Articles: pain.
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The radicular pain of sciatica was ascribed by Mixter and Barr to compression of the spinal root by a herniated intervertebral disc. It was assumed that root compression produced prolonged firing in the injured sensory fibers and led to pain perceived in the peripheral distribution of those fibers. This concept has been challenged on the basis that acute peripheral nerve compression neuropathies are usually painless. ⋯ Chronic injury of dorsal roots or sural nerve produces a marked increase in mechanical sensitivity; several minutes of repetitive firing may follow acute compression of such chronically injured sites. Such prolonged responses could be evoked repeatedly in a population of both rapidly and slowly conducting fibers. Since mechanical compression of either the dorsal root ganglion or of chronically injured roots can induce prolonged repetitive firing in sensory axons, we conclude that radicular pain is due to activity in the fibers appropriate to the area of perceived pain.
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In diabetes mellitus, pain and weakness in a lower extremity can result from lumbosacral radiculopathy. However, abdominal pain caused by a similar type of thoracic nerve root disease is not generally recognized. ⋯ Their clinical features were suggestive of malignant disease. Electromyographic examination revealed the correct diagnosis, and all four of the patients had a spontaneous and complete recovery.
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Arch. Immunol. Ther. Exp. (Warsz.) · Jan 1977
Comparative Study Clinical Trial Controlled Clinical TrialA double-blind comparative evaluation of aspirin, paracetamol and paracetamol + caffeine (finimal) for their analgesic effectiveness.
A double-blind, cross-over trial was made of three analgesic preparations--paracetamol, paracetamol with caffeine (Finimal) and aspirin in the relief of postoperative pain in 72 orthopedic inpatients and in 144 ambulatory outpatients suffering form common idiopathic headache. The combination of paracetamol and caffeine (Finimal) in this study shows the greatest pain relief in both groups of patients. This evaluation supports the results of BOOY3 demonstrating the superiority of the paracetamol-caffeine combination to paracetamol alone or aspirin.
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Comparative Study Clinical Trial Controlled Clinical Trial
Pain relief in the post-operative period: a comparative trial of morphine and a new analgesic buprenorphine.
In a comparative trial, buprenorphine 0-3 mg or morphine 10 mg was administered intramuscularly to patients post-operatively. The new drug buprenorphine produced more pain relief than morphine and appeared to have a longer duration of action. The side-effects produced by the two drugs were similar, as were the effect on respiratory and cardiovascular measurements.
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Arch Phys Med Rehabil · Jan 1977
Clinical Trial Controlled Clinical TrialTranscutaneous electrical stimulation: a double-blind trial of its efficacy for pain.
A double-blind trial was done using a stimulator and a placebo device on patients who had chronic pain to determine the effectiveness of transcutaneous electrical stimulation in controlling pain. Ninety-three patients were studied, and 83 of these completed the Minnesota Multiphasic Personality Inventory (MMPI). Thirty-three patients had low-back pain and 24 had neuropathies. ⋯ The stimulator was significantly more effective than the placebo in neuropathies when stimulating over the related nerve trunk (P less than .005), where the stimulator response was nearly three times better than that of the placebo. The duration of subsequent relief was not significantly different after treatment with the stimulator or with the placebo device. Follow-up showed significant declines in the use and effect of the stimulator with the greatest decline noted by the depressed group.