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At least 379 records · Page 21Linked to original sources
PubMed2004

Mobilized blood cells vs bone marrow harvest: experience compared in 171 donors with particular reference to pain and fatigue.

This prospective study compared the donor experience of blood cell (BC) mobilization and leukapheresis (n=116) with that of bone marrow (BM) harvest (n=55). Internal jugular catheters were inserted electively in 89% of BC donors. Most (80%) BM donors had a harvest with general anesthesia; 20% had epidural or spinal anesthesia. Pain and fatigue were frequent with both procedures and were compared in responses to questionnaires. A total of 85% of BM donors reported moderate or severe pain compared with 68% of BC donors (P=0.02). The median duration of pain was 14 days for BM donors compared with 3 days after BC mobilization (P<0.0001). More BM donors had pain for more than 7 days (75% vs 0%, P<0.0001). Severe fatigue was experienced by more BM donors (49 vs 16%, P<0.0001). Fatigue lasted significantly longer in BM donors (median 11 vs 4 days, P<0.0001) and more BM donors were fatigued for more than 1 week (69 vs 0%, P<0.0001). A total of 11 donors had both BM and BC collection; seven preferred the latter. Simply considered with respect to pain and fatigue, BC donation appears better tolerated by donors. However, there are other sequelae of both influencing the acceptability for individual donors.

Adolescent↗
PubMed2003

Chronic pain disorder associated with psychogenic versus somatic factors: a comparative study.

Fifty-one consecutive non-depressed patients with chronic pain referred to a multidisciplinary pain clinic were assessed. In 32 patients, pain was judged to be associated with psychogenic factors only, while pain in 19 patients could be attributed solely to a general medical condition. The methods of investigation comprised visual analogue scales (VAS) and pain drawings, the Dysfunctional Attitude Scale (DAS), the Karolinska Scales of Personality (KSP), locus of control (LOC) and EMBU (for assessing perceived parental rearing practices). Mean age, gender distribution, analgesic consumption, pain duration, percentage of body area pain as well as body localization of pain were comparable in both groups. Patients with psychogenic pain reported higher levels of general bodily discomfort but less concentration difficulties and memory disturbances compared with the somatic pain patients. There were no significant intergroup differences on any of the LOC, DAS, KSP or EMBU items. LOC turned out to be extremely external, whereas DAS, KSP and EMBU scores were comparable to normal controls in earlier work. The paucity of differences between the two patient groups and the unremarkable personality structure of patients led to somewhat conflicting conclusions, and the results of the study pose one more piece of evidence for the futility of the dichotomous organic vs. psychogenic distinction of chronic pain disorders.

Adult↗
PubMed1998

Coping with pain produced by physical activity in persons with chronic low back pain: immediate assessment following a specific pain event.

Coping with chronic pain during exposure to pain produced by activity was examined in 30 patients with chronic low back pain referred to a university pain management center. Patients' range of motion, autonomic responses, and anticipatory anxiety ratings before exposure and ratings of pain and anxiety after exposure were assessed, and the number of repetitions of the activities that produced the pain was recorded. Analyses showed that using coping self-statement was associated with lower skin conductance during anticipation and greater range of motion. Praying, hoping, and catastrophizing were associated with greater anticipatory anxiety, greater anxiety during the painful activity, and less range of motion from the onset of increased pain to the point of pain tolerance. Praying and hoping were associated with higher pain ratings and fewer repetitions of the activity. Assessment of coping during an incident of pain and multiple methods to measure pain and distress provided convincing evidence that patients' self-management responses influence the consequences of pain exposure.

Adaptation, Physiological↗
PubMedDate not supplied

Comparison of the redundancy, reliability, and responsiveness to change among SF-36, Oswestry Disability Index, and Multidimensional Pain Inventory.

OBJECTIVE: To compare the Medical Outcomes Trust Short-Form-36 (SF-36), the Multidimensional Pain Inventory (MPI), and the Oswestry Disability Index (ODI) measures on internal consistency, domain overlap, and responsiveness in detecting changes following multidisciplinary pain treatment. METHODS: 424 patients with chronic pain referred to a multidisciplinary pain center were assessed. Of these, 87 patients were assessed prior to and following treatment. Cronbach's alphas were calculated for each SF-36 and MPI domain, and for the ODI. Canonical correlation and regression analyses (R2) described overlap. Responsiveness to change was computed from treatment effect size and significance. RESULTS: Cronbach's alpha ranged from 0.69-0.92 for MPI domains, from 0.79-0.91 for SF-36 domains, and was 0.86 for the ODI. Three domains overlapped but several were unique (eg, the MPI "significant other" domains; R2 range 0.03-0.16). Significant changes following treatment were observed for the MPI Pain Severity, Interference and Outdoor Work Activities, the SF-36 Physical and Social Functioning, Bodily Pain, and the ODI. CONCLUSION: The MPI, SF-36, and ODI each have good psychometric properties. Three domains overlapped between the MPI and the SF-36: pain, Interference/Social functioning, and mental health. The MPI and the SF-36 each contributed unique domains such as the SF-36 General Health and Vitality domains and the MPI "significant other" and physical activity domains. Several of the MPI domains were among the most sensitive to change. Because of its large normative sample and samples of patients with diverse medical disorders, the SF-36 may be particularly useful to compare chronic pain patients to those with other medical conditions. The ODI has the lowest respondent burden. The MPI and SF-36, although containing much overlapping information, both make unique and complementary contributions to assessing patients with chronic pain.

Adult↗
PubMed1995

Referred ocular pain relieved by suboccipital injection.

Pain originating from ophthalmic disease has been well documented. A series of patients presenting with eye or periorbital pain attributed to cervical region dysfunction were diagnosed and treated with injections of subcutaneous lidocaine followed by triamcinolone acetonide. Twelve patients, 11 women and 1 man, ranging in age from 20 to 82 years had an evaluation including a complete eye examination, and laboratory tests and neuroimaging as dictated by the history to exclude structural abnormalities or systemic disease. All patients had marked focal suboccipital tenderness ipsilateral to the side of their headache and eye pain. A subcutaneous injection with 2% lidocaine followed by triamcinolone acetonide 40 mg was administered directly to the site of focal tenderness. After injection, five patients described total relief of pain, five patients described some degree of pain relief, and two patients had no relief of headache. Duration of pain relief ranged from several hours to 3 months. Patients may present with periorbital or eye pain as a result of disease affecting the cervical sensory roots with subsequent stimulation of the trigeminal apparatus. Subcutaneous injection of lidocaine and triamcinolone acetonide may be of help in the diagnosis of these patients and provide temporary relief.

Adult↗
PubMed2005

Intramuscular injection of hypertonic saline: in vitro and in vivo muscle tissue toxicity and spinal neurone c-fos expression.

Intramuscular injection of hypertonic saline (4-6% NaCl) is widely used to induce muscle pain in volunteers. The quality of the pain is comparable to clinical muscle pain with localised and referred pain. The objective was to evaluate the muscle toxicity of hypertonic saline by characterisation of 1) cytotoxicity in vitro, 2) local muscle toxicity in rabbits and 3) number of spinal dorsal horn neurones expressing c-fos after intramuscular injection in pigs as an indicator of nociception. Rat myocyte cultures and erythrocyte suspensions were treated with hypertonic NaCl solutions. The creatine kinase activity remaining in the myocytes and haemolysis were measured. Groups of six rabbits were given an intramuscular injection of 0.5 ml of 0.9, 3 or 6% NaCl. Three days later, creatine kinase activity was determined in injection site muscle tissue and normal contralateral muscle. The amount of injection site muscle tissue totally depleted of creatine kinase was calculated. Groups of two pigs were given an intramuscular injection of 3.0 ml of 6% NaCl. The spinal cord was sampled 1, 2 or 3 hr later and processed for stereological quantification of the number of dorsal horn neurones expressing c-fos. Saline was not toxic in vitro at 0.9-6%, but toxic to erythrocytes at 7% or higher and rat myocytes at 15% or higher. No muscle toxicity was seen in rabbits. The number of dorsal horn neurones expressing c-fos was not above basal level. In conclusion, 6% saline caused no in vitro or in vivo toxicity in sensitive models. Consequently, the pain caused by intramuscular injection of hypertonic saline is most likely not related to tissue damage. Consistently, intramuscular injection of 6% NaCl did not activate dorsal horn neurones in pigs to express c-fos beyond basal level.

Animals↗
PubMed1997

Radiographic patterns and response to corticosteroid hip injection.

OBJECTIVES: A prospective, open study of corticosteroid hip injection (CHI) was performed to determine if different radiological patterns of arthritis vary in their response. METHODS: Forty five patients (15 with rheumatoid arthritis, 27 with osteoarthritis, and three with anklyosing spondylitis) underwent hip injection with 80 mg methylprednisolone and lignocaine under x ray control. Outcome was assessed at two, 12, and 26 weeks for pain, range of hip movement, and graded functional questionnaire. Patients estimated their pain in four components, night pain, rest pain, weight bearing, and referred pain, each measured by 10 cm visual analogue score and summed to give a total score out of 40 cm. Hip radiographs were evaluated blindly for pattern and severity of arthritis, as well as for progression between 0 and 26 weeks. RESULTS: Median total pain score decreased from 29 cm at baseline to 22 cm at two weeks (p = 0.0001), 24 cm at 12 weeks (p = 0.03), but had returned nearly to baseline by 26 weeks (25 cm, p = 0.3). Greatest improvement was seen for night pain. Mean range of internal rotation increased from 16 to 28 degrees at two weeks (p = 0.03) and 21 degrees at 12 weeks (p = 0.06). Functional ability did not change. Hips with an atrophic pattern of arthritis on plain radiography gained negligible pain relief at two weeks compared with hips with a hypertrophic or mixed bone response (p = 0.04). The degree of pain relief was similar in patients with OA and RA, and was not influenced by radiographic severity or by the direction of migration of the femoral head. CONCLUSION: Pain and internal rotation improve for up to 12 weeks after CHI. CHI offers a useful and safe therapeutic option for patients with hip arthritis, with the exception of those with a purely atrophic radiological pattern.

Adult↗
PubMed2004

Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions.

BACKGROUND: Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. METHODS: Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine), in accordance with the criteria established by the International Association for the Study of Pain (IASP). The study was performed in the United States in a non-university based ambulatory interventional pain management setting. RESULTS: The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49%-61%), with thoracic spine pain was 42% (95% CI, 30%-53%), and in with lumbar spine pain was 31% (95% CI, 27%-36%). The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54%-72%) in the cervical spine, 55% (95% CI, 39%-78%) in the thoracic spine, and 27% (95% CI, 22%-32%) in the lumbar spine. CONCLUSION: This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain.

Adult↗
PubMed1997

The therapeutic potential of neuropeptide Y in central nervous system disorders with special reference to pain and sympathetically maintained pain.

Neuropeptide Y (NPY), a widely distributed peptide, has been shown to have numerous effects in both the central and peripheral nervous systems. In particular, NPY has an important role in mediating analgesia and hyperalgesia by distinct central and peripheral mechanisms. At least six NPY receptor subtypes are known to exist and the development of subtype-specific ligands targeted at NPY receptors will offer novel therapeutic agents. This article will review the involvement of NPY in diverse pathologies of the nervous system, including pain, and will propose a role for NPY in the maintenance of sympathetically maintained pain.

Journal Article↗