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Pain perception and personality measures as discriminators in the classification of fibrositis.

Twenty patients with fibrositis were compared to age and sex matched groups of patients with rheumatoid arthritis (RA) and normal controls regarding personality variables measured by the Basic Personality Inventory (BPI) and responsiveness to experimentally induced pain. The group with fibrositis scored significantly higher than the normal group on 4 of the BPI scales and had lower pain threshold and tolerance than the normal group. The group with RA was found to be significantly different from the normal group on hypochondriasis and pain tolerance. Using only pain and personality measures, a statistical discriminant function that was developed resulted in a 72% classification accuracy for the 3 groups studied and 85% accuracy when only the 2 clinical groups were considered.

Adult↗

The course of depression in recent onset rheumatoid arthritis: the predictive role of disability, illness perceptions, pain and coping.

BACKGROUND: This study aimed to investigate the course of depression for patients with recently diagnosed rheumatoid arthritis (RA) and to investigate predictors of depression. METHODS: Twenty-two patients with a history of recently diagnosed RA of less than 2 years were assessed on a variety of clinical outcome and process measures on six assessment occasions over a 21-month period. These 22 patients constituted the control group of a controlled trial and received standard outpatient clinic treatment during follow-up. RESULTS: Patients became significantly more depressed over time. A set of five factors were found to consistently predict depression at the following assessment. These were initial level of depression, disability, pain, beliefs about the consequences of arthritis and coping strategies. CONCLUSIONS: The results confirm the importance of psychological factors in early RA and their relative independence from physical findings. This is the first study to document the importance of illness perceptions in recent onset RA.

Adaptation, Psychological↗

An investigation of stress and pain perception during manual therapy in asymptomatic subjects.

Stress perceived by the patient during the application of a manual therapy treatment technique may account for the reported findings of sympathoexcitation and hypoalgesia immediately after its application. This study investigated whether there was a difference in the level of perceived stress and pain before, during and after the application of a treatment condition (treatment, placebo or control technique), or whether the difference related to the time course of subject involvement in the study.Twenty-four asymptomatic subjects participated in a double-blind, placebo-controlled, within-subjects study in which stress was measured with a stress rating scale and a stress visual analogue scale. Pain experienced by the subject during the application of the treatment technique was measured with a visual analogue scale and modified McGill pain questionnaire. There was no effect of the treatment condition on perceived stress, but there was a reduction in stress levels over the time course of involvement in the experiment, as demonstrated by pre-application levels of stress. Pain was not produced by the treatment technique.This study demonstrated that stress and pain were not features of the lateral glide manipulation of the cervical spine in asymptomatic subjects. If the dorsal periaqueductal grey region is responsible for the initial effects of manual therapy, as has been previously suggested, then stress and pain do not appear to play a role in activating this system during the application of a manual therapy treatment technique in asymptomatic subjects. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗

Role of intracellular calcium in acute thermal pain perception.

The role of intracellular calcium in acute thermal nociception was investigated in the mouse hot-plate test. Intracerebroventricular (i.c.v.) administration of TMB-8, a blocker of Ca++ release from intracellular stores, produced hypernociception. By contrast, i.c.v. pretreatment with thapsigargin, a depletor of Ca++ intracellular stores, produced an increase of the mouse pain threshold. Furthermore, non-analgesic doses of thapsigargin prevented the hypernociception produced by TMB-8. In mice undergoing treatment with heparin, an InsP3-receptor antagonist, or ryanodine, a ryanodine receptor (RyR) antagonist, a dose-dependent reduction of the pain threshold was observed. Pretreatment with D-myo inositol, compound which produces InsP3, and 4-chloro-m-cresol, a RyR agonist, induced an antinociceptive effect. The heparin hypernociception was prevented by D-myo inositol, but not by L-myo inositol, used as negative control. In the same experimental conditions, the antinociception induced by D-myo inositol was prevented by a non-hyperalgesic dose of heparin. Similarly, the reduction of pain threshold produced by ryanodine was reversed by non-analgesic doses of 4-chloro-m-cresol, whereas the antinocicpetion induced by 4-chloro-m-cresol was prevented by non-hyperalgesic doses of ryanodine. The pharmacological treatments employed did not produce any behavioral impairment of mice as revealed by the rota-rod and hole-board tests. These results indicate that a variation of intracellular calcium contents at a supraspinal level is involved in the modulation of acute thermal nociception. In particular, the stimulation of both InsP3- and Ry-receptors appears to play an important role in the induction of antinociception in mice, whereas a blockade of these receptors is involved in an hypernociceptive response to acute thermal pain.

Acute Disease↗

Pain perception expressed by postoperative analgetica need in patients with nephropathia interstitialis chronica e phenacetin.

The consumption of narcotic analgesics was investigated after uncomplicated renoallotransplantation of 21 patients with nephropathia interstitialis chronica e phenacetin and in a control group (N = 21) with renal insufficiency of another origin. We find significantly greater consumption in the former group. The possibility of a previously existing increased pain sensibility in these patients as a disposing factor is discussed.

Adult↗

["Tension-free technique" in open inguinal hernia repair. A prospective, randomized study of postoperative pain perception ("tension-free reconstruction" vs. Shouldice technique)].

A prospective randomized study was performed on 64 patients suffering from primary inguinal hernia. Two groups were formed, each consisting of 32 patients. The patients either underwent tension-free surgical treatment or Shouldice herniorraphy. The aim of the study was to determine if the tension-free operative technique on inguinal hernia patients reduces postoperative pain intensity by 2 days in comparison to the patients receiving Shouldice repair treatment. By using the VAS was shown that at no time was there any significant difference in the pain sensation levels between the two groups. The amount of pain tablets consumed among the patients was similar in each group. The number of complications in both groups was also comparable. During the postoperative follow-up of 6 days six patients in the tension-free surgical group and four patients in the Shouldice group developed uncomplicated hematomas on the 4th day, which were traced to the heparin medication. One patient from the Shouldice group suffered from temporary swelling of the scrotum. The advantage of open tension-free repair using extraperitoneally placed polypropylene mesh is that the technique is simple, size-adapted, and can be carried out easily and at any time under local anesthesia. With regard to the lower recurrence rate of hernia as published in the American literature, this can only be verified by randomized studies.

Adolescent↗

Pain perception in decapitated rat brain.

The question of humaneness of decapitation per se has been considered. The time required for the oxygen tension in decapitated rat brain to decline to a level at which the brain becomes unconscious was estimated to be 2.7 sec. Assuming that decapitation is a powerful arousal stimulus and that the resulting EEG activation (low voltage, fast activity) indicates a conscious awareness of pain and distress the maximum time the pain and distress could be perceived would be 2.7 sec. Hence, decapitation of rats per se may be considered humane.

Animals↗