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 1,063 records · Page 59Linked to original sources
PubMed1992

Clinicians' quick reference guide to postoperative pain management in adults. Pain Management Guideline Panel. Agency for Health Care Policy and Research, US Department of Health and Human Services.

The management of pain is an important part of a health professional's role. The challenge for clinicians is to balance pain control with concern for patient safety and side effects of pain treatments. This is the first of two articles that summarize the highlights of the Agency for Health Care Policy and Research's Panel to develop clinical practice guidelines for the management of pain. This first article includes a summary of the methods used to develop the guidelines and the clinical highlights of pain assessment and management in adults.

Adult↗
PubMed1988

Right testicular pain: unusual presentation of obstruction of the ureteropelvic junction.

The authors report a case of right ureteropelvic junction obstruction in an otherwise healthy 31-year-old man. Because of previous surgical manipulation of the right testicle, the diagnosis was obscured, delaying therapeutic intervention. Renal pain often refers to the testicle and groin, and testicular pain to the flank. Therefore evaluation of organs in the primary referral distribution must be considered in cases of obscure intractable pain in this area.

Adult↗
PubMed1995

The pathogenesis of chronic pain and fatigue syndromes, with special reference to fibromyalgia.

Syndromes characterized by chronic pain and fatigue have been described in the medical literature for centuries. Fibromyalgia is the term currently used to describe this symptom complex, and considerable research has been performed in the last decade to delineate the epidemiology, pathophysiology, and genesis of this entity. Although fibromyalgia is defined by its musculoskeletal features, it is clear that there are a large number of non-musculoskeletal symptoms, such that we now understand that there is considerable overlap with allied conditions such as the chronic fatigue syndrome, migraine and tension headaches, irritable bowel syndrome, and affective disorders. This article will review our current state of knowledge regarding fibromyalgia and these allied conditions, and present a unifying hypothesis that describes both the pathophysiology of symptoms and the genesis of these disorders.

Autonomic Nervous System↗
PubMed2003

Functional improvement after physiotherapy with a continuous infusion of local anaesthetics in patients with complex regional pain syndrome.

Three patients were referred to our pain clinic with evidence of complex regional pain syndrome in their extremities. Two presented at the atrophic stage with joint contractures. Multiple analgesics had been prescribed without long-lasting relief. Physiotherapy was required to improve physical activity but was severely limited by pain. We instituted local anaesthetic infusion with the possibility of self-supplementation to facilitate physiotherapy; two via brachial plexus catheters for hand pain and one via epidural catheter for knee pain. Although their resultant pain scores were variable after cessation of local anaesthetic infusion, all the affected joints exhibited marked improvement in range of movement. We propose that this technique is a useful option for patients in all stages of complex regional pain syndrome where the emphasis is now directed toward functional improvement.

Aged↗
PubMed1993

Pain in dreams.

Little is known about pain in dreams. Some studies indicate that it is rare and that it may be beyond the representational capability of dreaming. However, the present study describes experiences of dreamed pain that were reported incidentally in experiments on the effects of somatosensory stimulation administered during rapid eye movement (REM) sleep. Dreams were selected from five subjects who had reported at least one instance of dreamed pain in these studies. The subjects had undergone 42 stimulation trials over 20 nights and had reported a total of 13 dreams (31%) with one or more references to pain. Most often, these references appeared to be direct, untransformed incorporations of real sensations produced by stimulation. Pain was the principal motivating agent in a majority of these dreams and was in many cases associated with strong emotion--typically anger. Dreams often depicted the subjects' attempts to obtain relief from pain, in some cases by repetition of actions, in others by metaphoric renditions of the goal. The results indicate that although pain is rare in dreams, it is nevertheless compatible with the representational code of dreaming. Further, the association of pain with dream content may implicate brainstem and limbic centers in the regulation of painful stimuli during REM sleep.

Adult↗
PubMed1976

ICLH (Freeman/Swanson) arthroplasty in the treatment of arthritic knee: a 2 to 4-year review.

A prospective follow-up using a standardized data recording form was carried out by independent, experienced orthopedic surgeons on a small number (116) of knees operated upon at The London Hospital in the period January 1, 1971 to October 31, 1973. An additional 93 knees have been operated upon at other hospitals and followed prospectively using the same data recording system. A total of 159 knees have been reviewed 2 to 4 years after operation. The complications specific to ICLH arthroplasty have been unremarkable and generally correctable. Two tibial components have sunk and have been revised at The London Hospital. The results show that ICLH arthroplasty has been used to correct satisfactorily flexion deformities up to 70 degrees, valgus deformities up to 45 degrees, and varus deformities up to 35 degrees. (Deformities of greater magnitude can be corrected but were not present among the knees in this study.) The operation may be said to be "worthwhile" with reference to pain in 94 per cent of the knees, with reference to the ability to walk in 80 per cent of the knees, and with reference to the range of movement in 71 per cent. Overall, 47 per cent of the knees had no complaint postoperatively, while a further 47 per cent were improved; thus for 94 per cent the procedure was "worthwhile."

Adult↗
PubMed2001

Primary lymphoma of the epididymis: case report and review of the literature.

OBJECTIVE: To report an extremely rare clinical pathological observation of a case of primary lymphoma of the epididymis, without testicular or systemic involvement, and to update the relevant literature. MATERIALS AND METHODS: A 25-year-old white male patient complaining of right scrotal pain was referred to our department. Clinical examination detected a hard painful mass at the right epididymal head. Epididymitis was diagnosed and conservative therapy with antibiotics and anti-inflammatory drugs was given. After 2 months of therapy the patient was admitted to our department because a tumor was suspected. Tumor markers were normal. Right scrotal exploration was performed through a standard inguinal incision. The epididymal head was completely replaced by a hard white mass. Fresh frozen sections indicated a malignant tumor. Right radical orchiectomy was performed. RESULTS: High-grade primary epididymal non-Hodgkin's lymphoma with diffuse large cells (group G according to the Working Formulation) was diagnosed. Clinical pathological staging detected stage IE (extranodal) primary epididymal lymphoma. The patient was referred to the Hematologic Unit for combined chemotherapy, according to the VACOP-B protocol. After an 18-month follow-up the patient is well and disease free. CONCLUSIONS: When an epididymal mass does not benefit from medical treatment, scrotal exploration and fresh frozen sections of the lesion should be done. The possible bilateral involvement by primary epididymal lymphoma has to be kept in mind. Radical orchiectomy is the treatment of choice for primary lymphoma of the epididymis. Adjuvant chemotherapy is indicated in high-grade malignant lymphoma. Prognostic parameters of the disease may be the grade of malignancy and the size of the tumor.

Adult↗
PubMed2004

Out-patient chronic pain service in Hong Kong: prospective study.

OBJECTIVE: To examine the profile and referral pattern of patients attending an out-patient pain management service in Hong Kong. DESIGN: Prospective cross-sectional survey. SETTING: Regional public hospitals, Hong Kong. PATIENTS: All patients attending out-patient pain management clinics in the New Territories East public hospitals between 1 September and 31 December 2002. MAIN OUTCOME MEASURES: Demographic profiles, referring specialty, pain diagnosis, pain sites, duration and severity of pain, treatment modality, litigation, compensation, and social welfare status. Data were collected using a standardised questionnaire. RESULTS: Two hundred and forty-eight patients were interviewed. Most patients (70%) were middle-aged, with 21% over 60 years. Seventy-nine percent of patients were referred to the clinics either from orthopaedic surgeons (64.1%), general and other surgeons (14.9%), or general practitioners (3.6%). The median (range) duration of pain was 2.3 (0.08-26.7) years. The most common pain diagnoses were musculoskeletal back pain (46.4%) and neuropathic pain (27.8%). A total of 11.3% of the patients had two pain diagnoses, while 40.7% complained of pain in more than one location. Pain in the limbs was the most frequent complaint followed by the head, neck, and back. Approximately 38% of patients had tried four or more treatment modalities. Oral medication was the most common method (86.7%) of pain-relief treatment. More than half of the patients had also tried physiotherapy and traditional Chinese medicine. Approximately 37% of the patients were unemployed, while 31% were receiving social security subsidy. Eighty-six patients had pain associated with a work-related injury, and of these patients, 80% were involved in compensation claims. CONCLUSIONS: The profile of patients referred to the pain management clinics was complex. Patients were mainly referred from specialists. The economic implication in this group of patients is likely to be significant as many patients utilised multiple treatment modalities, were unemployed and on social welfare benefits, and were involved in compensation and litigation proceedings.

Chronic Disease↗
PubMed1984

Cancer-related pain--I. Prevalence in an outpatient setting as a function of stage of disease and type of cancer.

Cancer-related pain is a clinical problem of enormous significance that has received relatively little scientific study. Most reports of its prevalence and treatment have examined inpatient populations with varying degrees of regard for the stage of disease and the presence of non cancer-related sources of pain. In the present study, 208 consecutive ambulatory patients with cancer were evaluated. Nearly half (47.9%) reported no pain during the preceding week, 33.5% had pain directly referable to their cancer and 6.7% were suffering from pain related to therapy for their cancer. A small group (11%) had pain readily attributable to a source other than their cancer. Patients with metastatic disease, particularly those with bone metastases, reported cancer-related pain significantly more often than patients with local and regional disease (p less than 0.001). Patients with lymphoma reported the presence of cancer-related pain significantly less often than patients in all other diagnostic categories (p less than 0.001).

Adolescent↗
PubMed1996

A survey of pain in patients with advanced cancer.

One hundred eleven patients with advanced cancer and pain newly referred to a palliative care center completed the Brief Pain Inventory (BPI) weekly for up to 4 weeks. The aims were (a) to review the numbers and causes of pain, (b) to consider the usefulness of the BPI in the evaluation of pain in cancer patients, and (c) to determine the impact of treatment. A total of 370 pains were recorded initially, a median of 3 per patient; 85% had more than 1 pain and more than 40% had 4 or more pains. Causes of pain were cancer (46%), debility (29%), treatment (5%), concurrent disorder (8%), and no stated cause (12%). The top 10 individual causes accounted for 73% of the pains. Seventy-six (68%) of the patients completed two BRIs, but only 46 (41%) completed 5. After 4 weeks, the median number of pains had fallen to 1.5; 78% still had more than 1 pain, but only 20% had 4 or more pains. Intensity of pain also declined, particularly in the first 2 weeks. With their last BPI, 23% had become completely pain free and a further 27% achieved acceptable relief (worst pain scores 1-4), compared with none and 24% initially. Of those who completed all five BPIs, the final respective figures were 22% and 29%. In contrast, 23% of patients still had unacceptable severe pain noted on their last BPI (worst pain scores 8-10), compared with 36% initially. Of those who completed five BPIs, the final figure was 20%. Highly significant correlations were observed between all seven interference factors and present, worst, and average pain intensities. After 4 weeks, the pattern was more variable, particularly in relation to present pain, suggesting that interference factors may have a limited utility as a measure of satisfactory pain management. Many patients did not answer all the questions in the BPI. It was concluded that the BPI is not brief enough for routine clinical use, and that the short form of the BPI (BPI-SF) is too short. A pain diary card will be developed comprising mainly pain scores, a pain relief score and a satisfaction with pain management score.

Adult↗
PubMed1997

Quality of life in elderly subjects with pain in the hip or knee.

This study examines the quality of life (QOL) of community living elderly people aged 55-74 with chronic, episodic or sporadic pain in the hip or knee and of a reference group without pain (total n = 306). Firstly, it was hypothesized that the experienced QOL is lower in people with more chronic pain. Secondly, the potential mediating and moderating roles of disability and of coping with problems in general on the relationship between pain chronicity and QOL were assessed. A Visual Analogue Scale was used to assess global QOL. Physical as well as psychological disability was assessed with problems in general was assessed with the Utrecht Coping List. As expected, a significantly lower QOL was found in people with more chronic pain (n = 0.045). The difference in QOL between the group with chronic pain and a reference group without pain was 10%. A multivariate regression model showed that physical and especially psychological disability are mediators in the relationship between pain chronicity and QOL and that seeking social support as a coping style is a more important predictor of the experienced QOL than either pain chronicity or physical disability. No moderating role of the style of coping with problems was found.

Activities of Daily Living↗
PubMed2006

Skeletal imaging of Gorlin's syndrome.

OBJECTIVE: To report a case of a patient with many of the common manifestations of Gorlin's syndrome, a rare inherited condition. CLINICAL PRESENTATION AND INTERVENTION: A 26-year-old female with longstanding left hip pain was referred for bone scintigraphy to find the cause of pain. The findings on bone scintigraphy as well as prior radiographic studies illustrated many of the defining features of Gorlin's syndrome, i.e. jaw keratocysts, falcine calcifications, short and deformed ribs, Sprengel deformity and a sclerotic bone lesion. The past medical history also revealed dermatologic, cardiac and gynecological findings related to the syndrome. CONCLUSION: Our case highlights the multisystemic involvement of Gorlin's syndrome, based particularly on the skeletal findings. Practicing physicians, including imaging specialists, should be familiar with these findings to reach the diagnosis.

Adult↗
PubMed1995

Conservative management of posttraumatic cervical intersegmental hypermobility and anterior subluxation.

OBJECTIVE: To discuss the case of a young male football player who sustained a hyperflexion cervical injury, including radiographic evidence of intersegmental hypermobility and translational displacement with cervical hypolordosis and anterior subluxation. CLINICAL FEATURES: The patient suffered from neck pain, spasm, limited range of motion and mild sclerogenous referred arm pain. The results of neurological exams were normal. Radiographs of the cervical spine revealed cervical hypolordosis, intersegmental hypermobility and anterior subluxation. MRI was normal, with no evidence of disk herniation. INTERVENTION AND OUTCOME: The patient was immobilized for the first 10 days with a cervical collar and was administered adjunctive physiotherapy. Light cervical manipulative techniques were added in the subacute stage, as were isometric and tubing exercises. The patient responded quickly and favorably to care. Subsequent radiographs revealed a reversal and resolution of the abnormal findings of the cervical hypolordosis, anterior subluxation and intersegmental hypermobility that were initially seen. CONCLUSION: Conservative chiropractic management of hyperflexion injuries may be useful in reducing clinical symptoms, cervical hypolordosis, anterior subluxation and intersegmental hypermobility, as seen in follow-up radiographs. Chiropractic sports physicians have the diagnostic and therapeutic expertise to manage these types of athletic injuries.

Adolescent↗