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

Acute brachial neuropathy is an uncommon etiology of shoulder pain and disability. It can, however, present in association with athletic activity and therefore must be included in the differential diagnosis of athletes with such symptomatology. Findings that should alert the examiner to the possible presence of acute brachial neuropathy include 1) onset with noncontact as well as contact sports, 2) rather acute onset of pain without specific inciting trauma, 3) persistent, often severe pain that continues despite rest, 4) patchy brachial plexus and/or peripheral nerve involvement, and, 5) dominant arm predominance of symptoms and signs. Electromyography and nerve conduction studies often can confirm the diagnosis. Treatment begins with rest and continues through a rehabilitation phase. Followup of athletes with acute brachial neuropathy discloses that weakness may persist in the affected muscles. Absolute strength parity may be difficult to achieve, so permission to participate in athletics must be given on a case by case basis.
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PMID:Acute brachial neuropathy in athletes. 261 Feb 81

Shoulder pain is one of the most common musculoskeletal complaints in the elderly. The rewards of accurate diagnosis and early treatment often elude the orthopaedist without a systematic approach to this region. A thorough understanding of shoulder anatomy, pain referral patterns, and the pathophysiology of the aging process must be combined with an awareness of the latest treatment modalities and surgical techniques.
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PMID:Approaches to senior care #7. Shoulder pain in the geriatric patient. Part II. Treatment options. 264 63

The rotator cuff syndrome is defined as a cronical pain syndrome, originating from the rotator cuff with characteristic pain and referred pain. Disorders evolving from the rotator cuff and the rotator muscles comprise between 70 og 90% of the shoulder disorders. The rotator cuff syndrome may be of occupational origin, particularly in heavy work with tasks at or above shoulder level, e.g. shipyard welders and plate workers. Biomecanically surveys show that continuous blood flow in the rotator muscles ceases at about 30 degrees of flexion or abduction of the upper arm. Electromyographic examinations have shown high muscle tension in the same muscles in assembly plant employees. High prevalences of shoulder pain have been shown in these groups and it is considered that the workers are actually suffering from disorders in the rotator cuff and its muscles. The rotator cuff syndrome is on the list of occupational disorders in the Danish Workers' Compensation Act but, in the authors' experience knowledge on etiology, examination and treatment is insufficient. Diagnostic criteria are proposed with the object of improving clinical practice and medical insurance declarations.
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PMID:[The rotator cuff syndrome--a frequent disease caused by loading]. 267 48

A 39-year-old woman developed transient erythema and arthralgia in spring 1987. In June she had a tick bite followed by local erythema and later migrating skin changes. Furthermore she developed pain in various joints with Raynaud's phenomenon at the fingers, swelling of the knee joints and shoulder pain. Demonstration of antibodies against B. burgdorferi antigen was shown in one institution (IFL, Western blot) while the same serum in two other institutions remained negative (IHA, ELISA). Antibiotic treatment was only temporarily successful. While the demonstration of antinuclear factors could be attributed to cross-reacting antibodies in borreliosis failing effects of absorption of serum with this antigen led to the assumption SLE as the underlying disease. Further indications were lymphopenia, increasing titers of anti ds-DNA antibodies and renal involvement as erythrocyturia and proteinuria. Sudden relief of the symptoms after treatment with steroids may be taken as further prove for this assumption. The interference of both diseases and their similarity in symptoms may impede correct diagnosis.
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PMID:[Borrelia infection and systemic lupus erythematosus]. 269 42

Tendomyopathies (TM) comprise two subgroups. Both are caused by the irritation of nociceptors (IN). Type I results from IN within muscles and tendons with the consequence of local pain, whereas type II refers to TM occurring at a site distant from IN anywhere in the body. Such TM-type II are understood to serve for the protection of the organism from further IN and depend on the regulatoric role of the central nervous system ("reflectoric TM"). Reflectoric shoulder pain emerging from arthritis in carpal joints (Hiemeyer et al.: Z. Rheumatol. 48, 1989, 139-143) is quoted as an example of such "regulatoric pain". Abnormal spinal posture (ASP) is believed to cause IN at various sites of the sceletomotoric system with the consequence of localized or generalized fibromyalgic syndromes (FS) of the type II subgroup. Now clinical signs of TM such as pain during motion, compression or stretching as well as muscular stiffness and fatigue are characteristic for so called primary FS; in addition, the majority of such patients exhibits ASP, especially increased thoracospinal kyphosis (Hiemeyer et al.: Akt. Rheumatol. 14, 1989, 193-201). For these reasons we arrive at the conclusion that ASP is a disposing factor for the development of FS. Therefore FS should not be called primary unless spinal posture has not been examined thoroughly. As a result of this concept we consider control of spinal posture by physiotherapy as an essential part in the causal treatment of FS.
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PMID:[Pathogenesis of tendon-/muscle pain with special reference to posture--a concept related contribution to the understanding of generalized tendomyopathy]. 269 90

Rotator cuff problems present with shoulder pain on repetitive overhead activity. Chronic irritation may develop into impingement tendonitis, with weakness of abduction and external rotation and night pain. Conservative management with rest, anti-inflammatory medicine and physiotherapy resolves the majority of symptoms. If these persist, surgical decompression affords good relief of pain.
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PMID:Rotator cuff disorders. 269 2

Chronic inflammation and degenerative tendonitis of the supraspinatus muscle is an important cause of intrinsic shoulder pain. Injury to this muscle is usually caused, not by a single event, but by slight to moderate trauma repeatedly to the same anatomic area. The term repetition strain injury is used to describe this form of microtrauma. Repetition strain injury of the supraspinatus muscle is not an isolated event, but rather a form of microtrauma that affects the entire shoulder girdle. This functional unit must be evaluated and considered in the treatment plan. The authors discuss the diagnosis of this pain syndrome, which is based on the patient's work history, motion and strength testing, and palpation for trigger points. They also provide instruction in treatment involving manipulation with functional and counterstrain techniques combined with home exercise and modification of work posture.
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PMID:Shoulder pain and repetition strain injury to the supraspinatus muscle: etiology and manipulative treatment. 280 18

The relationship between psychologic work variables and reported neck and shoulder pain was examined among secretaries. A battery of questionnaires concerning the experienced psychologic work environment as well as musculoskeletal pain symptoms was completed by 420 secretaries at a large medical center. A relatively "poor" psychologic work environment was compared with an environment that was experienced as "good." A "poorly" experienced psychologic work environment was related to a higher frequency of neck and shoulder pain. The relative risk for frequent neck pain was 2.85 (95% confidence interval 1.28 to 6.32) and for frequent shoulder pain 3.32 (95% confidence interval 1.53 to 7.23). Furthermore, the subindexes of work content and social support at work were found to be related to pain, whereas no clear relationship was found for work demands. The results of this study demonstrate the possible importance of the psychologic work environment in the development of musculoskeletal pain disorders. Future investigations should replicate these findings as well as isolate specific mechanisms so that preventive measures may be instituted.
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PMID:Risk factors in the psychosocial work environment for neck and shoulder pain in secretaries. 276 56

A case report of a ligamentary ectopic pregnancy that failed to respond to prostaglandin E2 for induced abortion for sepsis at 24 weeks is presented. The 27-year-old nullipara had normal ultrasound findings for gestational age up to 21 weeks gestation. She had consulted at 5 weeks for abdominal pain and bleeding, at 14 weeks again for abdominal pain, shoulder pain and vaginal bleeding, although both times the pain and bleeding resolved spontaneously. She was seen again at 16 and 21 weeks gestation, when ultrasound scans were normal for dates. At 24 weeks, she experienced vaginal discharge of blood and tissue, and was managed as premature rupture of membranes. She became septic 12 days later. She was treated with transcervical PGE2 and iv oxytocin without response for 3 days. Surgical evacuation was successful, but bleeding persisted. During laparotomy she had a large left broad ligament hematoma, a left ruptured uterus, and open left internal iliac artery and vein. These were repaired, and she received 40 units of blood, 8 platelets and 14 of plasma. Only after histology was the diagnosis of ligamentary pregnancy made. The lack of response to PG for abortion should raise suspicion of ectopic pregnancy, although preoperative diagnosis of ligamentary pregnancy is extremely rare.
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PMID:A rare gynecologic contraindication to the use of prostaglandins and oxytocin to induce abortion. A case report. 279 68

Thirty-seven patients with chronic neck and shoulder pain were treated with a series of electro-acupuncture treatments. All patients had been unresponsive to previous conventional and placebo treatments for their pain. A double blind evaluation of acupuncture results and hypnotic profiles failed to demonstrate any correlation between the two. Twenty-four or 64.9% of our patients obtained significant long term improvement. An increase in regional microcirculation by peripheral sympathetic blockade from electro-acupuncture is thought to be responsible for the tissue healing and subsequent pain relief.
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PMID:Long-term therapeutic effects of electro-acupuncture for chronic neck and shoulder pain--a double blind study. 288 35


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