Pain
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In order to substantiate accidental observations on the influence of skin temperature on itch, and to elucidate a possible involvement of thermoreceptors in itch generation, the effects of thermostimulation on clinical and experimental itch were studied. Eighteen patients with atopic dermatitis rated the intensity of spontaneous itch on one of their forearms before, during, and after its immersion in a waterbath of either 10 degrees C or 45 degrees C. In 40 normal subjects itch was elicited by histamine topically applied to a 7 cm2 skin area of the volar forearm. ⋯ The results indicate that changes in skin temperature have a marked influence on itch intensity. Whereas cooling seems to act directly on the sensory receptors mediating itch, warm stimuli could have a central inhibitory effect. A direct role of thermoreceptors in the generation of itch is improbable.
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The successful management of 5 consecutive patients with intractable phantom limb pain is described. The main therapy is a combination of a narcotic and antidepressant. ⋯ There were no signs of habituation or addiction. We conclude that narcotics can be safely and successfully utilized for long-term management of phantom limb pain.
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Patients entering treatment for chronic benign pain often are asked to complete drawings indicating the intensity and location of their pain as part of the diagnostic process. While inferences have been made from pain drawings about the relative contributions of physiological and psychological factors to the patient's experience of pain, previous research has provided only equivocal support for this practice. A reliable method for assessing pain drawings is needed both for clinical use and to assess the validity of such interpretations. ⋯ Scorers achieved a high rate of inter-rater agreement with relatively little training. The body surface scores obtained were shown to correlate highly with the penalty point system developed by Ransford et al., suggesting that extent of pain may account for much of the variance in this system. The results are discussed in relation to the clinical and experimental uses for such a system.
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Review Comparative Study
The evaluation of therapeutic acupuncture: concepts and methods.
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A series of 26 patients with chronic pain were treated with percutaneous radiofrequency lesioning of the dorsal root ganglion. Ten patients had an excellent result, which persisted in 8 to the present time or death, and 5 had a good persistent result. A useful persisting result was therefore obtained in 13 patients with a further 2 patients having temporary benefit.