Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) advocated for use in painful and inflammatory rheumatic and certain nonrheumatic conditions. It may be administered orally or rectally using a convenient once or twice daily regimen. Dosage adjustments are not usually required in the elderly or those with mild renal or hepatic impairment although it is probably prudent to start treatment at a low dosage and titrate upwards in such groups of patients. Numerous clinical trials have confirmed that the analgesic and anti-inflammatory efficacy of naproxen is equivalent to that of the many newer and established NSAIDs with which it has been compared. The drug is effective in many rheumatic diseases such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and nonarticular rheumatism, in acute traumatic injury, and in the treatment of and prophylaxis against acute pain such as migraine, tension headache, postoperative pain, postpartum pain and pain associated with a variety of gynaecological procedures. Naproxen is also effective in treating the pain and associated symptoms of primary or secondary dysmenorrhoea, and decreases excessive blood loss in patients with menorrhagia. The adverse effect profile of naproxen is well established, particularly compared with that of many newer NSAIDs, and the drug is well tolerated. Thus, the efficacy and tolerability of naproxen have been clearly established over many years of clinical use, and it can therefore be considered as a first-line treatment for rheumatic diseases and various pain states.
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PMID:Naproxen. A reappraisal of its pharmacology, and therapeutic use in rheumatic diseases and pain states. 220 85

Naloxone per se causes no pain in normal man, indicating that opioidergic antinociceptive systems are not tonically active, but this might not be the case in chronic pain conditions. The present investigation tested the hypothesis that pain in chronic headache is the result of insufficiently attenuated nociceptive impulses. Forty-seven patients suffering from chronic tension headache entered the present double-blind cross-over trial of naloxone 4 mg i.v. versus saline. Adverse effects were negligible. Patients scored headache pain on a 100 mm visual analog scale and change in headache on a 5-point verbal rating scale after 5, 15, 30, 60 and 90 min. Mean arterial blood pressure decreased 4.2 mm Hg (P less than 0.05) after naloxone compared to saline, but naloxone had no effect on headache (P = 0.96). A bimodal distribution of acute pain patients into placebo responders and non-responders has been reported, but our chronic pain patients showed a homogeneous placebo response. Review of the literature indicates that acute clinical pain and stimulation-induced analgesia in experimental pain has a naloxone-responsive component. Chronic pain does not appear to be influenced by naloxone in moderate doses.
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PMID:Naloxone in moderate dose does not aggravate chronic tension headache. 268 74

The purpose of this study was to investigate how headache sufferers and headache-free controls differ in their responses to acute pain. Thirty-three women completed the study (15 headache sufferers and 18 controls). The cold pressor was used to induce pain, and a partially inflated blood pressure cuff was used as a nonpainful comparison task. Headache sufferers reported more discomfort during both tasks; however, the 2 groups did not differ in the number of facial expressions of pain displayed during the tasks. Headache sufferers reported a tendency to catastrophize during both tasks; positive coping did not differ between the 2 groups. These results offer evidence that recurrent tension headache sufferers are more sensitive to both painful and nonpainful stimuli and that they cope differently from controls with these physical stressors.
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PMID:Pain perception and coping in female tension headache sufferers and headache-free controls. 878 43

The present study compared the responses of women with headache (chronic tension-type, n = 27; migraine, n = 27) and controls (n = 27) to an acute pain laboratory task, the cold pressor test. Participants' pain perception (i.e., threshold and tolerance) and their fear/anxiety associated with pain were assessed during days 1, 2, or 3 of menses. Analyses pertaining to participants' responses to the cold pressor test (ie, pain threshold and tolerance) failed to show statistically significant group differences, even when covarying pain-related anxiety/fear. Analyses did, however, reveal significant group differences between migraineurs and controls in cognitive anxiety. Correlational analyses also revealed that cognitive anxiety, somatic anxiety, fear, and escape/avoidance were all significantly correlated with pain tolerance in the group with chronic tension-type headache, but not in the other two groups. Subsequent multiple regressions, however, showed that the relationship between anxiety and pain tolerance was primarily a function of somatic anxiety. These results suggest that headache frequency plays a role in mediating the relationship between fear of pain and pain tolerance and that the models by Lethem and colleagues and McCracken may be relevant for understanding tension headache sufferers' responses to head pain.
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PMID:Perceptions of pain in women with headache: a laboratory investigation of the influence of pain-related anxiety and fear. 1138 Jun 47

According to previous studies pain symptoms were a problem in multiple sclerosis (MS) patients. This is an important issue since symptom control, especially pain, assume high priorities in MS. The aim of study was to assess the incidence and type of pain symptoms in MS. In the study 104 consecutive patients with clinically definite MS, according to Posers criteria, were evaluated by questionnaire. In all patients brain MRI strongly suggested MS. 76% of patients had relapsing-remitting (RR) course of the disease. At any stage of the disease pain syndromes occurred in 70.2% of MS patients. In 8% patients pain was the first symptom of MS. The most common acute pain syndromes were: Lhermitte sign (26%) and painful tonic spasm (19%). The incidence of migraine was 8% and 26% had tension headache. Chronic pain occurred in 60% of MS patients. Most common were dysaesthetic extremity pain (45%), low back pain (34%) and painful leg spasm (22%). There was no correlation with age, sex, and duration of disease. Pain symptoms were more frequent in MS patients with higher EDSS score and spinal cord involvement. Pain syndromes are common in MS patients. There was no correlation with age, sex, and duration of the disease. Pain occurred more frequent in MS patients with higher EDSS score and in patients with spinal cord involvement.
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PMID:[Pain in the course of multiple sclerosis]. 1204 4

Dental pain is the most common acute pain presenting in the orofacial region; however, chronic pain conditions are also frequent and include; temporomandibular joint disorders (TMDs), primary headaches (neurovascular pain), painful post-traumatic trigeminal neuropathy (PPTTN) and less commonly referred pain and idiopathic or centralized pain conditions. All of these conditions can mimic toothache and vice versa. Many of these conditions are comorbid with high levels of tension headache and migraine reported in patients with TMD; however, dentists remain unfamiliar with headaches and medics unfamiliar with toothache's multiple presentations. The anatomical complexity of the region, the potential exhaustive differential diagnoses and the multiple siloed training of specialties, leads to incorrect and delayed diagnosis and often results in patients undergoing inappropriate surgical and medical treatments. The continued inappropriate interventions may also complicate the later presentation of the patient with pain, by changing its phenotype, preventing a timely and correct diagnosis. Due to the variable presentation of toothache, which can mimic many different chronic pains including; episodic throbbing pain of migraine, the dull continuous pain of myofascial and arthrogenous TMDs or centralized facial pain, diagnosis can be complex. Neuralgic pain occurs in the dentition in health and with disease, mimicking conditions like PPTTN, trigeminal neuralgia (TN), and trigeminal autonomic cephalalgias (TACs), many patients are inappropriately diagnosed and treated, either by general medical practitioners assuming that the neuralgia is due to TN rather than more commonly presenting toothache or by a dentists or other surgeons continuing to treat TN or TACs with routine surgical care. Many patients are prescribed countless courses of antibiotics and undergo multiple surgical interventions simply as a result of poor education due to siloed specialty training. This must be addressed to improve patient safety.
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PMID:Tooth-Related Pain or Not? 3167 12