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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 designed to assess the analgesic effects of interferential therapy (IFT) on experimentally induced muscular pain under randomized, double-blind, placebo-controlled conditions. After ethical approval and written consent were obtained, 40 healthy human volunteers (20 males: 20 females) aged 18-25 years were recruited and randomly assigned to one of four experimental groups (n = 10 per group: male = female): IFT 1, IFT 2, control or placebo. Delayed onset muscle soreness (DOMS) was induced in the elbow flexors of the non-dominant arm of each subject using a single bout of eccentric exercises to exhaustion. Measurements of isometric peak torque, resting angle, mechanical pain threshold and visual analogue scales were performed at set time points. Treatment was applied for 30 min daily over the biceps brachii muscle, for five consecutive days, according to group allocation. IFT 1 received 10-20 Hz, whilst subjects in IFT 2 were treated with 80-100 Hz (bi-pole; carrier frequency: 4 kHz; pulse duration: 125 microseconds). For the placebo group, the procedure was identical to that in the active treatment groups; however, no interferential current was delivered. The control group received no treatment. No significant between group difference was identified at any time point (P > or = 0.14). However, some inconsistent, yet significant differences in daily treatment effects, interactive effects and effects over time were detected. Based on the results of this study it can be concluded that application of IFT at the parameters used here, had no overall beneficial effect on DOMS.
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PMID:Interferential therapy: lack of effect upon experimentally induced delayed onset muscle soreness. 1248 7

The purpose of this study was to assess possible segmental (uni- and/or bilateral) and plurisegmental changes in pressure pain thresholds (PPTs) during static muscle contractions. Twenty-four healthy subjects (12 female, 12 male) performed a standardised isometric contraction with the dominant m. quadriceps femoris (MQF) and m. infraspinatus (MI), respectively. PPTs were assessed using pressure algometry at the contracting muscle, at the contralateral (resting) muscle and at a distant resting muscle (MI during contraction of MQF and vice versa). The PPT assessments were performed before, during and 30min. following each contraction. The contractions were held until exhaustion or for a maximum of 10 PPT assessments/muscle. During contraction of MQF PPTs increased compared to baseline at the middle ( p<0.001) and the end (p<0.001) of the contraction period at all assessed sites alike. During contraction of MI PPTs increased compared to baseline at the middle (p<0.001) and the end (p<0.007) of the contraction period at all sites. The increase was more pronounced at the contracting muscle compared to the contralateral (p<0.002; p<0.01) and the distant (p<0.002; p<0.002) site. No statistically significant difference was seen in PPTs between the latter two. Following the contractions PPTs returned to baseline. Submaximal isometric contraction of MQF and MI gave rise to a statistically significant increase in PPTs at the contracting muscle, the resting homologous contralateral muscle and at the distant resting muscle indicating that generalised pain inhibitory mechanisms were activated. Contraction of MI, but not of MQF, gave rise to an additional activation of unilateral segmental antinociceptive effects.
Eur J Pain 2003
PMID:Segmental and plurisegmental modulation of pressure pain thresholds during static muscle contractions in healthy individuals. 1272 48

Sedation and tiredness are among the most frequent symptoms among cancer patients. A detailed assessment of these symptoms is necessary to evaluate therapeutic effects, such as the use of methylphenidate or comparison of different opioids. The Brief Fatigue Inventory (BFI) has been validated as a short and comprehensive instrument to assess severity of fatigue and fatigue-related impairment in cancer patients. We validated the German version of the BFI in patients with chronic cancer-related and noncancer-related pain treated in a tertiary pain center. Patients treated in the Pain Clinic of the Department of Anesthesiology completed the BFI, the minimal documentation system (MIDOS) and the short form SF-36 quality-of-life questionnaire (SF-36). Test-retest reliability was assessed with a second BFI immediately after the consultation and in a subgroup of patients after 3 to 7 days. Nineteen percent of the 117 patients were treated for cancer-related pain (C); the other patients suffered from chronic severe pain of nonmalignant origin (NC). Patients reported mean values for average fatigue of 3.9 (C) and 4.9 (NC), and for worst fatigue of 5.5 (C) and 6.2 (NC). The mean score of the 6 impairment items was 4.3 in both groups. Factor analysis led to a solution with one common factor for all nine items. Fatigue on the BFI correlated highly with 'feeling tired' in the SF-36 and with 'sedation' in MIDOS, and less with 'being worn out' in SF-36 and 'weakness' in MIDOS. Internal consistency was high, as was test-retest reliability, with a correlation of the intensity, mean scores of 0.93 and the impairment mean scores of 0.87. In conclusion, we found the German version of the BFI to be reliable and valid for cancer and noncancer patients. Minor differences were seen in the validation compared to the original version.
J Pain Symptom Manage 2003 May
PMID:Validation of the German version of the brief fatigue inventory. 1272 43

The aim of the present study was to investigate how "double-shifts" (15.5 hours) affects sleep, fatigue and self-rated health. The study was carried out on male construction workers of which 80% were long-distance commuters. The schedule involved two work periods and each work period involved two double shifts in a row. The subjects filled in a sleep/wake diary at 8 times across a year and a questionnaire at 3 times. They also wore an actigraph during one shift cycle. The results showed that sleepiness, and to a certain extent, mental fatigue increased during double shifts and accumulated across days. The short rest time (8.5 hours) between days caused insufficient sleep and approximately 5.5 hours of sleep was obtained between double shifts. Questionnaire data showed that complaints of insufficient sleep, exhaustion on awakening and pain symptoms increased across the year. It was concluded that a shift system involving double shifts has a negative effect on fatigue, recovery and health-related well-being.
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PMID:The effects of double-shifts (15.5 hours) on sleep, fatigue and health. 1456 58

The purpose of this study was to investigate the effect of experimentally induced muscle pain on the motor-control strategies of synergistic muscles during submaximal fatiguing isometric contractions. The root mean square (RMS) and median frequency (MF) of the surface electromyographic (EMG) signal from synergistic plantarflexors and dorsiflexors were assessed to exhaustion. Ten subjects performed sustained dorsiflexions and plantarflexions at two contraction levels, 50% and 80% of maximum voluntary contraction, with or without muscle pain, induced by injection of 6% hypertonic saline in one synergist. In the painful contractions, the RMS of the EMG signal was decreased compared to the control condition in the initial phase of the contraction, in the muscles where pain was induced as well as in the nonpainful synergists. Moreover, the EMG signal MF decreased faster during muscle pain than in the control condition. The endurance time was shorter during muscle pain, and some of the nonpainful synergists showed increased compensatory activity at the end of the contractions to maintain the target force. The decreased EMG activation during pain was coupled with significantly decreased torque levels during the painful condition that would partly explain the results. However, the ratio between force and EMG amplitude was decreased for both the painful and nonpainful synergists, so other mechanisms might explain the present findings. This study shows that localized muscle pain can reorganize the EMG activity of synergists where no pain is present. These findings may have implications for the understanding of manifestations seen in relation to painful musculoskeletal disorders.
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PMID:The influence of muscle pain and fatigue on the activity of synergistic muscles of the leg. 1468 68

Previously, the subjective dimension of suffering from chronic pain has only infrequently been reported in the literature. However, in recent years qualitative psychosocial research has added new perspectives that describe how suffering from chronic pain affects life. The present paper refers to a qualitative study on the subjective experience of women diagnosed with chronic musculoskeletal pain. In a model for life adjustment, turning points and passages are described in three stages. In Stage I, there was increasing pain, disability, and physical and mental exhaustion. Alongside frustration and chaos there was a struggle to restore daily life; therefore, the picture of a healthy future was still intact. Acknowledging that pain may not be temporary marked the transition into Stage II, which was characterized by sorrow and loss, and the picture of the future faded. Once given an explanation of pain (a 'pain diagnosis'), a new understanding developed, with gradual improvement of coping skills. Adjustment eventually progressed into Stage III with the constructive use of past experiences, and competence and control increased. A new picture of the future emerged that could be handled. However, living with pain still required regular maintenance work. The outcome of qualitative investigations, including the one presented here, is discussed along with certain clinical implications. The following clinical implications are reviewed in the present study: distrust from health professionals may obstruct the adjustment process, prolong sick leave and hinder rehabilitation; providing the patient with a diagnosis (eg, an explanation of pain mechanisms) will facilitate life adjustment; acknowledging the individual experience of suffering from chronic pain will make concepts related to pain behaviour, secondary gain and sick role liable to question; and vocational rehabilitation measures should be harmonized with the actual stage of life adjustment.
Pain Res Manag 2004
PMID:The life adjustment process in chronic pain: psychosocial assessment and clinical implications. 1534 May 85

To determine the muscular concentration of bradykinin and kallidin during static contraction, microdialysis probes were implanted bilaterally in the trapezius muscles of healthy women. Three hours after probe implantation, 200 microM of the angiotensin-converting enzyme (ACE) inhibitor enalaprilat were added to the perfusion solution in one of the sides for 30 min. Thirty minutes later, the subjects performed a sustained bilateral shoulder abduction at 10% of the maximal voluntary contraction until exhaustion. This protocol was repeated twice, with an interval of at least 17 days. High intersession repeatability was observed in the concentration of bradykinin but not of kallidin. Enalaprilat induced a significant increase in bradykinin levels in the dialysate, without affecting kallidin levels. The sustained contraction induced a significant increase in dialysate levels of both kinin peptides. The contraction also induced a significant increase in pain ratings, as measured by a visual analog scale. During contraction, positive correlations were found between pain ratings and levels of kinin peptides in dialysate, predominantly in the side previously perfused with enalaprilat. Subjects with the higher pain ratings also showed larger increases in kinin peptides in the side previously perfused with enalaprilat. The present results show that both plasma and tissue kinin-kallikrein are activated during muscle contraction, but that their metabolic pathways are differently regulated during rest and contraction, because they showed a different response to ACE inhibition. They also indicate that intramuscular kinin peptides levels, and ACE activity, may contribute to muscle pain.
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PMID:Kinin peptides in human trapezius muscle during sustained isometric contraction and their relation to pain. 1547 93

The terms berserk and going berserk reflect the violent and ferocious warriors and ruthless murderers of Scandinavia and Northern Europe, active from before the Viking age until the advent of Christianity. The main source on the phenomenon is the Old Norse literature, mainly the Icelandic sagas with their sober descriptive accounts of the berserks and their behaviour. The berserks are frequently depicted as having had antisocial character traits; often as bullies who evince, by way of autosuggestion, an enormous and uncontrollable rage, slaughtering and killing. They felt no pain and hardly took in the environment they lived in. The fits were followed by exhaustion or sleep. Although the phenomenon waned completely by the advent of Christianity, it can hardly be discarded as just myth or folklore. Most likely it could be explained as a kind of dissociative reaction. The widespread idea of toadstool as causative agent is at best debatable. The conceptions of pre-Christian heathenism about the human mind are of importance to the understanding of suggestibility and capacity for trance reaction. The condition is considered a culture-bound syndrome. Comparisons are drawn to lycanthropy (werewolf madness), frequently considered an identical phenomenon. Clinically (i.e. historically) it was mainly something different, namely psychotic conditions.
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PMID:[The berserks--what was wrong with them?]. 1560 81

Ischemic bowel disease exhibits a complex spectrum of clinical presentations and in the athlete the disease may be superimposed on dehydration, hyperthermia, and exhaustion. Physicians caring for athletes should be aware of the manifestations of ischemic bowel disease and the optimum methods of diagnosis and treatment. Abdominal pain and diarrhea are typical initial symptoms of ischemia and these symptoms generally limit further damage. However, symptoms may be overridden in cases of extreme athletic competition or other significant endurance events such as combat. Athletes and coaches should be aware of the danger of ischemic bowel disease. Patients or athletes with recurrent symptoms of abdominal pain and diarrhea during exercise may be at increased risk for ischemic damage. However, no underlying anatomic abnormalities have been noted. Ischemic hemorrhagic gastritis is generally reversible and may be controlled with effective acid blockade. Ischemic colitis generally presents with pain, diarrhea, and bleeding. It is usually mild but may require volume and transfusion support, rarely progressing to need for resection or stricture. Severe presentations with intestinal infarction are rare but potentially life threatening. The athlete is usually able to ultimately resume his or her activities without restriction.
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PMID:Exercise-associated intestinal ischemia. 1576 45

Few studies have been devoted to patients with severe dementia living at home. Therefore their rate is difficult to evaluate, and their conditions too heterogeneous to allow a standard management. In these patients, suffering from severe cognitive deficits and psychobehavioral disturbances, interfering pathologies may alter the course of the disease. Environment must be adapted to ensure security, sustain perceptual and physical activity and back up space and time orientation. The role of the main caregiver is crucial for the psychological and physical support of the patient. Thus, he/she must be sustained by giving information about the disease and available practical and financial support, and by listening to his/her suffering. Consequently, the general practitioner is involved not only in medical decisions but also in family support. Too often, the general practitioner is alone to face complex and time-consuming situations. However, the setting of geriatric networks should allow him/her to be included in the elaboration of a global care project with nurses and physiotherapists. Nevertheless, various factors, such as caregivers' exhaustion, major behavioral disorders, or the end of life when coping with pain becomes a priority, can eventually make necessary the patient's transfer into a geriatric facility.
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PMID:[Patients with severe dementia living at home]. 1589 1


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