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

This study was based on 60 patients presenting with hand pain refractory to usual treatment. The aim of this study was to assess the pathophysiological and neuropsychological factors involved in a population of patients recruited in a hand surgery unit. Analysis of this series revealed the frequency of desafferentation mechanisms. These symptoms can be treated by means of antidepressants, antiepileptics and peripheral neurostimulation. Anxio-depressive factors were of limited importance in this series, at least in comparison with the population usually examined in a pain treatment centre. However, their presence in a subgroup of patients (26% of cases) and the limitations of symptomatic analgesic treatment justifie a global approach to chronic pain in order to establish the participation of the various factors in each particular case. It is useful to combine aetiological treatments with psychological treatments (antidepressants, relaxation therapy, for example) to increase the patient's tolerance of their persistent painful symptoms.
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PMID:[The chronically painful hand. A consecutive series of 60 cases]. 172 Sep 66

We describe the diagnosis, treatment, and follow-up of a group of 13 patients with hand pain traced to pathologic conditions of the second or third carpometacarpal joints. Missed diagnosis was universal. With suspicion raised by history of injury or repeated stress and point tenderness on examination, diagnosis was confirmed by complete pain relief after injection of 1% lidocaine locally. In management of patients with occult pain in the hand, attention should be directed to the second or third carpometacarpal joints. Arthrodesis with use of an inverted triangular graft from the base of the metacarpal provides predictable and lasting relief.
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PMID:Diagnosis and treatment of injury to the second and third carpometacarpal joints. 272 57

Pain is a frequent problem following recent traumatic spinal cord injury (SCI). Of specific concern in the rehabilitation setting is function-limiting hand pain which prevents optimal participation in therapy and limits independence. A treatable etiology of function-limiting hand pain in SCI is the reflex sympathetic dystrophy syndrome (RSDS). The presentation of RSDS in patients with recent SCI can be easily confused with that of dysesthetic (central origin) or radicular pain. Previous reports of RSDS associated with recent traumatic SCI have not been based on specific clinical criteria outlined in recent literature, and treatment has not been evaluated by objective outcome measures. This report describes 5 cases of RSDS associated with recent traumatic SCI that are identified by specific clinical criteria and are confirmed by a 3 phase bone scan. It is suggested that aggressive early intervention is necessary to obtain optimal functional outcome and minimize length of hospital-based rehabilitation.
Pain 1989 May
PMID:The reflex sympathetic dystrophy syndrome associated with traumatic myelopathy: report of 5 cases. 261 87

Ten patients with bilateral (deep second-degree and/or third-degree) hand burns requiring excision and grafting were included in a prospective randomized study to evaluate the efficacy of continuous passive motion (CPM) with burned hands. The purpose of the study was to evaluate: 1) if CPM is a useful alternative to supervised OT/PT for burned hands; 2) which patient populations benefit from CPM intervention; 3) if CPM use has deleterious effects on new grafts; and 4) what effect CPM has on hand pain. Eight hands in the control group and eight hands in the experimental group regained normal total active motion (TAMs) in an average of nine days (range three to 22 days). Two hands with tendon involvement in each group remained impaired at discharge. No patients suffered graft loss attributable to range of motion. Both groups reported only minimal pain during exercise.
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PMID:Efficacy of continuous passive motion (CPM) devices with hand burns. 322 Aug 54

Sixty consecutive patients admitted to the spinal cord injury unit at a Downey, California medical center were evaluated for hand and upper extremity pain. Patients averaged nine months postinjury and had an average age of 37 years. Seven patients (11.7%) complained of diffuse hand pain, swelling, and stiffness. All patients with complaints were evaluated with three-phase radionuclide scintigraphy. Six of those seven patients had scintigrams consistent with reflex sympathetic dystrophy (RSD), an overall incidence of 10%. Three of these six patients were treated with stellate ganglion blocks, which gave relief of symptoms and allowed return to their rehabilitation program. An awareness of RSD as a cause of pain in spinal cord injured patients should lead to earlier recognition and treatment.
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PMID:Reflex sympathetic dystrophy in cervical spinal cord injury patients. 340 17

Seventy-six women who worked in a hospital were surveyed for symptoms and signs of upper limb musculoskeletal disorders. The investigation was originally intended to study the effects of repetitive manual work that was performed by a group of garment assembly workers. Hospital workers were selected as the referent group on the assumption that they were unexposed to ergonomic stressors. However, the study showed that the prevalence of shoulder, wrist, and hand pain in these workers was sufficiently high (32%) to require that this assumption be reexamined. The hospital workers that were affected the most were employed in the nursing field and in manual work, i.e., food preparation, serving, and laundry. The women with upper limb pain were older and had been employed somewhat longer in hospital work than those without pain. Several jobs were observed to identify possible occupational risk factors for cumulative trauma disorders (CTDs). In addition to repetitive motion, these factors included forceful manual exertions and awkward postures required by work station design and layout.
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PMID:Upper extremity musculoskeletal disorders in hospital workers. 365 61

The history and physical examination allow early identification of the cause of hand pain in most patients. In some cases, however, the etiology of the pain is not obvious and a diagnostic problem arises. The less common causes of hand pain include atypical mycobacterial infection, occult fractures, bone fragments, incomplete carpal coalitions, carpal ligament injuries and several uncommon forms of tendinitis.
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PMID:Atypical causes of hand pain. 381 45

In this cross-sectional investigation of female garment workers the prevalence of soft tissue disorders of the hands and arms was studied. The findings were compared with the prevalence of disorders in a group of female hospital employees not required to use repetitive hand motion. One hundred and eighty-eight garment workers and 76 hospital employees were surveyed by questionnaire and physical examination. The prevalences of persistent shoulder, wrist, and hand pain were significantly greater among the garment workers (rate ratio 2, 4, and 3, respectively). In both groups about 60% of the persistent hand pain was consistent with carpal tunnel syndrome (rate ratio 3). These associations held when the comparisons were stratified by age and by length of employment. Workers whose native language was not English were significantly less likely to report symptoms (rate ratio 0.6). Workers in hand sewing and trimming suffered especially high prevalences of persistent pain in all upper limb sites. Stitchers had elevated rates of pain in the shoulders, wrists, and hands. Workers ironing by hand had a significant elevation in elbow pain rates. Garment assembly tasks appear to be associated with cumulative trauma of the hands and wrists; the biomechanical features of these jobs should be studied in greater detail.
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PMID:Soft tissue disorders in the upper limbs of female garment workers. 409 19

The analgesic effects of high frequency transcutaneous electrical nerve stimulation (TNS), "acupuncture-like" TNS and placebo TNS were evaluated in 33 patients with rheumatoid arthritis and chronic hand pain using a randomized, double-blind, non-crossover design. An oscilloscope was employed to monitor the stimulator output in the TNS treatment groups and to provide strong suggestion and a focus of attention in the placebo treatment group. The two forms of TNS were applied at the highest intensity that could be tolerated by patients. Assessments of resting pain, joint tenderness, grip strength and grip pain were made before and after treatment. The pain and joint tenderness measurements showed high frequency TNS, "acupuncture-like" TNS and placebo TNS to be equally effective in producing analgesia of similar degree and trend over time. The grip strength measurements showed no significant change. The results obtained with placebo are probably due to the suggestion and attention effects of the visual stimulus. The implications of these results in respect to pain control pathways are discussed. Although TNS given at high intensity was shown to be no better than placebo applied with strong suggestion, this does not preclude its use as a method of pain control in rheumatoid arthritis.
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PMID:The analgesic effects of transcutaneous electrical nerve stimulation and placebo in chronic pain patients. A double-blind non-crossover comparison. 661 76

A female drug abuser inadvertently injected an intravenous injection of an oral anorexiant, phentaramine (Preludin), into her own brachial artery. Severe hand pain, vasospasm, and ischemia occurred. Treatment with regional axillary block, intravenous dextran, intra-arterial priscoline, and salicylate anticoagulation may have influenced a favorable outcome. Intimal damage, vasospasm, and various additive effects after intra-arterial injection contribute to the potential for serious sequelae. Prompt diagnosis, vasodilatation, elevation and compression, pain relief and, in some cases, surgery appear to improve salvage of what is frequently a major extremity injury.
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PMID:Inadvertent intra-arterial injection of phentaramine: a complication of drug abuse. 746 55


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