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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

Acute pain produced by disease or injury is the net effect of highly complex interactions of various neural systems and psychological factors. Through the interaction of the afferent systems and neocortical processes, the individual is provided perceptual information regarding location, magnitude, and spatial and temporal properties of the noxious stimulus that activates motivational tendencies toward escape or attack and permits analysis of multimodal information, past experience, and probability of outcome of different response strategies. In contrast, chronic pain is a malefic force that taxes the physical, emotional, and economic resources of the patient, his famiily, and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The clinician must keep these differences in mind in order to provide patients with optimal relief of their pain.
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PMID:Neurophysiologic and pathologic aspects of acute and chronic pain. 1 80

The cybernetic model of analgesia is a simple servo-loop: altered sensory input--complaints--medication--temporary restoration of acceptable processing of the sensory input--return of altered sensations. Under ordinary clinical circumstances the functioning of this mechanism is masked by "noise" generated by the interaction of several persons who provide the medication and time factors prolonging the interval between the onset of complaints and the action of the medication. Demand analgesia (DA) has been designed to provide prompt pain relief under the patient's direct control. The technique turned out to be useful also for the investigation of acute pain's course. The present protocol was designed to study the precision with which patients respond to minute changes in the level of a narcotic (hydromorphone) at the target site: this was achieved by varying in a double-blind fashion the amount of narcotic delivered in response to triggering the apparatus and noting how the patient adapts the dosing interval in response to the imposed changes. Thirty-four patients were studied following extensive surgery. Observation times ranged from 16 to 75 h (median 45 h) during which 89 dose changes were initiated. While the majority of subjects adapted successfully to up to 4-fold variations in drug delivery, a sizeable minority (7/34) triggered the apparatus in response to some clue other than the amount of drug received. These non-drug responders seem to correspond to the "placebo reactors" of other therapeutic settings. Our calculations allowed the estimation of how large was the contribution of drug action and non-drug action to the overall therapeutic effect. In the drug-responsive group, the mean contribution of drug action was 78%, while among the non-drug responders this amounted to only 40%. The difference between these two figures is statistically significant (P less than 0.02), at the same time it also reveals important contributions of non-drug factors in drug responders and vice versa. Whether a subject behaves as a placebo reactor or not might depend on the circumstances rather than on innate mechanisms.
Pain 1979 Apr
PMID:Drugs or drums: what relieves postoperative pain? 8 10

The present study was undertaken in order to investigate the analgesic effect of needle puncture in a small self-selected group of patients with chronic or acute pain, and to examine the factors which determine success or failure of this treatment modality. We have found that in chronic painful conditions, needle puncture may be very effective in producing at least transient analgesia. It also can produce permanent relief of acute (self-limited) pains. Needle puncture was not helpful in the management of pain resulting from nerve damage. High score on psychometric indicators of anxiety and depression is a significant predictor os successful needle puncture analgesia in patients with chronic pain. Comparison of our results to studies of counterirritation indicate that the analgesia produced by needle puncture involves a mechanism similar to that of counterirritation-induced analgesia.
Pain 1976 Jun
PMID:Observations on the analgesic effects of needle puncture (acupuncture). 14 Oct 19

Chronic low back pain is more significant from the psychiatric point of view than the acute pain. As a persistent pain of organic origin it leads to typical psychopathological symptoms ("algogenic psychosyndrome"). The algogenic psychosyndrome must be differentiated diagnostically from neurotic developments and masked depressions. Psychosomatic low back pain is a warning of failure in the accomplishment of professional or family duties and chronic and chronic inhibited aggression. - An interdisciplinary study of the courses of 50 patients operated on for prolapse of the lumbar intervertebral disk showed that the psychopathological picture and the pain syndrome are usually determined by several factors. The majority of neurotic disordered personalities developed symptoms of new syndromes after the operation.
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PMID:[Psychiatric aspects of low back pain (author's transl)]. 14 4

Transcutaneous electrical neurostimulation relieves chronic and acute pain by blocking the transmission of pain impulses with comfortable electrical stimulation of light touch sensation. The original Gate Control Theory of Melzack and Wall provides a working model to explain the significant pain relief afforded patients. As high as 80% of selected patients presenting with a wide variety of causes could achieve some relief after treatment. This comfortable, safe method is finding wide application in clinical practice.
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PMID:Transcutaneous electrical neurostimulation: a new therapeutic modality for controlling pain. 14 20

Eighty-seven immunosuppressed patients (53 with localized and 34 with disseminated herpes zoster) from 10 institutions were enrolled in a controlled therapeutic trial of adenine arabinoside. A crossover design was employed; thus, 47 patients received drug for five days and then received placebo, and 40 were given the two substances in the opposite order. Resolution of acute pain and the cutaneous lesions were graded during a 10-day observation period. During the initial five-day period, treated patients showed a statistically significant resolution of pain and cutaneous lesions. Surprisingly, in many untreated patients, natural resolution occurred during this period so that crossover data could not be adequately assessed. Effects on visceral disease also could not be judged, because such disease was uncommon. Ratings of late complications such as postherpetic neuralgia were confused by the crossover design. Toxicity posed no problem. The data further emphasized the potential usefulness of adenine arabinoside as an antiviral chemotherapeutic agent, but also clearly indicated the need for a double-blind study to define this usefulness and to determine how it can most practically be used, if the risk-benefit factor remains favorable.
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PMID:Adenine arabinoside for therapy of herpes zoster in immunosuppressed patients: preliminary results of a collaborative study. 18 Jan 98

Patients with chronic orofacial pain must be treated with methods different from those used with patients with acute pain. If different methods are not used, the characteristics of chronic pain may become firmly entrenched. Dentists should be aware of the various methods of treatment for this separate pain entity.
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PMID:Recognition and treatment of patients with chronic orofacial pain. 29 56

In the emergency department of Dover Air Force Base Hospital, a primary care facility for active duty, retired, and dependent patients, transcutaneous electrical neurostimulation was employed for six months as initial treatment for musculoskeletal pain in 34 patients with acute symptoms. Pain relief ranging from 0 to 100% was achieved in a variety of acute pain states. Only one patient did not obtain pain relief. Although some patients did not receive permanent relief from pain, a significant number of patients did benefit from this new modality.
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PMID:Relief of acute musculoskeletal pain using transcutaneous electrical neurostimulation. 30 83

Relief of intractable pain was produced in six human patients by stimulation of electrodes permanently implanted in the periventricular and periaqueductal gray matter. The level of stimulation sufficient to induce pain relief seems not to alter the acute pain threshold. Indiscriminate repetitive stimulation produced tolerance to both stimulation-produced pain relief and the analgesic action of narcotic medication; this process could be reversed by abstinence from stimulation. Stimulation-produced relief of pain was reversed by naloxone in five out of six patients. These results suggest that satisfactory alleviation of persistent pain in humans may be obtained by electronic stimulation.
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PMID:Pain relief by electrical stimulation of the central gray matter in humans and its reversal by naloxone. 30 58


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