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

For fifty-five patients with acute low-back pain or radicular pain, ascending lumbar venography was as accurate as myelography (86 per cent) in localized herniation of a lumbar disc in surgically proved cases. Myelography and lumbar venography are complementary diagnostic studies which should be used together in doubtful cases. Lumbar venography is easily performed is well-tolerated, and is relatively painless. It is not associated with arachnoiditis and has a negligible complication rate.
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PMID:Ascending lumbar venography in lumbar-disc disease. 84 98

The purpose of this report concerned with the activities of the acupuncture clinic at UAB during the past 2 years and 3 months, is to objectively assess the role of acupuncture in the treatment of various pain disorders for which conventional pain relieving methods had failed to yield satisfactory results. In carefully analyzing the data provided by the patients through completed questionnaires, an attempt was made to look at the results obtained as unbiased as possible and to determine whether it is justified to continue the acupuncture activities at UAB or terminate them. From the data presented it appears that acupuncture helped in more than 50 percent of the patients by either completely or partially controlling the suffering from painful 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 little 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 problems, the better the response. Patients who had not had surgery to treat the pain syndrome responded better than those who had previous surgery. Patients with backache who had previously had laminectomy showed better response to acupuncture than the patients who had spinal fusion. It appears that good general health plays an important role in favorably responding to acupuncture treatment. It is apparent from this survey that acupuncture may be a valuable extension of a conventional pain clinic and an alternative in patients who are desperate in their desire to get relief from pain which they failed to obtain from other methods.
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PMID:Therapeutic effect of acupuncture for chronic pain. 84 56

The principal clinical features and radiological findings relating to the locomotor system have been studied in 32 consecutive hospital admissions of patients with Wilson's disease. 5 of these patients were recently diagnosed and had as yet received no treatment, while 27 were routine admissions for follow-up and biochemical supervision of their illness. No patient was specifically included or excluded from the series because of the presence or absence of locomotor symptoms. The most common radiological abnormality was a generalized increase of radiolucency, interpreted as skeletal demineralization (21 cases), followed by premature osteoarthrosis (8 cases). Changes in the spine were common and included osteochondritis, reduction of intervertebral joint spaces, osteoarthrosis, and a tendency to squaring of vertebral bodies. Other bony changes included fluffy irregularity of femoral trochanters, osteochondritis dissecans of the knees, osteophytic protrusions at bone ends, and bunches of tongue-like osteophytes at joint margins. The symptoms associated with these radiological abnormalities comprised back pain and stiffness with restricted movement, pain and stiffness of knees, hips, and wrists, and tenderness to pressure over margins of affected joints. Joint hypermobility was also observed in 9 patients. Episodes of acute polyarthritis with serological changes were seen in 5 cases; all these episodes appeared to be related directly to treatment with penicillamine.
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PMID:Arthropathy of Wilson's disease. Study of clinical and radiological features in 32 patients. 85 45

An 18-year-old woman was evaluated for aching mid thoracid back pain of 4 years' duration. At 13 degrees left thoracic scoliosis was noted in association with a sclerotic process involving the inferior portion of the vertebral body of T7 and the superior margin of T8 across a well maintained disk space. Open biopsy confirmed the impression of a nidus in the body of T7 which was histologically consistent with osteoid osteoma. The disk space was well maintained and the sclerotic changes in the superior margin of T8 appeared to represent reactive change. Postoperative relief of back pain was complete. The occurrence of reactive bone across an intact disk space in response to an osteoid osteoma nidus is unique to this case. Osteoid osteoma should be included in the differential diagnosis of chronic spine pain and reactive changes secondary to irritant property of the nidus may be widespread.
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PMID:Osteoid osteoma of a vertebral body: report of a case with extension across the intervertebral disk. 95 71

The paper is based on discussions which took place in a seminar at the European League against Rheumatism Meeting in Helsinki in 1975. The importance of assessing the emotional response in rheumatoid disease, as well as the disease process, is stressed. It is important to consider the effect of the discovery by the patient that severe disease is present. Considerable support by general practitioners and consultants may be necessary at this time. There has been much discussion as to whether patients suffering from rheumatoid arthritis have a different type of personality than other subjects. The evidence is not convincing. The role of stress in the aetiology of rheumatoid arthritis is not properly understood. Anxiolytic and antidepressant drugs may help patients to overcome the anxiety and depression associated with rheumatoid arthritis. Children suffering from the disease present a special problem. The incapacity and isolation, especially in old age, which osteo-arthritis brings may lead to depression and antidepressant therapy is often required. When rheumatic pain seems out of proportion to the physical findings, psychogenic rheumatism should be considered. Rheumatic pains occur in masked depression and low backache may be a depressive equivalent. Pain may be used by some patients to communicate distress.
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PMID:Psyche and rheuma. 108 66

27 patients with ascertained ankylosing spondylitis experiencing constant after-midnight-pain received, following three medication-free days, in a double blind, randomized, cross-over fashion indometacin (100 g/day) and d-2-(6'-methoxy-2'-naphthyl)-propionic acid (naproxen) (500 mg/day), as suppositories, for a period of six days each. The intensity of the night-pain was recorded daily. Naproxen was shown to be equally effective as indometacin in alleviating the after-midnight backache of ankylosing spondylitis. Side effects occurred under indometacin in 5 cases, under naproxen in 3 cases.
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PMID:[A double blind comparison of naproxen and indomethacin on the after-midnight-pain of patients with morbus bechterew]. 109 4

Thirty-nine patients with spinal epidural abscess were evaluated at the Massachusetts General Hospital between 1947 and 1974. Twenty had acute symptoms, and purulent epidural collections were present; 19 had prolonged courses, and epidural granulation tissue was observed at operation. Staphylococcus aureus was the most common etiologic agent (57 per cent), followed by streptococci (18 per cent) and gram-negative bacilli (13 per cent). The source of infection was osteomyelitis in 38 per cent of cases and bacteremia in 26 per cent. In 16 per cent epidural abscess was due to postoperative infection. The progression from spinal ache to root pain to weakness followed by paralysis continues to be characteristic of spinal epidural abscess. Although the disease is uncommon, the complications are so serious that prompt diagnosis and treatment are of paramount importance. The combination of back pain with fewer and local tenderness is an indication for cerebrospinal-fluid examination and, depending on the results, immediate performance of myelography.
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PMID:Spinal epidural abscess. 115 60

A portable device is described which can record contours of the spine when standing normally and in extreme postures of flexion and extension. It can also give a numerical record of the range of lumbar movement and of the angles to the vertical in which the sacrum and upper spine are held in relation to the lordotic curve. It is felt that the device may be useful for clinical reports, ongoing assessments of therapy, and for epidemiological studies. Its use as a predictor of those at risk to develop low-back pain or for prognosis in established cases remains to be tested. The device has been used in a back-pain clinic and in an epidemiological survey, where it has been found to be assay and quick to use. Further adaptations may be found to be desirable; these would not detract from the usefulness of the device in that successive readings would still be comparable.
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PMID:A combined flexi-rule/hydrogoniometer for measurement of lumbar spine and its sagittal movement. 116 36

The present review of disk space infection in children agrees with that carried out in 1962.12 The physician who encounters a child with back or hip pain, irritability, and a change in walking pattern should always suspect an infection of the vertebral column, particularly in the presence of limited spine motion, spasm, and an elevated sedimentation rate. S. aureus still is the usual primary infecting agent. Treatment consisting of rigid immobilization of the spinal column during the acutely painful phase appears to be adequate therapy. The use of antibiotics is not generally recommended. Because of this, hospitalization is usually not prolonged unneccessarily. The rationable for the use of antibiotics in one atypical case included recurrence of clinical signs and symptoms despite immobilization. These included persistent pain and spasm associated with a high sedimentation rate. Disk space aspiration probably is no longer necessary or desirable in the usual patient in whom immobilization is generally effective. The prognosis for most patients is good. Occasionally spinal fusion should be considered in this young age group if mechanical backache persists after the infection has been cured. The findings and recommendations regarding management of this disease in children should not be applied to the adult.
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PMID:Disk space infections in children. 117 66

A case of 58 year old female with chronic spinal epidural abscess demonstrating rapid progression of complete spinal cord paralysis without remarkable recovery by laminectomy was reported. Patient had a large subcutaneous abscess on left back, ten years ago. Three months before admission she fell down from stairs and had a compression fracture on the seventh thoracic vertebra. She has been troubled with slight spinal ache and left lower back pain since the fall accident. One month before admission she suddenly noted severe lower back pain with radiation to left side and the pain became more severe. Three weeks after she noted fecal retention without urinary retention. Five days before admission she noted gait disturbance accompanied by numbness of both foots. Three days later she developed inability to urinate and the same day, over the coure of a few hours, she became total paraplegia and anesthesia below the waist. On admission neurological examination and myelography disclosed complete spinal subarachnoid block with flaccid total paraplegia and anesthesia below the lower chest. The clinical diagnosis was spinal epidural mass lesion, probably neoplasm. Laminectomy from Th-6 through Th-9 was performed the next day: three days after complete paralysis. The epidural abscess included pus and soft granulation tissue was found and totally removed. Staphylococcus aureus sensitive to penicillin, chloramphenicol etc. was isolated on becteriologic culture. On seven months after operation, sensory and deep reflexes were considrable improved, but she remained paraplegic without sphincter control. Dicussion were made on the incidence, pathogenesis.
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PMID:[Chronic spinal epidural abscess (author's transl)]. 123 82


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