Pain
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This study compared 47 patients with chronic low back pain who were involved in personal injury litigation with 33 patients not seeking compensation who were also complaining of low back pain. Pain was assessed using a visual analogue scale and the adjectival check-list of the McGill Pain Questionnaire. Psychological state was assessed using the Zung Depression Scale, the State-Trait Anxiety Inventory, the Eysenck Personality Inventory and the Hostility and Direction of Hostility Questionnaire. ⋯ There was no difference between the two groups on ratings of pain severity or pain description, and no difference on measures of psychological disturbance. Both groups had significant elevations of mean depression, neuroticism, state anxiety and trait anxiety scores when compared with the normal population. It was concluded that there is no support for the claim that personal injury litigants describe their pain as more severe than do non-litigants, and that both groups show similar levels of psychological disturbance.
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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.