Pain
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To help clarify the nature of coping activities in chronic pain, this study compared how depressed (n = 37) and non-depressed (n = 40) chronic low back pain (CLBP) patients attempted to cope with pain-specific and general non-pain life stressors, relative to matched healthy control subjects (n = 40). We hypothesized that depressed mood, rather than pain alone, would account for differences in coping activities between groups. Specifically, we expected that depressed CLBP patients would report a greater proportion of passive and avoidant coping responses and less active problem solving coping attempts than non-depressed patients and controls. ⋯ Additionally, subjects across groups tended to report more passive-avoidant coping in response to the specific back pain stressor (i.e., exacerbation of back pain during activity) than to other life stressors. Finally, the magnitude of reported differences in coping attempts across groups varied as a function of the type of stressor (i.e., specific back pain stressor vs. general stressful life events), particularly with regard to a disinclination to seek social support in response to the back pain exacerbation. We conclude that: (1) chronic back pain patients may employ different coping activities when attempting to manage pain exacerbations than when confronting more general life stressors, and (2) an increased rate of passive-avoidant coping responses (relative to matched health controls) is associated with the combination of CLBP and concurrent depressed mood, rather than with CLBP alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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The aim of the study was to evaluate the effects of pre- and postinjury infiltration with lidocaine on alterations in mechanical and thermal sensitivity after heat injury to the skin. In the first part of the study, burn injuries (15 x 25 mm rectangular thermode, 50 degrees C, 7 min) were produced twice in each subject on the medial side of the left and right calves at least 24 h apart in 8 healthy, unmedicated male volunteers, in order to investigate the effects of the injury on sensitivity in untreated skin. In the second part of the study, burn injuries (15 x 25 mm rectangular thermode, 50 degrees C, 6 min) were produced twice in each subject on the medial side of the left and right calves at least 24 h apart (n = 10). ⋯ In the second part of the study, it was observed that pre-injury infiltration with lidocaine reduced hyperalgesia to pinprick and brush outside the injury more effectively than postinjury block, but only for the first 70 min after injury, while no significant difference was observed 100-190 min after injury. Likewise, there was no difference in thermal thresholds inside the injury between pre- and postinjury treatment at the end of the study period. It is concluded, that a shortlasting 'preemptive' infiltration with lidocaine may postpone but not prevent the occurrence of hyperalgesia outside a thermal injury.
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This study examines the incidence of sexual and physical abuse and its relationship to selected pain description and psychological variables in a sample of 36 chronic pelvic pain patients. Abuse was measured on a 6-item reliable scale, and abused and non-abused respondents were compared on 4 categories of variables expected to be related to the effects of abuse (pain description, functional impact of pain, other's response to pain, and psychosocial impact of pain). Results indicated that 19 of 36 patients reported prior abuse. ⋯ No differences between the abused and non-abused groups were noted on demographic, pain description, or the functional interference variables. On the psychological variables, however, the abused group reported less perceived life control, greater punishing responses to pain, and higher levels of somatization and global distress than the non-abused group. These results indicate a high incidence of sexual abuse in patients with chronic pelvic pain and suggest that abused and non-abused patients differ on psychological but not pain description or self-reported functional interference variables.
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Painful diabetic neuropathy is one of the most common complications of insulin-dependent diabetes in man. Conflicting results have been obtained in experimentally diabetic animals subjected to pain stimuli. This work aimed to systematically study the response of rats made diabetic (hyperglycemia > or = 14 mM) by injection of streptozocin (STZ) (75 mg/kg, i.p.), to various pain stimuli: mechanical, thermal (warm and cold) and chemical. ⋯ Spontaneous motor activity of the rats was lowered. This model is thus of interest as the observed reactions to noxious and non-noxious stimuli correspond to hyperalgesia and allodynia, symptoms encountered in painful diabetic neuropathy in man. Operating conditions for this model are discussed.
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Recent research has documented negative effects of chronic pain problems on patients' spouses and children. This study examined the adjustment of children of 35 chronic pain patients, compared with children of 29 healthy controls, and the relationship of specific parental characteristics to child adjustment. Pain group children had significantly more teacher-rated behavior problems and significantly lower teacher-rated social competence than did control group children. ⋯ Patient functional disability was significantly associated with parent-rated child behavior problems, but group membership, patient gender, patient depression, and patient marital satisfaction were not. Child social competence was predicted by patient gender, but was not predicted by patient depression or disability, group membership, or by patient marital satisfaction. The results suggest that children of chronic pain patients may be at risk for adjustment problems.