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

Due to international guidelines of treatment of acute low back pain (LBP), psychosocial risk factors like depressive mood and maladaptive pain-related coping strategies ('yellow flags') have to be assessed in the early phase of acute pain. Within this longitudinal study in patients with LBP and leg pain, we used an artificial neural network (ANN) to classify the pain intensity 6 months after the onset of treatment. Psychosocial risk factors were used as input neurons. The training of the three-layer ANN using the back-propagation algorithm yields to an accuracy of 83.1%. Further on, the complexity of this structure indicated the necessity of an early screening procedure that allows a differentiation between several high risk groups and a low risk profile in order to predict the long-term development of pain intensity.
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PMID:Classification of psychosocial risk factors (yellow flags) for the development of chronic low back and leg pain using artificial neural network. 1513 16

Etoricoxib (Arcoxia, Merck & Co., Inc.) is a selective inhibitor of cyclooxygenase-2 (COX-2), an enzyme involved in pain and inflammation. It is a member of the COX-2-selective (coxib) class of nonsteroidal antiinflammatory drugs (NSAIDs). Extensive clinical trials have confirmed its analgesic and antiinflammatory efficacy to be at least as good as and in some cases superior to nonselective NSAIDs in a number of disease and patient treatment settings. Etoricoxib displays improved gastrointestinal safety compared with nonselective NSAIDs and has a favorable overall safety and tolerability profile. It is rapidly and completely absorbed following oral administration providing a rapid onset of action. Its long plasma half-life allows for once-daily dosing. Etoricoxib is currently approved in a number of countries for various indications including the treatment of acute pain, acute gouty arthritis, chronic low back pain, primary dysmenorrhea, and chronic treatment for the signs and symptoms of osteoarthritis and rheumatoid arthritis. In countries where it is approved, the highest recommended daily dose for chronic use is 90 mg for rheumatoid arthritis and 60 mg for osteoarthritis and chronic low back pain. The recommended daily dose for acute pain relief treatment from primary dysmenorrhea and acute gouty arthritis is 120 mg. This review summarizes the published preclinical and clinical data relevant to the use of etoricoxib in clinical practice.
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PMID:Etoricoxib. 1531 95

Chronic back pain is one of our society's most important health problems, causing long periods of sick leave and early retirements. Recently the German Society of General Practice and Family Medicine (DEGAM) published an evidence-based guideline for low back pain. It has been developed according to the 10-step concept of guideline development of the DEGAM, aiming for early detection of complicated clinical conditions, avoidance of unnecessary diagnostic tests and prevention of chronicity. Complicated, uncomplicated and radicular pain are defined by patient history and a short clinical examination. Imaging and further diagnostic tests are reserved for patients at risk. Basic therapy consists of structured advice. The aim of the guideline is to get patients back to their usual activity supported by effective pain relief. Psychosocial factors which are important for the prognosis should be evaluated already during the first consultation. Manual therapy might help in acute pain. Patients with persistent pain symptoms and long periods of sick leave should be transferred to multiprofessional management including pain treatment, behavioural therapy and physiotherapy. A randomised controlled trial has been set up to study the efficacy of guideline implementation.
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PMID:[Guidelines for back pain]. 1561 54

Previous studies of the Fear-Avoidance Model of Exaggerated Pain Perception have commonly included patients with chronic low back pain, making it difficult to determine which psychological factors led to the development of an "exaggerated pain perception". This study investigated the validity of the Fear-Avoidance Model of Exaggerated Pain Perception by considering the influence of fear of pain and pain catastrophizing on acute pain perception, after considering sex and anxiety. Thirty-two males and 34 females completed the State-Trait Anxiety Inventory, the Fear of Pain Questionnaire, and the Coping Strategies Questionnaire. Subjects underwent a cold pressor procedure and tolerance, pain intensity, and blood pressure reactivity were measured. Sex, anxiety, fear of pain, and pain catastrophizing were simultaneously entered into separate multiple regression models to predict different components of pain perception. Tolerance was not predicted by fear of pain, pain catastrophizing, or anxiety. Pain intensity at threshold and tolerance were significantly predicted by fear of pain, only. Blood pressure reactivity to pain was significantly predicted by anxiety, only. These results suggest that fear of pain may have a stronger influence on acute pain intensity when compared to pain catastrophizing, while neither of the factors predicted tolerance or blood pressure reactivity.
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PMID:Fear of pain, not pain catastrophizing, predicts acute pain intensity, but neither factor predicts tolerance or blood pressure reactivity: an experimental investigation in pain-free individuals. 1609 35

A family history of chronic pain has previously been linked to increased incidence of spontaneous acute pain and risk for chronic pain. Mechanisms underlying these associations are unknown, although similar effects on both acute and chronic pain suggest that central endogenous analgesic system differences may be relevant. This study tested whether a positive parental chronic pain history (PH+) was associated with impaired endogenous opioid analgesic responses to acute pain. Seventy-three chronic low back pain patients (LBP) and 46 pain-free controls received opioid blockade (8mg naloxone i.v.) and placebo blockade (saline) in randomized, counterbalanced order in separate sessions. During each, subjects participated in a 1-min finger pressure pain task followed by an ischemic forearm pain task, providing pain intensity ratings during and immediately following each task. To assess opioid analgesic function, blockade effects were derived by subtracting placebo from blockade condition pain responses. Placebo condition analyses indicated that both PH+ subjects and LBP subjects reported greater acute pain sensitivity than respective comparison groups (p's<.05). Multivariate analyses indicated that, beyond any influence of current chronic pain status, PH+ subjects failed to exhibit any endogenous opioid analgesia to acute ischemic pain, whereas PH- subjects elicited effective opioid analgesia (p<.05). A significant multivariate PHxSubject Type interaction (p<.05) indicated that opioid analgesic impairments were most prominent in PH+ LBP subjects. Similar analyses for finger pressure pain blockade effects were nonsignificant (p>.10). The possible heritability of endogenous opioid analgesic dysfunction observed in individuals with a positive parental chronic pain history remains to be investigated.
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PMID:Parental history of chronic pain may be associated with impairments in endogenous opioid analgesic systems. 1672 61

There have been significant advances in our understanding of occupational low back pain over the last decade largely because of a noteworthy improvement in the number and quality of prospective trials. More recent work confirms that genetic factors may drive a large portion of thr risk factors. The importance of physical fitness and spine support muscle fitness is believed to protect against future occurrences. Psychosocial factors can play a role in increasing the risk of future low back pain and acute pain in becoming chronic. Some of the psychological influence may be through a muscular pain component. It is arguable that an emphasis should be placed on resources, education, and support to allow workers to be productive whether suffering from back pain or not.
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PMID:Epidemiology of occupational low back pain. 1696 73

The transition from acute pain to chronic pain and onward to disability is burdensome emotionally and financially to individual sufferers, loved ones, employers, and the health care system. Up to 40% of acute low back pain cases can become chronic and lead to disability in some cases. Treatments that reduce risk of chronic pain by successful management of acute low back pain are highly desirable. Prevention of acute low back pain is even more desirable. Exercise has been part of the armamentarium of treating and preventing acute low back pain, especially as a means of avoiding disability. This article critically reviews studies of the role of exercise in the management and prevention of low back pain.
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PMID:The role of exercise in the prevention and management of acute low back pain. 1696 78

Pain is the most popular complaint since the appearance of the human on earth, a very unpleasant feeling sometimes difficult to be treated. Therefore, we have many patients who complain of pain in our hospitals or clinics. When a patient with pain visits our institution, first of all, we must evaluate the grade of pain, and then start to treat the pain of the patient. Of course, we have many devices available to treat the patient with pain. In the following special articles, device for evaluation of pain, spinal stimulation device, device for electrical current therapy (ECT), LASER device for chronic and acute pain, epiduroscopy for lumbago, as well as disposable infusion pump for postoperative pain and cancer pain are described. The mechanism of pain may be understood by patients themselves. However, devices in these articles are very useful for the treatment of pain, especially intractable pain. I feel very happy if these articles contribute greatly for the treatment of patients with pain.
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PMID:[Devices for the relief and evaluation of pain: preface and comments]. 1698 4

Acupuncture is now accepted as a complementary analgesic treatment. Auricular acupuncture is a distinct form of acupuncture. Electrical stimulation of acupoints (electroacupuncture) increases the effects of acupuncture. Recently, an auricular electroacupuncture device, the P-Stim, has become available. Clinical studies in outpatients have investigated the P-Stim in chronic musculoskeletal pain and its use for minor surgery. In chronic cervical or low back pain, auricular electroacupuncture was more effective than conventional auricular acupuncture. The results in acute pain were controversial. Auricular electroacupuncture reduced pain and remifentanil consumption during oocyte aspiration when compared with conventional auricular acupuncture or a sham treatment. However, after third molar tooth extraction, auricular electroacupuncture and auricular acupuncture failed to reduce either postoperative pain or analgesic consumption. Further large-scale studies are required to evaluate the analgesic efficacy of auricular electroacupuncture.
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PMID:P-Stim auricular electroacupuncture stimulation device for pain relief. 1718 68

The anger management styles of anger-in (inhibition) and anger-out (direct expression) are positively associated with pain responsiveness. Opioid blockade studies suggest that hyperalgesic effects of trait anger-out, but not those of trait anger-in, are mediated in part by opioid analgesic system dysfunction. The current study tested the opioid dysfunction hypothesis of anger-out using an alternative index of opioid function: pain-induced changes in plasma endogenous opioids. Plasma beta-endorphin (BE) was assessed at rest and again following exposure to three laboratory acute pain tasks (finger pressure, ischemic, and thermal) in 14 healthy controls and 13 chronic low back pain (LBP) subjects. As expected, acute pain ratings correlated positively with measures of anger-in (both groups) and anger-out (LBP group; p's<.05). Greater pain-induced increases in BE were associated with significantly lower pain ratings in both groups (p's<.05). Hierarchical multiple regression indicated that greater anger-out significantly predicted smaller pain-induced BE increases (p<.05). Subject type did not moderate this association (p>.10). Anger-in did not display significant main or interaction effects on pain-induced BE changes (p's>.10). The significant association between anger-out and BE release partially mediated the hyperalgesic effects of anger-out on pain unpleasantness, and was not attenuated by statistical control of general negative affect. This suggests unique associations with expressive anger regulation. Elevated trait anger-out therefore appears to be associated with opioid analgesic system dysfunction, whether it is indexed by responses to opioid blockade or by examining circulating endogenous opioid levels. Possible "statextrait" interactions on these anger-related opioid system differences are discussed.
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PMID:Trait anger expressiveness and pain-induced beta-endorphin release: support for the opioid dysfunction hypothesis. 1719 88


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