Articles: pain-measurement.
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Hand disabilities are frequent causes of pain and disability in older people, yet knowledge regarding the characteristics and patterns of hand pain and problems over time is lacking. The main aim of this study was to identify subgroups of older individuals with distinct presentations (phenotypes) of hand pain and function, investigate how these might change over a 6-year period, and explore what characteristics and factors are associated with long-term status. The study population stemmed from the North Staffordshire Osteoarthritis Project, a large, general population-based, prospective, cohort study of adults aged 50 years and older. ⋯ There was a high level of stability in individuals in the "least-affected" or "severely affected" group at baseline. Individuals with widespread body pain, nodes, sleep problems, and pain in both hands at baseline were more likely to be in a severe hand phenotype at 6 years. The results provide clinically relevant information regarding the pattern of hand pain and problems over time and factors that predict transition to more severe hand phenotypes.
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Meralgia paresthetica (MP) is a neurologic disorder of the lateral femoral cutaneous nerve (LFCN), which is characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. In most patients with MP, symptoms can be successfully managed with conservative treatment. However, in a small group of MP patients who are refractory to medical treatment, more aggressive low-risk treatment should be considered. ⋯ PRF neuromodulation of the LFCN provides immediate and long-lasting pain relief without complications. Therefore, PRF of the LCFN can be used as an alternative treatment in patients with MP who are refractory to conservative medical treatment.
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Journal of neurotrauma · Mar 2016
Multidimensional neuropathic pain phenotypes after spinal cord injury.
Identifying clinical neuropathic pain phenotypes is a first step to better understand the underlying pain mechanisms after spinal cord injury (SCI). The primary purpose of the present study was to characterize multidimensional neuropathic pain phenotypes based on quantitative sensory testing (QST), pain intensity, and utilization of catastrophizing coping strategies. ⋯ A factor analysis including all CSQ subscales, the Neuropathic Pain Symptom Inventory (NPSI) total score, and thermal pain sensitivity above and below the LOI resulted in three factors: (1) adaptive pain coping including increasing activities, diverting attention, and reinterpreting pain sensations; (2) catastrophizing, neuropathic pain, and thermal sensitivity including greater NPSI total score, thermal pain sensitivity below the LOI, and catastrophizing; and (3) general pain sensitivity including greater thermal pain sensitivity above the LOI and lower catastrophizing. Our results suggest that neuropathic pain symptom severity post-SCI is significantly associated with residual spinothalamic tract function below the LOI and catastrophizing pain coping.
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The assessment of facial expressions associated with pain has been used to evaluate pain in humans and has recently found application in non-human mammals. These so called 'grimace scales' have the potential to be developed into a widely accepted non-invasive method of measuring pain in laboratory rodents. Currently, common methodologies to assess pain rely on nociceptive tests that assess stimulus evoked withdrawal responses. These tests, however, are limited to the assessment of a reflexive response without an affective component. This study aimed to use the recently developed Rat Grimace Scale (RGS) and assess its relationship with a conventional nociceptive test (the application of von Frey filaments). ⋯ This study confirms that the three pain models induce pain in rodents and showed that peak pain coincided with peak mechanical hypersensitivity. However, mechanical hypersensitivity remained once pain subsided, mimicking the human experience of CFA injection. These findings further our understanding of the roles of, and relationship between, these assays in the assessment of nociception and pain.
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Although the prevalence of sacroiliac joint (SIJ) pain is relatively high (15 - 30%), there is no unambiguous reference standard to diagnose SIJ pain. Pressure tenderness in the SIJ region is used for diagnostic purposes, but the clinimetric properties of this procedure remain to be determined. ⋯ Pressure pain algometry appears to be a reliable method to establish differences in PPTs between healthy volunteers and patients with SIJ pain. The diagnostic accuracy of this test should be investigated further.