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

A study was designed to establish whether acupuncture has any analgesic properties beyond those of suggestion. In three one-hour experimental sessions the increases in detection thresholds and tolerances for thermal pain at six body locations on 12 subjects were compared. A control session (without needles) was followed by one session in which electrically stimulated needles were inserted in accord with Chinese practice, and another in which the needles were inserted to avoid all recognised acupuncture "points." Acupuncture was significantly more effective than suggestion in raising overall body pain thresholds but just below significance for tolerances. A significant disproportionate effect on the epigastrium, predicted by the choice of acupuncture points, was found for tolerances but not thresholds.
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PMID:Acupuncture analgesia: an experimental investigation. 31 97

A procedure is reported in which radiofrequency lesions were stereotactically placed in the central cord region at the cervicomedullary junction to interrupt selectively the extralemniscal system. Physiological recognition of the target site was based upon the homuncular organization of the dorsal funiculi, which is analysed. Only subjective (segmentally unrelated) analgesia was achieved, usually without demonstrable sensory loss. Stimuli were not painful, while ability to localize it and the discrimination between sharp and blunt components were preserved. A rational approach is offered to certain central pain phenomena which resulted in abolition of hyperpathia and disappearance of, or marked reduction in, deep background pain. Both upper and lower body pain were easily dealt with. Pathways for automatic respiration or for micturition were not encroached upon. Therefore it was electively used for cases with diminished respiratory reserve and for cases with midline and/or bilateral pain.
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PMID:Stereotactic extralemniscal myelotomy. 76 15

The indications for and the results of hypophysectomy for advanced cancer of the breast or prostate gland are reviewed. The technic of open microsurgical transsphenoidal hypophysectomy is described. Since the metabolism of some breast cancers is influenced by estrogenic hormones, the major effect of hypophysectomy seems to be the complete suppression of estrogen production by the gonads and adrenal glands by removal of gonadotropin and ACTH, respectively. Other specific substances, such as growth hormone or prolactin, may also be factors. In cases of prostate cancer which relapse after castration, the adrenals seem to elaborate a significant amount of extradgonadal androgen. Hypophysectomy removes the source of ATCH and thus stops androgen production by the adrenal glands. Other hormones may also be important. In premenopausal patients with advancing cancer of the breast, oophorectomy should be the initial procedure. Most patients after a previous favorable response to oophorectomy get a subsequent objective improvement from hypophysectomy. In postmenopausal patients the effects of hormone therapy should 1st be tried. Many patients responding favorably to hormone therapy will also be benefited later by hypophysectomy. Remission rates are higher in older women. However, hypophysectomy should be carried out relatively early to obtain a useful remission. About 25% of those not responding to other methods will obtain a remission following hypophysectomy. Along interval after the mastectomy before metastases occurs is a favorable prognostic sign. While bony metastases respond best, other sites of metastases do not contraindicate the operation. Most patients with prostatic metastases obtain relief after hypophysectomy, even some of those who have not been benefited by other methods. Advanced age alone is not a contraindication. A preoperative evaluation should be done including a series of endocrine studies. Open microsurgical transsphenoidal hypophysectomy is considered the operation of choice. Complete removal of the gland is accomplished with less disturbance to the patient than an intracranial operation. General anesthesia is used. After the operation tests for pituitary reserve are repeated and a maintenance regimen of hydrocortisone prescribed. Thyroid replacement therapy is often needed. Subjective remissions are more common than objective ones, particularly relief of pain. This operation was done on 20 men with metastatic cancer of the prostate and 23 women and 1 man with metastatic cancer of the breast. Of the prostate cases, 3 patients died during the early postoperative period. Of the other 17, there have been 7 deaths from the cancers after 1-7 months. Of the 23 breast cases, severe body pain was the indication for the operation. Relief occurred in 19 (83%). There have been 7 deaths from the cancers. Hypophysectomy does not predispose to or lead to alterations in emotional state or mental function. Others with larger series of cases have reported that those responding favorably have lived an average of 25.8 months while average survival of those not so responding has been only 5.6 months.
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PMID:Hypophysectomy in the treatment of disseminated carcinoma of the breast and prostate gland. 127 14

Bilateral anterior cingulumotomy has been used to treat psychiatric diseases and chronic pain. We report an interesting case involving a young woman who underwent cingulumotomy for the treatment of intractable total body pain secondary to generalized reflex sympathetic dystrophy. Her initial response after two procedures was excellent though 1 year later her pain recurred and was resistant to a subsequent cingulumotomy.
Pain 1990 Apr
PMID:Bilateral cingulumotomy in the treatment of reflex sympathetic dystrophy. 169 63

The occurrence, location, and severity of muscle pain were determined when vecuronium was used in lieu of succinylcholine during outpatient laparoscopy. Postoperative muscle pain, in 11 body parts, was assessed by a linear analogue scale questionnaire that was completed by each patient on the evening of surgery and for the next three mornings. All patients had general endotracheal anesthesia with nitrous oxide, thiopental, and fentanyl. Succinylcholine 1.5 mg/kg (3-4 min after 3 mg of d-tubocurarine) was given to 14 patients for tracheal intubation and then by infusion for additional muscle relaxation. Another 14 patients received vecuronium 50 micrograms/kg iv as the only muscle relaxant used; all of these patients had residual neuromuscular blockade antagonized with glycopyrrolate 7 micrograms/kg and edrophonium 0.5 mg/kg iv. Both groups were similar in age, weight, length of procedure, time to discharge, and amount of thiopental and fentanyl used (P greater than 0.05). No difference was noted in either group with respect to the severity of pain by body part over time. Mean total body pain scores were generated for each group at all four intervals as an alternate type of analysis. No statistical significance was demonstrated by a Student's t test in any group at any interval sampled. The authors failed to demonstrate that the substitution of vecuronium for succinylcholine lowers the incidence of myalgia when used in outpatient diagnostic laparoscopy. They refrain from concluding that vecuronium contributes to postanesthetic myalgia, but feel justified in stating that the avoidance of succinylcholine did not lower the severity or occurrence of muscle pains after laparoscopy when vecuronium was used in its place.
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PMID:Muscle pain occurs after outpatient laparoscopy despite the substitution of vecuronium for succinylcholine. 256 62

A report is given on indications and results of treatment of chronic cancer pain using stereotactic mesencephalic tractotomy (SMT), based on own experiences in 202 patients. Percutaneous cervical cordotomy for upper body pain syndromes has been abandoned and replaced by SMT. Operative mortality of SMT was less than 0.5%, and also its morbidity was low and usually transitory. Bilateral procedures may be performed with an interval of at least seven days. Early recurrences within one month (15%) are due to insufficient coagulation. Late pain recurrence occurred in 4% and may be due to either nervous system regeneration (sprouting) or transmission of pain by alternate secondary pathways.
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PMID:Stereotactic mesencephalic tractotomy in the treatment of chronic cancer pain. 266 83

The paper describes possible psycho-dynamic connections between the complex relations of depression and pain with regard to the classical conversion theory of Freud as well as modern narcissistic approaches. According to our clinical experience the inner organisation of pain which most regularly appears during long-term illness is formed in compliance with the pattern of an "inner object choice". The pain thus is functioning as a personalized, imaginary internal object. Such an "internal structuring" has a depression reducing quality. An empiric pilot study on 37 patients with chronical though only partly proved body pain reveals that the psychic organisation of pain as an inner object is joined with significantly lower depression scored according to Beck-Depression-Inventory (BDI). Simultaneously the infirmity period is prolonged considerably. The consequences of these findings for the practical psychotherapeutic work will have to be discussed.
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PMID:[Object related function of pain and depression]. 274 88

Myofascial pain is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. We examined a series of 172 patients presenting to a university primary care general internal medicine practice. Of 54 patients whose reason for a visit included pain, 16 (30%) satisfied criteria for a clinical diagnosis of myofascial pain. These patients were similar in age and sex to other patients with pain, and the frequency of pain as a primary complaint was similar for myofascial pain as compared with other reasons for pain. The usual intensity of myofascial pain as assessed by a visual analog scale was high, comparable to or possibly greater than pain due to other causes. Patients with upper body pain were more likely to have myofascial pain than patients with pain located elsewhere. Physicians rarely recognized the myofascial pain syndrome. Commonly applied therapies for myofascial pain provided substantial abrupt reduction in pain intensity. The prevalence and severity of myofascial pain in this university internal medicine setting suggest that regional myofascial pain may be an important cause of pain complaints in the practice of general internal medicine.
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PMID:Prevalence of myofascial pain in general internal medicine practice. 278 62

This report compares patients with non-organic chronic intractable (NOCI) pain with those having chronic pain associated with diagnosed physical illness though it was insufficient to explain the severity and nature of pain. Samples were selected after strict screening procedures. The results reveal that NOCI pain is more often seen in those who are younger, unmarried, with higher education and belonging to a professional group of occupation. Chronic pain associated with physical illness is reported more by elderly, married, those with lesser education and housewives. However, only slight differences were noticeable in the clinical characteristics of pain. Thus there are two distinct groups of chronic pain patients. These differences, along with less predominance of low back pain and high number of whole body pain in the samples suggest cultural differences in localisation and presentation of chronic pain.
Pain 1984 May
PMID:Non-organic chronic intractable pain: a comparative study. 673 17

Video display terminal (VDT) operators (n = 150) in the editorial department of a large metropolitan newspaper participated in a study of day-to-day musculoskeletal symptoms. Work posture related to the VDT workstation and psychosocial work factors were also investigated for their contributions to the severity of upper body pain, numbness, and stiffness using a representative subsample (n = 70). Self-report measures included Karasek's Job Content Instrument and the author-designed Work Interpersonal Relationships Inventory. Independent observations of work posture were performed using techniques similar to those reported by Sauter et al. [1991]. Pain during the last week was reported by 59% (n = 88) of the respondents, and 28% (n = 42) were categorized by symptom criteria potentially to have musculoskeletal disorders. More hours per day of VDT use and less decision latitude on the job were significant risk factors for potential musculoskeletal CTDs. Head rotation and relative keyboard height were significantly related to more severe pain and stiffness in the shoulders, neck, and upper back. Lower levels of co-worker support were associated with more severe hand and arm numbness. For both the region of the shoulders, neck, and upper back and the hand and arm region, however, the contributions of relative keyboard and seat back heights to symptom severity were modified by psychological workload, decision latitude, and employee relationship with the supervisor. Alternative explanations for these findings are discussed.
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PMID:VDT-related musculoskeletal symptoms: interactions between work posture and psychosocial work factors. 783 8


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