摘要:

Measurement Is a Pain in the Neck

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:The aim of this study was to test the repeatability of dolorimeter measurements in subjects with and without neck—shoulder symptoms and interobserver agreement in manual palpation. The second aim was to analyze how subjects, measurers, and the order of attempt influenced the repeatability of pain threshold (PT) measurements.Design:Repeated measurements in 100 female volunteers who were office workers.Setting:Interobserver repeatability was tested by examining 60 female office employees twice during the same day, and intraobserver repeatability was tested by examining 40 female office employees at an interval of 2 days.Patients:Their mean age was 38 (20–55) years; height was 163 (149–174) cm; and weight was 60 (44–115) kg.Main Outcome Measures:PT measurement by dolorimeter and manual palpation findings of four defined palpation points.Results:The inter- and intraobserver repeatability coefficients of the dolorimeter varied from 0.87 to 0.65; they were lower in subjects with neck-shoulder symptoms (DS) than in subjects with no or occasional symptoms (NOS). The sensitivity and specificity of dolorimeter for neck-shoulder symptoms was poor. The interobserver repeatability of manual palpation at trigger areas of trapezius and levator muscles varied from 0.15 to 0.62.Conclusions:The repeatability of dolorimeter is good, but sensitivity and specificity for neck-shoulder symptoms are poor. The dolorimeter is a good device for measurement of cervicobrachial tenderness when the subject acts as his or her own control. The repeatability of manual palpation is poor.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:The aim of this study was to quantify myofascial tenderness by using manual palpation and the dolorimeter on female office employees with disturbing neck-shoulder symptoms (DS) and no or occasional neck-shoulder symptoms (NOS). The association among neck-shoulder symptoms, pain threshold, and age was also analyzed.Design:The cross-sectional study of female office employees selected on a voluntary basis from two offices.Setting:The manual palpation of neck-shoulder muscles was analyzed at 16 palpation points defined before the examination. The pain threshold (PT) was measured at four trigger areas of trapezius and levator muscles.Patients:160 female office employees with mean age 41 (21–60) years; height was 163 (149–178) cm; and weight was 62 (45–115) kg.Main outcome measures:Manual palpation findings of neck-shoulder muscles at 16 defined palpation points and PT measurement of trigger areas in trapezius and levator muscles by a dolorimeter.Results:The mean number of tender points was 7.25 (SD, 4.5) in subjects with DS and 3.44 (SD, 3.8) in subjects with NOS; the difference was significant (p < 0.0001). Suboccipital and trapezius muscles were tender in most cases in both symptom groups. The PTs of trapezius and levator muscles were significantly lower in subjects with DS than in subjects with NOS (p < 0.0001− 0.0005). The PT of the trapezius muscles in subjects 39 years old with DS was significantly lower than in those with NOS (p < 0.0007–0.0402). The PT of subjects with DS was lower in subjects 39 years old and older than in younger subjects, while the PT in subjects with NOS was higher in older subjects than in younger ones; the differences were statistically nonsignificant.Conclusions:Suboccipital and trapezius muscles are often tender in subjects with DS and in those with NOS. The finding that the PT of the trapezius muscle in older subjects with DSdecreaseswhile the PT in subjects with NOSincreasesis interesting and needs further investigation.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:We investigated the association between treatment setting and pain control attributions as assessed by the Pain Locus of Control Scale (PLOC).Design:Nonrandomized consecutive samples.Patients and Setting:The patient groups included an outpatient pain clinic sample of chronic pain patients (n = 48), a group of medical clinic outpatients with chronic pain (n = 28), and a group of medical clinic outpatients without current pain (n = 22). Medical clinic patients without current pain were asked to reply to the PLOC items in terms of their usual response when experiencing pain.Results and Conclusions:Results indicated that pain clinic patients were the least likely of the three groups to report predictable control of their pain as reflected by their significantly lower “powerful other” and higher “chance” dimension scores. Medical clinic patients without pain reported greater personal control of pain than the other two groups as evidenced by their higher “internality” dimension score and lower “chance” dimension score. Results indicate that pain control appraisals differ among patients with chronic pain and illness as a function of the treatment setting and suggest that differences in cognitive appraisal can affect treatment efficacy.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:The purpose of our study was to investigate whether Minnesota Multiphasic Personality Inventory-2 cluster solutions of chronic low-back pain patients would replicate those found in previous research with the Minnesota Multiphasic Personality Inventory.Setting:A multidisciplinary pain clinic in the southeastern United States.Patients:The subjects were 201 chronic low-back pain patients who had suffered a work-related back injury.Outcome Measures:The Minnesota Multiphasic Personality Inventory-2.Results:We found four relatively homogeneous subgroups of chronic low-back pain patients that were similar to those identified by previous researchers using data collected with the Minnesota Multiphasic Personality Inventory.Conclusion:These findings indicate that interpretations of the Minnesota Multiphasic Personality Inventory-2 should parallel those of the Minnesota Multiphasic Personality Inventory for chronic low-back pain patients. They further suggest that the results of Minnesota Multiphasic Personality Inventory-based studies are also applicable to Minnesota Multiphasic Personality Inventory-2.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:To evaluate whether symptoms of emotional distress related to pain affect patients' use of pain coping strategies. Relations between anxiety responses, as assessed by the Pain Anxiety Symptoms Scale, and coping strategies, as assessed by the Coping Strategies Questionnaire, were examined.Design:Cross-sectional, retrospective, correlational.Setting:A multidisciplinary pain management clinic in a university hospital.Participants:One hundred sixty-five patients (49.7% female) with chronic pain complaints. The most frequent complaint was low back pain (73%). Average age was 45.3 years (SD = 13.8).Main Outcome Measures:Pain coping strategy scores and ratings of ability to control and decrease pain.Results:Generally, cognitive anxiety was associated with less overall coping with pain, whereas physiological anxiety was associated with a greater coping with pain. Escape and avoidance anxiety responses were associated with greater use of overt pain behaviors for coping. Regression analyses indicated that anxiety symptoms combined across cognitive, motorie, and physiological response types accounted for significant variance in seven of eight coping strategy scores. These analyses also revealed significant unique relations of separate anxiety modalities with coping variables. Relations between anxiety scores and the Catastrophizing subscale of the CSQ were much greater than the relations of anxiety scores with other coping variables, suggesting that catastrophizing may be better conceptualized as a distress response rather than a coping strategy.Conclusions:These results show that different types of anxiety symptoms have differing relations with pain coping responses. Cognitive anxiety symptoms may interfere with coping, whereas physiological anxiety symptoms may enhance coping. Possible mechanisms and implications are discussed.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:To examine the correlation between childhood psychological trauma(s) and refractory back pain in patients with and patients without prior spine surgery.Design:Retrospective chart review survey of 101 consecutive patients who had undergone multidisciplinary evaluation for refractory back pain.Setting:Private practice, tertiary care spine center.Main Outcome Measures:Each psychological risk factor (physical abuse, sexual abuse, emotional neglect or abuse, abandonment, and chemically dependent caregiver) was rated as present or absent. Spinal pathology was graded as significant or not significant.Results:There were 56 patients with failed back surgery syndrome, 28 men and 28 women, with a mean age of 43 and mean pain duration of 45 months. There were 45 patients with no prior surgery, 26 men and 19 women, with a mean age of 43 and mean pain duration of 33 months. In the failed back surgery syndrome group, 27 (48%) had three or more risks and 39 (70%) had two or more. When the 12 patients with significant pathology are not considered, 24 of the remaining 44 (55%) patients had three or more risks. In the group with no prior surgery, 26 (58%) had three or more risks and 38 (84%) had two or more. When the five patients with significant pathology are not considered, 24 (60%) had three or more risks.Conclusions:Multiple childhood psychological traumas may predispose a person to chronic low back pain. In patients in this setting with refractory low back pain with or without prior lumbar spine surgery, three or more childhood psychological risk factors are prevalent, especially in patients with minimal structural pathology.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objectives:(a) To investigate the influence of previous pain experience and familial pain tolerance models on postsurgical pain; (b) to investigate the effect of personality traits on vicarious learning.Design:Before surgery, the patients completed the Minnesota Multiphasic Personality Inventory (MMPI), Eysenck Personality Inventory (EPI), and State-Trait Anxiety Inventory (STAI) personality tests. They also underwent a semi-structured interview to collect information on familial pain tolerance models and their own pain history. Postthoracotomy pain was assessed by measuring its latency (h), intensity (VAS 0–10), and duration (days).Setting:A unique protocol to minimize the use of pain killers and encourage the adoption of coping strategies to face postsurgical pain was in use in the Thoracic Department.Patients:A total of 126 patients who were free from chronic pain and undergoing thoracic surgery entered the study.Outcome:Most patients recalled a history of surgical or medical pain and good pain tolerance models in their original family. An almost equal number denied pain or had good pain tolerance models in their present family. Only a few patients reported poor tolerance models.Results:Patients who had previously been subjected to medical pain experienced a greater intensity of pain. In addition, those who had reported poor tolerance in the original family experienced both earlier and more severe pain. Some patients' personality traits were related to familial pain tolerance models.Conclusions:We conclude that knowledge of an individual's pain history and familial pain tolerance models can be useful in predicting and managing post-surgical pain.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:This study investigated the prevalence and causes of pain at the early stages of cancer.Design and patients:A total of 378 newly diagnosed (0–6 months from diagnosis) unselected cancer patients were asked to respond to a questionnaire on pain and other symptoms;Results:240 patients (64%) answered. Of these, 66 patients (28%) reported pain and were examined in the pain clinic. Thirty patients had pain caused by direct tumor growth, and 44 had pain secondary to cancer or its treatment. In 12 of 66 patients, the pain was unrelated to cancer. Fifteen patients had two or more different types of pain simultaneously.Conclusion:The results of this study indicate that awareness of pain and its management at early stages of cancer are essential.

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Abstract: Objective:To evaluate the prevalence of pain, how pain affects patients' lives, what treatments are being used, and the effectiveness of these pain treatments in ambulatory patients with human immunodeficiency virus (HIV) disease.Design:A self-administered pain survey (modified version of the Wisconsin Brief Pain Questionnaire).Setting:An ambulatory infectious disease clinic that deals mainly with ambulatory HIV patients.Patients:Ambulatory HIV patients.Outcome Measures:Results of the response to the questionnaire.Results:Eighty-two of 148 patients surveyed had pain due to their disease in the month prior to completing the survey. Of those reporting pain, 60–70% reported that their pain interfered with aspects of their daily lives from a moderate to severe degree. In patients with pain, 40% reported that they were not receiving any pain treatment. Those patients who were receiving treatment only obtained a mean pain relief of 65%.Conclusions:Pain is an important problem in terms of its prevalence and impact on patients with HIV disease. Pain control in this patient population is inadequate. Clinicians should realize that pain can be present regardless of the duration of the disease and its severity. Patients need to be educated about the proper use of pain medications and helped to understand that pain medications will not “worsen their disease.”

ISSN:0749-8047    

出版商:OVID    

年代:1993

数据来源: OVID