This cross validation study examined the reliability of the Multidimensional Pain Inventory (MPI) and the stability of the Multidimensional Pain Inventory Classification System of the empirically derived subgroup classification obtained by cluster analysis in chronic musculoskeletal pain. Reliability of the German Multidimensional Pain Inventory was only examined once in the past in a small sample. Previous international studies mainly involving fibromyalgia patients showed that retest resulted in 33-38% of patients being assigned to a different Multidimensional Pain Inventory subgroup classification. Participants were 204 persons with chronic musculoskeletal pain (82% chronic non-specific back pain). Subgroup classification was conducted by cluster analysis at 4 weeks before entry (=test) and at entry into the pain management program (=retest) using Multidimensional Pain Inventory scale scores. No therapeutic interventions in this period were conducted. Reliability was quantified by intraclass

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This study is aimed to elucidate the association between Pain Catastrophizing Scale Score and Postspinal Headache in Patients Underwent Cesarean Section With Spinal Anesthesia. Patients were asked to fill the questionnaire booklet including Pain Catastrophizing Scale, Beck Depression Inventory and Beck Anxiety Inventory before elective cesarean section in preoperative room in operating theater. In postoperative second and fourth day, patients will call by phone and be asked to have headache or any complaints. The intensity of headache will evaluate by using visual analog scale. Age, gender, and visual analog scale scores will be recorded ...

TY - JOUR. T1 - Translation, cross-cultural adaptation and validation of the Pain Catastrophizing Scale (PCS) into Bengali in patients with chronic non-malignant musculoskeletal pain. AU - Majumder, M.S.M.. AU - Ahmed, Shamim. AU - Shazzad, Md Nahiduzzamane. AU - Hasan, Abu Tahir Muhammad Tanveer. AU - Haq, Syed Atiqul. AU - Rasker, Johannes J.. PY - 2020/8/30. Y1 - 2020/8/30. N2 - Aim: To develop a culturally adapted and validated Bengali Pain Catastrophizing Scale (BePCS). Methods: The English PCS was translated, adapted and back-translated into and from Bengali, pre-tested by 30 adult patients with chronic non-malignant musculoskeletal pain. The BePCS was administered twice with 14 days interval to 90 patients. Convergent validity was measured by comparing the BePCS score with scores of the domains physical functioning and mental health of the Bengali Short Form 36, through Spearmans correlation coefficient. Test-retest reliability was assessed by intraclass correlation coefficient (ICC) and ...

OBJECTIVE: To examine patient-reported outcomes (PROs) in patients with different rheumatoid arthritis (RA) disease activity levels and identify residual symptoms. METHODS: Post hoc analyses of overall and Japanese data from two randomized controlled trials including RA patients with previous inadequate responses to methotrexate (NCT01710358) or no/minimal previous disease-modifying antirheumatic drug treatment (NCT01711359) (sponsor: Eli Lilly and Company). Week 24 assessments were disease activity (Simplified Disease Activity Index, Disease Activity Score/Disease Activity Score 28 joints-erythrocyte sedimentation rate) and PROs (pain visual analog scale [VAS], morning joint stiffness [MJS], Health Assessment Questionnaire-Disability Index, Functional Assessment of Chronic Illness Therapy-Fatigue, and Medical Outcomes Study Short Form 36 Health Survey Physical and Mental Component Scores ...

Objectives: A tool for measuring neck pain in patients with dizziness is needed to further investigate the relationship between the two symptoms. The objective of this study was to examine the reliability and validity of a hand‐held pressure algometer in measuring pressure pain threshold (PPT) in different cervical regions of dizzy patients. Methods: PPT was measured at two bilateral standardized sites of the neck by a trained physiotherapist in 50 patients with dizziness. Intraclass correlation coefficients (ICC) were calculated for intrarater and test-retest reliability. Concurrent validity was assessed by measuring the association between PPT and the American College of Rheumatology (ACR) tender points at each site and with the numeric pain rating scale (NPRS). Results: Almost perfect intrarater (ICC = 0.815-0.940) and within‐session test-retest (ICC = 0.854-0.906) reliability was found between the measures. On each site, a low PPT predicted a positive ACR tender point at each site (OR = ...

Specific Aim 1: To determine if, compared with current and customary analgesia, the addition of a multiple-day ambulatory continuous paravertebral block decreases the incidence and severity of post-mastectomy pain.. Hypothesis 1: Following mastectomy, the incidence and severity of breast pain will be significantly decreased in the week following surgery with a multiple-day ambulatory continuous paravertebral block as compared with patients receiving standard-of-care treatment (as measured on the 11-point numeric rating scale).. Hypothesis 2: Following mastectomy, the incidence and severity of chronic pain will be significantly decreased three months following multiple-day ambulatory continuous paravertebral blocks as compared with patients receiving standard-of-care treatment (as measured on the 11-point numeric rating scale). ...

Results of a study published in The Spine Journal indicate that the Oswestry Disability Index, Modified Swiss Spinal Stenosis Scale (SSS), and Patient Specific Functional Scale possess adequate psychometric properties to be used in the outcome assessment of patients with lumbar spinal stenosis. However, further investigation is needed to validate these findings in other samples of patients with lumbar spinal stenosis and nonspecific low back pain, the authors add. This cohort secondary analysis of a randomized clinical trial of patients with lumbar spinal stenosis receiving outpatient physical therapy included 55 patients (mean age, 69.5 years; standard deviation, ±7.9 years; 43.1% females).. Outcome measures were the Modified Oswestry Disability Index, SSS, Patient Specific Functional Scale, and Numeric Pain Rating Scale (NPRS).. All patients completed the Oswestry Disability Index, SSS, Patient Specific Functional Scale, and NPRS at the baseline examination and at a follow-up. In addition, ...

Results of a study published in The Spine Journal indicate that the Oswestry Disability Index, Modified Swiss Spinal Stenosis Scale (SSS), and Patient Specific Functional Scale possess adequate psychometric properties to be used in the outcome assessment of patients with lumbar spinal stenosis. However, further investigation is needed to validate these findings in other samples of patients with lumbar spinal stenosis and nonspecific low back pain, the authors add. This cohort secondary analysis of a randomized clinical trial of patients with lumbar spinal stenosis receiving outpatient physical therapy included 55 patients (mean age, 69.5 years; standard deviation, ±7.9 years; 43.1% females).. Outcome measures were the Modified Oswestry Disability Index, SSS, Patient Specific Functional Scale, and Numeric Pain Rating Scale (NPRS).. All patients completed the Oswestry Disability Index, SSS, Patient Specific Functional Scale, and NPRS at the baseline examination and at a follow-up. In addition, ...

Objectives: This study aims to evaluate the effects of two different doses of intraarticular ketamine on visual analog scale (VAS) scores at rest and movement, time to first analgesic requirement, and 24-h morphine consumption in patients undergoing arthroscopic meniscectomy as well as to assess the frequency of postoperative nausea&vomiting, respiratory depression, pruritus, urinary retention, and constipation and to compare the time to discharge.. Patients and methods: This prospective randomized double- blind study was performed between August 2013 and August 2014 on 75 patients (32 males, 43 females; mean age 46.7±13 years; range, 18 to 75 years) with American Society of Anesthesiologists scores of I-II scheduled for unilateral meniscectomy. Patients were randomized to receive 0.5 mg.kg-1 ketamine (group K1), 1 mg.kg-1 ketamine (group K2) or saline (group S) to a total volume of 20 mL intraarticularly at the end of the surgery. All patients were performed periarticular 10 mL 0.5% ...

A 44-year-old woman presented with lumbar pain (visual analog scale [VAS] = 9) secondary to adrenocortical carcinoma sclerotic L4-vertebral metastasis. The positron emission tomography-computed tomography hypermetabolic lesion (Fig 1a,d) was unresponsive to radiotherapy or chemotherapy. She refused surgery. Following general anesthesia and aseptic preparation, 2 power d rill-mounted (Aescula...

Objective. In lumbar foraminal spinal stenosis (LFSS), numerous ligaments may play an important role in causing radiculopathy by narrowing the exit of the nerve root. In order to achieve effective decompression of lumbar foraminal ligaments, a specially designed instrument for percutaneous lumbar extraforaminotomy (PLEF) was invented. The purpose of this study was to evaluate the effectiveness of PLEF in patients with intractable radiculopathy from LFSS. Design. A prospective, single-armed, observational pilot study. Setting. A pain center in a tertiary university-based hospital. Methods. The PLEF was performed in patients who suffered from radiculopathy with concordant imaging evidence of a mild to severe degree of LFSS. For each patient, an 11-point numerical rating scale (NRS) pain score, the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ) score, and any adverse events were evaluated at three-month follow- ups. Successful responder percentage defined as 40% ...

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PMID: 9656903 The McGill Pain Questionnaire is an instrument that is widely used to assess the multidimensional experience of pain. Although it was introduced more than 20 years ago, limited information is available about its use in patients suffering from persistent facial pain. The aim of this study was to investigate the response patterns of persistent facial pain patients to the McGill Pain Questionnaire, to correlate these patterns with patients beliefs about the seriousness of the condition, and to compare the findings with data reported from other painful conditions. The study sample consisted of 200 consecutive female patients referred to a tertiary care facial pain clinic. The Pain Rating Index scores of the McGill Pain Questionnaire subscales and the total number of words chosen by these patients closely matched the summary scores reported by Wilkie et al, who pooled data from seven pain conditions (cancer, chronic back, mixed chronic, acute/postoperative, labor/gynecological, dental, ...

4Dicle University, School of Medicine, Department of Neurosurgery, Diyarbakır, Turkey DOI : 10.5137/1019-5149.JTN.9087-13.0 AIM: Symptoms of thoracic outlet syndrome (TOS) may be vascular, neurological or combined symptoms involving both. Treatment of TOS is generally conservative. Surgical treatment is required when radiological results indicate anatomical abnormality. This study aims to present the surgical outcomes of TOS patients treated with supraclavicular approach via microsurgery.. MATERIAL and METHODS: 41 patients with thoracic outlet syndrome were rewieved retrospectively. The pain was determined using both on visual analogue scale (VAS) and Oswestry score both in the preoperative and postoperative period. All patients underwent electromyography including brachial plexus, ulnar and median nerves. Computed Tomography (CT) angiographic examination was applied dynamically with required manoeuvres.. RESULTS: Post-op VAS scores were recorded as 0.8 for the arm, 0.6 for the shoulder and 0.5 ...

Article 8.5 of the Directive 2011/24/EU states that the degree of patients pain must be taken into account in the process of the cross-border healthcare treatment authorization.. Member States should have transposed the Directive into their national legislation by October 2013 and, consequently, should have put in place mechanisms to assess the patients level of pain.Unfortunately, in the transposition process at national level only few Countries have formally recognized the importance of the assessment of the degree of patients pain as stated in article 8.5, setting the benchmark on the implementation of the cross-border healthcare directive.. In practice, do the National implementation measures include a reference to the intensity of pain? Do the medical records have now specific sections dedicated to the patients pain assessment? How common is pain measurement in the EU Member States? According to the intensity of pain, do patients receive any medical advice from their doctors about which ...

Data Synthesis:. We found good evidence that NSAIDs, skeletal muscle relaxants (for acute low back pain), and tricyclic antidepressants (for chronic low back pain) are effective for pain relief. The magnitude of benefit was moderate (effect size of 0.5 to 0.8, improvement of 10 to 20 points on a 100-point visual analogue pain scale, or relative risk of 1.25 to 2.00 for the proportion of patients experiencing clinically significant pain relief), except in the case of tricyclic antidepressants (for which the benefit was small to moderate). We also found fair evidence that acetaminophen, opioids, tramadol, benzodiazepines, and gabapentin (for radiculopathy) are effective for pain relief. We found good evidence that systemic corticosteroids are ineffective. Adverse events, such as sedation, varied by medication, although reliable data on serious and long-term harms are sparse. Most trials were short term (≤4 weeks). Few data address efficacy of dual-medication therapy compared with monotherapy, or ...

The Oxford Textbook of Paediatric Pain brings together an international team of experts to provide an authoritative and comprehensive textbook on all aspects of pain in infants, children and youth. Divided into nine sections, this resource analyses pain as a multifactorial problem and gives the reader a comprehensive understanding of this challenging subject. Topics covered include the biological, social, and psychological basis of pain, pain in specific populations, pain measurement, pharmacology, psychosocial and physical interventions, complementary therapies, education, and ethics of pain control in youths, children, and infants. Evidence-based chapters look in depth at areas ranging from the long-term effects of the pain in children, to sociodemographic differences in paediatric pain management. Case examples and online materials including scales, worksheets, and videos are provided to aid learning and illustrate the application of knowledge.

The efficacy of Qutenza, was established in two 12-week, double-blind, randomized, dose-controlled, multicenter studies. These studies enrolled patients with postherpetic neuralgia (PHN) persisting for at least 6 months following healing of herpes zoster rash and a baseline score of 3-9 on an 11-point Numerical Pain Rating Scale (NPRS) ranging from 0 (no pain) to 10 (worst possible pain). Qutenza and a control patch were each applied as a single 60-minute application. The control used in these studies looked similar to Qutenza but contained a low concentration of the active ingredient, capsaicin (3.2 mcg/cm 2, 0.04% w/w) to retain blinding regarding the known application site reactions of capsaicin (such as burning and erythema). The baseline mean pain scores across the 2 studies was approximately 6.0. Patients who entered the study on stable doses of pain-control medications were required to keep dosing stable throughout the duration of the study. Approximately half of the patients were taking ...

We identified 12 additional trials and included 22 trials with 8275 participants in this update. Oral oxycodone was studied in 10 trials, transdermal buprenorphine and oral tapentadol in four, oral codeine in three, oral morphine and oral oxymorphone in two, and transdermal fentanyl and oral hydromorphone in one trial each. All trials were described as double-blind, but the risk of bias for other domains was unclear in several trials due to incomplete reporting. Opioids were more beneficial in pain reduction than control interventions (SMD -0.28, 95% CI -0.35 to -0.20), which corresponds to a difference in pain scores of 0.7 cm on a 10-cm visual analogue scale (VAS) between opioids and placebo. This corresponds to a difference in improvement of 12% (95% CI 9% to 15%) between opioids (41% mean improvement from baseline) and placebo (29% mean improvement from baseline), which translates into a number needed to treat (NNTB) to cause one additional treatment response on pain of 10 (95% CI 8 to 14). ...

This non-experimental study was designed to investigate the congruence between in-labor report and postpartum recall of labor pain as measured by the McGill Pain Questionnaire (MPQ). Fifty married parturients, ages 19 to 39 at term with a normal pregnancy, served as subjects. Analysis of variance showed that postpartum report of labor pain on the Present Pain Intensity scale of the MPQ was not consistently congruent with pain reported during labor. In contrast, the Pain Rating Index of the MPQ provided postpartum data that was congruent with the in-labor report. Significant interaction effects, however, suggested that postpartally the women tended to devaluate the pain of early labor and inflate the pain of transitional labor when compared to their in-labor report. Theoretical and practical implications of the results for the measurement of labor pain are discussed. ...

JK Olsen et al. have tested the reliability of pain assessment with this new tool. Inter-rater and intra-rater reliabilities were all above the defined cutt off 0.75 for excellent results. The DoloCuff is now in production and has a great potential for systematic follow-up on sensitivity to pain, on both an individual basis and group wise. The article is accepted in Pain Pratice.. For more information on the study of the equipment, please contact [email protected]. ...

The objective of this study is to fill gaps in the literature regarding the effectiveness of cupping therapy on lumbar stiffness. Participants will be recruited from the University of South Carolina and from local clinics in Columbia, South Carolina. Individuals will be classified based on lumbar range of motion limitations, and then they will be equally dispersed into three treatment groups via stratified randomization. These groups include dynamic cupping, static cupping, or stretching. All participants will be assessed prior to selected treatment to obtain baseline values for four measures: back range of motion (BROM), pain pressure threshold (PPT), active straight leg raise (ASLR), and numeric pain rating scale (NPRS). Participants will be given each measure directly after treatment, followed by a follow-up measurement 24 hours after treatment.

In this systematic review and meta-analysis of 33 studies, we identified nine preoperative predictors that were negatively associated with pain control after surgery: young age, female sex, smoking, history of depressive symptoms, history of anxiety symptoms, sleep difficulties, higher BMI, presence of preoperative pain and use of preoperative analgesia. The most well-studied predictors were female sex (number of studies, n=20), young age (n=14) and the presence of preoperative pain (n=13). The strongest negative prognostic factors were a history of sleeping difficulties (number of studies, n=2) and depression (n=8), which were independently associated with approximately twofold higher odds of poor postoperative pain control. Our findings are consistent with and extend the results of the previous systematic review by Ip et al.20 In addition to the predictors previously described, we identified six additional preoperative predictors of poor postoperative pain control.20. Previous reports have ...

TY - JOUR. T1 - Timing interval from peri-prostatic block to biopsy impacts procedural pain. AU - Pathak, Ram A.. AU - Thiel, David D.. AU - Parker, Alexander. AU - Heckman, Michael G.. AU - Crook, Juliana. AU - Diehl, Nancy N.. AU - Tavlarides, Andrea. AU - Alford, Scott W.. AU - Igel, Todd C.. PY - 2017/6/1. Y1 - 2017/6/1. N2 - Introduction: To compare visual analog scale (VAS) pain scores between patients with a 2-minute versus 10-minute delay of peri-prostatic lidocaine injection prior to transrectal ultrasound-guided prostate biopsies (TRUS-bx). Materials and methods: Eighty patients who underwent standard 12-core TRUS-bx by a single surgeon were prospectively randomized into four different treatment arms: bibasilar injection with a 2-minute delay, bibasilar injection plus a single apical injection with a 2-minute delay, bibasilar injection with a 10-minute delay, and bibasilar injection plus a single apical injection with a 10-minute delay. Patients were asked to report their level of pain ...

View more ,Question Is Strain-Counterstrain treatment combined with exercise therapy more effective than exercise alone in reducing levels of pain and disability in people with acute low back pain? Design Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Participants 89 (55 female) participants between 18 and 55 years experiencing acute low back pain were randomised to experimental (n = 44) and control (n = 45) groups. Intervention Participants attended four treatments in two weeks. The experimental group received Strain-Counterstrain treatment and review of standardised exercises (abdominal bracing, knee to chest, and lumbar rotation). The control group performed the standardised exercises under supervision. Following the intervention period, all participants received exercise progression, manual therapy, and advice. Outcome measures The primary outcome was the modified Oswestry low back pain disability questionnaire, measured at 2 weeks (ie, end of ...

7thSpace has reprinted an article that was first published in BMC Musculoskeletal Disorders:. Prevalence of fibromyalgia in low socioeconomic status population. The aim of this study was to estimate the prevalence of fibromyalgia, as well as to assess the major symptoms of this syndrome in an adult, low socioeconomic status population assisted by the primary health care system in a city in Brazil.. Methods: We cross-sectionally sampled individuals assisted by the public primary health care system (n=768, 35-60 years old). Participants were interviewed by phone and screened about pain.. They were then invited to be clinically assessed (304 accepted). Pain was estimated using a Visual Analogue Scale (VAS).. Fibromyalgia was assessed using the Fibromyalgia Impact Questionnaire (FIQ), as well as screening for tender points using dolorimetry. Statistical analyses included Bayesian Statistics and the Kruskal-Wallis Anova test (significance level=5%).. Results: From the phone-interview screening, we ...

Chronic pain is generally regarded as being divided into two mutually exclusive pain mechanisms: nociceptive and neuropathic. Recently, this dichotomous approach has been questioned and a model of chronic pain being more or less neuropathic has been suggested. To test whether such a spectrum exists, we examined responses by patients with chronic pain to validated neuropathic pain assessment tools and compared these with ratings of certainty about the neuropathic origin of pain by their specialist pain physicians. We examined 200 patients (100 each with nociceptive and neuropathic pain) and administered the self-complete Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS score) and the Neuropathic Pain Scale (NPS). Clinicians were asked to rate their certainty of the presence of neuropathic pain mechanisms on a 100 mm visual analogue scale (VAS) (0 = not at all neuropathic in origin to 100 = completely neuropathic in origin). The whole sample was divided into tertiles based on ...

Listen to this podcast with Clifford Moy, MD, the behavioral health medical director at TMF Health Quality Institute, and Lindsay Botsford, MD, the market medical director for Iora Health in Houston, a clinical associate professor of the Department of Clinical Science at the University of Houston Co

Three nonpharmacological nursing interventions, relaxation, chosen music, and their combination, were tested for pain relief following intestinal (INT) surgery in a randomized clinical trial. The 167 patients were randomly assigned to one of three intervention groups or control and were tested during ambulation and rest on postoperative days 1 and 2. Pain sensation and distress were measured with visual analog scales (VAS). Multivariate analysis of covariance showed significantly less post-test pain in the intervention groups than in the control group on both days after rest and at three of six ambulation post-tests (p = .024-.001), resulting in 16-40% less pain. Mixed effects after ambulation were due to the large variation in pain and difficulty relaxing while returning to bed; but post hoc explorations showed effects for those with high and low pain. These interventions are recommended along with analgesics for greater postoperative relief without additional side effects.

TY - JOUR. T1 - Correspondence between EQ-5D health state classifications and EQ VAS scores. AU - Whynes, David K. AU - The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group. PY - 2008. Y1 - 2008. N2 - BACKGROUND: The EQ-5D health-related quality of life instrument comprises a health state classification followed by a health evaluation using a visual analogue scale (VAS). The EQ-5D has been employed frequently in economic evaluations, yet the relationship between the two parts of the instrument remains ill-understood. In this paper, we examine the correspondence between VAS scores and health state classifications for a large sample, and identify variables which contribute to determining the VAS scores independently of the health states as classified. METHODS: A UK trial of management of low-grade abnormalities detected on screening for cervical pre-cancer (TOMBOLA) provided EQ-5D data for over 3,000 women. Information on distress and multi-dimensional health ...

Treating persistent pain conditions with opioid medications is not only ineffective for long-term treatment but is also a preventable factor behind the current opioid crisis, which kills thousands of people each year. One way to address the opioid crisis is to identify better treatments to reduce pain. The purpose of this study is to determine the potential of a specific metabolite of ketamine named (2R,6R)-hydroxynorketamine (HNK) to be an effective alternative to opioids in reducing pain or opioid adjunct to make opioid pain treatment safer and more effective. The specific aims for this study are 1) to determine the pain reduction effects of (2R,6R)-HNK in healthy mice and mice with induced neuropathic and inflammatory pain, and 2) to examine the interaction between (2R,6R)-HNK and opioid-induced pain reduction in mice. To investigate these aims, C57BL/J6 mice will be tested utilizing various pain measurement tests after receiving (2R,6R)-HNK and compared to mice receiving saline as a placebo. ...

Around 14% of adults who experience pain report that it lasts 3 months to a year and 42% report pain that lasts more than a year.

This project is supported by the Canadian Institutes of Health Research (award #111062), Alberta Innovates - Health Solutions, and by The Metabolomics Innovation Centre (TMIC), a nationally-funded research and core facility that supports a wide range of cutting-edge metabolomic studies. TMIC is funded by Genome Alberta, Genome British Columbia, and Genome Canada, a not-for-profit organization that is leading Canadas national genomics strategy with funding from the federal government. Maintenance, support, and commercial licensing is provided by OMx Personal Health Analytics, Inc. Designed by Educe Design & Innovation Inc. ...

TY - JOUR. T1 - A prospective double-blind randomised controlled trial of intraoperative pelvic instillation with bupivacaine for management of pain following laparoscopy and dye. AU - Sripada, Sreebala. AU - Roy, S.. AU - Mathur, M.. AU - Hamilton, M. AU - Cranfield, K.. AU - Bhattacharya, Siladitya. PY - 2006. Y1 - 2006. N2 - The aim of this randomised, double-blind, placebo-controlled trial was to evaluate the effectiveness of intraperitoneal instillation of bupivacaine following laparoscopy and dye test. Women received either 15 ml of 0.9% saline (n=42) or 15 ml of 0.5% bupivacaine (n=43), which was instilled intraperitoneally. Pain and nausea scores were recorded on a visual analogue scale (VAS). Pain perception was no different in the bupivacaine group compared with the control group with median values of VAS at 2 hours (18, 19; P=0.8), 6 hours (21, 22; P=0.5), 12 hours (19, 25; P=0.8), 24 hours (27, 27; P=0.9) and 48 hours (21, 13; P=0.26). Women in the bupivacaine group were less ...

Pain assessment is a broad concept involving clinical judgment based on observation of the type, significance and context of the individuals pain experience. There are challenges in assessing paediatric pain, none more so than in the pre-verbal and developmentally disabled child. Therefore physiological and behavioural tools are used in place of the self-report of pain. However in children with developmental disabilities there can be incorrect assumptions and there is a risk of under-treating pain. It is important to take behavioral cues identified by parents and caregivers to improve pain assessment in these children. Pain assessment in infants and children is also challenging due to the subjectivity and multidimensional nature of pain. The dependence on others to assess pain, limited language, comprehension and perception of pain expressed contextually. In some children it can be difficult to distinguish between pain, anxiety and distress. Assessment and documenting pain is needed in order to ...

RATIONALE: Low back pain has a significant socioeconomic impact. Repetitive lifting, with combined twisting and flexion motions of the lumbar spine, increases the risk for low-back pain and injury to the supporting tissues. PATIENT CONCERNS: A 60-year-old male who presented with acute low-back pain, with a pain intensity of 6/10 on the visual analog scale (VAS) and an Oswestry disability index (ODI) score of 70%. The range of motion (ROM) of the lumbar spine on initial examination, relative to the normal peak ROM, was as follows: extension, 12°/30°; flexion, 15°/80°; left rotation, 15°/45°; and right rotation, 25°/45 ...

Background: Local anesthetics act by different mechanisms to produce their effects in control acute and chronic pain. Methods: A total of 22 patients (14 female, 8 male) who need tooth apisectomy under infiltration local anesthesia were examined in two situations: Before and after administration of local anesthesia. For all patients salivary sample has been collected by salivette to estimate the level of opiorphin using ELISA Kits, the pain was assessed after administration of local anesthesia using Visual Analogue Scale (VAS). Results: the results showed a significant differences of salivary opiorphin before and after administration of local anesthesia (5.96+5.38) ng/ml and (14.49±3.66) ng/ml respectively with p0.05). Conclusions: local

Description: M.Cur. , Midwives are responsible to assess pain before treating it; then they should reassess the pain to evaluate the effectiveness of the interventions and plan future therapy. Accurate and objective measures of labour pain continue to be scarce and the discrepancy in labour pain perceptions between parturients and health-care providers remains challenging. Various pain measurement tools are currently in use measuring chronic and acute pain, but many problems were encountered applying these methods to the woman in labour. The charts were detailed and required too much time to complete. The aim of the study was to develop a multidimensional labour pain assessment instrument to assist clinicians and midwives with labour pain control. Objectives for developing a valid and reliable instrument to accurately measure labour pain included refinement of the labour pain assessment instrument developed from literature, testing of the refined instrument on patients during labour, compilation ...

to the editor: I was pleased to read the article1 on management of nonmalignant pain. The undertreatment of pain is a widespread issue in the United States, and helping to educate practicing family physicians in the most current pain management techniques is an important, even critical, goal.. I was disappointed, however, by the relative lack of information in the article on the two newest classes of oral analgesics: (1) tramadol (Ultram) and (2) cyclooxygenase-2 (COX-2) inhibitors, which represent a new type of non-steroidal anti-inflammatory drug (NSAID).. Tramadol has been available in the United States for five years. It is effective not only for an acute episode of neuropathic pain (as suggested in the article), but also for chronic neuropathic pain syndrome, fibromyalgia, osteoarthritis pain2 and chronic low back pain.3 Tramadol may be most notable for what it is not-tramadol is not an NSAID, nor is it a typical opioid. Tramadol has a dual mechanism of action: it acts centrally at ...

DUBLIN, IRELAND, July 9 (Korea Bizwire) - Research and Markets (http://bit.ly/VZyRjp) has announced the addition of Jain PharmaBiotechs new report Global Pain Therapeutics Report 2014: Drugs, Markets and Companies - The Latest Concepts of Pathomechanisms of Pain to their offering.. This report describes the latest concepts of pathomechanisms of pain as a basis for management and development of new pharmacotherapies for pain. Major segments of the pain market are arthritis, neuropathic pain and cancer pain. Because pain is a subjective sensation, it is difficult to evaluate objectively in clinical trials. Various tools for pain measurement are described, including brain imaging.. Most of the currently used analgesic drugs fall into the categories of opioids and nonsteroidal antiinflammatory drugs such as COX-2 inhibitors. Non-opioid analgesics include ketamine, a N-methyl-D-aspartate receptor antagonist. Adjuvant analgesics include antidepressants and antiepileptic drugs used for the treatment ...

Methods The cross - sectional survey included 124 patients with RA (male to female ratio 4,4:1), mean age 49,4 [44; 56] years, mean duration of disease ranged from 3 months to 41 years (10,8 [3,5;13]). RA diagnosis based on ACR/EULAR criteria of 2010. Pain was recorded using a visual analog scale (VAS). Chronic pain Coping Questionnaire was used in determing coping strategies. Patients were divided into 2 groups: the 1st group included patients that took NSAID daily, the 2nd group - patients that used NSAID every 2-3 days or less. DAS 28 in both groups corresponded to the high activity of RA (5,65 [5,15; 6,4] vs 5,16 [4,4; 5,64]), p,0,05. The significance of differences was determined by Mann - Whitney test, differences were considered significant at p,0,005. ...

VAS = visual analogue scale, NRS = numerical rating scale, RDQ = Roland Morris Disability Questionnaire, ODI = Oswestry Disability Index, QBDQ = Quebec Back Pain Disability Questionnaire. Strategie voor zoeken en selecteren van literatuur. Er werd eerst oriënterend gezocht naar klinisch relevante verschillen bij rugpijn bij uitkomsten als pijn (gemeten met Visual Analogue Scale, VAS of numerical rating scale, NRS), kwaliteit van leven (gemeten met EQ-5D) en functionaliteit (gemeten met Roland Morris Disability Questionnaire, Oswestry Disability Index of Quebec Back Pain Disability Questionnaire). Vervolgens werd er voor de afzonderlijke uitgangsvragen aan de hand van specifieke zoektermen gezocht naar gepubliceerde wetenschappelijke studies in het Engels en Nederlands in de elektronische databases Medline (OVID) en Embase (Embase.com) over de periode 1990- juni 2011. De zoekstrategieën zijn te vinden in bijlage 1. Tevens werd er aanvullend handmatig gezocht naar studies in de referentielijsten ...

TY - JOUR. T1 - Effect of roptrotherapy on pressure pain thresholds in patients with non-specific low back pain.. AU - Farasyn, Andre. AU - Meeusen, Romain. PY - 2007. Y1 - 2007. N2 - *To investigate 1. the pressure pain thresholds [PPTs] with respect to low back pain related muscles, and to the M. Triceps brachii as an muscle unrelated to lower back region; 2. to explore the effect of several weekly deep cross-friction massage sessions [roptrotherapy] on PPTs, pain sensitivity and disability in order to verify the model of central sensitization. Methods: Sixty-five consecutive patients with subacute1 non-specific low back pain [nLBP] were allocated in this clinical trial. The primary outcome measures were the PPTs of levels L1, L3, L5 of the M. Erector spinae and the M. Gluteus maximus. The middle of the left M. Triceps brachii was chosen as a neutral measuring point which is unrelated to nLBP. In addition, pain rating and disability variables were examined. In order to establish reference ...

Case pain visual analog score persisted above 10 mm, patient was rejected and the same bupivacaines concentration was administered to the next patient.. Bupivacaines minimum analgesic concentration was calculated by Massey and Dixons formula 8.. Upper sensory block level and Bromage scores were compared between effective and ineffective concentrations by Mann-Whitney test. Significance level was established to 5%.. RESULTS. Demographics data of both samples are shown in table I.. Study I. Figure 1 shows the responses to different bupivacaine concentrations. Bupivacaines MAC-LA could not be calculated because data did not meet essential Massey and Dixon formulas requirements. There were 6 effective responses, 15 ineffective and 7 rejections. Mean bupivacaine concentration in this sample was 0.18% ±0.05%. Mean effective bupivacaine concentration was 0.19% ±0.07% and mean ineffective concentration was 0.18% ±0.055% (p,0.05). Median pain visual analog score (extremes) before bupivacaine ...

The study was conducted at the Toronto University Health Network in the Diabetic Neuropathy Research Clinic from October 2000 to February 2001. Approval from the University Health Network Research Ethics Board was obtained before commencing the study. Informed consent was obtained from each subject before enrollment.. A total of 50 patients with painful DSP were enrolled in the study. Eligible patients included men or women aged ≥18 years who had DSP for at least 3 months. Diagnosis of DSP was based on the Toronto Clinical Neuropathy Score (Table 1). It was required that pain be present in both feet and significant enough to score ≥4 on the visual analog scale (VAS) of the Short-Form McGill Pain Questionnaire (SF-MPQ) (14). The use of analgesic or adjuvant analgesic medications (e.g., opiates, antidepressants, anticonvulsants, local anesthetics) was allowed but was unchanged for at least 4 weeks before entering the study and for the duration of the study. Patients were excluded from the ...

TY - JOUR. T1 - Comparative Ability of the Pain Disability Questionnaire in Predicting Health Outcomes. AU - Lippe, Ben. AU - Gatchel, Robert J.. AU - Noe, Carl. AU - Robinson, Richard. AU - Huber, Elizabeth. AU - Jones, Stephanie. PY - 2016/6/1. Y1 - 2016/6/1. N2 - As chronic pain contributes to tremendous personal and societal costs, efforts at identifying and understanding pain-related disability via the biopsychosocial model have become increasingly important in addressing pain-related health outcomes. This study attempted to compare the predictive ability of the Pain Disability Questionnaire against other established measures in terms of health and pain-related outcomes. The sample consisted of 254 adult chronic pain patients seeking treatment through an interdisciplinary chronic pain management clinic. Participants were administered a battery of assessments including the Pain Disability Questionnaire and other established measures of health and pain-related outcomes (e.g., NIH PROMIS ...

The majority of women recover from pregnancy-related lumbopelvic pain within 3 months of delivery. Since biomechanical and hormonal changes from pregnancy are largely reversed by 3 months postpartum, consequently, it is assumed that other factors might interfere with recovery. Relative to the fear-avoidance model and with reference to previous studies, we chose to investigate some pre-decided factors to understand persistent lumbopelvic pain. The evaluation of lumbopelvic pain postpartum is mostly based on self-administered questionnaires or interviews. Clinical classification of the lumbopelvic pain may increase our knowledge about postpartum subgroups. Two hundred and seventy-two consecutively registered pregnant women evaluated at 3 months postpartum, answered questionnaires concerning disability (Oswestry disability index), pain intensity on visual analog scale, health-related quality of life (HRQL, EQ5D), activity level, depressive symptoms (Edinburgh postnatal Depression Scale) and ...

article{0b9ce1d6-6757-49b9-aeef-85083886f46c, abstract = {Inguinal hernia repair is associated with a 5%-30% incidence of chronic pain, but the pathogenesis remains unknown. We therefore evaluated pain and sensory dysfunction by quantitative sensory testing 6-12 mo after open herniorrhaphy. Before sensory testing, all patients (n = 72) completed a short-form McGill Pain Questionnaire and a functional impairment questionnaire. Sensory dysfunction in the incisional area was evaluated by quantification of thermal and mechanical thresholds, by mechanical pain responses (von Frey/pressure algometry), and by areas of pinprick hypoesthesia and tactile allodynia. The incidence of chronic pain was 28% (20 of 72). Quantitative sensory testing and pressure algometry did not demonstrate differences between the pain and nonpain groups, except for a small but significant increase in pain response to von Frey hair and brush stimulation in the pain group. Hypoesthesia, or tactile allodynia, in the incisional ...

Background - Cerebral vasomotor reactivity, defined as the cerebral vasculature response to hypoxia, is not wellunderstood in fibromyalgia (FM) patients. This study investigated the difference in the cerebrovascular reactivity (i.e., responsiveness to hypercapnia was evaluated by use of breath- holding index) to the breath-holding index (BHI) between patients with fibromyalgia and a group of normal controls. Methods - The study included 40 FM patients and 40 healthy subjects. Cerebrovascular reactivity was evaluated using the BHI, which is a nonaggressive, well-tolerated, real-time, reproducible screening method to study cerebral haemodynamics. Insonation depth and basal velocity were symmetrical and not significantly different between the two groups (p|0.05). All patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), visual analogue scale (VAS), and the somatization subscale of the SCL-90-R symptom checklist. Results - The BHI ranged from

TY - JOUR. T1 - Reliability and validity of a visual analog scale for acute abdominal pain in the ED. AU - Gallagher, E. John. AU - Bijur, Polly E.. AU - Latimer, Clarke. AU - Silver, Wendy. PY - 2002/1/1. Y1 - 2002/1/1. N2 - The objective of the study was to assess the validity and reliability of the visual analog scale (VAS) in the measurement of acute abdominal pain, and to identify the minimum clinically significant difference in VAS scores among patients with acute abdominal pain. The study was undertaken in preparation for a randomized clinical trial of opioid use in acute abdominal pain. A prospective, observational cohort study of a convenience sample of patients presenting to 2 urban EDs with the chief complaint of acute abdominal pain was conducted. At time 0 and 1 minute later each subject indicated pain severity on a 100mm VAS. This was repeated every 30 minutes for 2 hours. Patients were also asked to contrast their current pain severity with their pain in the preceding 30 minutes ...

Its estimated that about one-in-seven adults in the United States have chronic low back pain (lasting longer than three months), which can have a major effect on ones ability to carry out their daily activities. As such, its important to identify which factors may be associated with an increased risk for progressing from acute low back pain to chronic low back pain.. A systematic review published in 2020 reported that 26% of patients who seek treatment for new-onset low back pain will still have back pain three months later, and a third of these patients will continue to have low back pain at the six-month mark.. A February 2021 study reviewed data concerning 5,233 acute low back pain and found that 32% transitioned into chronic low back pain. Further analysis identified the following risk factors for chronic low back pain: smoking; obesity; severe initial disability; depression/anxiety; and a high score on the STarT Back screening tool, which looks at nine specific items (pain referred to ...

OBJECTIVES: To determine the efficacy of a complementary analgesic modality, percutaneous electrical nerve stimulation (PENS), for the treatment of chronic low back pain (CLBP) in community-dwelling older adults. DESIGN: Randomized, controlled clinical trial. SETTING: University of Pittsburgh Pain Evaluation and Treatment Institute. PARTICIPANTS: Thirty-four English speaking, community-dwelling adults aged 65 and older with CLBP of at least moderate intensity experienced every day or almost every day. INTERVENTION: Subjects were randomized to receive twice-weekly PENS and physical therapy (PT) or sham PENS and physical therapy for 6 weeks. MEASUREMENTS: At baseline, immediately after the 6-week intervention period, and 3 months later, the primary outcome measures pain intensity and pain-related disability were assessed. The secondary outcome measures physical performance (timed chair rise, functional reach, gait speed, static and isoinertial lifting), psychosocial factors (mood, sleep, and life ...

TY - JOUR. T1 - Postoperative Pain and Wound Healing After Coblation-Assisted Barbed Anterior Pharyngoplasty (CABAPh). T2 - An Observational Study. AU - Rinaldi, Vittorio. AU - Costantino, Andrea. AU - Moffa, Antonio. AU - Cassano, Michele. AU - Mantovani, Mario. AU - Casale, Manuele. AU - Pignataro, Lorenzo. PY - 2019. Y1 - 2019. N2 - Despite the numerous progresses in the palatal surgery, one of the critical aspect of snoring and OSA surgery is the postoperative pain. Over the last decades several surgical palatal procedures have been proposed. Our aim was to evaluate the tolerability of the coblation-assisted barbed anterior pharyngoplasty (CABAPh) in terms of postoperative pain and wound healing, compared with bipolar assisted barbed anterior pharyngoplasty (BAPh). An observational study on 20 patients with simple snoring was conducted. The outcomes measured to assessing pain were a 10 cm visual analog scale (VAS) and the dose of paracetamol + codeine administrated postoperatively. The wound ...

Evidence on management of low back pain. Recently, van Tulder and collegues have published a series of reviews on evidence about effectiveness of conservative treatments in acute and chronic low back pain (1999). The systematic reviews were performed according to high methodological standards. Many different treatment modalities are studied. To summarise, in persisting back pain problems (duration longer than 6 weeks) an activating approach is useful, e.g. with exercise. Prevention of chronicity is the most important treatment goal in this phase. In longlasting, chronic back pain disability the use of multidisciplinary programmes can be helpful.. A new clinical model of low back pain and disability. In 1987 Waddell described a new clinical model for the treatment of low back pain. This model is also well presented in the book The Back Pain Revolution . Starting from the disease model other important elements is the development of chronic disablity are described and incorporated in a more ...

TY - JOUR. T1 - Measuring pain intensity in patients with neck pain. T2 - Does it matter how you do it?. AU - Kamper, Steven J.. AU - Grootjans, Sanneke J.M.. AU - Michaleff, Zoe A.. AU - Maher, Christopher G.. AU - Mcauley, James H.. AU - Sterling, Michele. PY - 2015/2/1. Y1 - 2015/2/1. N2 - The aim of this study was to investigate whether variations in the way that pain intensity is measured in patients with neck pain influences the magnitude of pain ratings. The study uses data from 3 longitudinal studies (n = 361 at baseline) on people with neck pain due to whiplash injuries. Pain measures included verbal rating scales, numerical rating scales and a visual analog scale. Different measures asked patient to rate current pain, average pain over 24 hours, over 1 week, or over 4 weeks. Scores were converted to a 0-100 scale and tracked over time, correlations between measures were calculated. Mixed models regression was used to explore the factors which influenced the differences between scores ...

The purpose of the present study was to investigate the influence of the evaluation technique on the outcome of the Cloward procedure in cervical radiculopathy. The retrospective study included 94 consecutive patients operated on with anterior decompression and fusion with heterologous bone (Surgibone, Unilab). There were 56 men and 38 women, with a mean age of 48 years (range 27-78 years). Sixty-six patients had a single-level fusion, 26 a two-level fusion and one patient had a three-level fusion. The follow-up rate was 91/94 (97%) and evaluation was performed by an independent observer. Pain was quantified by visual analogue scale (VAS, range 0-100), functional disability by the new functional index Cervical Spine Functional Score (CSFS, range 0-100) and by the Neck Pain Disability Index (NPDI, range 0-100). The overall clinical outcome was assessed as excellent, good, fair or poor by both the patient and by the independent observer using Odoms criteria. At a mean follow-up of 26 months ...

Results: In the care units, practical nurses were working alone in shifts (evening, night shifts) were equally responsible in pain assessment with the register nurses. The data analysed produced eleven themes. Seven themes were developed under the nurses approaches in pain assessment: Facial, body language and vocal as pain assessment, Physiological changes as pain indicator, non-medical approach, terminal illness as pain indicator, relatives information as work force, knowledge on individual needs, medical history as pain assessment and the remaining four themes consisted under the factors affected in pain assessment were education role, lack of documentation, communication as a barrier in pain assessment, and pain tools in pain assessment. Behaviour and psychological approaches were not mentioned(separately) as possible pain indicators. It was considered more as a dementia process than pain related. Which was discussed under the communication barrier. Theses experience of nurses showed the ...

Purpose: We evaluated the effectiveness of microsurgical ligation for painful varicocele and predictive factors of pain resolution. Materials and Methods: Between January 2006 and March 2009, a total of 114 patients (mean age, 30.2 +/- 18.9 years), who underwent microsurgical inguinal varicocelectomy for painful varicocele, were included and followed up for 1 year after the surgery. The quantity of preoperative and postoperative pain was assessed by means of 11-point numeric rating scale (NRS). We retrospectively analyzed the outcome of surgical ligation and predictive factors of pain resolution using patient age, height, weight, body mass index, grade and location of varicocele, duration, quantity and quality (dull, dragging, aching) of pain, and postoperative pain resolution. Results: In 104 patients (91.2%), complete or marked resolution of pain was reported at follow-up I year after surgery. Only 10 patients (8.8%) had recurrent or persistent pain (,= 3 points in NRS scores). On multivariate ...

Mohn, Christine; Vassend, Olav & Knardahl, Stein (2012). Cardiovascular responses to and modulation of pressure pain sensitivity in normotensive, pain-free women. Scandinavian Journal of Pain. ISSN 1877-8860. 3(3), s 165- 169 . doi: 10.1016/j.sjpain.2011.12.001 Vis sammendrag Background and purpose: The psychophysiological responses to and modulation of pressure pain stimulation are relatively new areas of investigation. The aims of the present study were to characterize subjective and cardiovascular (CV) responses to pressure pain stimulation, and to examine the relationship between CV responding and pain pressure pain sensitivity. Methods: Thirty-nine pain-free, normotensive women were included in the study and tested during the follicular phase of their menstrual cycles. Pain threshold and tolerance were recorded at the right masseter muscle and the sternum, and visual analogue scales (VAS) were used to rate both pain intensity (the sensory dimension) and discomfort (the affective dimension). ...

TY - JOUR. T1 - Ultrasound imaging for the rheumatologist XXIX. Sonographic assessment of the knee in patients with osteoarthritis. AU - Iagnocco, A.. AU - Meenagh, G.. AU - Riente, L.. AU - Filippucci, E.. AU - Delle Sedie, A.. AU - Scirè, C. A.. AU - Ceccarelli, F.. AU - Montecucco, C.. AU - Grassi, W.. AU - Bombardieri, S.. AU - Valesini, G.. PY - 2010. Y1 - 2010. N2 - Objective. To investigate the prevalence and severity of sonographic-detected abnormalities in knee osteoarthritis (OA) and to correlate ultrasound (US) findings with clinical data. Methods. Outpatients with chronic, painful knee OA according to the ACR criteria were consecutively recruited and underwent clinical and US examinations. An expert rheumatologist recorded the presence of knee joint pain, swelling and tenderness, patients global assessment of knee pain using visual analogue scale (VAS), and Lequesne Index of severity for knee OA.A second rheumatologist, blinded to the clinical data, performed the knee US ...

There is evidence from animal studies that serotonin (5-HT) can influence the antinociceptive effects of opioids at the spinal cord level. Therefore, there could be an influence of genetic polymorphisms in the serotonin system on individual variability in response to opioid treatment of pain. The serotonin transporter (5-HTT) is a key regulator of serotonin metabolism and availability and its gene harbors several known polymorphisms that are known to affect 5-HTT expression (e.g. 5-HTTLPR, rs25531). The aim of this study was to investigate if the triallelic 5-HTTLPR influences pain sensitivity or the analgesic effect of opioids in humans. 43 healthy volunteers (12 men, 31 women, mean age 26 years) underwent heat pain stimulations before and after intravenous injection of Remifentanil; a rapid and potent opioid drug acting on μ-type receptors. Subjects rated their perceived pain on a visual analogue scale (VAS). All participants were genotyped for the 5-HTTLPR and the rs25531 polymorphism. We recruited

TY - JOUR. T1 - Clinical validation of FLACC. T2 - preverbal patient pain scale.. AU - Manworren, Renee C B. AU - Hynan, Linda S.. PY - 2003. Y1 - 2003. N2 - PURPOSE: To test the validity of the Faces, Legs, Activity, Cry and Consolability (FLACC) pain assessment tool by measuring changes in scores in response to analgesics. METHOD: METHODS: Pediatric nurses used the FLACC scale to assess pain in 147 children under 3 years of age who were hospitalized in the pediatric intensive care unit (PICU), post-anesthesia care unit (PACU), surgical/trauma unit, hematology/oncology unit, or infant unit. FLACC is an observational tool for quantifying pain behaviors. Facial expression, leg movement, activity, cry, and consolability are each scored 0-2, for a total FLACC score of 0-10. The FLACC measurements were done pre-analgesia, at predicted onset of analgesia, and at predicted peak analgesia. FINDINGS: Pre-analgesia FLACC scores were significantly higher than post-analgesic scores and significantly higher ...

Approximately 33% of the patients with lumbar spinal stenosis (LSS) who undergo surgery are not satisfied with their postoperative clinical outcomes. Therefore, identifying predictors for postoperative outcome and groups of patients who will benefit from the surgical intervention is of significant clinical benefit. However, many of the studied predictors to date suffer from subjective recall bias, lack fine digital measures, and yield poor correlation to outcomes. This study utilized smart-shoes to capture gait parameters extracted preoperatively during a 10 m self-paced walking test, which was hypothesized to provide objective, digital measurements regarding the level of gait impairment caused by LSS symptoms, with the goal of predicting postoperative outcomes in a cohort of LSS patients who received lumbar decompression and/or fusion surgery. The Oswestry Disability Index (ODI) and predominant pain level measured via the Visual Analogue Scale (VAS) were used as the postoperative clinical outcome

Spinal cord injury related neuropathic pain has proven to be largely refractory to analgesic medications & other treatments. Alpha-Stim has been effective.

Methods Forty patients with chronic low back pain randomly divided into two groups of 20 patients. 20 patients in the first group received low-energy laser + exercise treatment, other group received low-energy laser treatment alone. The parameters such as pain and muscle strength were assessed in all patients pretreatment and posttreatment. Pain measurement was done using the visual anologue scale. Muscle strength measurement (m. rectus abdominus, oblicus, hip abductors, hip adductors, extensors and internal rotators, knee flexors and extansors, foot flexors and extansors, and dorsal extansors) was done using the manual muscle strength testing. ...

Pain Assessment in Impaired Cognition (PAIC): content validity of the Dutch version of a new and universal tool to measure pain in dementia Annelore H van Dalen-Kok,1 Wilco P Achterberg,1 Wieke E Rijkmans,1 Sara A Tukker-van Vuuren,1 Suzanne Delwel,2,3 Henrica CW de Vet,4 Frank Lobbezoo,2,5 Margot WM de Waal1 1Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, 2Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, 3Department of Clinical Neuropsychology, Faculty of Behavioral and Movement Sciences, VU University, 4Department of Epidemiology and Biostatistics, The EMGO Institute for Health and Care Research, VU University Medical Center, 5MOVE Research Institute Amsterdam, VU University, Amsterdam, the Netherlands Objectives: Detection and measurement of pain in persons with dementia by using observational pain measurement tools is essential. However, the evidence for the psychometric

The first objective of this study is to evaluate the efficacy of intramuscular administration of VM202 in subjects with painful diabetic peripheral neuropathy in the lower extremities, when compared to placebo, on pain.. The second objective of the study is to evaluate the safety of intramuscular injections of VM202 in subjects with painful DPN in lower extremities.. The sample size for the primary efficacy endpoints is calculated based on the hypothesis for the primary efficacy endpoints. The primary efficacy endpoints are as follows:. 1. The change in the average pain score from baseline to the 3-month follow-up obtained from the Daily Pain and Sleep Interference Diary.. 2. The outcome of at least 50% reduction (i.e. ≥ 50%) in the average pain score from baseline to the 3-month follow-up obtained from the Daily Pain and Sleep Interference Diary.. ...

Twenty patients undergoing elective cholecystectomy were prospectively randomised to receive either intrapleural (bolus 20 ml followed by 10 ml/h) or thoracic epidural (bolus 9 ml followed by 5 ml/h) bupivacaine 0.5% for 8 h postoperatively to assess the effect of these two techniques on pain, pulmonary function and the surgical stress response. As assessed by the visual analogue scale (VAS), both groups received good but not total pain relief. Both groups had a 50% reduction in forced expiratory volume (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) after operation, and there was no observed effect on the stress response as measured by plasma glucose and cortisol. It is concluded that while both techniques provide good analgesia, the degree and extent of nerve blockade are not sufficient to affect the afferent neurogenic stimuli responsible for the observed effects on pulmonary function and the stress response ...

1. The aim of this study was to establish a simple and reliable experimental pain model that could distinguish the analgesic effects of non-steroidal anti-inflammatory drug (NSAID) treatment from placebo in human volunteers. 2. The reproducibility and reliability over time of subject pain ratings was compared using cutaneous electrical stimuli applied to either the thenar eminence or the ear lobe at varying intensities and modes. Subjects were asked to respond firstly, when the stimulus became clearly sharp and painful (first pain) and secondly, when the sensation became deep and burning and no further increase in stimulus intensity could be tolerated (second pain). 3. Constant voltage stimuli were found to be more reproducible than constant current stimuli. Both phasic (intermittent) and tonic (continuous) stimulation modalities produced first and second pain sensations. The latter sensation was more reproducible, and was perceived as a burning pain which is akin to clinical pain. 4. Analgesics

The aims of this study were to assess the predictive relationship between activity and disability at 3 months in a sub-acute LBP population. This prospective cohort study recruited 101 consenting patients with sub-acute LBP (, 6 weeks) who completed the Roland Morris Disability Questionnaire (RMDQ), the Visual Analogue Scale, and resumption of full normal activity question (Y/N), at baseline and 3 months. Physical activity was measured for 7 days at both baseline and at 3 months with an RT3 accelerometer and a recall questionnaire ...

The management of your pain is of great importance to us. We will be assessing your level of pain from the time of admission until you receive our postoperative call at home. We need to inform and prepare you for each step of the process. This education will begin with our first contact. You will be repeatedly asked to rate your pain from a numerical scale called the Visual Analog Pain Scale, or for children, the Faces Pain Scale. Using the results of our communication we will alter the therapy as needed in order to assure your comfort.. The management of your pain will be taken very seriously. We will often use a combination of different modalities to help make you comfortable, choosing from oral medications, intravenous medications, nerve blocks, injection of local anesthetic during the surgery, etc. Prior to the surgery, the management of your pain should be discussed with both your anesthesiologist and surgeon. Please feel free to bring up any concerns or fears you may have. Remember that ...

BACKGROUND: Thirty-five Cochrane Reviews of randomised trials testing the analgesic efficacy of individual drug interventions in acute postoperative pain have been published. This overview brings together the results of all those reviews and assesses the reliability of available data. OBJECTIVES: To summarise data from all Cochrane Reviews that have assessed the effects of pharmaceutical interventions for acute pain in adults with at least moderate pain following surgery, who have been given a single dose of oral analgesic taken alone. METHODS: We identified systematic reviews in The Cochrane Library through a simple search strategy. All reviews were overseen by a single Review Group, had a standard title, and had as their primary outcome numbers of participants with at least 50% pain relief over four to six hours compared with placebo. For individual reviews we extracted the number needed to treat (NNT) for this outcome for each drug/dose combination, and also the percentage of participants achieving

Presented by: Dr. Vitaly Napadow, Professor in Radiology, Harvard Medical School, USA ​. Abstract: Pain catastrophizing is prominent in chronic pain conditions such as fibromyalgia, and has been proposed to contribute to the development of pain widespreadness. However, the brain mechanisms responsible for this association are unknown. We hypothesized that increased resting Salience Network (SLN) connectivity to nodes of the Default Mode Network (DMN), representing previously reported pain-linked cross-network enmeshment, would be associated with increased pain catastrophizing and widespreadness across body sites.We applied functional Magnetic Resonance Imaging (fMRI) and digital pain drawings (free-hand drawing over a body outline, analyzed using conventional software for multivoxel fMRI analysis) to investigate precisely-quantified measures of pain widespreadness and the associations between pain catastrophizing (Pain Catastrophizing Scale, PCS), resting brain network connectivity ...

An evaluation of two different methods of coccygectomy in patients with traumatic coccydynia Hasan Ulas Ogur, Firat Seyfettinoğlu, Ümit Tuhanioğlu, Hakan Cicek, Sefa Zohre Department of Trauma and Orthopedics, Adana Numune Training and Research Hospital, Adana, Turkey Purpose: The aim of this study was to evaluate the results of partial and total coccyx excisions in patients with traumatic coccydynia resistant to conservative treatment.Patients and methods: The study included 22 patients (from a total of 27) who underwent partial or total coccygectomy because of persistent coccydynia between December 2007 and January 2014. There were 15 females and 7 males with a mean age of 33.6 years (range 23–46 years). Partial coccygectomy was performed in 14 patients and total coccygectomy in 8. They were evaluated according to their pre- and postoperative visual analog scale (VAS) scores. The mean follow-up period was 28 months (range 16–48 months).Results: The mean VAS scores in the total

INTRODUCTION: Three clinical scales (the Nociception Coma Scale adapted for Intubated patients [NCS-I], its Revised version [NCS-R-I], and the Behavioral Pain Scale [BPS]) and videopupillometry were compared for measuring pain in intubated, noncommunicating, critically ill, brain-injured patients. METHODS: Pain assessment was performed before, during, just after, and 5 minutes after 3 procedures: the reference non-nociceptive procedure (assessment of the Richmond Agitation Sedation Scale) and 2 nociceptive procedures (turning and tracheal suctioning). The primary endpoint was construct validity (discriminant and criterion validation), determined by comparing pain measurements between different times/procedures. Secondary endpoints were internal consistency, inter-rater reliability, and feasibility. RESULTS/DISCUSSION: Fifty patients (54% women, median age 63 years [56-68]) were included 13 [7-24] days after brain injury (76% hemorrhagic or ischemic strokes). All tools increased significantly more (p|0

|i|Objective|/i|. To evaluate the effectiveness of a whole-foods, plant-based diet (WFPB) to reduce symptoms of osteoarthritis. |i|Methods|/i|. Six-week, prospective randomized open-label study of patients aged 19–70 with osteoarthritis. Participants were randomized to a WFPB (intervention) or continuing current diet (control). Outcomes were assessed by mixed models analysis of participant self-assessed weekly SF-36v2 domain t scores, weekly Patient Global Impression of Change (PGIC) scales, and mean weekly Visual Analog Scale (VAS) pain assessment. Mixed models analysis also evaluated pre-post change from baseline level for standard clinical measures: weight, BMI, body temperature, pulse, and blood pressure. |i|Results|/i|. Forty participants were randomized. Thirty-seven of them, 18 control and 19 intervention, completed the study. The intervention group reported a significantly greater improvement than the control group in SF-36v2 energy/vitality, physical functioning, role physical, and the

Needle fear is a common problem in children undergoing immunization. To ensure that the individual childs needs are met during a painful procedure it would be beneficial to be able to predict whether there is a need for extra support. The self-reporting instrument facial affective scale (FAS) could have potential for this purpose. The aim of this study was to evaluate whether the FAS can predict pain unpleasantness in girls undergoing immunization. Girls, aged 11-12 years, reported their expected pain unpleasantness on the FAS at least two weeks before and then experienced pain unpleasantness immediately before each vaccination. The experienced pain unpleasantness during the vaccination was also reported immediately after each immunization. The level of anxiety was similarly assessed during each vaccination and supplemented with stress measures in relation to the procedure in order to assess and evaluate concurrent validity. The results show that the FAS is valid to predict pain unpleasantness ...

The 35 patients (15 male and 17 female, average age of 43.4 years) were treated between 1999 and 2002. Of these, 32 patients (with 35 discs) were followed up to 11 years after treatment. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used for clinical outcomes.. From baseline to 11-year follow up, patient VAS scores fell from 8.5 to 1.46 (p=0.0015) and ODI scores fell from 41.36 to 13.21 (p=0.0047). Hai said that 28 patients (87.5%) had a successful clinical outcome.. Seven patients had a range of motion of less than 2 degrees at 11 years and the mean of the remaining 28 prostheses was 5.4 degrees. Upper adjacent level range of motion decreased from 6.7 degrees to 5.2 degrees (p=0.0143) and lower adjacent level range of motion decreased from 4.5 degrees to 2.4 degrees (p=0.0027). Intervertebral disc height of the index level decreased by 2.1mm compared with preoperative height (p=0.061), and intervertebral disc heights were not significantly affected (p=0.21).. There were ...

Background: The pharmacokinetics and analgesic effects of intravenous and rectal paracetamol were compared in nonventilated infants after craniofacial surgery in a double-blind placebo controlled study. Methods: During surgery all infants (6 months-2 years) received a rectal loading dose of 40 mg·kg-1paracetamol 2 h before anticipated extubation. On admittance to the pediatric surgical ICU, the children were randomized to receive either a 15 min intravenous infusion of 40 mg·kg-1propacetamol, a prodrug of paracetamol, or 20 mg·kg-1paracetamol rectally every 6 h. A population pharmacokinetic analysis of the paracetamol plasma concentration time-profiles was undertaken using nonlinear mixed effects models. The visual analogue scale (VAS) (score 0-10 cm) and COMFORT Behavior scale (score 6-30) were used to monitor analgesia in the 24-h period following surgery. Results: Twelve infants received intravenous propacetamol and 14 paracetamol suppositories. Paracetamol pharmacokinetics were described ...

Author(s): Ibrahim, John M; Singh, Paramjit; Beckerman, Daniel; Hu, Serena S; Tay, Bobby; Deviren, Vedat; Burch, Shane; Berven, Sigurd H | Abstract: Study Design:Retrospective case series. Objectives:Both the rate and complexity of spine surgeries in elderly patients has increased. This study reports the outcomes of multilevel spine fusion in elderly patients and provides evidence on the appropriateness of complex surgery in elderly patients. Methods:We identified 101 patients older than70 years who had ≥5 levels of fusion. Demographic, medical, and surgical data, and change between preoperative and >500 days postoperative health survey scores were collected. Health surveys were visual analogue scale (VAS), EuroQoL 5 Dimensions (EQ-5D), Oswestry Disability Index (ODI), Scoliosis Research Society questionnaire (SRS-30), and Short Form health survey (SF-12) (physical composite score [PCS] and mental composite score [MCS]). Minimal clinically important differences (MCIDs) were defined for each survey.

TY - JOUR. T1 - Pain assessment in dementia. T2 - Evaluation of a point-of-care technological solution. AU - Atee, Mustafa. AU - Hoti, Kreshnik. AU - Parsons, Richard. AU - Hughes, Jeffery D.. PY - 2017/8/29. Y1 - 2017/8/29. N2 - Pain is common among people with moderate to severe dementia, but inability of patients to self-report means it often goes undetected and untreated. We developed the electronic Pain Assessment Tool (ePAT) to address this issue. A point-of-care App, it utilizes facial recognition technology to detect facial micro-expressions indicative of pain. ePAT also records the presence of pain-related behaviors under five additional domains (Voice, Movement, Behavior, Activity, and Body). In this observational study, we assessed the psychometric properties of ePAT compared to the Abbey Pain Scale (APS). Forty aged care residents (70 females) over the age of 60 years, with moderate to severe dementia and a history of pain-related condition(s) were recruited into the study. Three ...

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Dr. Beth: Many chronic pain conditions, such as autoimmune conditions, migraine and fibromyalgia, are up to 10 times more common in women. So women are simply more likely to acquire chronic pain than men.. Once women have chronic pain, they suffer more from it than men. Research shows women experience pain more frequently, severely, and for a longer duration than men do.. There are many reasons why women have more pain than men. Sex/gender differences in hormones, pain processing, and psychological factors known to influence pain (such as cognition, anxiety, depression and history of abuse) are just a few known reasons.. Pain becomes more common as we age and menopause is known to worsen chronic pain due to hormonal changes. Also, women live longer than men and thus have more years of life to experience pain!. There is growing need to better understand pain in women and how to best treat it. I believe the future of the field of pain medicine is sex-specific pain treatment (medical and ...