Pain
-
Eighteen patients with chronic musculoskeletal pain completed a trial of EMG feedback where each subject was exposed to biofeedback, a control condition and a waiting list. Pain scores were determined pre- and posttrial, and the percentage change calculated for each subject. EMG activity and present pain measured during the trial gave an EMG/pain correlation for each patient. ⋯ In addition, patients with high EMG/pain correlations had a better outcome and this measure also correlated with pain scores. The relationship between self-concepts and EMG/pain correlations is discussed. The Illness Self-Concept Repertory Grid appears capable of predicting treatment outcome and shows promise as a prognostic tool.
-
Visual analogue scales (VAS) of different lengths (5, 10, 15 and 20 cm) and with different end-phrases (troublesome, miserable, intense, unbearable and worst pain imaginable) were used to record pain in 50 male and 50 female patients with pulpitis or pericoronitis. All 100 patients successfully completed the questionnaire. High correlation was found between the scores on all the scales. ⋯ The scale with the end-phrase 'worst pain imaginable' was found to be the best choice for comparing present pain or worst pain between different groups. Using this scale no significant difference was found between the scores of males and females or between those of patients with pulpitis and pericoronitis. This study suggests the use of 10 cm visual analogue scales with the end-phrase 'worst pain imaginable' as being the most suitable for measuring dental pain.
-
Sixty-two patients with intractable pain secondary to cancer of the pelvic organs were managed with intrathecal injections of morphine. Forty-six patients experienced pain relief from an initial test dose that ranged from 0.5 to 2.0 mg. In order to provide long-term pain relief, these 46 patients were further treated with repeated single injections (14 patients), external catheter (28 patients), or implanted pump (4 patients). ⋯ When side effects developed, they were generally itching, sphincter disorder and somnolence. No serious respiratory depression was noted. Intrathecal morphine offers a hopeful alternative to systemic narcotics or ablative neurosurgical procedures in the management of terminal cancer pain.
-
Two patients with severe thalamic pain and one patient with causalgia from the shoulder-hand syndrome are described whose pain was markedly improved or abolished by anticholinesterase drugs. Both short-acting parenteral and oral anticholinesterase preparations were employed. Anticholinesterase drugs are a new and potentially valuable approach to the treatment of chronic pain.