[Perception of touch and pain in the various phases of the menstrual cycle].
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Female↗
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Results for “Pain Perception”
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The relationship between pain and uterine contractions during laser vaporization of the cervix.
Laser vaporization of the uterine cervix to treat cervical dysplasia is usually described by patients as moderately painful. Many describe the pain as uterine cramping, but most authorities attribute the pain to heat buildup during the procedure. To specify the mechanism of pain, intrauterine pressures were measured in 16 subjects (randomly divided into placebo and control groups of eight each) before and during cervical laser vaporization for dysplasia. The women were told what to expect during intrauterine pressure recording and laser vaporization and that a study of pain medication during laser vaporization was being conducted. The session began with 5 minutes of baseline intrauterine pressure recording. Subjects were then randomly given oral placebo or ibuprofen, 600 mg. Thirty to 45 minutes later, the intrauterine catheter was reinserted and the pressure recorded during 5 minutes of cervical laser vaporization. Laser vaporization increased significantly the frequency (P less than .025) and amplitude (P less than .03) of contractions in the placebo group but not in subjects given ibuprofen. However, post-procedure pain questionnaires showed no difference in pain perception between the groups. This study shows that pain during laser vaporization of the cervix is not due to increased uterine contractions, and that pain was not significantly relieved by ibuprofen.
Cervix Uteri↗
Tension perception in patients having pain associated with chronic muscle tension.
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Chronic Disease↗
Nurses' perceptions of cancer patients' pain.
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Adult↗
Nonmedicinal treatments in primary fibromyalgia.
To date, few nonmedicinal treatments for primary fibromyalgia have been studied using acceptable scientific standards. This has led to rather arbitrary use of disparate treatment modalities, often in a haphazard sequence. Because primary fibromyalgia syndrome is a chronic painful condition, rationale for treatment should be based on present concepts of pain perception supported by studies in the basic sciences. Recent clinical studies in the treatment of primary fibromyalgia syndrome conforming to the scientific method have been discussed in light of what is presently known about pain transmission and perception.
Biofeedback, Psychology↗
Hypnotic analgesia: 1. Somatosensory event-related potential changes to noxious stimuli and 2. Transfer learning to reduce chronic low back pain.
Fifteen adults with chronic low back pain (M = 4 years), age 18 to 43 years (M = 29 years), participated. All but one were moderately to highly hypnotizable (M = 7.87; modified 11-point Stanford Hypnotic Susceptibility Scale, Form C [Weitzenhoffer & Hilgard, 1962]), and significantly reduced pain perception following hypnotic analgesia instructions during cold-pressor pain training. In Part 1, somatosensory event-related potential correlates of noxious electrical stimulation were evaluated during attend and hypnotic analgesia (HA) conditions at anterior frontal (Fp1, Fp2), midfrontal (F3, F4), central (C3, C4), and parietal (P3, P4) regions. During HA, hypothesized inhibitory processing was evidenced by enhanced N140 in the anterior frontal region and by a prestimulus positive-ongoing contingent cortical potential at Fp1 only. During HA, decreased spatiotemporal perception was evidenced by reduced amplitudes of P200 (bilateral midfrontal and central, and left parietal) and P300 (right midfrontal and central). HA led to highly significant mean reductions in perceived sensory pain and distress. HA is an active process that requires inhibitory effort, dissociated from conscious awareness, where the anterior frontal cortex participates in a topographically specific inhibitory feedback circuit that cooperates in the allocation of thalamocortical activities. In Part 2, the authors document the development of self-efficacy through the successful transfer by participants of newly learned skills of experimental pain reduction to reduction of their own chronic pain. Over three experimental sessions, participants reported chronic pain reduction, increased psychological well-being, and increased sleep quality. The development of "neurosignatures of pain" can influence subsequent pain experiences (Coderre, Katz, Vaccarino, & Melzack, 1993; Melzack, 1993) and may be expanded in size and easily reactivated (Flor & Birbaumer, 1994; Melzack, 1991, 1993). Therefore, hypnosis and other psychological interventions need to be introduced early as adjuncts in medical treatments for onset pain before the development of chronic pain.
Adult↗
The Pain Beliefs and Perceptions Inventory: further evidence for a 4-factor structure.
This study employed the Pain Beliefs and Perceptions Inventory (PBPAI) (Williams and Thorn 1989) with a German sample (n = 193) of pain patients. The original version has 3 subscales: (1) self-blame (S-B), (2) perception of pain as mysterious (MYST), and (3) beliefs about the temporal stability of pain (TIME). Item statistics, factor structure, and discriminant validity are reported. Factor analysis favored a 4-factor structure and replicated a finding by Strong et al. (1992). The TIME scale can be subdivided into 2 subscales: beliefs that pain is a constant and enduring experience ("Constancy"), and beliefs about the long-term chronicity of pain ("Acceptance"). Constancy showed higher correlations with self-reported psychological symptomatology (anxiety, general physical troubles, pain intensity) than did Acceptance, MYST, and S-B.
Adaptation, Psychological↗
The nociceptive response of stressed and lithium-treated rats is differently modulated by different flavors.
Pleasant and unpleasant flavors and odors can modulate pain perception, and the efficacy of sweet flavors in reducing pain seems to be related to its hedonic value. Chronic variate stress paradigm is a model of depression, and is suggested to induce anhedonia. We observed previously that lithium may prevent behavioral and neurochemical alterations induced by chronic stress; so we hypothesized that chronically stressed animals may present different nociceptive response to pleasant and unpleasant tastes that could be prevented by lithium treatment. Adult male Wistar rats were divided into four groups, control and stressed, treated or not with lithium. A Chronic Variate Stress paradigm was used, and lithium was added to the chow. After 40 days of treatment, the tail flick latency of the animals was evaluated, and rats were immediately placed in a box with access to a 5% acetic acid solution (acid flavor). After 5 min, tail flick latency was measured again. On the following day, animals were submitted to the same procedure, with the substitution of acetic acid by condensed sweet milk (sweet flavor). The stressed group was the only group who did not present analgesia after sweet taste exposition. All groups, except the control group, presented increased tail flick latency after exposition to the acid flavor. These results indicate that pleasant and unpleasant flavors present different relevance for the induction of antinociception in stressed animals, and the absence of sweet flavor-induced analgesia may represent an anhedonic effect of the chronic variate stress paradigm. On the other hand, perception of different flavors may be more prominent in animals treated with lithium.
Animals↗
Psychophysical evidence for long-term potentiation of C-fiber and Adelta-fiber pathways in humans by analysis of pain descriptors.
Long-term potentiation of human pain perception (nociceptive LTP) to single electrical test stimuli was induced by high-frequency stimulation (HFS) of cutaneous nociceptive afferents. Numerical pain ratings and a list of sensory pain descriptors disclosed the same magnitude of nociceptive LTP (23% increase for >60 min, P < 0.001), whereas affective pain descriptors were not significantly enhanced. Factor analysis of the sensory pain descriptors showed that facilitation was restricted to two factors characterized by hot and burning (+41%) and piercing and stinging (+21%, both P < 0.01), whereas a factor represented by throbbing and beating was not significantly increased (+9%, P = 0.47). The increased perception of the burning pain quality for >1 h after HFS is interpreted as a LTP-like facilitation of the conditioned cutaneous C-fiber pathway. Additionally, the increase of the stinging pain quality supplied evidence for facilitation of a sharpness-sensitive Adelta-fiber pathway.
Adult↗
Perception of gonadal pain in paraplegic patients.
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Gonads↗
Pain and attention: attentional disruption or distraction?
UNLABELLED: The effect of pain processing on attention capacity during visual search was examined in 2 experiments. In the first experiment, we investigated whether pain draws on the same limited resources as attentional task performance. It was hypothesized that pain would negatively affect task performance under different load manipulations. Low and high load conditions of a visual search task were presented in a mixed design combined with a painfully cold or neutral cold pressor test. Performance was not affected by pain. In experiment 2, low and high load conditions were separated in different blocks to study whether pain perception was affected when task load could be anticipated. Again, pain did not significantly affect task performance. In contrast, subjective pain intensity scores were significantly lower after performing the high load compared with the low load condition. Simultaneous recordings of event-related potentials indicated an increased negativity during the pain compared with the control condition. Also, in the early (350 to 450 msec) interval of event-related potentials, an increase in negativity was found for the high load compared with the low load condition. Topographic distributions suggested that pain and task load are mediated by qualitatively different resources. PERSPECTIVE: Our findings indicate that highly demanding attentional task performance and pain processing interfere as a result of difficulties in allocating attention. The clinical relevance of this finding is that performing a highly demanding task might distract attention from pain.
Adult↗
Social support and experimental pain.
OBJECTIVE: The purpose of this experimental study was to supplement and expand on clinical research demonstrating that the provision of social support is associated with lower levels of acute pain. METHODS: Undergraduates (52 men and 49 women) performed the cold pressor task either alone or accompanied by a friend or stranger who provided active support, passive support, or interaction. Pain perception was measured on a 10-point scale. RESULTS: Participants in the active support and passive support conditions reported less pain than participants in the alone and interaction conditions, regardless of whether they were paired with a friend or stranger. CONCLUSIONS: These data suggest that the presence of an individual who provides passive or active support reduces experimental pain.
Adolescent↗
Pain and vascular reflexes in man elicited by prolonged noxious mechano-stimulation.
Interdigital webs of the hands of human volunteers were pinched for periods of 2 min duration to induce tonic pain perceptions. During stimulation, the subjects gave estimates of their pain level at 10-sec intervals on a visual analogue scale, and the stimulus induced changes of the skin blood flow in the stimulated hand was assessed by photo-plethysmography. Sustained pinching induced a tonic reflex vasoconstriction in the stimulated hand with rather slow adaptation rate and no signs of habituation between trials. Step increases of the pinching force in the course of a stimulus were reflected by a decrease in plethysmogram amplitude as well as by increased pain ratings, although the subjects were usually unaware of these steps. Lowering the stimulus strength induced opposite, albeit much smaller effects in both pain ratings and vascular reactions. It is concluded that the vasomotor responses described in this paper are mediated by nociceptor input and reflect the processing of this input mainly at a spinal level.
Blood Flow Velocity↗
Modulation of electrically induced pain by paired pulse transcranial magnetic stimulation of the medial frontal cortex.
OBJECTIVE: Aim of this study was to investigate whether paired pulse transcranial magnetic stimulation (ppTMS) applied over the medial frontal cortex (MFC) affects acute Adelta fiber-mediated electrically induced pain. In addition, we investigated whether this effect depends on the time course of the stimulation, on the noxious stimulus intensity or on the ppTMS intensity. METHODS: For painful stimulation, the electrical stimulus for the nociceptive flexion reflex (NFR) was used. PpTMS (ISI: 50 ms) was applied over the medial frontal cortex at different intervals ranging from 0 to 1,000 ms following the previous elicited NFR in 10 healthy volunteers. Three sequences at 3 different NFR stimulus intensities (at NFR threshold, 1.3 x and 1.6 x NFR threshold) with a ppTMS stimulus intensity at 1.2 x resting motor threshold (RMT) and one sequence with elevated ppTMS at 1.6 x RMT stimulus intensity were performed. Pain intensity and pain unpleasantness were assessed by visual analogue scales. RESULTS: Pain ratings differed in dependence of the interstimulus interval between NFR and ppTMS. Post-hoc t-tests revealed an increased verbal pain report within interstimulus intervals from 25 to 75 ms at NFR threshold as well as for 25 ms at 1.3 x NFR threshold when ppTMS was applied at 1.2 x RMT and from 0 to 75 ms at 1.6 x NFR threshold when ppTMS was applied at 1.6 x RMT. CONCLUSIONS: The present data suggest that ppTMS over MFC-applied in a certain time window-can enhance pain perception of acute Adelta fiber-mediated electrically induced pain. We hypothesize that the increase of pain is due to interference between ppTMS and the incoming nociceptive input. Further pain processing might be modulated by direct effects on MFC or indirect effects on anterior cingulate cortex (ACC) or spinal nociception. SIGNIFICANCE: Brain areas involved in cognitive and emotional adaptation to pain can be used, in place of primary motor areas, as cortical targets in TMS trials of experimental or ongoing pain.
Adult↗
Wound care pain in hospitalized adult patients.
BACKGROUND: Wound care (WC) is an important part of treatment for hospitalized patients with wounds. There is a paucity of data about the type or amount of pain patients experience during WC. OBJECTIVES: The purpose of this study is to describe patients' (n = 412) WC-related pain perceptions and responses, examine the relationships between patients' WC pain and demographic variables, and describe the distress associated with WC. METHODS: A repeated-measures design was used to examine pain before, during, and after WC in hospitalized patients (n = 412) with wounds healing by secondary intention. RESULTS: Pain intensity was greatest during WC. It was most frequently described as tender, sharp, stinging, aching, and stabbing. Behaviors that occurred most often were no verbal response, no body movement, grimace, and complaints of pain. There were no differences in pain between genders. Nonwhites had significantly greater WC pain than whites. Pain during the procedure was the same in younger and older patients, and procedural distress was mild. CONCLUSION: Patients experience pain and distress with WC. Some behaviors and words consistently describe WC pain. Further work is warranted to refine pain assessment and management in patients undergoing WC procedures.
Bandages↗
Tasmanian nurses' knowledge of pain management.
The aim of this research was to obtain information concerning knowledge of the pain management practices of Tasmanian nurses. We examined the knowledge of Tasmanian Registered Nurses in relation to pain management issues such as addiction, use of analgesics and the assessment of pain. In addition, we queried them about their satisfaction with information they had received about how to manage pain in both workplace programs and in their initial education. A total of 2768 registered nurses were mailed a 29-item survey examining knowledge of pain management practices. One thousand and fifteen valid surveys were returned. Mean scores on the knowledge questions (72% correct) of the survey revealed deficits in knowledge. Nurses specifically lacked up-to-date knowledge concerning the pharmacological management of pain, but displayed a more up-to-date knowledge concerning the effect of patient variables on pain perception. Nurses also rated the information they received about pain management during workplace programs as poor, feeling that they acquired significantly more in-depth information during their initial education. The results of this study have implications for institutions involved in both patient pain management and pain management education.
Adult↗
Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain.
PURPOSE: The purpose of this study was to analyze the impact of transcatheter embolotherapy on pain perception and menstrual cycle in women with chronic pelvic pain caused by the presence of ovarian and pelvic varices (ie, women with pelvic congestion syndrome or pelvic venous incompetence). MATERIALS AND METHODS: From July 1998 to August 2000, 56 patients (mean age, 32.3 y) were treated for chronic pelvic pain. Diagnostic venography of the ovarian veins was followed by transcatheter embolotherapy with a sclerosing agent and coils. A second session was completed to embolize the internal iliac veins in 43 of 56 patients. Visual analog scales (VAS) used to measure pain were administered before embolization and at 3-, 6-, and 12-month follow-up. Questionnaires regarding menstrual history were used as part of the postprocedural analysis. RESULTS: Percutaneous transcatheter embolotherapy of ovarian and pelvic varices was technically successful in 56 of 56 patients (100%); three patients developed recurrent varices, two of whom were treated with repeat transcatheter embolotherapy. Two patients, early in the experience, had complications in which coils placed in the internal iliac veins embolized to the pulmonary circulation; the coils were snared without clinical sequelae. On the VAS, the mean baseline pain level was 7.8 (range, 3.2-9.8; n = 56); at 3-month follow-up, it was 4.2 (range, 0.0-7.2; n = 56); at 6 months, 3.8 (range, 0.0-6.7; n = 41); and at 12 months, 2.7 (range, 0.0-6.9; n = 32). Differences were significant (P <.001) between baseline pain levels and those at all follow-up intervals (ie, 3, 6, and 12 months). The mean decrease in VAS was 5.1 (65% decrease). The clinical follow-up in this series ranged between 6 and 38 months; the mean was 22.1 months. Regarding the impact of embolization on menstruation, all 24 patients responding to questionnaires indicated no change in menstrual cycle. CONCLUSION: For patients with ovarian/internal iliac varices, transcatheter embolotherapy provides a nonsurgical treatment option. There is a significant decrease in pain based on VAS without any notable impact on menstrual cycle.
Adolescent↗
High voltage stimulation. Effects of electrode size on basic excitatory responses.
The purpose of this study was to examine the effects of electrode size on thresholds of sensory and motor excitation, strongest motor excitation without pain perception, and strongest motor excitation coupled with maximally tolerated painful stimulation. A high voltage stimulator with monophasic pulsatile current was applied to the quadriceps femoris muscles of 14 healthy subjects. Voltage output, pulse-charge density, and isometric muscle torque were measured during random application of four electrode pairs measuring 3 X 3, 6 X 6, 9 X 9, and 5 X 16.2 cm. Results indicated a dependence of the measured variables on electrode size; the larger electrodes required greater voltage output but less pulse-charge density than the smaller electrodes. The two largest electrodes evoked significantly greater non-painful and maximally tolerated painful muscle torques. Maximal volitional contraction increased 13.3% after completion of all stimulations. Electrode size should be considered by physical therapists when administering transcutaneous electrical nerve stimulation.
Adult↗