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

Esophageal pain was investigated in 200 consecutive patients prior to surgical correction of reflux. the pain has been analyzed to determine its characteristic and its atypical features. Arm distribution of pain and exercise induced pain were the most a typical features and led to diagnostic difficulty. Although acid perfusion studies reproduced some component of the pain in 94% of patients, reproduction of arm pain was possible in only 37.2% of those with this symptom. The importance of cardiologic evaluation in patients with atypical esophageal pain is emphasized.
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PMID:Characteristics of esophageal pain. 694 44

Cervical spondylosis may be the most common cause of arm pain in the elderly. Although patients describe this pain as "severe," they seem able to ease it by massaging the area, which is not the case with other painful rheumatoid conditions. Elevated serum uric acid in an arthritis patient is not always a sign of gout. A definite diagnosis of gout can be made only when urate crystals are found in the joint fluid.
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PMID:Arthritis: avoiding diagnostic pitfalls. 697 31

The paper presents a 13-year-old patient suffering from erythromelalgia in whom arm pain and burning ceased for 3 years after unilateral stereotactic cryodestruction of the thalamic ventrolateral nuclei. Following a relapse, reoperation on the other side turned out to be ineffective. Then the patient underwent destruction of the inlet areas of the spinal dorsal roots by breaking the cervical pain-conducting tracts. Pain and other autonomic manifestations of the disease came to an end. The authors give an anatomic and neurophysiological rationale for surgery.
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PMID:[The surgical treatment of erythromelalgia by the destruction of the inlet areas of the posterior spinal nerve roots]. 762 33

In 98 out-patients who visited our pain clinic, we evaluated their psychological status before the first examination and one month after the treatment, using self-rating depression scale (SDS) and state-trate anxiety inventory (STAI). SDS, state anxiety, and trate anxiety scores were significantly higher in the patients with pain (trigeminal neuralgia, neck-shoulder-arm pain syndrome, lumbago and psychological pain, n = 55) compared with the patients without pain (sudden deafness and facial nerve palsy, n = 43) (P < 0.01, 0.05, 0.01). Of the patients with pain, patients with psychogenic pain showed the highest score in every test. The scores of SDS and state anxiety became significantly lower one month after the treatments compared with ones before the first examination (P < 0.01). It was considered that the decline in every score was due to the treatments in our pain clinic. In patients whose score of trate anxiety before the first examination was more than 50 points, the SDS and state anxiety showed high scores even one month after the treatments. This finding suggests that these patients need psychosomatic managements.
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PMID:[Psychological evaluation of out-patients in our pain clinic using self-rating depression scale and state-trate anxiety inventory questionnaire]. 774 89

Approximately 3000 Norplant insertions have been performed to date at the Grady Health System in Atlanta, Georgia (US). In a 12-month study of a subset of women who terminated this method, 10.1% cited pain at the site of insertion as the major reason for contraception discontinuation. Given the proximity of major nerves and veins to the implant site, some of this pain may result from neurovascular injury associated with Norplant insertion. In fact, a disproportionate number of women with arm pain had the implants inserted immediately over the brachial groove. The Wyeth-Ayerst manufacturer's brochure suggests only that the implants be inserted on the inner aspect of the upper arm 8-10 cm above the elbow crease. Insertion of the implants deeply over the brachial groove introduces potential for trauma to the ulnar and median nerves, the basilic vein, and the brachial artery. This risk is increased when the trocar is advanced forcibly during insertion of the implants and when the tissue around the implants is dissected during the removal of deeply placed implants in the brachial groove. Recommended, to reduce the risk of significant injury, is insertion of the implants over the medial surface of the biceps brachii.
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PMID:Neurovascular injury during removal of levonorgestrel implants. 784 17

A telephone interview was conducted to explore the occupational musculoskeletal problems and potential risk factors among typists in a government department. Of the 330 typists, 170 (51.5%) were interviewed; all of them were female with about 84% in their twenties and thirties. Local fatigue and musculoskeletal pain were found to be quite prevalent among typists. More than 50% of the typists had local fatigue affecting the shoulders, neck, back and fingers (in order of decreasing frequency), and most of these occurred within 1-2 h of continuous typing. Among the musculoskeletal problems, low back pain was the most common (53%), followed by neck pain (50%), arm pain (27.6%) and finger pain (27.6%). Univariate analyses showed that poor matching of desk height with chair height was found to be related to low back pain, neck pain and arm pain; it was also related to local fatigue of the shoulder and neck regions. Fatigue and pain at the lower back were related to bending of the back at work. Finger pain and arm pain were related to the period of time which they had worked as a typist. Multivariate analyses were done with logistic regression to sort out the relative influence on the outcome of the different risk factors adjusted for age and for each other.
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PMID:Self reported musculoskeletal problems amongst typist and possible risk factors. 796 84

A 6-year-old boy presented with a large, rapidly growing osteosarcoma of the upper humerus and severe neuropathic arm pain. Despite large doses of morphine (100 micrograms/kg/hr), which resulted in intermittent somnolence and respiratory depression, his pain was poorly controlled. An interscalene brachial plexus catheter was inserted, and bupivacaine was injected on ten occasions over 5 days, with markedly improved analgesia and decreased opioid requirement. Cancer pain in children can be controlled by opioids in 95% of cases; however, circumstances such as intractable neuropathic pain may require specific regional anesthetic techniques.
J Pain Symptom Manage 1994 May
PMID:Continuous brachial plexus neural blockade in a child with intractable cancer pain. 808 45

Microcirculation in the upper portion of the right and left trapezius muscles was measured percutaneously by laser-doppler flowmetry (LDF) during two 10-min-long series of alternating 1-min periods of static contraction and rest determined electromyographically (EMG). Twenty-five patients with pain persisting after a soft-tissue injury of the neck were studied. Pain assessments by using visual analogue scales and drawings showed 13 patients with predominantly unilateral and 12 with bilateral neck-shoulder pain, in some cases with arm pain and numbness. Mean age was 41 (23-58) and 39 (22-54) years and a female/male ratio 8:5 and 10:2, respectively. Stepwise increased contraction was induced by keeping straight arms at 30 degrees, 60 degrees, 90 degrees and 135 degrees of elevation, and repeated with a 1 kg (women) or 2 kg (men) hand loads. Signal processing was done on-line by using a 386SX computer. LDF and EMG values were normalized. Spectral shift of EMG mean power frequency (MPF) for fatigue was analyzed. Muscle blood flow on the "normal" side in the unilateral pain group showed an ordinary increase at increased angle of arm elevation, shoulder torque and EMG amplitude. On the painful side, during increased muscle tension and fatigue, the ability to increase blood flow appeared to be impaired, and there was no consistent increase in either side of the bilateral pain group. EMG amplitude showed a significant positive correlation to the angle of arm elevation and shoulder torque. The rms-EMG (root mean squared EMG) increase was lower in the painful side at high force contraction (non-normalized data).(ABSTRACT TRUNCATED AT 250 WORDS)
Pain 1994 May
PMID:Chronic pain after soft-tissue injury of the cervical spine: trapezius muscle blood flow and electromyography at static loads and fatigue. 809 May 14

The purpose of the study was to investigate whether fibromyalgia patients (n = 50) differed from patients with rheumatoid arthritis (n = 22) and ankylosing sponylitis (n = 31) with respect to pain experience, pain coping and fatigue. A high general pain intensity level was recorded by the McGill Pain Questionnaire (p < 0.01) and the visual analogue scale (p < 0.01) in the fibromyalgia group compared to the other groups. The pain was of continuous duration in the fibromyalgia patients while the rheumatoid arthritis and ankylosing spondylitis patients experienced intermittent pain. A high correlation between sensory and affective pain rating indexes was determined in all patient groups (p < 0.01). No statistically significant difference between the groups in pain coping was recorded. A high frequency of reported gastrointestinal problems (p < 0.01) and high intensity of fatigue (p < 0.01) were seen in the fibromyalgia group compared to the other groups. In the fibromyalgia group there was no correlation between the sleep problems and fatigue intensity. Thus, the fibromyalgia patients differed from the other groups in reporting frequently shoulder and upper arm pain, continuous pain, higher levels of fatigue and pain intensities as well as high frequency of gastrointestinal problems.
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PMID:Pain and fatigue in patients with rheumatic disorders. 812 15

The ability of Elvey's "brachial plexus tension test" to identify pain referred from the cervical region was investigated in 50 patients with unilateral shoulder and upper arm pain: 25 reported symptoms commencing after open heart surgery, indicating a high probability of referred pain due to that procedure; 25 were athletes with injuries from throwing movements, a cause appearing much less likely to cause referred pain. Twenty-five asymptomatic subjects with no history of spinal or limb pain also were tested. Cervical and upper limb maneuvers of the test were assessed goniometrically. The cardiac group showed significantly greater test results than those of the other groups, suggesting that the test is able to discriminate referred and local sources of upper limb pain.
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PMID:Noninvasive discrimination of brachial plexus involvement in upper limb pain. 815


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