Pain
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The practice and theoretical basis of pain measurement is reviewed and critically examined in the areas of animal research, human subjects laboratory investigation and clinical study. The advantages and limitations of both physiological and behavioral methods are discussed in each area, and subjective report procedures are evaluated in human laboratory and clinical areas. The need for procedures that bridge these areas is emphasized and specific issues are identified. Progress in the technology of pain measurement over recent decades is reviewed and directions for future work are suggested.
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Low back pain and sciatica have been treated with peridural local anesthetics for over 80 years and with epidural and subarachnoid steroid injections for a quarter of a century. This review surveyed the literature concerning the evolution, pathophysiology, complications and results of this type of therapy. The volume injected and the method used vary with different physicians and no standard has been established. ⋯ It is the authors' opinion that the rationale for the use of spinal local analgesics or steroids or intramuscular steroids has not been scientifically proven. Complications with the use of subarachnoid steroids are sufficiently serious that this form of therapy should be condemned. In this age of accountability it is imperative that therapies with questionable benefits should be critically evaluated.
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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. ⋯ 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.