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

This study examined the resolution of symptoms, functional limitations and neuromuscular impairments following carpal tunnel release. Thirty-five patients were evaluated preoperatively and 6 weeks, 3 months, 6 months, and a mean of 27 months postoperatively. Evaluation consisted of physical examination (performed in a subset of patients) and previously validated questionnaire scales measuring symptoms, functional limitations, and satisfaction. Nocturnal pain, tingling, and numbness improved within 6 weeks after surgery. Weakness and functional status improved more gradually. Grip and pinch strength worsened initially, returned to pre-operative levels after about 3 months, and improved significantly by 24 months. The Tinel and Phalen signs remained positive in two and seven patients, respectively, after 2 years, and two-point discrimination remained abnormal in over half of patients after 2 years. These temporal patterns should be discussed with patients to foster realistic expectations of the response to surgery.
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PMID:Symptoms, functional status, and neuromuscular impairment following carpal tunnel release. 759 77

Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as "repetitive stress injury" (RSI) or "carpal tunnel syndrome" (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded; upon palpation, they have pain and tenderness at the spinous processes C5-T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low level laser (100 mW) was used and directed at the tips of the spinous processes C5-T1. The laser rapidly alleviated the pain and tingling in the arms, hands and fingers, and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labelled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser. Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulder posture by taping, cervical collars, and clavicle harnesses as well as improved work ergonomics.
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PMID:Successful management of female office workers with "repetitive stress injury" or "carpal tunnel syndrome" by a new treatment modality--application of low level laser. 762 Jun 90

The vast majority of patients with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have symptoms or signs involving the feet and lower extremities. Patients presenting to podiatrists with foot complaints may, in fact, have neurologic complications of HIV originating in any level of the neuraxis, and multiple levels may be involved. These include multiple classes of peripheral neuropathy and myopathy, inflammatory radiculopathy, myelopathy, and central nervous system lesions caused by direct HIV infection or opportunistic infections. Common complaints such as pain, numbness, burning, tingling, weakness, cramps, unsteady gait, and others should be systematically evaluated with both podiatric and neurologic etiologies in mind for early diagnosis and intervention.
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PMID:Neurologic conditions affecting the lower extremities in HIV infection. 764 14

Trauma and compression along the course of the median, ulnar or radial nerve from the brachial plexus to the fingers may cause pain, weakness, numbness or tingling of the upper extremity. Diabetes, smoking, alcohol consumption, rheumatoid arthritis and hypothyroidism are risk factors for nerve entrapment, although these disorders typically produce bilateral symptoms. Carpal tunnel syndrome, the most common nerve entrapment condition, results from median nerve compression at the wrist. The diagnosis is suggested by decreased pain sensation and numbness in the thumb and index and middle fingers; symptoms are reproduced by wrist hyperflexion and median nerve percussion. Volar splinting and steroid injection often ameliorate symptoms. Decreased sensation of the little finger and the ulnar aspect of the ring finger, along with intrinsic muscle weakness, may be caused by cervical radiculopathy, thoracic outlet syndrome or compression of the ulnar nerve above the elbow (cubital tunnel syndrome) or at the wrist (ulnar tunnel syndrome). Electromyography and radiography may help differentiate these conditions. Radial tunnel syndrome occasionally accompanies inflammation of the common wrist extensors and lateral epicondylitis ("tennis elbow"). A radial nerve block can help exclude concomitant radial tunnel syndrome in patients with symptoms of lateral epicondylitis.
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PMID:The numb arm and hand. 776 75

The temporal characteristics of the oral perception of menthol solutions were explored in two experiments. In Experiment 1, 10 samples of either 0.03% or 0.30% menthol were presented at 1 min intervals and rated for the perceived intensity of cooling and irritation. Reports of sensation quality (burning, tingling, stinging and numbing) and pain were also collected. At the higher concentration, a significant decrease in perceived intensity was observed over time for irritation, but not for cooling. Experiment 2 was designed to explore further the nature of the decline in irritation observed in Experiment 1. Employing 1-min and 5-min inter-stimulus intervals between solutions, it was found that the decrease in menthol irritation more closely resembled desensitization than adaptation. Decreases in the frequency of reports of the burning and stinging qualities, but not the tingling, numbing or cooling qualities, suggested that menthol has a specific desensitizing effect on a population of mucosal nociceptive fibers.
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PMID:Sensory irritation and coolness produced by menthol: evidence for selective desensitization of irritation. 782 66

We have performed single-neuron recording and microstimulation in the region of the thalamic principal sensory nucleus (ventrocaudal nucleus, Vc) prior to implantation of a deep brain-stimulating electrode in a patient with pain secondary to arachnoiditis and with a past history of unstable angina. Cells located in the 16 mm lateral plane had cutaneous receptive fields on the chest wall. At and posterior to the location of these cells stimulation coincided precisely with the sensation of angina (stimulation-associated angina). The description of stimulation-associated angina was measured using a questionnaire and was identical to the patient's usual angina except that it began and terminated suddenly. Stimulation-associated angina was coincident with a tingling sensation in the leg. Clinical, hemodynamic, electrophysiologic and biochemical measures of cardiac function showed no evidence of myocardial strain or injury related to stimulation-associated angina. Since cells in the region of the principle sensory nucleus of thalamus respond to cardiac injury in animals, the present results suggest that this region mediates the sensation of angina.
Pain 1994 Oct
PMID:The sensation of angina can be evoked by stimulation of the human thalamus. 785 92

To determine the value of a detailed evaluation of neuropathic sensory complaints in assessing diabetic polyneuropathy, a questionnaire listing different sensory symptoms was compared with a clinical and neurophysiological examination of the peripheral nerves. Thirty-seven insulin dependent and thirty-one non-insulin dependent diabetic patients who were consecutively referred because of suspected polyneuropathy were investigated. In all patients both clinical and neurophysiological examination confirmed the diagnosis of polyneuropathy. Only the scores of the clinical examination were significantly correlated with the scores of the sensory symptoms (r = 0.31, P < 0.01). Using a factor analysis, a dimension of complaints of sensory alteration could be distinguished from a dimension of complaints of neuropathic pain (alpha coefficients 0.88 and 0.86, respectively). Tingling sensations turned out to be an expression of the dimension of complaints of sensory alteration. The scores of clinical and neurophysiological examinations were only significantly correlated with the dimension of sensory alteration (r = 0.38, P < 0.002; r = 0.37, P < 0.02, respectively). We conclude that only symptoms of numbness and tingling sensations in hand and feet are associated with objectively assessed diabetic polyneuropathy.
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PMID:Complaints of neuropathy related to the clinical and neurophysiological assessment of nerve function in patients with diabetes mellitus. 787 47

A 35-year-old man with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with acute bilateral optic neuritis is described. At age 33, he noticed a tingling sensation in his toes followed by weakness in the lower limbs. He was admitted to our hospital because he became unable to walk without support. His motor and sensory symptoms gradually resolved during 7 months admission only with physical rehabilitation. At age 35, in July 1988, he noticed a tingling sensation in his toes and fingers, which reached to the knees and elbows in October 1988, when he developed weakness in the lower limbs. Motor and sensory symptoms were almost stationary thereafter and in March 1989, he experienced bilateral blurred vision of acute onset without ocular pain. He was readmitted to our hospital in April 1989. The neurological examination revealed decreased visual acuity of both eyes without any abnormality of the optic disks, mild weakness on flexion and extension of toes, an absence of Achilles reflex, and distal impairment of pain and touch sensations in the upper limbs, and of pain, touch and vibration sensations in the lower limbs. After laboratory examinations, CSF protein was elevated (122 mg/dl), and sensory nerve conduction velocity of the right median nerve was decreased (37.1 m/sec). The sural nerve action potential was not elicited on electrical stimulation. Central scotoma was found in both eyes by the visual field examination. P100 latency was seen to be normal by repeated pattern-reversal visual evoked potential (VEP) studies. CT and MRI of the brain were unremarkable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with acute bilateral optic neuritis with normal findings on pattern-reversal visual evoked potential study]. 801 88

Carpal tunnel syndrome (CTS) has been linked to repetitive motion only in the past 15 years or so. Often the studies supporting this proposed link have not used strict clinical criteria and have rarely had electrodiagnostic confirmation of the diagnosis. In order to better assess the actual incidence of CTS in patients in a repetitive-motion job who had pain, numbness, tingling, or all three in the hand, wrist, or forearm, we examined 112 consecutive charts of such patients referred to a consulting neurologist for a possible diagnosis of carpal tunnel syndrome. Thirty-five percent of those patients had either classic clinical symptoms or positive electrodiagnostic results, but only half of these (17% of the total) actually had both. It is thus suggested that the incidence of CTS in patients doing repetitive motion may have been overestimated in the literature, and very strict clinical and electrodiagnostic criteria should be used before a diagnosis of carpal tunnel syndrome is made or surgery is contemplated in these patients.
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PMID:Carpal tunnel syndrome: classic clinical symptoms and electrodiagnostic studies in poultry workers with hand, wrist, and forearm pain. 813 52

This case report describes a 41-year-old female patient who had chronic de Quervain's tenosynovitis, which had progressed to include involvement of the cervical spine, shoulder girdle, and upper extremity. The patient complained of aching over the left scapula, a band of pain around the upper arm, and sharp shooting pain in the forearm, with numbness and tingling in the fingers. On examination, she had abnormal palpatory findings in the cervical spine, the shoulder quadrant maneuver was limited, and the upper-limb tension tests (neural structures) were positive. The case report demonstrates the use of an Australian approach to manual therapy as described by Maitland. This approach includes (1) development, refinement, and rejection of working hypotheses as to the possible cause(s) of a patient's symptoms; (2) development of a long-range treatment plan; and (3) use of data from treatment responses to guide further treatment selection.
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PMID:A patient with de Quervain's tenosynovitis: a case report using an Australian approach to manual therapy. 814 Jan 44


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