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At least 19 recordsLinked to original sources

PubMed1985

The McGill Pain Questionnaire in the assessment of phasic and tonic experimental pain: behavioral evaluation of the 'pain inhibiting pain' effect.

The McGill Pain Questionnaire (MPQ), supplemented with a German version, was administered to 10 healthy subjects to evaluate two laboratory pain models. Ischemia pain was induced as a tonic pain model and electrical intracutaneous stimuli were applied as a model of phasic pain. In addition, both pain models were employed simultaneously in order to evaluate their mutual influence. Tonic pain was rated higher than phasic pain on the affective, evaluative and miscellaneous MPQ subscales. Furthermore, the sensory descriptor choices for the two pain models were dissimilar, although the number of words chosen as well as the intensity represented by these words were of equal magnitude. These findings indicate that the sensory quality of the pain models is different and that the aversive component is much greater for the tonic pain than for the phasic pain. When applied simultaneously, tonic pain was able to inhibit phasic pain perception. This modulation could be demonstrated on visual analog scales of intensity (-44%) and aversiveness (-49%), on a 10-point category scale (-27%), and on the MPQ scores present pain intensity (PPI) (-29%), number of words chosen (NWC) (-25%) and pain rating intensity (PRI) (-28%). Differences were significant on the 5% level for the visual analog scales, the category scale and PPI. Evaluation of the MPQ subscales revealed that mainly the affective dimension of phasic pain was reduced under concurrent tonic pain. It is concluded that the MPQ is as well-suited to characterize differential analgesic effects as it is to differentiate properties of pain models.

Adult↗

PubMed1986

Pain behavior and pain coping strategies in low back pain and myofascial pain dysfunction syndrome patients.

Pain behavior and pain coping strategies were systematically measured in a group of 32 chronic low back pain (LBP) and 32 myofascial pain dysfunction (MPD) syndrome patients. Both groups reported high levels of psychological distress on the SCL-90R. The LBP patients were significantly less active, took more narcotic and sedative-hypnotic medications, and showed higher levels of motor pain behavior (guarding, rubbing, and bracing) than the MPD patients. The LBP patients used attention diversion, and praying or hoping as pain coping skills to a much greater extent than the MPD patients. The relationship of these findings to prior research is described, and future research needs in this area are identified.

Activities of Daily Living↗

PubMed1989

Labour pain: correlations with menstrual pain and acute low-back pain before and during pregnancy.

Low-back pain is a major component of labour pain in a substantial number of women. The purpose of this study was to determine whether episodes of acute low-back pain prior to pregnancy is a predictor of low-back pain during labour. 114 women received the Short-Form McGill Pain Questionnaire (SF-MPQ) during labour and were asked to describe the pain separately for front and back contraction pain or continuous pain. The day after the birth of the child the women were interviewed to determine whether they had (a) a history of episodes of acute low-back pain before pregnancy, (b) low-back pain during pregnancy, and (c) low-back pain during menstruation. The results show that episodic low-back pain before pregnancy is not correlated with any aspect of labour pain. However, it is significantly correlated with episodes of low-back pain during pregnancy. In contrast, low-back pain during menstruation is significantly correlated with labour pain scores recorded for back and front contraction pain as well as for continuous back pain. The significant correlation of labour pain with back pain during menstruation suggests that both share a common underlying mechanism. Similarly, the correlation of low-back pain during pregnancy with episodes of acute low-back pain before pregnancy suggests that the strain on back muscles during pregnancy may activate the mechanisms that underlie the usual forms of low-back pain.

Abdomen↗

PubMed1988

Cluster headache pain vs. other vascular headache pain: differences revealed with two approaches to the McGill Pain Questionnaire.

We compared cluster headache pain and other vascular (migraine and mixed) headache pain on pain intensity ratings and the McGill Pain Questionnaire (MPQ). Cluster headache sufferers reported not only more intense pain and more affective distress, but also different pain qualities than did migraine and mixed headache sufferers. The pain qualities that best distinguished cluster headaches from other vascular headaches were the presence of punctate pressure and thermal sensations and the absence of dull pain. Although cluster headache sufferers and other vascular headache sufferers endorsed different sensory pain qualities, MPQ subscales proved no better than pain intensity ratings at distinguishing these two groups. This finding may have occurred because MPQ subscale scores include an intensity component and do not provide information about specific pain qualities such as that provided by MPQ sensory items. These findings provide evidence that cluster headaches are characterized by distinct pain qualities and are not simply a more intense version of the same vascular headache pain experienced by migraine and mixed headache sufferers. They further suggest than when the MPQ is used to assess specific pain qualities, sensory items and not the sensory subscale are the preferred units for analysis.

Adult↗

PubMed1985

Pain and deception: use of verbal pain measurement as a diagnostic aid in differentiating between clinical and simulated low-back pain.

The pain reports of 553 patients with low back pain and 347 healthy subjects faking low back pain were compared to determine if pain language can be employed as diagnostic aids in differentiating between clinical groups and groups attempting to feign a clinical condition. The best set of discriminating words correctly identified 90% of the subjects using 18 to 54 words in pain description, and 83% using 4 to 17 words in their pain report. The same pain words were used to categorize 366 new pain cases and 202 new fake cases. Cross-validation shrinkage was 8 and 7% respectively. Effectiveness in discriminating between pain and simulation was increased using selective cut-off scores. Patients in active treatment for back pain whose choice of pain words resemble those of the simulators reported 21% more clinical pain in a follow-up validation study suggesting that an accurate representation of malingering may have been achieved using a simulation research design.

Adult↗

PubMed1991

Electromyographic recordings of low back pain subjects and non-pain controls in six different positions: effect of pain levels.

Surface electromyographic (EMG) activity recordings of bilateral paraspinal muscle tension were measured twice on 20 non-pain controls and on 46 low back pain subjects (21 individuals with intervertebral disk disorders and 25 subjects with unspecified musculoskeletal backache) during 6 positions: standing, bending from the waist, rising, sitting with back unsupported, sitting with back supported, and prone. Back pain subjects were measured during both low pain and high pain states. Results revealed a non-significant trend for all subjects, regardless of diagnosis, to have higher paraspinal muscle tension levels on the second (or high pain) assessment. A significant diagnosis by position interaction was observed which was similar to the interaction in our previous study which employed only a single measurement session. Analysis of simple main effects revealed this to be due to control subjects during the standing position having lower EMG levels than the back pain groups, and intervertebral disk disorder subjects having higher EMG levels than the other groups during the supported sitting position. As in our previous study, diagnosis was found to be a clinically significant factor, in that controls had much fewer clinically abnormal readings than back pain patients. The lack of a significant effect for pain state is congruent with findings in the headache literature. The importance of clearly defined diagnostic categories in low back pain research and the utility of measuring subjects in various positions is discussed, as are possible explanations for lack of significant pain state findings.

Adolescent↗

PubMed1991

Pain and impairment beliefs in chronic low back pain: validation of the Pain and Impairment Relationship Scale (PAIRS).

Few validated instruments are available to assess beliefs and attitudes that patients have regarding pain, or ability to function despite discomfort. The Pain and Impairment Relationship Scale (PAIRS) was developed to tap these important beliefs and attitudes in chronic pain patients. Preliminary data indicate that the PAIRS is internally consistent and significantly related to impairment in a highly selected pain clinic sample of patients, including some chronic low back pain patients. The present study was designed to extend the validation of the PAIRS to a more general sample of chronic benign low back pain patients. Furthermore, additional tests supported the discriminant, convergent and divergent validity, as well as the reliability and relative independence from favorable self-report response bias of the PAIRS, by respectively demonstrating that: (1) the impairment beliefs assessed with the PAIRS were more prominent in chronic low back pain (CLBP) patients than in matched non-pain, healthy controls; (2) scores on the PAIRS were significantly related to measures of physical impairment, but not to physicians ratings of disease severity; (3) the impairment beliefs assessed with the PAIRS are readily distinguishable from cognitive distortions and emotional distress; (4) PAIRS scores for chronic low back pain patients are relatively consistent over time; and (5) PAIRS scores are not significantly associated with measures of favorable self-report response bias. We conclude that the PAIRS has demonstrated at least preliminary utility for applications by researchers and clinicians interested in chronic pain.

Adult↗

PubMed1990

Pain extent: relations with psychological state, pain severity, pain history, and disability.

The present study examined relationships between pain extent and measures of psychological state, pain-related disability, pain severity, and pain history in 416 patients with chronic pain. Previous research has examined the pain extent-psychological state relationship and has generally concluded that it is weak. Results of multiple regression analyses in this study indicated a moderate association between pain extent and psychosomatic symptoms. Weaker relationships were obtained for depression, pain severity, and length of time in pain. Results are discussed in light of prior studies of psychological state and pain extent.

Adult↗

PubMed1991

Symptom report in orofacial pain patients: relation to chronic pain, experimental pain, illness behavior, and personality.

A study was conducted to determine symptom report patterns in a heterogenous population of orofacial pain patients and to evaluate how symptom patterns relate to various dimensions of the human pain experience. Results indicated that symptoms frequently associated with chronic orofacial pain disorders can be described by four indices related to the temporomandibular joint (TMJ) and its movement; discomfort of and parafunctional activities related to the masticatory muscles; interference of pain with activities of daily living; and presence of orofacial pain unrelated to myogeneous or arthrogenous TMJ disorders. Of these four symptom indices, only the pain interference (symptom) index was related to clinical pain and illness behavior. None was related to personality. Two of the indices were influenced by diagnosis. Biomechanical symptoms and parafunctional activities appear to be insignificantly related to perceived pain intensity, pain responsiveness, illness behavior, or personality, but are related to diagnosis. The results indicated that relatively simple symptom checklists have potential utility in screening orofacial pain patients and in evaluation of treatment outcome.

Adolescent↗

PubMed1992

Implementation of the American Pain Society Quality Assurance Standards for Relief of Acute Pain and Cancer Pain in oncology nursing practice.

Cancer pain represents a high-incidence problem that requires ongoing monitoring and evaluation. The recently published American Pain Society Quality Assurance Standards for Relief of Acute Pain and Cancer Pain provides an excellent basis for developing a quality assurance (QA) program in cancer pain assessment and management. These standards contain five critical areas for monitoring and evaluation related to cancer pain. The purpose of this article is to provide a useful framework for oncology nurses to develop a QA program in cancer pain assessment and management. The Oncology Nursing Society Position Paper on Cancer Pain and the American Nurses Association/Oncology Nursing Society Standards of Oncology Nursing Practice are incorporated into the framework to develop specific monitoring criteria. Practical suggestions are provided for implementing a QA program on cancer pain in a variety of oncology practice settings, using the standards of the American Pain Society.

Analgesics↗

PubMed1989

A comparative study of pain, sleep quality and pain responsiveness in fibrositis and myofascial pain syndrome.

Twenty patients with fibrositis and 19 patients with myofascial pain syndrome were compared with regard to pain levels, sleep quality, general pain threshold and localized pain responsiveness at fibrositic tender points. Patients with fibrositis had significantly lower pain responsiveness (p less than 0.01), lower pain threshold (p less than 0.05) and higher pain levels (p less than 0.05) than patients with myofascial pain syndrome when differences in age between the groups were controlled. No significant difference was found for sleep quality. Regional pain levels influenced local measures of pain sensitivity. A discriminant function, developed on the 4 main study variables, resulted in an almost 80% correct classification to groups.

Adult↗

PubMed1987

Quantitative pain assessment for routine care of rheumatoid arthritis patients, using a pain scale based on activities of daily living and a visual analog pain scale.

Pain was assessed quantitatively as a component of routine visits of 385 outpatients with rheumatoid arthritis, using a pain scale based on activities of daily living (ADL) and a visual analog scale. The ADL pain scale met psychometric criteria for validity and reliability. Scores on the 2 pain scales were correlated significantly with one another and with other measures of disease status, including joint count, grip strength, walking time, button test, morning stiffness, erythrocyte sedimentation rate, global self-assessment, ADL difficulty, and ADL dissatisfaction scales. Correlations of ADL pain scale scores with other measures were higher than were correlations of visual analog scale scores with other measures, in both unadjusted and adjusted analyses. Significantly more patients completed the ADL pain scale without assistance than the number of those who completed the visual analog pain scale. The ADL pain scale was more sensitive to problems in ADL than were the ADL scales for difficulty and dissatisfaction. The ADL and visual analog pain scales appear to provide useful data for quantitative assessment of pain in the routine care of rheumatoid arthritis patients.

Activities of Daily Living↗

PubMed1989

Visual analogue scales as a measure of pain in arthritis: a study of overall pain and pain in individual joints at rest and on movement.

Visual analogue scales (VAS) for overall and individual joint pain at rest and on movement were completed by 105 patients with polyarthritis as part of a study of the relationship between overall pain and pain in individual joints. Not all subjects recorded pain on a conventional VAS although all had at least 2 painful joints on movement. At best only 25% of the variance in overall pain was explained by pain in individual joints. Our findings suggest that conventional overall measures of pain in arthritis may neglect aspects of pain experience which relate to individual joints and to pain on movement.

Adult↗

PubMed1990

What do chronic pain patients think of their pain? Towards a pain cognition questionnaire.

The three-systems model of chronic pain emphasizes the partially independent relationship among physiological, gross motor and verbal-cognitive responses of chronic pain patients. This study describes the development of an assessment instrument representing a measure for the verbal-cognitive response system of chronic pain. Fifty items, each of which is assigned to one of five factors (pain impact, catastrophizing, outcome efficacy, acquiescence and reliance on health care) constitute the new Pain Cognition List (PCL). The PCL was developed using a Dutch back pain population and proves to be stable across sex and back pain diagnosis. By means of three experiments the PCL is shown to be reliable and sufficiently valid. The PCL might be a promising tool for identifying pain patients whose pain problem is mainly controlled by cognitive factors.

Activities of Daily Living↗

PubMed1985

Familial pain models: the relationship between family history of pain and current pain experience.

Recent evidence has underscored the importance of parental models and vicarious learning in the etiology of pain behavior. The present study investigated the relationships between the number of familial pain models to which an individual has been exposed, the individual's reports of current pain experiences, and the role of gender. One hundred and twenty male and 168 female college students reporting occasional pain episodes completed the Parameters of Pain Questionnaire. Results indicated that a significant positive relationship exists between the number of pain models in an individual's familial environment and the frequency of his/her current pain reports. Additionally, pain models had a greater impact on females than on males. These findings are discussed in terms of vicarious learning and health locus of control processes.

Adult↗

PubMed1988

Adenosine-induced chest pain in patients with silent and painful myocardial ischaemia: another clue to the importance of generalized defective perception of painful stimuli as a cause of silent ischaemia.

Adenosine is formed from adenosine triphosphate within the ischaemic cells from where it is released into the coronary circulation. Adenosine exhibits several cardiovascular effects which tend to protect the ischaemic myocardium. Based on the observation that in healthy volunteers the intravenous infusion of adenosine produces angina-like chest pain, it has been recently proposed that another cardioprotective action of this substance could be provocation of angina. If this is the case adenosine should not produce chest pain in patients with silent ischaemia. To test this hypothesis we infused this substance intravenously at increasing doses of 50, 100, 150, 200, 250 and 300 micrograms kg-1 min-1 in eight patients with silent ischaemia (group A). All of them developed ST depression (1.8 +/- 0.2 mm) during exercise testing and seven also during adenosine infusion (1.1 +/- 0.8 mm). However, none of the patients had chest pain during exercise while seven had chest pain during adenosine. We then infused adenosine in eight other patients (Group B) who had painful ischaemia and an exercise tolerance similar to that of Group A patients (time to 1 mm ST depression 8.6 +/- 2.7 min and 8.4 +/- 3 min, respectively, P = NS). Adenosine induced chest pain in all Group B patients. The time to pain onset during adenosine was similar in the two groups (9.3 +/- 2.3 min in Group B and 12.4 +/- 4.9 min in Group A).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗

PubMed1989

The quality of pain in arthritis: the words patients use to describe overall pain and pain in individual joints at rest and on movement.

One hundred and five patients with polyarthritis chose from 14 sensory and 5 affective pain descriptors derived from the McGill Pain Questionnaire (MPQ), and completed visual analogue scales (VAS) for overall and individual joint pain at rest and on movement. The relative frequency of sensory pain descriptor choice varied for the 4 different circumstances of pain. Over one third of patients volunteered affective words not included in the MPQ. This study suggests that conventional overall measures of pain, such as the MPQ, when used for patients with arthritis may neglect differences in pain experience perceived in individual joints and on movement.

Adult↗

PubMed1990

Experimental changes in pain threshold and severe pain threshold for electrically induced pain.

Pain and severe pain thresholds were measured in groups of 15 (Experiment 1) and 20 (Experiment 2) normal volunteers. In Experiment 1, the subjects underwent a series of ten constant level, painful stimuli each of 10 sec duration at an arbitrarily chosen level between the thresholds. This level was recorded. It ranged from 14% to 81% of the difference between thresholds. The thresholds were then remeasured. For the second experiment the experimental stimulus commenced at a non-painful level and increased over a period of 5 sec to a level midway between thresholds for a series of three stimuli and again thresholds were remeasured. An overall effect was demonstrable only in Experiment 2, where the severe pain threshold was significantly reduced (p less than 0.001). There was a marked individual variation with increases and decreases in both thresholds occurring in different individuals at significance levels varying from p less than 0.05 to p less than 0.001. No subject changed the two thresholds in opposite directions. Examination of the responses in Experiment 1 suggested that for any increase in either threshold to occur it was necessary that the repeated painful stimulus should be at a level below the mid-point between the two thresholds, but that this was not a sufficient condition.

Adult↗