Pain
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Stressors in the family and job environments have been proposed to play a role in the modulation of pain, yet direct empirical support for such a role is limited. The present study investigated the relationship between general stress, family and work environments (perceived social climate), psychological distress (anxiety, depression), and pain experience (sensory, affective, evaluative) in 33 ambulatory chronic low back pain (CLBP) subjects and 35 healthy controls matched for age, sex, socioeconomic status (SES), weight, and height. Results indicated that environmental stressors/social climate measures, including family conflict, family control, and general stress (Social Readjustment Rating Scale), were greater in the CLBP group. ⋯ Less peer cohesion, less physical comfort, and less job clarity were correlated with increased pain, but not distress. Work pressure was associated with decreased depression and less pain. These findings suggested the presence of both stress and operant mechanisms in the modulation of pain in the family, while operant and distraction mechanisms appear to characterize the relationship among work environment factors and pain.
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The relationship between labor pain and concomitant psychological state, in terms of prenatal anxiety levels and post-partum mood, has been studied. A consecutive series of primiparae (n = 129) was assessed at intervals over the course of their pregnancy and after delivery. State anxiety was measured at recruitment (10-14 weeks of pregnancy), 10 weeks, 32 weeks and at labor. ⋯ Anxiety scores at 32 weeks accounted for a further 5% of the variance and emerged as the best predictor of MPQ evaluative scores and visual analog ratings. A significant association was found between pain ratings and ratings of post-partum mood. Neither attendance at preparatory classes nor initial attitudes towards the neonate were related to pain scores.
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Comparative Study Clinical Trial Controlled Clinical Trial
A modified cold stimulation technique for the evaluation of analgesic activity in human volunteers.
This report describes the effects of a modified cold pressure technique (MCP) on the dominant hand of 6 healthy right-handed volunteers, after single p.o. doses of codeine (60 mg), aspirin (1 g) and placebo in a cross-over, double-blind design. The method employed 9 serial tests on each study day, involving 5 consecutive 2 min periods of hand immersion in an equilibrating bath at constant temperature (37 degrees C), followed by a stimulating bath (0 degree C +/- 0.5) containing 15% ethylene glycol. ⋯ Codeine was statistically different from placebo (P less than 0.05). It is concluded that this modified technique offers a stable and sensitive method for the early assessment of analgesic activity.
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Comparative Study
Corticosteroids suppress ectopic neural discharge originating in experimental neuromas.
Some injured sensory fibers ending in an experimental neuroma in the rat sciatic nerve discharge spontaneously. Furthermore, many become sensitive to a range of physical and chemical stimuli. ⋯ These corticosteroids also produce a rapid and prolonged suppression of ongoing discharge in chronic neuromas that have already become active. The kinetics of corticosteroid suppression of neuroma discharge suggest a direct membrane action rather than an anti-inflammatory action.
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The objectives of this study were to investigate the duration of analgesia and the development of tolerance following continuous intrathecal administration of morphine and norepinephrine alone, and morphine followed by norepinephrine via mini-osmotic pumps in the rat. Analgesia was assessed by the tail-flick test. In single pump experiments morphine 1 microliter (10 micrograms)/h (7 days) and 0.5 microliter (10 micrograms)/h (14 days) produced analgesia with tolerance by days 5-7. ⋯ Following continuous intrathecal morphine 1 microliter (10 micrograms)/h for 5 days, norepinephrine 1 microliter (15 micrograms)/h for 7 days failed to produce a significant increase in analgesia. This was in contrast to the increase in analgesia seen when the norepinephrine infusion followed a saline infusion. Determination of the norepinephrine concentration in the solution from the osmotic pumps verified that the norepinephrine is stable for the treatment period.