Pain
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Dorsal column stimulation was undertaken in 10 patients referred to the Pain Relief Clinic for management of otherwise intractable angina pectoris. All patients were on maximal medical therapy and were determined to be unsuitable for coronary artery revascularization by the referring cardiologists. Dorsal column stimulation was beneficial in all patients by decreasing the frequency and severity of anginal attacks. The mechanism of action of dorsal column stimulation in this condition is uncertain.
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Comparative Study
Ankle joint urate arthritis (AJUA) in rats: an alternative animal model of arthritis to that produced by Freund's adjuvant.
Injection of sodium urate crystals into one ankle joint in the rat produces arthritis which is fully developed within 24 h. The time-course and dose-response of associated inflammation and sensory abnormalities are described. Following intra-articular sodium urate rats reduce the weight placed on the paw of the treated hind limb and develop a limp in their gait. ⋯ Joint pathology is reflected by tissue oedema and the infiltration of polymorphonuclear leucocytes. However, there is no destruction or decrease in density of bone. It is proposed that this model of arthritis may have ethical and scientific advantages over adjuvant arthritis in the study of some aspects of the neural mechanisms of arthritis.
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This study used behavioral assessment techniques to analyze pain in osteoarthritis (OA) patients. Eighty-seven OA patients having chronic knee pain served as subjects. Pain behavior was evaluated using a standard observation method and functional impairment was assessed using the Arthritis Impact Measurement Scales. ⋯ Patients receiving disability support payments were much more functionally limited than those not receiving this financial support. Patients scoring high on the Pain Control and Rational Thinking factor of the CSQ were much less functionally impaired, walked a 5 m course more rapidly and moved from a standing to a sitting or reclining position more quickly than patients scoring low on this factor. The implications of these results for behavioral treatment of OA knee pain are discussed.
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The McGill Pain Questionnaire (MPQ) and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 72 subjects with burning mouth syndrome (BMS) who were also requested to match the levels of their clinical pain to line lengths on a visual analogue scale (VAS) and to experimentally induced warm and painful thermal stimuli. The responses of 102 toothache pain subjects and 43 asymptomatic age- and sex-matched control subjects were used to compare the responses of the BMS subjects on the MPQ and MMPI, respectively. The results indicated that BMS pain is quantitatively similar to, but qualitatively different from, toothache pain, that self-reports of BMS pain appear to be valid, that when compared to the asymptomatic control subjects, BMS subjects show elevations in certain personality characteristics which are similar to those seen in other chronic pain patients, and that these personality disturbances tend to increase with increased pain. Therefore, our findings indicate that the pain of BMS is more severe than has previously been suggested and that the severity of this pain may explain some of the personality changes which occur in the BMS subjects.
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Clinical Trial Controlled Clinical Trial
The development of a German language (Berne) pain questionnaire and its application in a situation causing acute pain.
The adjectives used in the McGill Pain Questionnaire were translated into German. Nine of the 76 adjectives could not be translated satisfactorily. Accordingly, 10 new German adjectives were added by 22 physicians and psychologists, who were also asked to judge the grouping of the words and how adequately they express pain. ⋯ Our conclusions are: the translation of the MPQ into German was successful, and its validity could be shown. In our experiment, it differentiated acute, short lasting pain as well as the visual analogue and the verbal rating scales. The BPQ is a tool worth being examined in the laboratory and in studies of clinical pain syndromes.