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

The clinical features of GCA can be classified into: (1) the systemic manifestations of malaise, weight loss, fever, night sweats and depression; (2) the proximal muscle pain and stiffness of polymyalgia rheumatica; (3) arteritic manifestations of pain or tenderness due to local inflammation; and (4) arteritic manifestations of ischaemia due to narrowing or occlusion of vessels. These may occur singly or in any combination and may come and go with the passage of time. Thus GCA can result in many different clinical signs and symptoms. The feared ocular and cerebrovascular complications of the condition can be prevented by the early institution of corticosteroid treatment. Early diagnosis is therefore vital. This is a simple matter when GCA presents in the classical textbook manner, but in atypical cases diagnosis can be exceedingly difficult. The absence of a reliable way of excluding the disease means that diagnosis is often a clinical exercise. A sound knowledge of the many and varied clinical manifestations of GCA is therefore required if the physician is going to prevent the ocular and cerebrovascular complications of GCA by early diagnosis and treatment.
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PMID:Clinical features of giant cell arteritis. 180 19

Fifty patients diagnosed with TMJ internal derangement, myalgia, and headaches, who had not responded well to nonsurgical management and subsequently underwent TMJ surgery, were retrospectively evaluated. The patients were mailed a survey asking them to evaluate the following symptoms: joint pain, joint noise, facial muscle pain, cervical and shoulder muscle pain, headache frequency and intensity, and overall head and neck pain. The majority of patients reported their symptoms as moderate to severe prior to treatment. In addition to reporting decreases in TMJ pain and noise after surgery, the majority of patients responding also reported decreases in myalgia and headaches. Twenty-two patients managed nonsurgically at the same center were also surveyed. The proportion of patients reporting their symptoms as moderate to severe prior to treatment was lower in this group. Patients reporting decreases in myalgia and headaches were in the minority. The study demonstrates that myalgia and headache symptoms associated with TMJ dysfunction that are poorly responsive to nonsurgical management may improve following TMJ surgery.
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PMID:Improvement in myofascial pain and headaches following TMJ surgery. 181 48

A 22-year old unmarried healthy woman was admitted to the Swedish department with low fever, tiredness, SR 75 mm, positive uricult, but no urinary tract symptoms. Urinary tract infection was suspected and treatment was started with norfloxacin. Nevertheless, the urine culture proved to be negative. A few weeks later she had increasing trouble with stiff knee and shoulder joints and the left foot became swollen. The subfebrile status continued, and tonsillitis was suspected and diagnosed. V-penicillin and cefaklor treatment was applied. She was transferred to the infectious diseases ware, where fever was confirmed with leukocytosis (19 x 1 billion/1), C-reactive protein at 66 (normal value 10) mcg/ml, pronounced blood pressure increase (160/130 mm Hg), anemic signs, and pathological liver status with increased transaminases (ASAT 6.3-10.4 and ALAT 8.,8-16 ukat/1). ALP increased slightly to 6 ukat/1. The symptoms of weight loss indisposition, and muscles and joints aches, especially in foot ache continued. Collagen disease was suspected, and she was transferred to the internal medicine department. She regularly had tachycardia and high blood pressure. She had to use crutches for mobility because of the pain. S-albumin was 32 (normal 36- 50) g/l and S-hepatoglobin was 2.7 (normal value .4-1.8) g.l. Various others tests were normal. Ulnaris neuropathy was suspected on the left hand. Intensive blood pressure reducing combination treatment was started with 200 mg x 1 of metoprolol, 10 mg x 2 nifedipin, and 20 mg x 1 enalapril. The Desolett oral contraceptive (containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel) she had been taking for a few months were discontinued. Quick improvement of clinical and laboratory parameters followed. SR and leukocytosis became normal. The values of ALP, ASAT, and ALAT became normal some days later. She was discharged shortly thereafter, and blood pressure medication was gradually discontinued. In the 1940s there were reports about the hepatotoxic effects of synthetic estrogens followed by carbohydrate, lipid, and protein metabolism alterations. Jaundice has also been reported, and the Swedes have an ethnic susceptibility to it. The global incidence rate is 1/10.000 vs. 1/100 and 1/4000 in Sweden induced by high-dose OCs containing more than 50 mcg ethinyl estradiol, but with low-dose OCs this rate is much lower. Both estrogens and gestagens can increase blood pressure. A 1969 study reported that 22 young women developed arthritis, arthralgia, and myalgia after taking pills for 3- 12 months. Rheumatic symptoms were also recorded with pill use. Thus, it is very likely that OCs were responsible for the patient's symptoms, especially since her status rapidly improved after discontinuing them.
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PMID:[Were the severe adverse effects on several organs and the marked blood pressure increase caused by oral contraceptives?]. 182 62

A nationwide two-phase survey was carried out of the adult population of the Netherlands regarding fasciculation, muscle pain and muscle cramp. We conducted a population-based telephone interview with 780 Dutch adults, followed by a questionnaire covering more clinical details, filled out by 311 subjects, who had been interviewed by telephone previously. From these data the frequencies of fasciculation (men 50%, women 61%), muscle cramp (men 28%, women 42%) and muscle pain (men 48%, women 60%) in the Dutch adult population in 1988 were estimated. The combined occurrence of frequent fasciculation and frequent muscle cramp as well as of frequent fasciculation and frequent muscle pain was reported only sporadically. Although the muscular pain-fasciculation syndrome and the muscular cramp-fasciculation syndrome represent combinations of common neuromuscular phenomena, their occurrence in the general population proved to be rare. This finding supports their clinical identity as distinct motor unit hyperactivity syndromes rather than mere coincidences of fasciculation, muscle cramp and muscle pain.
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PMID:Estimation of the frequency of the muscular pain-fasciculation syndrome and the muscular cramp-fasciculation syndrome in the adult population. 183 78

Muscle pain occurs in various neuromuscular disorders with characteristic physiological or biochemical abnormalities. There is, however, a group of patients in whom there is no clear physiological or structural basis for their pains. This syndrome has been called fibrositis or fibromyalgia. Sleep abnormalities have been reported in some of these patients, but have not been confirmed by others. We studied 8 patients with this disorder and found sleep abnormalities that were characterized by nocturnal myoclonus, alpha-delta sleep, and abnormalities compatible with depression. Polysomnography was, therefore, instrumental in helping direct the treatment of these patients. Therapeutic approaches aimed to correct the specific disorders were effective in improving the pain symptoms.
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PMID:Polysomnography in idiopathic muscle pain syndrome (fibrositis). 184 93

Subjective feeling of general fatigue and physiological strain were studied in one hundred female professional employees of industrial worker and full-time nurses. Using an interview questionnaire the feeling of fatigue were studied. The subjects were asked to indicate on the body diagram all the areas of musculoskeletal pain from which they perceived discomfort. Furthermore physical strength test consisting of grip test, back and leg strength test were carried out before and after work on all subjects. The results indicated that the two groups of employees showed different symptoms of "pain" and/or "fatigue," with regard to the different parts of body. It was also noted that the physical strength after work was lower for both groups as compared to before work and even lower for the industrial workers than the nurses. The feeling of fatigue between the two investigated groups was not significantly different, but for the musculoskeletal pain was highly significantly different. The worker group used also more pain-killing drugs for releasing the muscle pain. It was evident that ergonomics intervention for female professional workers was of great importance and urgency, particularly for making the workplace more human. Improvement of the working conditions, better organization of work, and ergonomics interventions are suggested as necessary measures for reduction of pain and feeling of discomfort.
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PMID:Musculoskeletal discomfort and feeling of fatigue among female professional workers: the need for ergonomics consideration. 184 73

Eight normal male volunteers performed 4 repeated sustained voluntary isometric protrusive jaw muscle contractions of 25, 50, 75 and 100% of maximum effort. Each contraction was sustained until maximum pain tolerance was reached, and all 4 contractions were completed within a single 120-min experimental period. A 30-min rest period followed each sustained contraction. The following measurements were made before and 1, 2, 3, and 7 days after the experiment: (1) superficial masseter and anterior temporalis muscle pain threshold; (2) maximum active pain-free jaw opening and lateral excursion; and (3) current overall jaw pain level. None of these measurements showed any significant post-experimental changes. Contrary to common clinical belief, these results suggest that in healthy male subjects, significant jaw pain and tenderness following repeated sustained isometric protrusion efforts are difficult to induce.
Pain 1991 Apr
PMID:Jaw pain and tenderness levels during and after repeated sustained maximum voluntary protrusion. 186 75

Muscle pain and poor sleep commonly occur together. Whether pain induces poor sleep or vice versa is difficult to know. Muscle pain is also observed in the presence of some types of dyskinesia or movement disorders. The interaction between sleep, movement disorders, and some musculoskeletal pain appears to be complex and may be influenced by various concomitant psychological and (or) biological factors.
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PMID:Muscle pain, dyskinesia, and sleep. 186 20

The importance of muscle as a source of pain should not be underestimated. Proper diagnosis of the four types of muscle pain (tension, spasm, muscle deficiency, and trigger points) is essential to effective management. Pain-diagnostic instruments can quantify tenderness and spasm and help evaluate treatment results.
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PMID:Diagnosis and treatment of myofascial pain. 187 61

Fatigue, pain, and emotional upset remain the most common problems affecting humanity and for which we still know so very little. Chronic fatigue syndrome is most likely a number of as yet unproven various undifferentiated illnesses that are exceedingly difficult to distinguish from depression. There probably is a subset of patients with CFS who do have true immune dysfunction and persistent viral infection, and this particular group of patients should be further investigated. This group is the minority of patients who present with chronic fatigue. Although chronic fatigue syndrome may be the result of an organic illness in psychologically susceptible individuals, it remains most important to assess underlying psychologic factors that then need to be addressed. These factors may very likely have a profound effect on immune function, but more research is needed in this area. The diagnostic evaluation of patients with chronic fatigue syndrome should initially focus on causes for fatigue other than Epstein-Barr viral infection. Significant underlying medical conditions should be ruled out, and extensive inquiry into symptoms suggestive of depression and anxiety should be aggressively pursued. Treatment should include psychiatric support and counseling, good nutrition, adequate rest, and a gradual increase in activity. Anti-inflammatory agents and serotonin-replenishing antidepressants are helpful when muscle pain and tenderness are a major part of the patient's symptoms. Psychoactive drugs are useful when indicated. Low doses of antidepressants such as doxepin (10-25 mg at night) are generally well tolerated and have shown efficacy in numerous patients, although there are no reports of controlled trials.
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PMID:Chronic fatigue and depression in the ambulatory patient. 187 21


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