droxicam group and two in the piroxicam group reported subjective complaints of mild intensity that did not require additional treatment or interruption of the study.
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PMID:A clinical trial comparing a new NSAID (droxicam) and piroxicam in spinal osteoarthritis. 225 50

Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in all patients showed changes consistent with an acute radiculopathy. All patients responded to anti-inflammatory therapy in combination with phenytoin, carbamazepine, amitriptyline, or local nerve block. TNRD is a condition that may be diagnosed earlier if clinical suspicion is increased, thus sparing patients excessive testing and surgery, and affording quicker relief.
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PMID:Thoracoabdominal radiculopathy. 282 60

Spondyloarthritis (Sp) is newly defined as arthritis that is clinically, pathologically, and genetically related to and predisposed to ankylosing spondylitis (AS) and Reiter's syndrome (RS) rather than to rheumatoid arthritis (RA). A diagnosis of Sp does not necessarily imply arthritis of the spine and does not depend on the demonstration of roentgenographic sacroiliitis that, in this conceptualization, is recognized not as the essential hallmark, but rather merely as a diagnostic "way station" on a continuum of disease, which may (but need not necessarily) begin with RS or be complicated during its course by AS or RS. Spondyloarthritis is distinctively characterized morphologically and clinically by disproportionate inflammation at the entheses, the sites of attachment of tendons and ligaments to bone. Family history or presence of enthesopathic pain, psoriasis, inflammatory bowel disease, uveitis, recurrent urethritis, prostatitis or cervicitis, keratoderma blennorrhagicum, HLA-B27, and asymmetric pauciarticular lower lower extremity arthritis without rheumatoid factor or rheumatoid nodules suggests a diagnosis of Sp rather than RA.
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PMID:Spondyloarthritis and enthesopathy. Current concepts in rheumatology. 621 89

This presentation will briefly describe the operation of this Pain Center and discuss the two chronic pain problems most commonly seen in our geriatric population: osteoarthritis of the spine and herpetic neuralgia. Osteoarthritis of the spine is the most common radiologic finding in middle-aged and older people with low back pain. 32% of our patients have this diagnosis as the basis of their chronic pain. The typical patient is 72 years old and has a past pain history which includes several years of back pain treated by various physicians with anti-inflammatory agents and analgesics to no avail. Past history of surgery and drug abuse is rare; however, depression is common. Therapy at the Pain Center is primarily the use of an exercise program and epidural and/or subarachnoid steroids. At the last visit, approximately 70% of the patients have had significant improvement. Herpetic neuralgia is found in 13% of all patients seen at the Mount Sinai Medical Center Pain Center. Our typical patient is 73 years old and has had PHN for 10 months unrelieved by various topical and oral medications. Although rarely is there a history of drug abuse or surgery, extreme depression is common. If the duration of the neuralgia is less than one year, 85% of patients get significant or complete relief from the use of sympathetic nerve blocks and/or the subcutaneous infiltration of steroids and local anesthetic. Once the PHN has been present for more than one year, only 55% of the patients are improved.
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PMID:Treatment of osteoarthritis of the spine and herpetic neuralgia at the Pain Center, Mount Sinai Medical Center. 626 70

137 out-patients suffering from osteoarthritis of the spine were treated for two-weeks by pirprofen (600 mg/day), indomethacin (75 mg/day), or placebo. At the end of the trial, spontaneous pain disappeared in 47% of patients in the pirprofen group, 38% in the indomethacin group, and 17% in the placebo group. The efficacy of pirprofen and indomethacin, compared to the placebo, is demonstrated with respect to both spontaneous pain (p less than 0,01) and functional disorders (p less than 0,05). Side effects, especially digestive, were noted in 29% of patients treated by pirprofen, 33% of those treated by indomethacin and 17% of those on placebo. Tolerance was satisfactory in 86%, 80% and 90% of patients. Pirprofen is thus judged an effective drug for the treatment of osteoarthritis of the spine.
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PMID:[Comparative double blind study of pirprofen, indomethacin, and placebo in the treatment of osteoarthritis of the spine]. 713 73

A new oral dosage form of diclofenac sodium, enabling the single administration of the daily dose of 150 mg, has been tested for treatment of 20 patients suffering from osteoarthritis of the spine. A control group of 20 patients with the same diagnosis instead received 3 enteric-coated tablets/day, each containing 50 mg of the drug. Treatments lasted in both groups one month. Clinical efficacy was monitored by evaluating the changes in the disease's symptoms and signs (pain, cramps, alterations of function capacity, morning stiffness) and in some laboratory parameters (ESR, C-reactive protein, Rheuma test). Treatment tolerability was evaluated through the routine laboratory blood and urine tests, and by registering any complaint at the gastrointestinal level, as well as any adverse event. The two posology schemes were equally effective in favourably reducing the disease's clinical and laboratory manifestations. Also systemic and local tolerability were superimposable and on the whole good: only a few episodes of mild epigastralgia were reported (3 cases in each group), as expected during a treatment course with NSAIDs.
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PMID:Effective treatment of osteoarthritis with a 150 mg prolonged-release of diclofenac sodium. 917 25

The authors report a case of C1-C2 fusion which was performed in a 64-year-old woman with unilateral atlantoaxial osteoarthritis, who consulted because of incapacitating occipital pain and decreased cervical rotation without neurological deficit. The diagnosis of unilateral C1-C2 osteoarthritis was confirmed by an open-mouth radiograph, a bone-scan, a computerised tomography scan, and magnetic resonance imaging. C1-C2 fusion was performed using a computer assisted navigation system and posterior instrumentation. This resulted in marked relief of pain, and distinct improvement in quality of life. The prevalence of atlantoaxial osteoarthritis is about four per cent in patients suffering from peripheral or spinal osteoarthritis. However, many primary-care providers are not familiar with this entity. C1-C2 fusion remains rare, due to the difficulties related to the diagnosis of atlantoaxial osteoarthritis, its established non-operative treatment options, and the fact that it has not received adequate attention in the orthopaedic literature. However, based on review of the literature, it can be stated that C1-C2 fusion is an effective and safe procedure providing distinct reduction of pain and increased quality of life in case of failure of conservative treatment.
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PMID:Osteoarthritis--a rare indication for atlantoaxial fusion. A case report and review of the literature. 1548 28

Spondyloarthritis (SpA), a family of inflammatory back diseases including ankylosing spondylitis, is an important and under-recognized cause of chronic back pain in younger patients who are likely to participate in sports and athletic activities. These diseases are characterized by the presence of inflammatory back pain--lumbar or buttock/hip pain lasting longer than 3 months associated with improvement with activity, worsening with rest, relief with non-steroidal anti-inflammatory drugs (NSAIDs), and morning stiffness lasting longer than 30 min. There are also characteristic radiographic findings involving the sacroiliac joints, vertebrae, and in certain diseases, the peripheral joints. Exercise has long been recognized as a key component of the therapy of SpA, yielding benefits in mobility, pain, stiffness, functionality, and depression. Sports also pose a risk to patients with SpA as these patients are at high risk of spinal fracture and spinal cord injury.
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PMID:Spondyloarthritis: clinical suspicion, diagnosis, and sports. 1914 77

Analgesic effects of etidronate, alendronate and risedronate were compared in patients with osteoporosis and/or osteoarthritis by measuring the fall of skin impedance along with conventional subjective pain-estimation by visual rating scale (VRS). One hundred ninety-nine postmenopausal women consulting the Osteoporosis and Osteoarthritis Clinic of Katsuragi Hospital complaining of back and/or knee pain were randomly divided into four groups; Group A (49 subjects) given 5 mg/day alendronate, Group E (50 subjects) 200 mg/day etidronate, Group R (50 subjects) 2.5 mg/day risedronate and Group P no bisphosphonate. None of the four groups showed significant deviation from others as to age and parameters of bone metabolism. Proportions of subjects with osteoporosis was 18-40%. Those with osteoarthritis of the spine and knee, higher than Grade II according to the Nathan and Lawrence-Kellgren scale, respectively, was 45 and 61%, respectively, without a significant difference among the four groups. Significant positive correlation was found between the fall of skin impedance and pain expressed in VRS. Attenuation of exercise-induced fall of skin impedance and also subjective pain expressed in VRS was greatest in Group E with a highly significant difference from Groups A (P = 0.0002 and P < 0.0001), R (P < 0.0001 and P = 0.0014) and P (P < 0.0001 and P < 0.0001). Neither A nor R showed significant difference from P as to the fall of skin impedance. Among the three bisphosphonates tested, etidronate appeared to be outstanding in analgesic effects.
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PMID:Comparison of the analgesic effects of bisphosphonates: etidronate, alendronate and risedronate by electroalgometry utilizing the fall of skin impedance. 1921 75


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