Pain practice : the official journal of World Institute of Pain
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While Hippocratic writings make no reference to the actual Olympics, there is frequent mention of diet, exercise, and the treatment of injuries sustained by the athletic participants. Indeed, Galen in his Composition of Medicines gives details of a remedy prescribed for the relief of pains and swellings, which was reserved for use by the winners of Olympic events, the so-called "Fuscum Olympionico inscriptum"--(ointment) entitled "dark Olympic victor's." In a time when the Olympic games have recently returned to their homeland, we examine the potential efficacy of this ancient remedy in terms of pain relief, the novelty of transdermal pain management, and the ability of ancient physicians to attend to the sports-related needs of highly tuned athletes.
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Multicenter Study
Patient burden of trigeminal neuralgia: results from a cross-sectional survey of health state impairment and treatment patterns in six European countries.
Trigeminal neuralgia (TN) is an uncommon neuropathic condition associated with excruciating facial pain. It is important to determine the effect of TN pain on patient functioning and to characterize relevant pharmacologic treatment patterns and health resource utilization in general practice. Eighty-two patients with TN were identified in a general practice setting during an observational survey of broad neuropathic pain syndromes in six European countries. ⋯ Pain severity was significantly associated with reduced EQ-5D health state valuation (P < 0.001) and greater pain interference (mBPI-SF) (P < 0.001). These findings demonstrate that TN pain presents a substantial patient burden expressed as interference with daily functioning and reduced health status associated with pain severity. This burden may result from both suboptimal management strategies and the frequent resistance of this neuropathic condition to treatment, and suggests a need for more effective pain management strategies.
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Comparative Study
The role of mood states underlying sex differences in the perception and tolerance of pain.
While sex differences in pain reporting are frequently observed, the reasons underlying these differences remain unclear. The present study examined sex differences in self-report and physiological measures of pain threshold and tolerance following the administration of two laboratory pain-induction tasks. The primary study aim centered on determining whether repeated exposure to such tasks would yield sex differences in terms of pain threshold and tolerance. ⋯ Results indicated that women evidenced greater pain tolerance than men on both a behavioral and physiological level; however, they reported greater pain severity than men. Fatigue was also found to be particularly important to reports of pain severity in men and pain tolerance in response to noxious stimuli for women. Possible pathways in which mood states influenced these endpoints are discussed.
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Multicenter Study Clinical Trial
Quantitative sensory testing for spinal cord stimulation in patients with chronic neuropathic pain.
A prospective pilot study was conducted, attempting to identify objective tests that would help clinicians to assess the efficacy of spinal cord stimulation (SCS) trial preceding permanent device implantation. ⋯ Our findings, which agree with those of a few other studies, suggest that the vibration threshold and the tolerance to electrical stimulation at 5 and 250 Hz tests can assist the clinician to select the right patients for permanent stimulation.
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Review Case Reports
The use of spinal cord stimulation in refractory abdominal visceral pain: case reports and literature review.
Patients will commonly seek medical attention for refractory abdominal pain. The many causes of abdominal pain include pathologies of the gastrointestinal, genitourinary, musculoskeletal, and nervous systems. Unfortunately, a large number of patients will develop chronic abdominal pain that is recalcitrant to definitive therapies and nonspecific treatments such as cognitive-behavioral, physical, and pharmacologic therapies. ⋯ We describe our experience with spinal cord stimulation in two patients with refractory abdominal pain. Although the exact etiology in these complex patients is not defined, it is theorized that visceral hypersensitivity is at least one component. Finally, we will summarize the applicable literature in order to explain a possible mechanism of analgesia in visceral disease.