Articles: back-pain.
-
Pain perception is a complex psychosomatic phenomenon and is influenced by different psychological variables. Apart from their pain perception, chronic pain patients also suffer from different bodily complaints. The clinical significance of this finding is not yet clear. Bodily complaints in chronic pain patients may represent (a) a bodily expression of depressive symptoms, (b) a sign of chronicity, and (c) the expression of a heightened bodily awareness in the sense of hypochondriasis. ⋯ From a cognitive-behavioral perspective the results support the hypothesis that psychological disturbance in chronic pain is a cause of long-standing pain perception and the result of the chronification process.
-
In the healthy back only the outer third of the annulus fibrosus of the intervertebral disc is innervated. Nerve ingrowth deeper into diseased intervertebral disc has been reported, but how common this feature is and whether it is associated with chronic pain are unknown. We examined nerve growth into the intervertebral disc in the pathogenesis of chronic low back pain. ⋯ Our finding of isolated nerve fibres that express substance P deep within diseased intervertebral discs and their association with pain suggests an important role for nerve growth into the intervertebral disc in the pathogenesis of chronic low back pain.
-
Regional anesthesia · Jul 1997
Randomized Controlled Trial Clinical TrialBack pain following epidural anesthesia with 2-chloroprocaine (EDTA-free) or lidocaine.
Severe lumbar pain following epidural injection of 2-chloroprocaine is usually associated with the Nesacaine-MPF solution available in the United States. The purpose of this study was to determine if the solution distributed in Canada (Nesacaine-CE), which contains calcium disodium edetate (0.1 mg/mL) and sodium bisulfite (0.7 mg/mL) but no disodium ethylenediaminetetraacetic acid, is associated with back pain or spasm when compared with epidural lidocaine. ⋯ No cases of severe backache were observed. However, epidural Nesacaine-CE 3% was associated with mild back pain, generally confined to the area of needle insertion, when compared with lidocaine 1.33%.