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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The recent literature on pain states shows: pain thresholds are relatively constant for an individual, but pain tolerance is influenced by psychological state; the expression of pain is a function partly of ethnic membership and degree of extroversion; pain complaints are determined as well by cultural and extroversive factors, and also degree of neuroticism. Studies of pain patients reveals that those with acute pain tend to show normal personality profiles, but the degree of pain experienced is related to the degree of anxiety present. Most chronic pain patients, like those with psychogenic pain, show somatic preoccupations and reactive depression. The treatment and/or rehabilitation of pain patients has developed in three areas. In cases of peripheral neuropathy and some spinal cord lesions, electrical stimulation with "neural pacemakers" can often "close the gate" to pain signals and provide significant reduction or abolition of pain. Psychotropic medications, particularly the tricyclic antidepressants, sometimes in combination with phenothiazines and antihistamines, are effective in many instances of central pain, and help increase the pain tolerance and decrease the need for narcotics in other pain states. Operant conditioning, including the use of biofeedback, extinguishes pain behavior and increases pain-incompatible behaviors, with good long-term results.
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PMID:Psychophysiology of pain. 0 84

This study investigates the capacity of the MMPI to discriminate among groups of patients with different types of pain. When multivariate analysis of variance is used, the standard set of MMPI scales discriminates between acute pain and chronic pain but not between chronic pain of two different etiologies (surgical-iatrogenic vs. unknown). The three scales that discriminate acute from chronic pain patients are those in the "neurotic triad," Hs, D, and Hy. The possibility that the unknown pain etiology group could be broken down into psychogenic pain and undetected somatogenic pathology subgroups was explored using cluster analysis. This procedure did not yield any group of patients who could be identified as having chronic pain of psychogenic origin. These results suggest that the MMPI is not a reliable tool for the differential diagnosis of chronic pain. It appears, however, that patterns of findings are partly contingent on population characteristics. Researchers should be cautious about generalizing to populations other than those from which samples are drawn.
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PMID:The MMPI and chronic pain: the diagnosis of psychogenic pain. 75 72

A nationwide survey of physical therapy departments was conducted to investigate the clinical use of transcutaneous electrical nerve stimulation for patients with pain. The majority (64.8%) of the 196 respondents used TENS to relieve chronic pain (and, less frequently, acute pain) from a variety of disorders. Any one of eight modalities was reported to be used in conjunction with TENS for the same pain problems. Seven criteria were used to evaluate the effectiveness of TENS in relieving pain. Most clinicians applying TENS were satisfied with the effectiveness of the modality in relieving acute, chronic, and psychogenic pain. Pain relief with short-term use of TENS was more satisfactory than with long-term use.
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PMID:Clinical uses of TENS. A survey of physical therapists. 696 23

The efficacy of inpatient psychosomatic psychotherapy was proved by a naturalistic prospective study with 50 psychogenic pain patients over an average time period of 12 weeks. At the end of inpatient psychotherapy about 60% of all patients achieved pain mitigation. According to the aim of our therapeutic concept to specially improve the perception and verbalization of their own conflicts or affects about 86% of all patients judged to have an enhanced competence in problem solving. The hypothesis that depression may often occur as a consequence of several years lasting chronic pain, could not be confirmed in our study. In contrast no remarkable correlation was found between symptom duration and depressive or anxious mood respectively. Concerning prognosis it seems to be significant that an increased tendency for rationalization or intellectualization diminished clinical outcome success as well as it occurred with enhanced acute pain sensation.
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PMID:[Inpatient psychotherapy with chronic psychogenic pain patients]. 797 47

Despite their long histories, acupuncture and hypnosis have only recently been acknowledged as valuable by the medical establishment in the U.S. Few studies have used rigorous prospective measurement to evaluate the individual or relative merits of hypnosis and acupuncture in specific clinical settings. In this study, 25 patients with various head and neck pain were studied. Each had an initial assessment of their pain, as well as of their attitudes and expectations. All patients received acupuncture, followed by a reassessment of their pain. After a washout period they received another assessment of pain before and after hypnosis therapy. Preferences for therapy were sought following the hypnotic intervention. Both acupuncture and hypnosis were effective at relieving pain under these conditions. The average relief in pain reported was 4.2 units on a ten point scale, with hypnosis reducing pain by a mean of 4.8 units, compared to 3.7 for acupuncture (p = 0.26). Patient characteristics appeared to impact the effectiveness of treatment: patients with acute pain benefited most from acupuncture treatment, whereas patients with psychogenic pain were more likely to benefit from hypnosis. Patients with chronic pain had more variation in their results. Patients who received healing suggestions from a tape during a hypnotic trance benefited more than those who received no such suggestion, and acupuncture patients who were needle phobic benefited less than those who were not fearful of needles. This study demonstrates the benefits of well designed studies of the effectiveness of these alternative modalities. More work is needed to help practitioners identify which patients are most likely to benefit from these complementary therapies.
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PMID:Acupuncture and clinical hypnosis for facial and head and neck pain: a single crossover comparison. 1159 Oct 81

Pain is classified into physical and psychological pain. Physical pain is nociceptive, inflammatory, or neuropathic. Pain can be categorized into acute or chronic pain depending on the duration of pain and mechanism of onset. Acute pain heals as the underlying cause is resolved and includes naturally curable nociceptive and potentially curable neuropathic pain. Chronic pain is caused by incurable conditions or requires a long time to heal and is persistent: it includes chronic nociceptive pain, established neuropathic pain, and psychogenic pain. The therapeutic strategies for pain depend on the underlying pathological conditions: (1) For nociceptive pain, analgesics, narcotic analgesics, and nerve block are indicated. (2) For neuropathic pain, supplementary analgesics, but not analgesics, are indicated, and some narcotic analgesics are also effective: the recommended supplementary analgesics include calcium channel alpha-2-delta ligands, tricyclic antidepressants (TCAs), and serotonin-noradrenaline reuptake inhibitors (SNRIs). (3) For psychogenic pain, analgesics and nerve block are not indicated, except in the setting of a placebo effect: in paticular, narcotic analgesics should not be used. Psychological therapy, tranquilizer administration, cognitive behavior therapy, and patient education are indicated for this kind of pain.
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PMID:[Diagnosis and treatment of chronic pain by pain clinicians]. 2313 43