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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A close correlation between the threshold of the nociceptive flexion reflex and pain threshold makes this reflex useful for the examination of pain and analgesia level. Earlier investigations showed that in sciatica the threshold of the nociceptive reflex was decreased in the extremity with pain, and that the degree of this decrease was proportional++ to pain intensity and intensity of radicular sings. In the presently reported study the nociceptive flexion reflex was investigated in 20 patients after epidural injection of 5 mg of morphine. After this blockade the degree of analgesia and the value of the reflex were determined. Improvement was obtained in 80% of patients, with complete disappearance of pain in 55%. In all improved patients the previously decreased threshold of the nociceptive flexion reflex increased again to normal values.
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PMID:[Use of nociceptive flexion reflex in the evaluation of morphine analgesia]. 240 8

The leaves of Nyctanthes arbor tristis, besides being used in the treatment of sciatica and arthritis, are advocated for various kinds of fevers and painful conditions by the Ayurvedic physicians. In the present study, the water-soluble portion of an ethanol extract of the leaves was screened for analgesic, antipyretic and ulcerogenic activities. The extract exhibited significant aspirin-like antinociceptive activity but failed to produce morphine-like analgesia. It was also found to possess antipyretic activity against brewer's yeast-induced pyrexia in rats. The extract also produced gastric ulcers following oral administration for six consecutive days in rats. Results of the present study tend to substantiate the use of this plant in fevers and painful conditions by Ayurvedic physicians.
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PMID:Analgesic, antipyretic and ulcerogenic activity of Nyctanthes arbor tristis leaf extract. 349 8

In a double blind study, repeated irradiation with a low-power (1 mW) helium-neon laser produced relief in subjects with chronic pain. Analgesia was observed after exposure of the skin overlying the radial, medial and saphenous nerves and in some cases, irradiation of the appropriate painful nerve. Exposure of areas of skin not innervated by these nerves did not result in pain relief. Of the patients with trigeminal neuralgia, post-herpetic neuralgia, sciatica and ostearthritis, 19 of 26 experienced pain relief without the use of drugs. Patients who received sham stimulation reported no analgesia. Subjects who were exposed to laser irradiation had a large increase in the urinary excretion of 5-hydroxyindoleacetic acid, the degradation product of serotonin.
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PMID:Relief from chronic pain by low power laser irradiation. 620 Aug 8

Since April 1995 this endoscope assisted laser technique has been used for widening the lumbar exit route foramina. Patient selection included individuals with primarily unilateral sciatica as well as low back pain and referred buttock pain following various operative interventions. Endoscopic laser foraminoplasty (ELF) utilises an endoscope, a uniportal posterolateral approach and a side firing holmium laser probe. Under direct vision and within the protection of saline solution, epidural scarring, extruded and sequestrated disc protrusions and/or osteophytes are removed by holmium laser ablation. The patient is responsive and aware under neurolept analgesia and this ensures the protection and the integrity of the nerve root. A total of 219 such interventions has been performed up to January 1, 1997. The first 48 cases with a follow-up exceeding 12 months have been included in this preliminary review. Initial experience is encouraging. The ELF seems to provide another means of addressing sequelae of primary degenerative disorders as well as the common consequences of conventional spine surgery. ELF provides an alternative to minimal intervention fenestrectomy and open surgical undercutting for predominantly unisegmental and unilateral lateral recess stenosis and in selected cases it may prevent or delay the indication of spinal fusion.
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PMID:Endoscopic laser foraminoplasty on the lumbar spine--early experience. 956 57

Fifty-six patients with low back pain and sciatica following radiological investigation were found to have abnormalities at multiple levels, more than one of which could be responsible for the clinical picture or at a single level, which correlated poorly with the clinical findings. Thirty-four patients had a diagnostic peri-neural root infiltration to clarify whether surgery would be appropriate. Evaluation of the technique was by reduction in analgesia. Eighteen patients have had surgery, 14 with a successful, two a moderate and two a poor outcome. Four patients have been denied and two are awaiting an operation. Ten patients referred for a diagnostic procedure deferred surgery in favour of a therapeutic course. Of 22 patients referred directly for a therapeutic course, 15 had a successful, three a moderate and four a poor result. CT-directed peri-radicular root infiltration is a useful adjunct in the management of low back pain and sciatica.
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PMID:A retrospective study to assess the results of CT-directed peri-neural root infiltration in a cohort of 56 patients with low back pain and sciatica. 1056 40

Acupuncture is a valuable method of complementary medicine with broad application in neurology. It is based on the experiences of traditional Chinese medicine as well as on experimentally proven biological (biochemical and neurophysiological) effects. Acupuncture-induced analgesia is mediated by inhibition of pain transmission at a spinal level and activation of central pain-modulating centers by release of opioids and other peptides that can be prevented by opioid antagonists (naloxone). Modern neuroimaging methods (functional MRI) confirmed the activation of subcortical and cortical centers, while transcranial Doppler sonography and SPECT showed an increase of cerebral blood flow and cerebral oxygen supply in normal subjects. Clinical experience and controlled studies confirmed the efficacy of acupuncture in various pain syndromes (tension headache, migraine, trigeminal neuralgia, posttraumatic pain, lumbar syndrome, ischialgia, etc.) and suggest favorable effects in the rehabilitation of peripheral facial nerve palsy and after stroke. Appropriate techniques, hygiene safeguards and knowledge of contraindications will minimize the risks of rare side effects of acupuncture which represents a valuable adjunction to the treatment repertoire in modern neurology. There is sufficient evidence of acupuncture to expand its use into conventional medicine and to encourage further studies of its pathophysiology and clinical value.
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PMID:[Principles and application of acupuncture in neurology]. 1107 28

Minimally invasive injection therapy is an effective approach for the treatment of sciatica with less complications. This therapy is a sufficient option in cases without absolute indications for operation.The paper describes in detail the different injection techniques like spinal nerve analgesia, epidural dorsal/perineural injections, vertebral joint infiltrations, and radiculographies.
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PMID:[Minimally invasive injection therapy in lumbar syndromes]. 1718 Jun 97

Lumbar disk herniation (LDH) is a common orthopaedic disorder. Many clinical and basic science researches have been conducted recently on using Chinese medicinal herbs to treat LDH. Literature review reveals that the common basic formulas include Duhuo Jisheng decoction (DHJST), Buyang Huanwu decoction (HYBWT), Shentong Zhuyu decoction (STZYT), Taohong Siwu decoction (THSWT), Yanghe decoction (YHT) and Tongdu Huoxue decoction (TDHXT). A basic formula can be modified by adding more herbs or removing some herbs from the formula according to clinical symptoms and traditional Chinese medicine (TCM) syndrome differentiation. Literatures show that herbal treatment have better clinical effects, the medicinal herbs make low-back pain, sciatica and low limb numbness disappeared or alleviated; and restore normal low limb sensation, muscle strength and daily activity. These formulas have also been used to treat LDH postoperative remaining pain, postoperative discitis, postoperative recurrent LDH, and to prevent epidural scar formation and dura mata adhesion. Herbs in these formulas include 5 categories of drugs classified by TCM. They are blood circulation promoting herbs for relieving pain; liver and kidney nourishing and tendons and bones strengthening herbs; blood circulation promoting herbs for unblocking collaterals; pathogenic wind and dampness expelling herbs; and qi invigorating herbs. These herbs have actions of analgesia, anti-inflammation, immunomodulation, phagocytosis of macrophages enhancement, blood circulation improvement, nerve protection, collagen synthesis enhancement. Future research needs to focus on the effects of herbs on four aspects: to enhance collagen synthesis in the disks and inhibit disk degeneration; to promote the resorption of herniated nucleus pulposus and epidural hemorrhage; to prevent nerve cell apoptosis and promote nerve cell regeneration, and to inhibit nociception in the nerve system.
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PMID:[Advances on study of treatment of lumbar disk herniation by Chinese medicinal herbs]. 1743 34

Radicular pain in the distribution of the sciatic nerve, resulting from herniation of one or more lumbar intervertebral discs, is a frequent and often debilitating event. The lifetime incidence of this condition is estimated to be between 13% and 40%. Fortunately, the majority of cases resolve spontaneously with simple analgesia and physiotherapy. However, the condition has the potential to become chronic and intractable, with major socio-economic implications. This review discusses the history, epidemiology, pathophysiology, and natural history of sciatica. A Medline search was performed to obtain the published literature on the sciatica, between 1966 and 2006. Hand searches of relevant journals were also performed. Epidemiological factors found to influence incidence of sciatica included increasing height, age, genetic predisposition, walking, jogging (if a previous history of sciatica), and particular physical occupations, including driving. The influence of herniated nucleus pulposus and the probable cytokine-mediated inflammatory response in lumbar and sacral nerve roots is discussed. An abnormal immune response and possible mechanical factors are also proposed as factors that may mediate pain. The ongoing issue of the role of epidural steroid injection in the treatment of this condition is also discussed, as well as potential hazards of this procedure and the direction that future research should take.
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PMID:Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. 1770 89

Pain has both physical and emotional components. Physical noxious stimuli activate peripheral sensory neurons that, in turn, relay signals to the spinal and supraspinal nuclei. Subsequently, these signals activate areas within the brain associated with pain. Despite considerable knowledge in this area, analgesics may provide pain complete relief in only one out of five patients. Failure to manage pain may be due to a lack of understanding of the neurobiological processing of pain. Factors such as anticipation, anxiety and pain history play roles in the perception of pain. Non-neuronal cells such as those of the immune system influence perception and modulation of pain by the nervous system. In post-dental surgery patients, the severity of the pain and the relief following administration of anti-inflammatory analgesics has been linked to the time course of inflammatory mediators. Similarly, the relief of post-operative pain after abdominal surgery is also associated with a reduction in expression of pro-inflammatory mediators. Administration of anti-cytokines to sciatica patients and subsequent pain relief further emphasizes the role of pro-inflammatory mediators in modulation of pain. Increased expression of inflammatory mediators may also alter response to analgesia. For example, rheumatoid patients with temporal mandibular joint disease with increased expression of interleukins prior to treatment demonstrate inadequate pain relief after administration of anti-TNF-. In addition, pain or its trauma impairs absorption of oral analgesics causing therapeutic failure. Improved analgesic pharmacotherapy may require a better understanding of the involvement of the inflammatory pathways.
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PMID:Drug disease interactions: role of inflammatory mediators in pain and variability in analgesic drug response. 1826 75


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