Articles: pain.
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Applied neurophysiology · Jan 1983
Spinal stimulation: statistical superiority of monophasic stimulation of narrowly separated, longitudinal bipoles having rostral cathodes.
A prospective study of a large number of spinal stimulating electrodes permitted a statistical comparison of stimulus parameters, including phase, polarity and orientation of bipolar electrodes. For the treatment of pain, the technical grade of a stimulator is proportional to the range of stimulation, which was found to be significantly greater under the conditions listed in the title.
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The biomechanical evaluation of patients with painful heels has received only limited attention although the potential morbidity and disability associated with such an ailment can be severe. An objective analysis of the patient's foot function during gait can produce useful information to assess the underlying pathology. This method can also help to evaluate the efficacy of various existing treatment protocols. ⋯ Characteristic deviations from the normal impulse distribution were noted in these patients which provided the basis for differentiating the pathological condition between the patients with painful heel pads and those with plantar fasciitis. The effectiveness of using heel cups as a therapeutic device was also assessed. Although significant gait changes were not associated with the insertion of heel cups, they did seem to shift the foot-floor impulse forward from the heel region, which made them effective in patients afflicted with localized heel pain, but not in those with plantar fasciitis.
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Pain is a complex physiological phenomenon that begins with the stimulation of free nerve endings in peripheral tissues and culminates in the perception of a physical and psychological state. The pain experience may be facilitated or inhibited through the action of several neurologic circuits which utilize several neurotransmitters. Therapeutic analgesia is achieved either through interference with pain-facilitating mechanisms or enhancement of pain-inhibiting mechanisms; practical applications are reviewed.