Articles: pain-measurement.
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Intensity, sensory-discriminative and affective-motivational quality of pain were assessed over a period of 14 days by means of the Bonn Pain Diary in 16 fibromyalgia (FM) patients and 18 rheumatoid arthritis (RA) patients. Additionally, patients reported pain and sleep duration, daily iratations, and pain-reducing interventions. FM patients differed from RA-patients by higher scores in the sensoric-discriminative component of pain. ⋯ Furthermore, the groups differ statistically significantly with respect to interactions of scaled pain with the preferred interventions in order to reduce pain. Conclusions concerning pain-referring cognitions are drawn. In general, the evaluation of self-reports about pain by behavioral parameters is recommended.
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A self-administered questionnaire consisting of 21 questions, diagrams for chief pain location, and a digital pain scale was used prospectively to sort 92 patients with orofacial pain into three categories: (1) musculoligamentous (ie, temporomandibular disorders); (2) neurologically based (ie, migraine, trigeminal neuralgia, tension-type headache, cluster headache, and atypical facial pain); and (3) dentoalveolar pain. Sensitivity, specificity, as well as negative and positive predictive values suggest that this questionnaire may be used reliably to identify patients with orofacial pain that fits the above-described pain categories without prior knowledge of the clinical diagnosis. ⋯ Patients with musculoligamentous or dentoalveolar pain selected the lowest digital pain scale values up to 15 times more frequently than those with neurologically based pain. Although this questionnaire may be used for initial categorization of pain, there is still no substitute for a thorough history and clinical examination.
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All 338 lower limb amputees under the care of one disablement services centre were asked to assess phantom pain severity at different times after amputation. Of 212 (63%) replies, 13 had died, 22 were non-limb wearers and 22 were unable to complete the questionnaire. In all, 176 useful replies were received--96 below-knee, 74 above-knee and 6 through-knee. ⋯ Phantom pain decreased with time, was present equally in traumatic and vascular amputees, and was related to the amount of preoperative pain (P < 0.005). Only 22% felt phantom pain had impaired their rehabilitation. Rehabilitation score was related to phantom pain severity at the time of questionnaire completion (P < 0.05), but not at other specified times after operation.
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Clinical rheumatology · Dec 1993
Comparative StudyPain and fatigue in patients with rheumatic disorders.
The purpose of the study was to investigate whether fibromyalgia patients (n = 50) differed from patients with rheumatoid arthritis (n = 22) and ankylosing sponylitis (n = 31) with respect to pain experience, pain coping and fatigue. A high general pain intensity level was recorded by the McGill Pain Questionnaire (p < 0.01) and the visual analogue scale (p < 0.01) in the fibromyalgia group compared to the other groups. The pain was of continuous duration in the fibromyalgia patients while the rheumatoid arthritis and ankylosing spondylitis patients experienced intermittent pain. ⋯ A high frequency of reported gastrointestinal problems (p < 0.01) and high intensity of fatigue (p < 0.01) were seen in the fibromyalgia group compared to the other groups. In the fibromyalgia group there was no correlation between the sleep problems and fatigue intensity. Thus, the fibromyalgia patients differed from the other groups in reporting frequently shoulder and upper arm pain, continuous pain, higher levels of fatigue and pain intensities as well as high frequency of gastrointestinal problems.
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This paper reviews several recently developed animal models that allow a quantitative assessment of the magnitude of nocifensive behavioral responses across a range of noxious stimulus intensities. Models discussed in detail include: (a) the rodent tail flick reflex, and a modification that allows measurement of tail flick magnitude, (b) rat hindlimb flexion withdrawal reflex elicited by noxious thermal stimulation of the paw, and (c) a learned operant response (nose bar press) evoked by noxious thermal stimulation of the rat's tail. These models are discussed in terms of their advantages over previous methods measuring response threshold, their fulfillment of criteria for ideal pain assessment models, and the neuronal circuitry underlying the behavioral response.