Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of 19 patients with upper limb symptoms is presented; 3 patients had bilateral symptoms. The patients were young (22-44 years) and only 4 were women. The symptoms were usually precipitated by injury. Aching pain the the neck and shoulder area, upper arm and forearm, with some intermittent numbness were the main complaints. These symptoms may be aggravated or relieved by altering posture. The most constant and diagnostic physical finding was tenderness and reproduction of symptoms with pressure over the neurovascular bundle underneath the coracoid process and pectoralis minor. There are no constant positive findings on regular radiographs. Electromyography and venography were of doubtful diagnostic significance. Conservative measures were rarely curative but often alleviated some of the symptoms. These measures included local heat, and postural exercises with elevation and rotation of the shoulder forward. The neurovascular bundle was decompressed by dividing the pectoralis minor surgically in 10 limbs. This relieved the radiating symptoms in each case although mild aching pain in the shoulder had remained in 4 instances. This syndrome can be recognized clinically and may be controlled in half of the cases by conservative means. If the diagnosis is well localized, surgical release offers good relief.
 ...
PMID:Subcoracoid neurovascular entrapment. 113 31

A variety of rheumatologic disorders affect the elderly. Some of these problems are seen almost exclusively in the elderly, such as temporal arteritis and pseudogout. Because of underlying chronic diseases, these patients are also at increased risk for joint infection and resultant sepsis. Evaluation of synovial fluid from the inflamed joint is important. Light microscopy evaluation with a red polarizing compensator can help diagnose crystal-mediated disease, such as gout or pseudogout. Examination of Gram stains can help diagnose infectious arthritis. Thus, appropriate processing of synovial fluid is mandatory for the diagnosis of many rheumatologic disorders that occur in the elderly. A variety of metabolic disorders are associated with pseudogout and should be searched for on laboratory evaluation. Appropriate laboratory evaluation and follow-up following the acute episode are important in the care of these patients. For example, temporal arteritis with resultant blindness is a feared disorder in the elderly. Transient blindness, headaches, jaw claudication, and an elevated Westergren sedimentation rate suggest this diagnosis. Aches and pain in the neck and shoulder area, especially in the morning, are typical of polymyalgia rheumatica. Polymyalgia rheumatica may also be a symptom of temporal arteritis.
 ...
PMID:Acute rheumatologic disorders in the elderly. 218 87

The reliability of distinguishing central, musculoskeletal, and syringomyelic pain by two points of history: (1) pain quality and (2) pain location relative to the level of paralysis in spinal cord injury patients was tested by (1) physical examination, and (2) by radiographic imaging. Fifty five incidents of chronic pain (median duration 10 years, range 3 weeks-42 years) were found in a survey of 66 spinal cord injured patients. Central pain was suggested in 24 patients on the basis of a predominant 'neurogenic' pain quality: burning, stabbing, needles and pins, or numbness; and a location at or distal to the level of paralysis. Neurogenic pain was not associated with structural pathology in these patients. Musculoskeletal pain was suggested in 20 instances on the basis of predominantly aching pain and a location at or distal to the level of paralysis. Aching pain was associated with degenerative joint disease (11 each); scoliosis, shoulder dislocation, contractures (2 each); fracture, soft tissue calcium deposit (1 each) in 19 patients. Syringomyelic pain was suggested in 11 instances solely on the basis of pain location above the level of paralysis. Magnetic resonance imaging revealed extensive syringomyelia in 8 patients. It is proposed that the quality and location of chronic pain can quickly suggest confirmatory examinations, sometimes revealing correctable causes.
 ...
PMID:Chronic pain after spinal cord injury: an expedient diagnostic approach. 225 Sep 89

The purposes of this study were to determine pain characteristics in female patients with rheumatoid arthritis (RA) and to determine the relationship between the outcome of the Ritchie Articular Index (RAI) and pain intensity as measured by the visual analogue scale (VAS). The sample consisted of 30 female patients with a definite diagnosis of RA and a functional capacity of class II. The results indicated that the pain fluctuated during the day. The intensity level of present pain was lower than that of usual pain. Eight patients reported that their worse pain occurred several times/day. Ache was the word most frequently chosen by the subjects to denote their pain sensations. A high correlation r = 0.86 (P less than 0.01) was found between the scores of RAI and present pain on the VAS. This finding suggests that the pain in RA is associated with the hyperalgesic state induced by the inflammatory condition associated with RA. There was no significant correlation between blood tests like ERS, WBC and VAS or RAI.
Pain 1990 Apr
PMID:Rheumatoid arthritis: determination of pain characteristics and comparison of RAI and VAS in its measurement. 235 64

The intention of the present study was to characterize patients with central post-stroke pain (CPSP) with regard to type and location of the cerebrovascular lesion (CVL), the characteristics of the pain and the neurological symptoms and signs in addition to the pain. Twenty men and 7 women with a mean age of 67 years and a mean pain duration of 44 months were examined 9-188 (mean 53) months after their stroke. The clinical symptoms and signs and the CT scans indicated that the CVL were located in the lower brain-stem in 8 patients, involved the thalamus in 9 patients and were located lateral and superior to the thalamus in 6 patients. In the remaining 4 patients the location of the CVL could not be determined with certainty. The 3 identified hematomata were all located in the thalamus. The onset of the pain was immediate in 4 patients, within the first post-stroke months in 10 patients and delayed by 1-34 months in the rest. The pain was on the left side in 18 patients. Twenty patients had hemipain. Most patients experienced more than one type of pain. The most common qualities were burning, aching, pricking and lacerating, with some differences in the frequencies according to the location of the CVL. Burning pain was most common, except among the patients with thalamic CVL, in whom lacerating pain was more common. Aching and pricking pain were also frequent. All patients considered the pain to be a great burden and most rated the pain intensity as high on a visual analogue scale. The intensity was increased by external stimuli, the most common being joint movements, cold and light touch. Five patients reported aggravation by emotional stimuli. Besides pain, the only neurological symptom common to all patients was decreased temperature sensibility, as shown by quantitative methods. It is possible that pain sensibility was also abnormal in all. Hypersensitivities to cutaneous stimuli, including evoked dysesthesias were found in 88% of the patients, while the detection thresholds for touch and vibration were abnormal in only 52% and 41%, respectively. Similarly, low figures were found for paresis and ataxia, which were present in 48% and 62%, respectively. It is concluded that only a minority of patients with central pain after stroke have thalamic lesions.(ABSTRACT TRUNCATED AT 400 WORDS)
Pain 1989 Jan
PMID:Central post-stroke pain--neurological symptoms and pain characteristics. 291 91

This paper aims at elucidating to what extent patients with lumbago-sciatica in the presence of an herniated intervertebral disc, are inclined to describe their pain in a characteristic way. The material comprised 50 patients with clinical and radiological signs indicating herniation of the L4/5 or L5/S1 discs. The assessment of pain was performed by formal oral interview, focussing on spatial distribution and somatosensory dimensions of pain in various regions of the back and leg. In conformity with the fact that a range of sensible nerves are affected by the herniation pain description is represented by a variety of pain qualities. The pattern of pain description tends to exhibit certain characteristic traits: only half of the patients had low-back pain, and pain was most frequently occurring in the gluteal region, thigh and calf. The frequency of superficially localized pain tended to increase in the proximo-distal direction. Aching-like pain was the most common pain quality, and this variant of pain as well as flashing and jerking sensations were commonly reported in the gluteal region, thigh and calf. Warmth was most frequently experienced in these regions, cold sensations in distal parts. A feeling of punctate pressure was common in the gluteal region, incisive pressure and paraesthesia in the thigh and calf, and a cramp-like feeling in the calf region. Reduced sensibility was frequently experienced in distal parts and never in the lumbar region. Pain quality differs in patients with a short and a long duration of the actual attack of sciatica. The mapping of pain seems to represent a diagnostical aid. A high degree of homogeneity of the patients is required for pain description to be a valid and reliable instrument. The clinical application of pain mapping is to be shown through a paper-and-pencil administration of a questionnaire based upon the findings from this study.
Pain 1983 Jul
PMID:Descriptions of pain and other sensory modalities in patients with lumbago-sciatica and herniated intervertebral discs. Interview administration of an adapted Mcgill Pain Questionnaire. 622 64

The role of snowmobile driving as a factor in symptoms of the locomotive organs was examined in 1,793 reindeer herding men using a postal questionnaire. Thirty-eight % of the respondents reported troubles in the upper limbs and shoulders which according to their own judgement were caused by snowmobile driving, and 34% reported such symptoms in the knees and 42% in the back. Aching, pain or tenderness upon movement in at least one joint during the current year, inquired by independent questions, were reported by 46% of the men. The prevalence of joint symptoms felt in the elbow (reported by 15% of the subjects), wrist (13%), fingers (10%), shoulder (22%) and knees (20%) increased by a factor of 1.6-2.5 from those driving a snowmobile 1-20 days a year to those driving 150 days or more. The findings confirm earlier reports of increased occurrence of symptoms in the locomotive organs in snowmobile drivers and justify technical and other preventive measures.
 ...
PMID:Snowmobile driving and symptoms of the locomotive organs. 771 May 91

It has been recognized that the remarkable decline in infant mortality and the extension in human lifespan involving both developing and developed countries alike, has been influenced by social and economic developments and public health orientated measures (such as clean water and sewerage) rather more than by developments in medical research. However, the identification of important disease risk factors for a number of common conditions such as smoking, solar exposure, dietary fat and alcohol has led to further reductions in disease prevalence and mortality, at least in some countries. The varied success of strategies to reduce the mortality from circulatory, nutritional and diseases due to infection has had the predictable result of leaving communities more exposed to the chronic non-communicable diseases, especially those affecting the elderly. The COPCORD community-based studies, carried out largely in tropical Asia/Pacific countries, have indicated that the burden of musculoskeletal conditions as far as pain and disability, as well as from an economic point of view, are substantial and WHO has called for increased research and educational activities into the causes and consequences of chronic disease and in particular rheumatic diseases. To the problems of an increasing ageing population can be added the rapid growth of urban populations, new occupational stresses, lifestyle changes and a number of other factors (WHO, 1984). The common community-based rheumatic diseases are not RA or SLE that dominate admissions to hospital arthritis clinics. Pain and disability are most often caused by osteoarthritis, especially knee OA, and various soft tissue rheumatic problems producing neck, back, shoulder and elbow pain. Viral and reactive arthritis cannot be ignored and the complications from osteoporosis (although not normally considered a rheumatic condition), are a significant threat to ageing populations worldwide. It is clear that for many of these conditions, certain risk factors have been identified and that preventative strategies are becoming available although far more detailed research is still required (Wigley, 1993). Community education is an essential part of prevention and treatment and the ILAR-sponsored publication Aches and Pains--Living with Arthritis and Rheumatism (Hampton, 1992) is available in at least 10 different languages and fills an important need. Education helps to influence not only knowledge but also skills and attitudes.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Tropical rheumatology. Epidemiology and community studies: Asia/Pacific region. 772 73

Workers are selected into and out of physically demanding jobs with regard to their health. The study of occupational mortality and morbidity is hampered by this selection. Furthermore, social selection and rapid turnover are involved in health selection. Because different stages of disease form only one continuum (dissatisfaction-death), the correct interpretation of the results also requires measures softer than mortality. Earlier studies have concluded that soft and hard measures of health follow one another as explanations for the termination-of-employment rate. The aim of this study was to determine which age and exposure categories are the most prone to health selection. Mortality and morbidity were studied on three different exposure levels defined primarily according to the physical demands of the work: heavy level (iron foundries); medium level (manufacture of metal products); and light level (manufacture of electrical devices). The population comprised 15,714 men hired in 1950-1976 to work in the three branches of the metal industry. Another cohort, a cross-sectional one, of 1292 workers (who had been hired earlier and were still working in 1950) in the three industrial branches was used to clarify selection due to disability and mortality. Data for the mortality and disability analyses were obtained from national death and disability registers. The period of follow-up was 1950-1978. A questionnaire on occupational history, morbidity, and the causes of turnover was sent to 400 current and 600 former workers from each industrial branch. A questionnaire concerning occupational history was also sent to the nearest relatives of a total of 450 decidents. The occupational histories of the current and former workers were compared for changes in the exposure level throughout their complete occupational histories. The occupations during the workers' life-times were also classified into three exposure levels on the basis of physical demands (heavy, medium, and light). The three exposure levels showed different patterns of change according to age throughout the workers' complete occupational histories. Selection into and out of jobs within and between different exposure levels appeared to be a continuous process, a chain of selection. This conclusion was ascertained when the complete occupational histories were analyzed according to the exposure levels (heavy, medium, light) of the occupations from which the workers came and to which they transferred. The foundry workers entered the industry from either heavy or medium-level occupations, and most of them sought lighter work in medium-level occupations. The metal product workers either began their work lives within the metal product industry or they transferred to it from work that entailed the same exposure level. After leaving a job, the metal product workers generally moved to medium (i.e., the same level) or light occupations. The electrical workers switched from medium-level work, or they began their worklives within that industrial branch. When they left a job, they chose medium or light work in the metal industry. Due to the chain of selection from one exposure level to another, the mortality and morbidity rates for a certain exposure level can be underestimated or overestimated if complete occupational histories are not available. The selection process was different for different diseases and was manifested as different stages of disease. Ache or pain in the musculoskeletal system within the last 12 months was more frequent among the foundry and metal product workers than among the electrical workers. Both the currently employed and former foundry workers had significantly more earlier-diagnosed musculoskeletal diseases than the electrical workers. The younger age classes of foundry workers (< 45 years) had a higher occurrence of musculoskeletal diseases than the metal product workers; in the older age classes the opposite was true. (ABSTRACT TRUNCATED)
 ...
PMID:Mortality, morbidity and health selection among metal workers. 931 71

Using diaries, eight women documented how they were living with their fibromyalgia on a daily basis for 3 months. Aches and pains were the most common symptoms experienced on nine to 81 of the 84 days of data collection. Cross-correlations revealed significant patterns related to pain, sleep and weather conditions for individual women. The narrative portion of their diaries supports that pain is physical and mental, knowing the self helps to control the intensity of the illness, and distraction helps to decrease the associated discomforts. Use of diaries and active listening (validation) are supported as interventions for these women.
 ...
PMID:Health patterns of women with fibromyalgia. 937 78


1 2 Next >>