Pain
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Comparative Study
Two separate components of pain produced by the submaximal effort tourniquet test.
Human subjects could discriminate two separate components of pain during the submaximal effort tourniquet test. Since the effect of several test parameters was different on these two pain components it is suggested that attention would be paid to the discrimination of these pain components in the future studies with this methodology.
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A 41-year-old female developed spontaneous burning pain (causalgia) and stimulus-induced dysesthesia (allodynia) of the dorso-lateral part of her right foot following trauma. An L3 and L4 sympathectomy eliminated the spontaneous burning pain for only 1 year, but did not affect the stimulus-induced dysesthesia. We evaluated her two years post-sympathectomy with grouped sequential anesthetic blocks and sensory testing. ⋯ When sural block was added to the peroneal block the stimulus-induced dysesthesia was eliminated, and sensation in the sural distribution was lost. We conclude that the sural distribution received overalapping innervation for touch and pin-prick perception, but that heat perception, burning pain and the stimulus-induced dysesthesia were sural nerve dependent. Further, we were able to dissociate causalgia pain from allodynia in this patient.
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Endurance to ischaemic pain was assessed in healthy subjects receiving either continuous or trains of transcutaneous electrical nerve stimulation (TENS) at different intensity levels. Control subjects received no stimulation. Self-reports of pain thresholds and pain tolerance levels were obtained, and on-going pain was assessed by means of two linear pain scales. ⋯ High intensity continuous stimulation raised pain tolerances and endurance of pain, but was associated with higher levels of reported pain when tolerance was reached. Low intensity trains of stimulation raised pain thresholds and tolerance levels but did not increase endurance to induced ischaemic pain. Our results suggest that the response to induced ischaemic pain can be selectively modified by peripheral electrical stimulation depending on its temporal and intensity characteristics.
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A study was undertaken to investigate if the concepts pain, ache and hurt differ from each other in intensity and quality and to identify discriminating semantic correlates for each of these concepts. Forty-one nurses with different backgrounds in nursing and 12 patients with chronic pain syndrome were included in the study. The methods used were a questionnaire, the visual analogue scale (VAS), and the McGill Pain Questionnaire (MPQ). ⋯ Pain was shown to have the highest intensity, followed by ache with hurt having the lowest. Semantic correlates consisting of sensory and affective words which best discriminate between the concepts pain, ache and hurt were identified. Semantic correlates for pain were: cutting, crushing, tearing, sharp, dreadful, killing, torturing and suffocating: for ache were: aching, pulling, gnawing, irritating, annoying, troublesome, exhausting, unbearable and terrifying; for hurt were: pricking, pinching, stinging, sore, fearful, unhappy.
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In the present study 366 patients suffering acute or chronic musculoskeletal pain of different origin were given vibratory stimulation for the pain. Many of the patients had previously had treatments of various kinds without satisfactory relief. The effect of vibratory stimulation was assessed during and after stimulation using a graphic rating scale. ⋯ The best pain reducing site was found to be either the area of pain, the affected muscle or tendon, the antagonistic muscle or a trigger point outside the painful area. In most patients the best pain reducing effect was obtained when the vibratory stimulation was applied with moderate pressure. To obtain a maximal duration of pain relief the stimulation had to be applied for about 25-45 min.