Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392326 (discomfort)
 22,423 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eleven chronic low back pain (CLBP) and 11 age- and sex-matched control subjects were tested during two separate sessions for the perception of radiant heat and uncomfortably loud tones. Following the determination of a subject's pain threshold (PT) for radiant heat, a standard signal detection methodology was used to present 26 trials each of 4 stimulus levels. The stimuli were rated on a 9-point scale ranging from 'nothing' to 'very strong pain.' A similar procedure was used for the tone stimuli with the 9-point scale ranging from 'nothing' to 'very strongly uncomfortable.' It was found that the CLBP group had both higher heat pain and tone discomfort thresholds than the control group. For radiant heat only, the CLBP group had poorer discrimination as determined by P(I). The results are discussed within the framework of the hypervigilance and adaptation theories of pain perception.
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PMID:Signal detection and threshold measures to loud tones and radiant heat in chronic low back pain patients and cohort controls. 622 63

A six-week exercise program for people with low back pain was established at YMCAs throughout the United States. Classes met twice weekly with trained instructors. Participants exercised at home as well. About 80 percent of the nearly 12,000 participants reported a decrease in discomfort, including those who had previously undergone back surgery. A decrease in pain correlated with adherence to the program and with measured improvement in strength and flexibility.
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PMID:Evaluation of an exercise program for back pain. 622 22

There is a lack of information dealing with the musculoskeletal profile of common injuries in women rowers. Strength and flexibility of trunk/pelvic muscles were qualitatively described in 17 elite lightweight women rowers. Questionnaires regarding incidence of musculoskeletal injuries in this population were completed. Correlations between musculoskeletal profiles and incidence of injury were determined. Results indicate elite lightweight women rowers have a high incidence of low back pain and discomfort. Seventy-five percent of the sample demonstrated hyperflexion of the lumbar spine. There was a high positive correlation between hyperflexion motion of the lumbar spine and incidence of low back pain. There was a high negative correlation between adherence to a regular stretching program and incidence of low back pain.
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PMID:Musculoskeletal profile and incidence of musculoskeletal injuries in lightweight women rowers. 623 1

Seventy-seven patients treated by chymopapain and laminectomy were compared before, and 6 and 14 weeks after, treatment. A standardized, multidimensional scale of low back pain providing scores on 7 independent dimensions of sensory and affective discomfort and one measure of intensity were used. Fourteen weeks after surgery, patients treated by chymopapain were functioning as well as those treated by laminectomy. Major differences, however, characterized the course of recovery. Chymopapain produced rapid change, which was maintained over the 3 1/2-month period. Healing following laminectomy was slower, but the end results were essentially the same. These findings, using sophisticated measurement techniques, support previous research suggesting that chymopapain is an effective alternative to laminectomy in the treatment of lumbar disk disease.
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PMID:A comparison of patients treated by chymopapain and laminectomy for low back pain using a multidimensional pain scale. 644 50

The roles of bedrest, antiinflammatory medication, and analgesic medication in the treatment of acute back strain were objectively analyzed to determine whether they have a measurable effect on the return of patients to full daily activities as well as on the relief of pain. Two hundred patients were studied prospectively. Each patient had the diagnosis of acute back strain, which was defined as nonradiating low-back pain. The results of the patient's neurologic examination, straight leg raising test, and lumbosacral spine roentgenograms had to be within normal limits for the patient to be included in the study. The results showed that bedrest, as compared with ambulation, will decrease the amount of time lost from work by 50%. Bedrest will also decrease the amount of discomfort by 60%. Analgesic medication, when combined with bedrest, will further decrease the amount of pain incurred, particularly when used in the first three days of the healing process. However, analgesic medication will not allow a more prompt return to work. Antiinflammatory medication, when added to bedrest in the treatment of lumbago, does not provide an advantage over bedrest alone.
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PMID:Acute low-back pain. An objective analysis of conservative therapy. 645 Apr 48

Fifty-eight patients with a variety of causes of chronic low back pain underwent posterolateral intertransverse process lumbar arthrodesis utilizing autologous iliac bone graft. The overall success rate of achieving fusion was 92%. Most of the failures occurred at the L4-L5 level. The economic and functional improvement as a result of this operation was between 70% and 80%, indicating that achievement of lumbar arthrodesis does not necessarily mean a successful surgical result. Overall improvement did not correlate specifically with levels of fusion or with performance of a laminectomy, but a history of prior low back surgery significantly lowered the success rate, regardless of achievement of a solid arthrodesis. Persisting discomfort at the iliac crest bone graft donor site somewhat lowered the overall improvement rate. Intertransverse process lumbar arthrodesis appears to be a highly satisfactory and perhaps a superior method of achieving lumbar fusion, when arthrodesis is indicated.
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PMID:Intertransverse process lumbar arthrodesis with autogenous bone graft. 700 17

Chronic low back pain is experienced by many. Pain management programs have been developed to help patients cope with their condition and learn ways to modify their lifestyle to reduce discomfort. This article describes the development, implementation, and evaluation of a chronic pain management program at one facility.
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PMID:Chronic pain management support group: a program designed to facilitate coping. 806 23

The rehabilitation of this client with chronic back pain was successful secondary to the efforts of her entire medical team. As demonstrated by the termination letter written by the employer when the client's medical leave exceeded 1 year, this client could not have returned to her former position without work hardening. With implementation of the Americans With Disabilities Act, changes in such employer policies might be forthcoming. The occupational therapy principles of activity analysis (Trombly & Scott, 1977) and the therapeutic acceptance of gradual gains in functional abilities contributed to her resumption of both work and nonwork tasks. Although enrolled in a work program, this client was not viewed as simply a worker. The examination and treatment of her life tasks as a parent and homemaker outside her worker role was a crucial aspect of her program (Kielhofner, 1985). It was obvious to her treatment team that the largest gains occurred when the client realized she was capable of performance despite back discomfort. The foundation for return to work was laid when the client set her own goal of working the third shift. The client did not acquiesce to a therapist's goal; she actively formulated her own. Typically, a client with chronic low back pain, a history of knee problems, and an absence from work of more than 1 year has a low probability of successful rehabilitation and return to work (Isernhagen, 1988). Yet this woman was able to overcome those obstacles to return to both work and a more active life-style.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Work hardening for a client with low back pain. 832 86

More than 410,000 people participated in the National Marrow Donor Program (NMDP) as of October 1, 1991, and more than 850 volunteers had donated marrow. While the incidence of serious morbidity as a result of bone marrow donation is rare, the incidence of lesser complications and the long-term consequences of marrow donation are not known. To determine the incidence of donor complications and measure the recovery time of volunteer, unrelated marrow donors, we analyzed the results of surveys of the first 493 persons who donated marrow through the NMDP. The marrows were collected at 42 centers. The median age of the donors was 37.9 years (range 19.1 to 55.6 years). The median volume of marrow collected was 1,050 mL (range 180 to 2,983 mL). Autologous red blood cells were transfused to 89.8% (439) of donors but only 0.6% (3) of donors received allogeneic blood. Acute complications related to the collection procedure occurred in 5.9% of donors; but a serious complication, apnea during anesthesia, occurred in only one donor. When donors were questioned approximately 2 days following discharge from their hospitalization, most donors described symptoms related to the collection; 74.8% experienced tiredness, 67.8% experienced pain at the marrow collection site, and 51.6% of the donors experienced low back pain. Donors were surveyed repeatedly until they felt that they had recovered completely. Mean recovery time was 15.8 days; however, 42 (10%) donors felt that it took them > or = 30 days to recover fully. The duration of the marrow collection procedure and duration of anesthesia both positively correlated with donor pain and/or fatigue following the collection; but the duration of the collection procedure had the highest correlation with post-collection pain and fatigue. The volume of marrow collected per unit of donor weight was more weakly correlated with donor pain and/or fatigue than the anesthesia and collection times. When multivariate analysis was used to analyze the correlation between donor recovery time and these variables, only the duration of the collection was found to correlate significantly with donor recovery time (P = .001). This analysis demonstrates that marrow donation is well tolerated with few complications. To decrease further the incidence of donor discomfort and recovery time following donation, the duration of the collection procedure, and probably the duration of anesthesia, and the volume of marrow collected, should be kept to a minimum.
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PMID:Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program. 846 78

Insufficiency fractures of the pelvis are commonly overlooked as causes of severe hip and low back pain. Predisposing factors include postmenopausal osteoporosis, corticosteroids, and local irradiation. Differential diagnosis includes metastatic disease to bone. We present the case of a 65-year-old woman who had a two-month history of low back pain and left groin pain. Her medical history included osteoporosis and endometrial cancer that was treated with radiation therapy to the pelvis 1 year prior to presentation. Despite bed rest, analgesics, and therapeutic modalities, her pain remained intractable and prevented ambulation. Plain radiographs showed no fracture. Computed tomography (CT) and magnetic resonance imaging showed fractures of the pelvis but were suggestive of malignancy. CT-guided bone biopsy was consistent with radiation osteonecrosis. After diagnosis and continued therapy, the patient progressed to ambulation with moderate discomfort. Failure to diagnose insufficiency fractures could lead to further pelvic irradiation, compromising already weakened bones and causing prolonged disability.
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PMID:Pelvic insufficiency fractures after irradiation: diagnosis, management, and rehabilitation. 860 69


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