[Current possibilities for pain therapy. Acute pain--chronic pain--pain disease].
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Acute Disease↗
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Results for “Chronic 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.
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Psychophysiology of chronic pain: do chronic pain patients exhibit symptom-specific psychophysiological responses?
Theoretical as well as methodological issues associated with psychophysiological mechanisms of chronic pain syndromes are reviewed and discussed. Results of studies on psychophysiological responses in patients with recurrent headaches, chronic back pain, and temporomandibular pain disorders are presented. These studies are evaluated on the basis of a set of 12 theoretical and methodological criteria that include diagnostic procedures, use of control groups, sample description, use of multiple and relevant physiological measures, introduction of ecologically valid and actually stress-inducing stressors, use of adequate adaptation and baseline periods, adequacy of data acquisition, and analysis. Results on baseline levels, reactivity to stress and pain stimuli, and return to baseline levels are presented. When only the most methodologically sound studies are included, the data suggest that baseline levels, regardless of type of physiological measure, are not generally elevated in chronic pain patients. The presence of symptom-specific stress-related psychophysiological responses is more commonly observed, and the evidence on return to baseline is at this time inconclusive.
Arousal↗
What is chronic pain?
Chronic pain leads to individual suffering and to major costs for all developed countries. Previous studies suggest that both the incidence of disabling chronic pain and the amount of health care consumption due to chronic pain are rapidly increasing. Western medicine is not only often ineffective but may be one of the causes of this epidemic. This article will address the issue of chronic pain of unknown etiology and has the goals of: (1) identifying the factors which have led to our confusion about this topic, and (2) proposing alternative ways of conceptualizing chronic pain and its ensuing behaviors and social consequences. It is concluded that it is essential to discriminate between tissue damage, pain, suffering, pain behaviors, health care consumption, impairment and disability if one is to develop a meaningful conceptualization of the medical, social, economic and political problems of chronic pain. Successful treatment must be defined in behavioral terms such as restoration of normal activities. Disabling chronic pain is often a sign of overwhelming stress engendered by the individual's failure to cope with the demands of industrialized society.
Activities of Daily Living↗
A multidisciplinary approach to chronic pain.
Chronic pain often is frustrating to nurses and patients, since many times it has not been responsive to traditional medical approaches. The purpose of this article is to discuss the chronic pain syndrome and the role of nursing within a multidisciplinary chronic pain rehabilitation program designed to return the patient to a functional lifestyle. The purpose and rationale for each treatment modality within the pain management program is described, although the treatment plans are individualized for every patient. Nurses play a crucial role, because they are the only professionals who are constantly available to the patient. Nurses collect data and continually assess the patient to develop comprehensive nursing care plans. In this intensive educational program, nurses also assist in teaching the patient positive health practices to control the pain. Further evaluations of these chronic pain rehabilitation programs are needed.
Analgesia↗
Cortisol and prolactin responses to dexamethasone in major depression, chronic pain, and chronic pain with major depression.
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Chronic Disease↗
The pharmacologic approach in differential diagnosis of chronic pain.
Chronic pain of unknown cause below waist level was evaluated in 100 patients by using the Differential Spinal Block (DSB) in a multidisciplinary pain clinic setting. The classic DSB approach, refined for better control of psychologic variables, was found to be a safe and effective means of differentiating various pain mechanisms. We found that, of all patients tested, 55% had pain of central or psychogenic origin and 30% had sympathetically mediated pain, as compared with 15% who had somatic pain. A long-term follow-up of these patients confirmed this impression. These results substantiated the importance of psychologic variables, in dicating the necessity for use of behavioral-based therapies in conjunction with the routine use of the refined diagnostic DSB procedure in patients with chronic pain.
Adolescent↗
An approach to the management of chronic pain.
Chronic pain can often be managed without the use of drugs. A psychotherapeutic approach using hypnosis is outlined. Understanding and relieving the suffering component allow a more effective control of pain by hypnosis, and make a return to normal possible.
Adult↗
Release of opioid peptides from the spinal cord of rats subjected to chronic pain.
Chronic localized pain increased the level of the opioid peptides, dynorphin (DYN), alpha-neoendorphin (ANEO), Met-enkephalin (MET) and Mets-enkephalin-Arg6-Gly7-Leu8 (MEAGL), in the lumbar enlargement of the rat spinal cord. It was accompanied with a reduction of the spontaneous and K+-stimulated release of ANEO and MEAGL from spinal cord slices in vitro and a decreased release of ANEO from the spinal cord in vivo. The results indicate that the reduction in the activity of endogenous opioid peptide systems might occur in the spinal cord of rats subjected to chronic pain.
Animals↗
Depression and chronic fatigue in the patient with chronic pain.
Chronic benign pain is commonly associated with chronic fatigue and depression. Depression and chronic fatigue syndrome are also associated with each other and often include pain. Psychologic factors are prominent in these conditions, and they may share neurobiologic factors as well. Management requires separately addressing each component of patients' distress and usually includes physical rehabilitation, education, administration of nonhabituating medications and often counseling. Depression may be a favorable prognostic sign, as it suggests a treatable condition and provides incentive for recovery.
Chronic Disease↗
The influence of physical and psychosocial factors on accuracy of memory for pain in chronic pain patients.
Pain patients' retrospective reports of pain are important to physicians and other health professionals in helping to decide on future treatment plans. Unfortunately patients' memory of pain can be inaccurate and subject to overestimation. This study examined variables which influenced accuracy of remembering pain in 93 chronic pain patients. The patients were initially evaluated by a physician and completed a comprehensive pain questionnaire and an SCL-90. All patients were asked to monitor their pain intensity every hour for 1 week. At the end of this period each patient was asked to estimate their average pain intensity ratings for 4 times during the day for the previous week. These estimations were compared with the actual mean pain ratings. Results showed that most patients tended to overestimate their pain intensity levels. Cervical and low back pain patients were found to be more accurate than headache and abdominal pain patients in remembering their pain. Patients who reported more emotional distress, who had conflicts at home, who were less active and who relied on medication tended to be the most inaccurate in remembering their pain.
Adolescent↗
[Chronic pain--a chronic headache for health services?].
Chronic, non-malignant pain is becoming a problem of increasing dimension in our national health system. Chronic pain is essentially different from acute pain. Therefore, it must also be treated by different means and from a different therapeutical angle. Doctors and other therapists often meet the patient with chronic pain with mild rejection and other defensive reactions. This is not only unprofessional but also unjust towards the patient. Further more it helps to turn these patients into excessive consumers of health services. This article proposes two distinct measures that can both humanize the treatment of chronic pain, and make it more economic: Training/re-education of doctors and therapists in the treatment of chronic pain. Ambulatory group treatment for patients with a cognitive/behavioural profile.
Analgesia↗
Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy.
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Chronic Disease↗
American Chronic Pain Association: strategies for surviving chronic pain.
The American Chronic Pain Association (ACPA) is a nonprofit, self-help organization designed to help individuals suffering with chronic nonmalignant pain. The program is directed toward educating the individual about a multidimensional view of pain, identifying pain-illiciting and pain-aggravating situations and behaviors, and teaching various coping skills. The techniques that are used include exercise, relaxation instruction, goal selection, priority setting, self-awareness sensitization, and assertiveness training.
Humans↗
From acute pain to chronic pain: a personal journal.
In 1985 I had back surgery, and I began to keep a journal. I thought it would help me track my progress. I wrote in it often, sometimes two or three times a day. It became a lifeline for me. Four years and ten volumes later it tells my story, the story of my struggle with pain.
Activities of Daily Living↗
Comparing chronic pain from spinal cord injury to chronic pain of other origins.
Acknowledged as a serious complaint of spinal cord injured (SCI) patients, chronic pain in this population is neither well studied nor well understood. To assess the quality and intensity of pain, a group of 49 SCI patients seeking treatment for chronic pain was compared to a general group of 95 patients from the Comprehensive Pain Clinic (CPC) on selected demographic variables, the McGill Pain Questionnaire (MPQ) and the Minnesota Multiphasic Personality Inventory (MMPI). The SCI patients were categorized as functionally incomplete SCI (SCI-I) or complete SCI (SCI-C). Multivariate analyses revealed differences among groups on the MPQ for Number of Words Checked, Rank Sum, and the Affective dimension. In all cases the CPC group scored higher than the SCI-C group. The MMPI profiles were elevated and typical for the CPC and SCI-C groups and substantially less elevated for the SCI-I group. We suggest in cases where chronic pain is secondary to a chronic medical catastrophe, aspects of the MPQ and the MMPI assess the person's total medical disability and not just the meaning and impact of pain.
Adult↗
Tactual sensitivity of chronic pain patients to non-painful stimuli.
Chronic pain research tends to focus on responses to thresholds, tolerance, and discrimination involving painful stimuli. This investigation, however, examines responses of individuals with chronic pain to non-painful stimuli. Two-point thresholds were obtained from 19 chronic pain patients and 17 pain-free individuals. The chronic pain patients had a significantly higher two-point threshold, 40.3 mm (S.D., 15.0 mm) than that of the control group, which had a two-point threshold of 30.8 mm (S.D., 7.4 mm). The results indicate that chronic pain decreases tactual sensitivity to non-painful stimuli.
Chronic Disease↗
Pain corner: chronic pain? Have you considered the stepwise approach?
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Analgesics↗
Reinterpretative cognitive strategies in chronic pain management.
This preliminary study was conducted to test the effectiveness of cognitive treatment of clinical pain. Chronic pain patients were trained in a self-control cognitive strategy procedure. Specifically, they were provided with a conceptualization of their pain, instructed in an awareness of their thoughts prior to and during their experience of pain, and trained in the use of several cognitive strategies to replace these thoughts and relabel their pain experience. Training was provided in a group setting to further consolidate the use of the instructions by enabling patients to roleplay the instructions to one another. Patients were also encouraged to verbally reinforce themselves each time they used the procedure. The experience of pain was measured by the McGill pain questionnaire, a behavioral checklist and staff reports. Results suggest that cognitive strategies can effectively alter the experience of clinical pain. Moreover, pain as a cognitive label for a nonspecific state of arousal is suggested.
Cognition↗