PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Referred Pain”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed2005

An experimental study of viscero-visceral hyperalgesia using an ultrasound-based multimodal sensory testing approach.

Widespread visceral hypersensitivity and the overlap of symptom complexes observed in functional gastrointestinal disorders may be related to central sensitization and neuroplastic changes. A multimodal and multi-segmental model was developed to evaluate viscero-visceral hyperalgesia induced by experimental esophageal sensitization in healthy volunteers. Twelve healthy subjects were studied using a double-blinded, placebo-controlled design. The sensitivity to mechanical and heat stimulations was assessed in the proximal esophagus, duodenum and rectum before and after perfusion of the distal esophagus with acid or saline. A special-designed probe was used allowing cross-sectional ultrasound imaging during mechanical and heat stimulation of the esophagus and duodenum. Another probe was used for mechanical stimulation of the rectum. The referred somatic pain areas to gut pain stimulations were also assessed. Following acid perfusion 11 of 12 volunteers showed increased sensitivity to one or more stimulation modalities. An overall increased sensitivity to mechanical stretch in the three gut segments was seen (P=0.0001). Posthoc analysis showed that this was mainly due to increased sensitivity in the rectum (P<0.001). No changes were seen to thermal stimulations (all P-values>0.4). The somatic referred pain area to duodenal stimulations increased (P=0.04), while it was unaffected to esophageal and rectal stimulations (P>0.3). The present method demonstrated a new approach to assess multimodal sensitivity to experimental sensitization of the esophagus and related viscero-visceral hyperalgesia. Central mechanisms can explain the remote hyperalgesia to mechanical visceral stimulation and the increase in referred pain areas. The present method may be used to explore pathophysiology and pharmacological interventions in patients with visceral hypersensitivity.

Abdominal Pain↗
PubMed1976

Clinical analysis of angina pectoris and angina-like pain --With special reference to ECG during attack, "cervical spondylosis" and selective coronary arteriography.

In a series of 63 patients, 60 with angina pectoris and 3 with cervical spondylosis and "thoracic spondylosis" showing angina like pain detailed assessments were made of the mode of onset of attack, including electrocardiography during attacks, X-ray examination of the thoracic and cervical vertebrae and neurological examinations, along with coronary arteriography in some cases, with the following results: 1. The cases of angina pectoris were classifiable grossly into two groups according to mode of onset of chest pain: Group A: Angina began with pain in the anterior chest (39 cases); Group B: Angina in the anterior chest was preceded by "pain" occurred elsewhere in the chest (21 cases). The cases in group B were further classified under two categories, types BI and BII, the former being characterized by a sudden onset of "pain" in a somatic area or areas other than the anterior chest where there is usually no dysesthesia, followed by development of retrosternal or precordial pain (6 cases), while the latter type of angina began with paroxysmal exacerbation of preexistent dysesthesia in the nape, shoulder and arms and eventuated in pain in the anterior chest (15 cases). There were two subtypes in the type BII angina viz. types BIIa and BIIb. There was no ECG evidence of ischemic changes at exacerbation of the nucha-omo-brachial dysesthesia in type BIIa while significant ischemic ECG changes were evident in association of aggravation of dysesthesia in the type BIIb patients. 2. Concomitant "cervical spondylosis" with radiographic evidence of abnormalities in cervical vertebrae and associated subjective symptoms accounted for 22.9% of group A and for 71.4% of group B. In no case of type BI was there evidence of such complication whilst all the cases of type BII had this complication. 3. The mode of appearance of pain in patients with cervical spondylosis showing angina like pain resembled to that of angina pectoris in type BII but ECG during attack did not reveal any significant ischemic changes. 4. As for interrelation between findings by selective coronary angiography (26 cases of angina pectoris) and complication of "cervical spondylosis", the complication of "cervical spondylosis" was higher in incidence in the group of cases with low-grade coronary arterial changes (degree of occlusion less than 50%) than in the group with greater arterial changes (degree of occlusion over 50%). The findings described suggest the possibility that the mode of manifestation of anginal attack may be modified by the concomitant presence of "cervical spondylosis".

Adult↗
PubMed1997

A pilot assessment of alternative methods of quantifying dental pain with particular reference to dentine hypersensitivity.

OBJECTIVE: The overall aim of this pilot study was to establish the usefulness and comparability of selected verbal and non-verbal methods in the quantification of sensory and affective aspects of dental pain associated with dentine hypersensitivity (DH). DESIGN: The assessment of dental pain was conducted during an eight week clinical study. Patients were asked to rate their perception of dental pain using selected methods of quantification following tactile (Yeaple Probe-an electronic pressure-sensitive probe) and evaporative (cold air from a dental air syringe) stimulation; together with an overall assessment of perception to daily stimuli (e.g., cold air/water, toothbrushing, sweet and sour foods). The assessment methods used to quantify pain arising from DH were a continuous visual analogue scale (VAS), a 0-10 numerical rating VAS scale (NRS), and a separate intensity verbal descriptor (IVD) and unpleasantness verbal descriptor (UVD) word scales. SETTING: A specialist department at a postgraduate dental institute and hospital in London, UK. SUBJECTS: Twenty-five adult patients (8M + 17F) with a mean age of 42.6 years (95 per cent C.I. 38.8 to 46.4 years) attending the department for a clinical study evaluating the efficacy of a desensitising toothpaste agreed to participate. OUTCOME MEASURES: The study compared a continuous visual analogue scale (VAS), a 0-10 numerical rating visual analogue scale (NRS), and a separate intensity (IVD) and unpleasantness verbal descriptor (UVD) scales to quantify sensory and affective aspects of pain. An unweighted moving average technique was used to construct graphs of the relative frequency of reported severity gradings over a range of 0-10. RESULTS: The results of the study indicated that cold air appeared to cause greater discomfort to the patient than tactile sensitivity, with the air intensity curve for both IVD and 0-10 VAS peaking at a severity score of 5 while continuous VAS peaked at a score of 3-4. All methods peaked at score 2 for tactile sensitivity. The UVD scale peaked at score 2-3 and again at 6 for air sensitivity, but conformed to the other scales by peaking at score 2 for tactile sensitivity. NRS and IVD scales therefore appeared to provide acceptable alternatives to continuous VAS, but the UVD scale, probably because of the imprecise nature of the words used in the scale, did not. CONCLUSIONS: This study partially confirms previous conclusions that both verbal and non-verbal techniques quantify sensory and affective aspects of pain. However, the imprecise nature of UVD words provided misleading information in terms of both accuracy and sensitivity (except at very low levels of discomfort), when assessing pain arising from dentine hypersensitivity. In view of the highly subjective data arising from studies of this nature, the use of a moving average technique may be considered a more pragmatic method of analysis.

Adult↗
PubMed1988

Fine structure of the dorsal part of the nucleus submedius of the rat thalamus: an anatomical study with reference to possible pain pathways.

The dorsal portion of the nucleus submedius of the rat thalamus receives spinal and trigeminal projections which may convey noxious inputs. The present study was undertaken to analyse the fine structure of the nucleus with particular reference to a possible trigemino-thalamo-prefrontal cortical pathway relaying in nucleus submedius. Presynaptic terminals in the dorsal portion of the nucleus submedius were classified into three broad categories usually observed in thalamic nuclei: "small round", "flat" and "large round" types. Axonal tracing using either anterograde transport of horseradish peroxidase or degeneration methods indicated that some "small round" terminals originate from the pre-frontal cortex. Some "large round" terminals were labelled from the trigeminal subnucleus caudalis. These "large round" terminals exhibited distinct morphological features when compared with trigeminal terminals in other thalamic nuclei. In particular they made synaptic contacts predominantly with dendritic protrusions and were surrounded by multilamellate astrocytic processes. Double-labelling experiments were performed by means of the combined retrograde transport of horseradish peroxidase and Wallerian degradation techniques. Terminals degrading after lesion of the trigeminal subnucleus caudalis contacted submedius neurons labelled retrogradely from the prefrontal cortex. These observations demonstrate the existence of a direct monosynaptically relayed pathway from subnucleus caudalis to prefrontal cortex which relays in the dorsal part of nucleus submedius.

Afferent Pathways↗
PubMed1986

Quantification of changes in myofascial trigger point sensitivity with the pressure algometer following passive stretch.

In order to determine the relationship between trigger point sensitivity and the referred symptoms of myofascial pain, VAS ratings of referred pain intensity and pressure algometer measures of myofascial trigger point sensitivity were taken pre and post treatment of the muscle containing the trigger point with passive stretch. The results in 20 subjects, experiencing unilateral or bilateral myofascial head and neck pain, showed that myofascial trigger point sensitivity decreases in response to passive stretch as assessed by the pressure algometer, and that trigger point sensitivity and intensity of referred pain are related.

Adult↗
PubMedDate not supplied

Randomized prospective study of local transdermic anesthetic in fine needle aspiration biopsy for breast lumps.

AIM: To evaluate the use of local transdermic anesthetics in fine needle aspiration biopsy (FNAB) in breast lesions. METHODS: Prospective randomized study of 119 patients having breast lesions, all being indicated for FNAB. The patients were divided into three groups: 40 patients entered in the active group (lidocaine + prilocaine); 40 patients underwent the placebo group (aqueous extract of Triticum vulgaris); and a control group of 39 women in whom FNAB was performed without the administration of any substance. Both the anesthetic and placebo were administered an hour before FNAB. Pain was quantified through a visual analogic scale of pain. The type of pain was also classified in terms of occurrence: only during the puncture, only during the movements and both. RESULTS: The visual linear analogic scale of pain showed an average of 3.3 in the active group, 3.5 in the placebo and 4.0 in the control group (NS). Analysis of the type of pain which was referred by the patient showed that 15% of the patients in the active group, 12.5% of those in the placebo group and 5.1% in the control group did not refer to any sensation of pain. Pain, when felt, was similar in all three groups (p < 0.4). CONCLUSIONS: Both the quantification and the type of pain referred to were similar in all three groups. However, there was a tendency of the patient to refer to less pain when the active substance or the placebo were used, when results were compared to the control group.

Administration, Cutaneous↗