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

The incidence of the postpartum sequelae of headache, backache, pain in the legs and difficulties in micturiton, was studied in 219 normal vaginal deliveries. 135 of the parturients received continuous segmental epidural analgesia at the level of Th 10--12 for pain relief during the first stage of labour. The remaining 84 parturients served as controls. The results showed that segmental epidural analgesia did not increase the occurrence of postpartum sequelae either in primiparous or in multiparous parturients.
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PMID:Segmental epidural analgesia and postpartum sequelae. 15 Feb 49

From the data presented it appears that acupuncture helped in more than 50% of the patients by either completely or partially controlling pain from certain disorders. Patients helped by acupuncture received 8.55 treatments on the average, while patients not helped by acupuncture only received 4.75 treatments. There is difference between the male and female patients as to the response to acupuncture. However, we noticed that the younger the patient and the shorter the duration of their of problems, the better the response. Patients who had not had surgery to treat the pain syndrome responded better than those who had had previous surgery. Patients with backache who had previously had laminectomy showed better response to acupuncture than patients who had had spinal fusion. It appears that good general health plays an important role in favorable response to acupuncture treatment. Acupuncture may be a valuable extension of a conventional pain clinic and an alternative in patients who are desperate to obtain relief from pain which they failed to obtain from other methods.
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PMID:Two and a half years of acupuncture in Alabama. 15 Jun 45

Sixty patients requiring repeat surgery after lumbar disc excision are reviewed. Thirty-one had had their initial surgery performed by the authors and represent a 5.9% frequency of repeat surgery after initial laminectomy for sciatica. Of the 60 patients, 49 suffered recurrent radicular pain, 20 suffered from back pain, and 8 had other problems (infection, extradural cysts, etc.). In patients with recurrent sciatica, perineural fibrosis and recurrent herniation were the most common problems; those patients with the latter pathologic condition responded most favorably to repeat surgery. Of 520 patients who had undergone disc excision, only 9 required secondary fusion.
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PMID:Repeat surgery after disc excision. 15 69

Anterior lumbar disc herniations can easily and clearly be evidented by discography. The morbidity and, especially, the clinical importance of this entity, however, has been described by some authors only. According to our own experience with discography, ventral lumbar disc herniation seems to be correlated with a painful syndrome consisting of both a typical and circumscribed backache and pain radiating into the abdominal cavity and genital area along the lateral aspect of the lumbar region.
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PMID:[Anterior lumbar disc herniations (author's transl)]. 15 25

Studies that used the MMPI to predict the response of chronic low back pain patients to standard medical treatment have not produced definitive results. Patients seen in a university hospital orthopedic back pain clinic were given the MMPI before treatment, and 6 to 12 months later 76 patients completed follow-up forms that indicated their level of intensity during the previous week and their ratings of the success of treatment in relieving their pain as well as in enabling them to return to normal activities. Predictions of poor response were made in terms of either single MMPI scales or code types. Patients with poor outcome on two of the three criteria (level of pain intensity and ability to return to normal activities) had significantly higher scores on the Hs scale. The predicted high risk code types very accurately identified patients with poor response on the same two criteria; however, the code-type procedure overpredicted poor response in the good outcome group.
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PMID:The MMPI as a predictor of response to conservative treatment for low back pain. 15 39

Pain descriptors of patients with low back pain were analyzed to determine their usefulness in identifying patients without demonstrable organic disease. Using a standardized back pain questionnaire which scales qualities of pain along 7 independent factors, it was possible to make clear distinctions between the subjective reports of patients with and without demonstrable organic disease of the lower back. Pain described by patients with demonstrable organic disease tends to be consistent and specific; whereas pain described by patients without demonstrable organic disease tends to be more variable and diffuse. Pain reported by the latter group was also more intense. Factors which may underlie these findings were discussed.
Pain 1979 Apr
PMID:Low back pain in patients with and without demonstrable organic disease. 15 3

The majority of patients with a recent onset of back pain that developed rapidly over a few hours have nonspecific spinal disease. The disorder is likely to be self-limited. In contrast, patients presenting with an insidious onset of pain that has lasted for several weeks may have ankylosing spondylitis. Since management differs for the two types of disease, the correct diagnosis is mandatory. The diagnosis of ankylosing spondylitis is confirmed radiologically.
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PMID:Back pain: mechanical or inflammatory? 15 67

Low-back pain may originate in the thoraco-lumbar joints. Due to motion and stress, the latter constitute a high-risk transitional zone. Pain is transmitted by the posterior branches of the D11, D12 or L1 spinal nerves, which innervate the cutaneous and subcutaneous levels of the low-back and upper buttocks region. It is experienced as a deep-seated pain. Clinical examination makes it possible to determine the level responsible. The lumbar pain disappears with anesthesia of the interapophysary articulation. Appropriate medical treatment most often succeeds. If its fails, surgery can provide a solution. It consists of a capsulectomy on the level responsible, and on the upper and lower adjoining regions. This operation also destroys the posterior branch, which is closely joined to the capsule. Out of the 10 cases operated on, there was 1 failure, 6 very good results and 3 good results after follow-up periods of 20 months to 6 months. Without prejudging the future, it seems that there is hope for the treatment of unexplained back pains or those persisting after operations on lumbar disks that are not relieved by appropriate medical treatment of the thoraco-lumbar joints.
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PMID:[First results of a surgical treatment of a persistant low-back pain of dorso-lumbar origin]. 15 19

Low back mobility and electromyographic movements were performed in 121 normal subjects, grouped by age and sex. Women tended to show greater ranges of motion for straight leg raising, trunk rotation and lateral bending while vertebral separation (forward flexion) was greater in men. A sex-age interaction was observed only in lateral bending, thus implying that for other mobility measurements, data within the age groupings employed in this study can be combined for men and women. Electromyographic data were integrated and quantified using EMG biofeedback equipment for unilateral or bilateral recordings made primarily from the erector spinae muscle between lumbar 3-4 and lumbar 4-5 levels, three centimeters lateral to the spinous processes. Dynamic (trunk flexion-extension, lateral rotation-standing, stooping) and static (quiet sitting, rotation-sitting) movements were performed over a ten second interval. Data analyses verified previous electromyographic studies by demonstrating the trunk extensor function of the erector spinae and the relatively greater unilateral activity when turning to the opposite direction in the erect posture. EMG silence was seen during full trunk flexion. Noticeable sex-age interaction were observed for all dynamic movements but not for static activities. Therefore, it is suggested that EMG data during dynamic movements in a normal population cannot be grouped for men and women within a specified age distribution. These data represent one series of baselines to which mobility and movement patterns in a back pain patient group can be compared. Suggestions are offered for the use of EMG biofeedback during dynamic lower back movements as a possible method of alleviating the pain state, perhaps by altering the patient's posture.
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PMID:Normative data on low back mobility and activity levels. Implications for neuromuscular reeducation. 15 15

The piriformis is a deep-seated muscle, most of its muscular portion being part of the dorsal wall of the pelvis. The lateral portion and its insertion is extra-pelvic and lies deep to the glutei. Like more superficially located and therefore more easily accessible skeletal muscles, the piriformis too can be the seat of trigger points, giving rise to symptoms indistinguishable from those of other causes of low backache, unless a deliberate search is made for the signs specific to the piriformis syndrome. Having made a presumptive diagnosis, confirmation is gained by palpating the muscle itself via rectum or vagina and reproducing the pain by digital pressure. If this test also is positive, the muscle is injected, the approach being either through the sciatic notch, from the perineum, or through the vagina. Immediate relief of pain is experienced after the solution of local anaesthetic and steroid has been deposited deep within the fleshy portion of the muscle.
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PMID:Chronic pain syndromes and their treatment. III. The piriformis syndrome. 15 71


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