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Results for “Referred Pain”

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At least 397 records · Page 22Linked to original sources
PubMed2003

Intra-articular bupivacaine hip injection in differentiation of coxarthrosis from referred thigh pain: a 10 year study.

The authors conducted a retrospective study to validate the specificity of intra-articular injection of local anaesthetic to identify the source of pain in patients with coxarthrosis but ill-defined clinical and radiological features. Forty-seven patients received intra-articular injection of the hip joint as a diagnostic procedure. Twenty-four patients showed a positive response with relief of pain. All of them underwent total hip replacement and remained pain free following surgery. In twenty-three patients intra-articular injection did not relieve the pain; three of these underwent successful total hip replacement two years later. Other negative responders were further evaluated and appropriately managed. This study confirms that intra-articular injection of local anaesthetic is a valuable tool in diagnostic dilemma. The calculated sensitivity of 88% and specificity of 100% is similar to other published series.

Adult↗
PubMed2004

[Pathophysiologic basis of the treatment of neurogenic pain].

According to the International Association for the Study of Pain (IASP) neuropathic pain is "pain initiated or caused by a primary lesion or dysfunction or transitory perturbation in the peripheral or central nervous system". Neuropathic pain is usually classified according to the etiology, location of the lesion, and pain characteristics--individual symptoms and signs, but also according to the possible mechanisms involved. Identifying the underlying pain mechanisms during the diagnosis becomes essential for treatment strategies. The clinical picture of neuropathic pain is similar in many cases, and clinical features include: ongoing spontaneous or evoked pain in an area with sensory loss, positive sensory symptoms such as allodynia and hyperalgesia, wind-up pain following repetitive stimulation, referred pain and abnormal sympathetic activity. The understanding of the mechanisms underlying neuropathic pain has increased over the last decade. The primary pathophysiologic mechanisms that produce pain are: nociceptor sensitization, nerve trunk inflammation, sympathetic nervous system involvement, ectopic neuronal discharges, pathologic synaptic reorganization--neuroplasticity and central sensitization. In most clinical features, there is a complex interaction that involves peripheral and central nervous system rather than a single mechanism. Because numerous mechanisms are implicated, the traditional approach to pain control using single drug therapy may not be most effective, and therapeutic combinations are a better choice. Neuropathic pain is poorly responsive to conventional analgesics. In spite of a variety of drug classes used to treat neuropathic pain including antidepressants, anticonvulsants, antiarrhythmics, opioids, local anesthetic blockers, neuropathic pain remains difficult to treat. The possibility to select specific drugs and treatments for the individual patient lies in elucidating the relationships between clinical neuropathic states and underlying pathophysiologic changes. Progress in defining the mechanisms involved in neuropathic pain, based on further clinical studies and fundamental investigations, will improve therapeutic management of neuropathic pain.

Animals↗
PubMedDate not supplied

Naproxen sodium for OB/GYN use, with special reference to pain states: a review.

The effectiveness of naproxen sodium and its parent compound, naproxen, has been assessed in the treatment of a variety of obstetric and gynecologic problems, particularly pain states. This article summarizes the literature on the efficacy of the naproxen compounds in treatment of the following conditions: primary and secondary dysmenorrhea, insertion of a contraceptive intrauterine device, suction curettage, postpartum pain, pelvic inflammatory disease, gynecologic surgery, menorrhagia, premature labor and menopause. The data from the studies compiled demonstrate the usefulness of naproxen sodium or naproxen as an effective analgesic in treating pain and inflammation associated with these conditions.

Clinical Trials as Topic↗
PubMed1985

[A roentgenographical study on the aging process of alignment of the lower extremities in children--with special reference to pain in the lower extremity].

To date, detailed reports are not available in large number concerning the alignment of lower extremities of children. Moreover, those already published are primarily concerned only with normal children, failing to make a sound comparison of lower extremity alignment between normal children and children with complaints about lower extremity alignment. Following is the summary of extensive research the author has done by comparing statistical data obtained--such as measurements of condylar distance, malleolar distance, and alignments of lower extremities--from 269 cases of normal children (538 lower extremities), from 2 years to 15 years, and 173 cases of children with pain (215 lower extremities), from 3 years to 15 years. Most of the children aged five years and older, whose main complaint is pain in their lower extremities, were found to show significant variations in the alignment of their lower extremities and were compared to normal children. When the intercondylar distance is greater than 10 mm, it is imperative to carefully investigate the alignment of the patient's lower extremities, because the pain is almost always found due to the malalignment. Bow legs and knock knees are not only deformity but also frequently accompanied by pain. Therefore, Lanz's method is most useful to evaluate bow legs and knock knees.

Adolescent↗
PubMed1982

[Pathogenesis and clinical features of painful dysfunctions of the locomotor system].

In the pathogenesis of painful dysfunctions of the locomotor apparatus superficial pain, deep pain and compression pain as well as referred pain play a role. The development of this pain is discussed. The differential diagnosis of radicular and pseudoradicular forms of pain of the vertebral column is discussed. The most clinical important rheumatic pain syndromes, myalgia, arthritis and arthrosis as well as the development of pain in gout attacks are described according to the natural history and clinical presentation of the disease. Therapeutic indications are given. The importance of the differential diagnostic evaluation of pain syndrome is stressed, in particular if it seems, that there is no organic background.

Afferent Pathways↗
PubMed1996

Fever, leukocytosis, and referred thigh pain.

The patient, a 43-year-old man with insulin-dependent diabetes mellitus, presented four days after sustaining a dog bite on his right hand, complaining of excruciating, intermittent, right thigh pain. He was febrile (temperature, 38.3 degrees C [101 degrees F]) and had a leukocyte count of 27.8 x 10(9) per liter (27,800 per mm3). On physical examination, he had a 2-cm open wound with minimal purulent drainage on the fourth digit of his right hand. He had some limited range of motion of the right hip and focal muscular tenderness in the medial thigh, but no other infectious or neurologic findings. A radiographic evaluation included chest, lumbar, right femur, and pelvic films and a computed tomographic (CT) scan of the abdomen; all were normal. In addition, a nuclear medicine scan showed no signs of infection. A CT scan and a magnetic resonance image (MRI) of the pelvis were done (Figures 1 and 2).

Adult↗