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1

Calcaneal osteosarcoma: a rare cause of heel pain in the paediatric population  

PubMed Central

Osteosarcoma is the most common primary non-haemopoietic malignant bone tumour in children and adolescents. However, it rarely occurs in the calcaneus with only a few case reports in the literature. We report a case of a 14-year-old boy with calcaneal osteosarcoma, who presented with heel pain followed by swelling. The pain was initially thought to be related to a benign process and treated with analgesics, delaying the diagnosis. We discuss the clinical presentation, the differential diagnosis, multi-imaging and pathological findings of a calcaneal osteosarcoma, its clinical outcome and the importance of early diagnosis to improve outcome. PMID:23386499

Taslakian, Bedros; Issa, Ghada; Saab, Raya; Jabbour, Mark N; Khoury, Nabil J

2013-01-01

2

Heel pain  

MedlinePLUS

Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

3

Heel Pain in Recreational Runners.  

ERIC Educational Resources Information Center

Provides physicians with the signs, symptoms, and management of heel/sole pain in recreational runners (usually due to plantar fasciitis, Achilles tendinitis, and calcaneal stress fractures). Remedies involve palliative treatment of symptoms, correction of underlying biomechanical problems, and flexibility exercises. (SM)

Bazzoli, Allan S.; Pollina, Frank S.

1989-01-01

4

Plantar and medial heel pain: diagnosis and management.  

PubMed

Heel pain is commonly encountered in orthopaedic practice. Establishing an accurate diagnosis is critical, but it can be challenging due to the complex regional anatomy. Subacute and chronic plantar and medial heel pain are most frequently the result of repetitive microtrauma or compression of neurologic structures, such as plantar fasciitis, heel pad atrophy, Baxter nerve entrapment, calcaneal stress fracture, and tarsal tunnel syndrome. Most causes of inferior heel pain can be successfully managed nonsurgically. Surgical intervention is reserved for patients who do not respond to nonsurgical measures. Although corticosteroid injections have a role in the management of select diagnoses, they should be used with caution. PMID:24860133

Lareau, Craig R; Sawyer, Gregory A; Wang, Joanne H; DiGiovanni, Christopher W

2014-06-01

5

Plantar heel pain.  

PubMed

Plantar heel pain is a common complaint encountered by orthopedic surgeons, internists, and family practitioners. Although it is most often caused by plantar fasciitis, this is a diagnosis of exclusion. Other mechanical, rheumatologic, and neurologic causes must be considered first. The history and physical examination are typically all that is needed to make the proper diagnosis, but diagnostic adjuncts are available to assist the clinician. When plantar fasciitis is diagnosed, conservative modalities must be tried first. Corticosteroid injections and extracorporeal shock-wave therapy may also be used. After 6 months of failed conservative treatments, surgical intervention should be considered. PMID:24559879

Rosenbaum, Andrew J; DiPreta, John A; Misener, David

2014-03-01

6

Chronic bilateral heel pain in a child with Sever disease: case report and review of literature  

PubMed Central

We are presenting a case report of a 10-year-old male with a 1 year history of bilateral heel pain. Sever disease is self limiting condition of calcaneal apophysis. It is the most common cause of heel pain in the growing child. There is no documented case of this condition in this region. This case highlights the clinical features of this self limiting disorder as seen in this patient and reviews the current literature. PMID:20069067

2009-01-01

7

Gastrocnemius shortening and heel pain.  

PubMed

Pain and reduced function caused by disorders of either the plantar fascia or the Achilles tendon are common. Although heel pain is not a major public health problem it affects millions of people each year. For most patients, time and first-line treatments allow symptoms to resolve. A proportion of patients have resistant symptoms. Managing these recalcitrant cases is a challenge. Gastrocnemius contracture produces increased strain in both the Achilles tendon and the plantar fascia. This biomechanical feature must be properly assessed otherwise treatment is compromised. PMID:25456718

Solan, Matthew C; Carne, Andrew; Davies, Mark S

2014-12-01

8

Lung cancer presenting as heel pain: A case report.  

PubMed

Bone metastasis as the first symptom of lung cancer is common, particularly in the axial skeleton. The calcaneus is an unusual site of metastatic involvement. Chronic plantar heel pain (CPHP) is one of the most common complaints of the foot requiring medical treatment. The most typical symptom of CPHP is pain under the medial heel during weight-bearing, and this symptom is therefore generally initially diagnosed as CPHP by clinicians. The current case study reports a female patient never-smoker with non-small cell lung cancer accompanied by calcaneal metastasis presenting as heel pain. The patient was initially diagnosed with CPHP without any imaging examinations. As there was no relief from the heel pain six months later, a foot X-ray was performed, which revealed a lesion of the calcaneus. The analysis of a biopsy obtained from the lesion resulted in a diagnosis of adenocarcinoma. The present case indicates that patients suspected to have CPHP should be conventionally examined with radiography of the foot during the initial diagnosis. Similarly, if a patient with lung cancer has symptoms such as CPHP, distant metastasis should be accounted for; despite their rarity, clinicians should maintain a high level of suspicion, since accurate diagnosis and timely treatment is important in management and outcome. PMID:25009652

Dai, Hao; Qiang, Minfei; Chen, Yanxi; Zhai, Weitao; Zhang, Kun

2014-08-01

9

Simultaneous use of lateral calcaneal ostectomy and subtalar arthroscopic debridement for residual pain after a calcaneal fracture.  

PubMed

Inadequate primary treatment of calcaneal fractures frequently results in persistent, residual pain. This can be caused by subtalar arthritis, an increased calcaneal width, and/or calcaneal fibular impingement of the peroneal tendons. Many patients experience multiple disorders simultaneously, requiring a combination of procedures to treat the injury. The purpose of the present study was to evaluate the clinical outcomes of arthroscopic debridement with lateral calcaneal ostectomy for residual pain after a calcaneal fracture. Four feet (4 patients) were treated with arthroscopic debridement and lateral calcaneal ostectomy. The patients were 3 males and 1 female, with a mean age of 55.3 ± 14.1 years. The mean follow-up duration was 33.5 ± 10.5 months postoperatively. Three patients received worker's compensation as a result of their condition. The patients were examined for improvement in pain levels using the numeric pain intensity scale and healing was assessed using the Japanese Society of Surgery of the Foot score. The mean Japanese Society of Surgery of the Foot score improved from 64.5 ± 13.8 preoperatively to 82.5 ± 7.1 postoperatively. The mean postoperative numeric pain intensity scale score was 2.3 ± 1.9. No complications, such as deep infection or problems with wound healing, were observed in any of the patients. The simultaneous use of arthroscopic subtalar debridement and lateral calcaneal ostectomy is a valuable intervention for the treatment of residual pain after a calcaneal fracture in patients who present with increased calcaneal width and mild or no degenerative changes in the subtalar joint. PMID:25459094

Yoshimura, Ichiro; Ichimura, Ryuji; Kanazawa, Kazuki; Ida, Takahiro; Hagio, Tomonobu; Karashima, Hirotaka; Naito, Masatoshi

2015-01-01

10

Heel pain-plantar fasciitis: revision 2014.  

PubMed

The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to nonarthritic heel pain. PMID:25361863

Martin, Robroy L; Davenport, Todd E; Reischl, Stephen F; McPoil, Thomas G; Matheson, James W; Wukich, Dane K; McDonough, Christine M

2014-11-01

11

Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality.  

PubMed

Plantar fasciitis (PF) is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF). Following a diagnostic medial calcaneal nerve (MCN) block at its origin, we observed reduction in verbal numerical rating scale (VNRS) in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF). All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF. PMID:24963184

Thapa, Deepak; Ahuja, Vanita

2014-03-01

12

Bilateral calcaneal stress fractures: a case report.  

PubMed

The majority of plantar heel pain is diagnosed as plantar fasciitis or heel spur syndrome. When history or physical findings are unusual or when routine treatment proves ineffective, one should consider an atypical cause of heel pain. Stress fractures of the calcaneus are a frequently unrecognized source of heel pain. In a normal populat?on, the possibility of calcaneal stress fractures must be borne in mind with patients who have bilateral heel pain. When a stress fracture is considered, clinicans have different imaging options. First of all, x-rays must be used to evaluate for any visible osseous pathology. If plain films are inconclusive, the clinician can proceed with a bone scan or Magnetic Resonance Imaging. In the literature, calcaneal stress fractures are mostly reported in soldiers or athletes, but our case is one of a 44-year-old housewife with bilateral heel pain treated as Achilles tendinitis and plantar faciitis for a long time. Her final diagnosis was bilateral calcaneal fracture by Magnetic Resonance Imaging. PMID:23208939

Imerci, Ahmet; Incesu, Mustafa; Bozoglan, Muhammet; Canbek, Umut; Ursavas, Hüseyin Tamer

2012-01-01

13

Aspects of treatment for posterior heel pain in young athletes.  

PubMed

Posterior heel pain occurs in young athletes involved in running and jumping. Due to the pain, the child often limits his/her physical activity level, with a possible negative effect on health and well-being. Although numerous research studies have examined the cause and treatment of heel and Achilles tendon pain in adults, there are no randomized clinical trials on treatment in children and adolescents. Therefore, there is limited evidence for how to treat young athletes with this type of complaint. The purpose of this review was to analyze critically and summarize the literature in regards to the cause and treatment of posterior heel pain in young athletes. The various diagnoses and clinical presentations relating to posterior heel and Achilles tendon pain are discussed. The theory and mechanism behind various recommended treatment strategies are also reviewed in the context of use in the young athlete. In summary, it is important to perform a thorough evaluation of each young athlete with heel pain to determine the appropriate diagnosis and to treat the deficits found and allow for a gradual progression to training. However, the recommendations at this time are based on clinical experience and a few retrospective studies, so further well designed prospective studies with validated outcome measures are urgently needed for the young athlete. PMID:24198561

Elengard, Thomas; Karlsson, Jón; Silbernagel, Karin Grävare

2010-01-01

14

Aspects of treatment for posterior heel pain in young athletes  

PubMed Central

Posterior heel pain occurs in young athletes involved in running and jumping. Due to the pain, the child often limits his/her physical activity level, with a possible negative effect on health and well-being. Although numerous research studies have examined the cause and treatment of heel and Achilles tendon pain in adults, there are no randomized clinical trials on treatment in children and adolescents. Therefore, there is limited evidence for how to treat young athletes with this type of complaint. The purpose of this review was to analyze critically and summarize the literature in regards to the cause and treatment of posterior heel pain in young athletes. The various diagnoses and clinical presentations relating to posterior heel and Achilles tendon pain are discussed. The theory and mechanism behind various recommended treatment strategies are also reviewed in the context of use in the young athlete. In summary, it is important to perform a thorough evaluation of each young athlete with heel pain to determine the appropriate diagnosis and to treat the deficits found and allow for a gradual progression to training. However, the recommendations at this time are based on clinical experience and a few retrospective studies, so further well designed prospective studies with validated outcome measures are urgently needed for the young athlete. PMID:24198561

Elengard, Thomas; Karlsson, Jón; Silbernagel, Karin Grävare

2010-01-01

15

Psychological variables associated with foot function and foot pain in patients with plantar heel pain.  

PubMed

It is widely accepted that psychological variables are associated with self-reported pain and self-reported physical function in patients with musculoskeletal pain. However, the relationship between psychological variables and foot pain and foot function has not been evaluated in people with plantar heel pain. Eighty-four participants with plantar heel pain completed the Depression, Anxiety and Stress Scale short version (DASS-21) and Foot Health Status Questionnaire. Using a hierarchical regression analysis, a baseline model with age, sex and BMI explained 10 % of the variability in foot function. The addition of depression and stress in separate models explained an additional 7.3 % and 8.1 % of foot function scores, respectively. In the respective models, depression was a significant predictor (??=?-0.28; p?=?0.009) as was stress (??=?-0.29; p?=?0.006). Females drove the effect between stress and foot function (??=?-0.50; p?=?0.001) and depression and foot function (??=?-0.53; p?pain, depression, anxiety and stress did not contribute significantly to pain scores. When the data was stratified by sex, stress (??=?-0.36; p?=?0.024) and depression (??=?-0.41; p?=?0.013) were significantly associated with foot pain in females but not in males. For participants with plantar heel pain, stress and depression scores were significantly associated with foot function but not foot pain. When the data was stratified by sex, stress and depression were significant predictors of foot pain and function in females. PMID:24647980

Cotchett, Matthew P; Whittaker, Glen; Erbas, Bircan

2014-03-20

16

Heel pain due to psoriatic arthritis in a 50 year old recreational male athlete: case report  

PubMed Central

Heel pain is a common presentation in a sports injury practice, with a list of common differentials including achilles tendinopathy and retrocalcaneal bursitis. However, seronegative arthritis can also cause enthesopathies that produce heel pain and should be considered in a differential diagnosis list. In this case, a 50 year old recreationally active male presented with non-traumatic insidious heel pain and without history of any skin conditions or any other symptoms of seronegative spondyloarthritis. Clinical suspicion led to laboratory testing and radiographs/bone scan which yielded the diagnosis of psoriatic arthritis. PMID:22131565

Yedon, Dominique Forand; Howitt, Scott

2011-01-01

17

Extracorporal shock wave therapy in patients with tennis elbow and painful heel  

Microsoft Academic Search

The aim of this study was to evaluate the effect of extracorporal shock wave therapy (ESWT) in tennis elbow and painful heel.\\u000a Nineteen patients with tennis elbow and 44 patients with painful heel in which conservative treatment had failed underwent\\u000a ESWT. Both groups received 3000 shock waves of 0.12 mJ\\/mm2 three times at weekly intervals. After a follow-up of 5

Dietrich S. Hammer; Stefan Rupp; Stefan Ensslin; Dieter Kohn; Romain Seil

2000-01-01

18

Kangaroo Care Modifies Preterm Infant Heart Rate Variability in Response to Heel Stick Pain: Pilot Study  

PubMed Central

Background Heel stick is the most common painful procedure for preterm infants in neonatal intensive care units. Resultant pain causes adverse physiological effects in major organ systems. Kangaroo Care (KC), involving mother-infant skin-to-skin contact is a promising analgesic for infant pain; however, the effect of KC on the autonomic nervous system's response to pain is unknown. Aim To determine if KC results in improved balance in autonomic responses to heel stick pain than the standard method where infants remain in an incubator care (IC) for the heel stick. Study Design A randomized cross-over trial. Subjects Fourteen preterm infants, 30-32 weeks gestational age and less than 9 days postnatal age. Outcome Measures Infant behavioral state, heart rate, heart rate variability (HRV) indices including low frequency (LF) and high frequency (HF) power, and the LF/HF ratio measured over Baseline, Heel Warming, Heel Stick, and Recovery periods in KC and IC conditions. Results HRV differences between KC and IC were that LF was higher in KC at Baseline (p<.01) and at Heel Stick (p< .001), and HF was higher in KC at Baseline than in the IC condition (p< .05). The LF/HF ratio had less fluctuation across the periods in KC than in IC condition and was significantly lower during Recovery in KC than in IC (p< .001). Conclusions Infants experienced better balance in response in KC than IC condition as shown by more autonomic stability during heel stick. KC may be helpful in mediating physiologic response to painful procedures in preterm infants. PMID:19505775

Cong, Xiaomei; Ludington-Hoe, Susan M.; McCain, Gail; Fu, Pingfu

2009-01-01

19

Calcaneal brown tumor with primary hyperparathyroidism caused by parathyroid carcinoma: an atypical localization.  

PubMed

Brown tumors are one of the characteristics of primary hyperparathyroidism, although, in some cases, they are noted with secondary hyperparathyroidism as well. The authors present a case of a 50-year-old woman with primary hyperparathyroidism caused by parathyroid carcinoma with an unusual location of a brown tumor in the calcaneus. She first presented with pain and swelling over the heel and ankle, and the diagnosis was suspected by radiographs. Biopsy of the calcaneal lesion confirmed a brown tumor. After the parathyroid lesion was removed surgically, her symptoms were relieved. The calcaneal lesion was treated with immobilization of the foot. PMID:15284814

Do?an, Ali; Algün, Ekrem; Kisli, Erol; Harman, Mustafa; Kösem, Mustafa; Tosun, Nihat

2004-01-01

20

An Atypical Calcaneal Fracture in a Child: A Literature Review Concerning the Treatment  

PubMed Central

Calcaneal fractures are considered uncommon accounting for 0.005-0.41% of all children fractures. Few reports concerning treatment are available. Most of these fractures are non-displaced/minimally displaced and are associated with a fall of less than 1 m. The aim of this case report was to discuss the diagnosis and treatment of a child calcaneal fracture, an atypical presentation despite the high energy mechanism of trauma. A 7-year-old child fell from a 5-m ladder with all his weight on his right heel. Significantly hind-foot reduced range of motion associated with a lateral/plantar calcaneal swelling and pain was found. Neurovascular examination and other parts of the body were normal. Radiograph showed an undisplaced calcaneal body fracture and computed tomography confirmed no subtalar joint involvement. A splint followed by plaster was applied. Weight bearing and deambulation were not allowed. After 4 weeks, no pain and limping was reported by the child’s parents. Plaster was removed and radiograph showed fracture consolidation. Patient had no complaints of pain, no restrictions in range of motion and normal walking. Limping in children is a difficult complaint to assess. Differential diagnoses of a calcaneal fractures should be performed, even without a history of trauma or a history of trivial trauma. PMID:25368703

Guterres, Leonardo Waihrich; Ribeiro, Deryck Aguiar; Ribeiro, Tiango Aguiar

2015-01-01

21

Comparison of different energy densities of extracorporeal shock wave therapy (ESWT) for the management of chronic heel pain  

Microsoft Academic Search

Objective: To compare the effectiveness of different energy densities of extracorporeal shock wave therapy (ESWT) for managing chronic heel pain.Design: A randomized clinical trial.Setting: Hospital-based practice.Subjects: Fifty-seven patients with chronic heel pain were recruited; eight patients withdrew from the study.Interventions: Subjects were randomized into three groups receiving: (1) a ‘fixed’ energy density, (2) ‘maximum tolerable’ energy density, or (3) control

Intonia H W Chow; Gladys LY Cheing

2007-01-01

22

Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial  

Microsoft Academic Search

BACKGROUND: Skin-to-skin contact, or kangaroo mother care (KMC) has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates. The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates. METHODS: Preterm neonates (n = 61) between 28 0\\/7 and 31 6\\/7 weeks gestational

C Celeste Johnston; Francoise Filion; Marsha Campbell-Yeo; Celine Goulet; Linda Bell; Kathryn McNaughton; Jasmine Byron; Marilyn Aita; G Allen Finley; Claire-Dominique Walker

2008-01-01

23

Effectiveness of trigger point dry needling for plantar heel pain: study protocol for a randomised controlled trial  

PubMed Central

Background Plantar heel pain (plantar fasciitis) is a common and disabling condition, which has a detrimental impact on health-related quality of life. Despite the high prevalence of plantar heel pain, the optimal treatment for this disorder remains unclear. Consequently, an alternative therapy such as dry needling is increasingly being used as an adjunctive treatment by health practitioners. Only two trials have investigated the effectiveness of dry needling for plantar heel pain, however both trials were of a low methodological quality. This manuscript describes the design of a randomised controlled trial to evaluate the effectiveness of dry needling for plantar heel pain. Methods Eighty community-dwelling men and woman aged over 18 years with plantar heel pain (who satisfy the inclusion and exclusion criteria) will be recruited. Eligible participants with plantar heel pain will be randomised to receive either one of two interventions, (i) real dry needling or (ii) sham dry needling. The protocol (including needling details and treatment regimen) was formulated by general consensus (using the Delphi research method) using 30 experts worldwide that commonly use dry needling for plantar heel pain. Primary outcome measures will be the pain subscale of the Foot Health Status Questionnaire and "first step" pain as measured on a visual analogue scale. The secondary outcome measures will be health related quality of life (assessed using the Short Form-36 questionnaire - Version Two) and depression, anxiety and stress (assessed using the Depression, Anxiety and Stress Scale - short version). Primary outcome measures will be performed at baseline, 2, 4, 6 and 12 weeks and secondary outcome measures will be performed at baseline, 6 and 12 weeks. Data will be analysed using the intention to treat principle. Conclusion This study is the first randomised controlled trial to evaluate the effectiveness of dry needling for plantar heel pain. The trial will be reported in accordance with the Consolidated Standards of Reporting Trials and the Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines. The findings from this trial will provide evidence for the effectiveness of trigger point dry needling for plantar heel pain. Trial registration Australian New Zealand 'Clinical Trials Registry'. ACTRN12610000611022. PMID:21255460

2011-01-01

24

[To reduce the pain of heel prick in the newborn: comparison of six types of lancets].  

PubMed

Heel prick is an usual method performed to get a blood sample for newborn screening. Its wide use justifies the effort in reducing the pain as much as possible and some simple steps, including the use of spring heelsticks, are recommended by national and international guide-lines. But not all the heelsticks cause the same pain and allow to get enough blood for the screening. The aim of this work was to test six automatic heelstick devices with regard to the pain in heel prick measured with NIPS scale and, at the same time, to value their effectiveness in getting a blood sample suitable for filter paper for newborn screening. The following devices were assessed: Amnes Minilet Lancets, Wuxi Xinda Ltd, Exxe Safe Blade, Lifescan Stik Johnson & Johnson, One Touch Ultra Soft, Accu-Chek Safe T Pro Plus. The device Exxe Safe Blade statistically differs from all others: it is the least painful and it doesn't need any prick repetition. PMID:23173410

Ballardini, G; Spruzzola, A; Boneschi, L; Visentin, R; Boscardini, L; Barbaglia, M; Guala, L A

2012-01-01

25

A comparison of the effectiveness of extracorporeal shock wave and ultrasound therapy in the management of heel pain  

NASA Astrophysics Data System (ADS)

The aim of this study was to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and ultrasound therapy (US) for managing heel pain. Thirty-seven subjects received either: ESWT (once a week), US (three times a week), or CONTROL (no treatment) for 3 consecutive weeks and were followed-up for 3 more weeks. A visual analogue scale (VAS), the maximum tolerable duration for prolonged walking or standing, and the Mayo clinical scoring system (MCSS) were evaluated. Mixed models treating baseline measures as covariates were adopted for statistical analysis. By week 3, intensity of heel pain on palpation was reduced by 37% (VAS score from 7.5 to 4.6) in the ESWT group, 24% (from 5.3 to 4.2) in the US group, and increased by 3% (5.6-5.7) in the control group; this difference was significant after adjusting for baseline VAS scores ( p = 0.022). The improvements in the maximum tolerable duration of prolonged walking or standing was only significant in the ESWT group (157% increase, p = 0.043) but not the other two groups. Both active treatment groups maintained the treatment effect at the three-week follow-up. We conclude that ESWT is potentially more effective in reducing heel pain than ultrasound therapy but additional evidence is needed due to the various limitations of the study.

Cheing, G. L. Y.; Chang, H.; Lo, S. K.

2007-11-01

26

A Single-Blind Pilot Study to Determine Risk and Association Between Navicular Drop, Calcaneal Eversion, and Low Back Pain  

Microsoft Academic Search

ObjectiveSyndromes causing mechanical low back pain (MLBP) continue to plague the US health care system. One hypothesis is that flatfeet are a risk factor for MLBP. This pilot study evaluated whether subjects with flatter feet are at greater risk for MLBP than subjects without flatter feet.

James W. Brantingham; Katy Jane Adams; Jeffery R. Cooley; Denise Globe; Gary Globe

2007-01-01

27

Detachable high heel shoe construction  

E-print Network

The goal on this investigation was to develop a detachable high heel shoe construction that could enter the current high heel market. The impact of high heel shoes on women's fashion is enormous but there are associated ...

Morales, Alfredo Louis

2007-01-01

28

Dual energy x-ray laser measurement of calcaneal bone mineral density  

NASA Astrophysics Data System (ADS)

In dual energy x-ray absorptiometry (DXA) the photon attenuation is assumed to be similar in soft tissue overlying, adjacent to and inside the measured bone. In the calcaneal dual energy x-ray laser (DXL) technique, this assumption is not needed as attenuation by soft tissues at the local bone site is determined by combining DXA and heel thickness measurements. In the present study, 38 subjects were measured with DXL Calscan, Lunar PIXI and Lunar DPX-IQ DXA instruments and Hologic Sahara ultrasound instrument, and the performance and agreement of the instruments were analysed. Furthermore, numerical simulations on the effect of non-uniform fat-to-lean tissue ratio within soft tissue in heel were conducted. In vivo short-term precision (CV%, sCV%) of DXL Calscan (1.24%, 1.48%) was similar to that of Lunar PIXI (1.28%, 1.60%). Calcaneal areal bone mineral densities (BMD, g cm-2) measured using DXL Calscan and Lunar PIXI predicted equally well variations in BMD of femoral neck (r2 = 0.63 and 0.52, respectively) or lumbar spine (r2 = 0.61 and 0.64, respectively), determined with Lunar DPX-IQ. BMD values measured with DXL Calscan were, on average, 19% lower (p < 0.01) than those determined with Lunar PIXI. Interestingly, the difference in BMD values between instruments increased as a function of body mass index (BMI) (r2 = 0.17, p < 0.02) or heel thickness (r2 = 0.37, p < 0.01). Numerical simulations suggested that the spatial variation of soft tissue composition in heel can induce incontrollable inaccuracy in BMD when measured with the DXA technique. Theoretically, in contrast to DXA instruments, elimination of the effect of non-uniform soft tissue is possible with DXL Calscan.

Hakulinen, M. A.; Saarakkala, S.; Töyräs, J.; Kröger, H.; Jurvelin, J. S.

2003-06-01

29

Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up  

SciTech Connect

Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

Niewald, Marcus, E-mail: marcus.niewald@uks.eu [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)] [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany); Seegenschmiedt, M. Heinrich [Radiotherapy Center, Hamburg (Germany)] [Radiotherapy Center, Hamburg (Germany); Micke, Oliver [Franziskus Hospital, Bielefeld (Germany)] [Franziskus Hospital, Bielefeld (Germany); Graeber, Stefan [Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany)] [Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany); Muecke, Ralf [Lippe Hospital, Lemgo (Germany)] [Lippe Hospital, Lemgo (Germany); Schaefer, Vera; Scheid, Christine; Fleckenstein, Jochen; Licht, Norbert; Ruebe, Christian [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)] [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)

2012-11-15

30

Achilles Pain.  

ERIC Educational Resources Information Center

Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

Connors, G. Patrick

31

Muscle activation of paraspinal muscles in different types of high heels during standing  

PubMed Central

[Purpose] This study researched the effects of different types of high heels on the muscles surrounding the cervical spine, the thoracic spine, and the lumbar spine by analyzing muscle activation of the paraspinal muscles during standing while wearing high heels. The high heels were all of the same height: 8?cm. [Subjects and Methods] The 28 subjects in this experiment were females in their 20s with a foot size of 225–230?mm and a normal gait pattern. To measure the muscle activation of the paraspinal muscles, EMG electrodes were attached on the paraspinal muscles around C6, T7, and L5. The muscle activation during standing while wearing 8-cm-high wedge heels, setback heels, and French heels was then measured. The measurements were performed 3 times each, and the mean value was used for analysis. [Results] The levels of muscle activation of the paraspinal muscles induced by standing on wedge heels, setback heels, and French heels in the cervical and lumbar areas were significantly higher than those induced by standing on bare feet. But there was no significant difference according to the heel types. [Conclusion] The height of the heels presented a greater variable than the width of the heels on the muscle activation of paraspinal muscles. Therefore, wearing high heels is not recommended for those who have pain or functional problems in the cervical and/or lumbar spine. PMID:25642040

Han, Dongwook

2015-01-01

32

Heel seats and shoe wear.  

PubMed

Seventy-two children with excessive heel valgus and markedly uneven shoe wear were treated by Helfet heel seats for 18-36 months. Of the 52 children reviewed in this study, 44 had improved shoe wear. Simple heel seats offer economical treatment for children whose foot deformities destroy their shoes. PMID:7814590

Theologis, T N; Gordon, C; Benson, M K

1994-01-01

33

Mountaineer’s heel  

Microsoft Academic Search

Mountaineers are at risk of skin lesions caused by constant boot friction. This is the case of a 35 year old mountaineer who presented with large and deeply ulcerated lesions over the medial aspects of both heels after a two and a half day climb using crampons. A number of factors such as the length of the climb in cold

R M Strauss

2004-01-01

34

Calcaneal loading during walking and running  

NASA Technical Reports Server (NTRS)

PURPOSE: This study of the foot uses experimentally measured kinematic and kinetic data with a numerical model to evaluate in vivo calcaneal stresses during walking and running. METHODS: External ground reaction forces (GRF) and kinematic data were measured during walking and running using cineradiography and force plate measurements. A contact-coupled finite element model of the foot was developed to assess the forces acting on the calcaneus during gait. RESULTS: We found that the calculated force-time profiles of the joint contact, ligament, and Achilles tendon forces varied with the time-history curve of the moment about the ankle joint. The model predicted peak talocalcaneal and calcaneocuboid joint loads of 5.4 and 4.2 body weights (BW) during walking and 11.1 and 7.9 BW during running. The maximum predicted Achilles tendon forces were 3.9 and 7.7 BW for walking and running. CONCLUSIONS: Large magnitude forces and calcaneal stresses are generated late in the stance phase, with maximum loads occurring at approximately 70% of the stance phase during walking and at approximately 60% of the stance phase during running, for the gait velocities analyzed. The trajectories of the principal stresses, during both walking and running, corresponded to each other and qualitatively to the calcaneal trabecular architecture.

Giddings, V. L.; Beaupre, G. S.; Whalen, R. T.; Carter, D. R.

2000-01-01

35

Computed tomography of calcaneal fractures  

SciTech Connect

Computed tomography (CT) of 25 fractured calcanei was performed to investigate the potential of CT in evaluating the pattern and biomechanics of these fractures. The characteristic findings of typical fractures are presented, including the number and type of principal fragments, size and dislocation of the sustentacular fragment, and involvement of the anterior and posterior facets of the subtalar joint. In 17 cases, the calcaneus consisted of four or more fragments. Furthermore, in 17 cases the sustentacular fragment included all or part of the posterior facet joint. In 18 of the 25 cases, the sustentacular fragment was displaced. It is concluded that well performed CT is an invaluable adjunct in understanding the fracture mechanism and in detecting pain-provoking impingement between the fibular malleolus and the tuberosity fragment.

Heger, L.; Wulff, K.; Seddiqi, M.S.A.

1985-07-01

36

Explicit finite element modelling of heel pad mechanics in running: inclusion of body dynamics and application of physiological impact loads.  

PubMed

Many heel pathologies including plantar heel pain may result from micro tears/trauma in the subcutaneous tissues, in which internal tissue deformation/stresses within the heel pad play an important role. Previously, many finite element models have been proposed to evaluate stresses inside the heel pad, but the majority of these models only focus on static loading boundary conditions. This study explored a dynamics modelling approach to the heel pad subjected to realistic impact loads during running. In this model, the inertial property and action of the body are described by a lumped parameter model, while the heel/shoe interactions are modelled using a viscoelastic heel pad model with contact properties. The impact force pattern, dynamic heel pad deformation and stress states predicted by the model were compared with published experimental data. Further parametrical studies revealed the model responses, in terms of internal stresses in the skin and fatty tissue, change nonlinearly when body dynamics changes. A reduction in foot's touchdown velocity resulted in a less severe impact landing and stress relief inside the heel pad, for example peak von-Mises stress in fatty tissue, was reduced by 11.3%. Applications of the model may be extendable to perform iterative analyses to further understand the complex relationships between body dynamics and stress distributions in the soft tissue of heel pad during running. This may open new opportunities to study the mechanical aetiology of plantar heel pain in runners. PMID:24980181

Chen, Wen-Ming; Lee, Peter Vee-Sin

2015-11-01

37

Investigations on the viscoelastic behaviour of a human healthy heel pad: in vivo compression tests and numerical analysis.  

PubMed

The aim of this study was to investigate the viscoelastic behaviour of the human heel pad by comparing the stress-relaxation curves obtained from a compression device used on an in vivo heel pad with those obtained from a three-dimensional computer-based subject-specific heel pad model subjected to external compression. The three-dimensional model was based on the anatomy revealed by magnetic resonance imaging of a 31-year-old healthy female. The calcaneal fat pad tissue was described with a viscohyperelastic model, while a fibre-reinforced hyperelastic model was formulated for the skin. All numerical analyses were performed to interpret the mechanical response of heel tissues, with loading conditions and displacement rate in agreement with experimental tests. The heel tissues showed a non-linear, viscoelastic behaviour described by characteristic hysteretic curves, stress-relaxation and viscous recovery phenomena. The reliability of the investigations was validated by the interpretation of the mechanical response of heel tissues under the application of three pistons with diameter of 15, 20 and 40 mm, at the same displacement rate of about 1.7 mm/s. The maximum and minimum relative errors were found to be less than 0.95 and 0.064, respectively. PMID:23662350

Matteoli, Sara; Fontanella, Chiara G; Carniel, Emanuele L; Wilhjelm, Jens E; Virga, Antonio; Corbinz, Nadège; Corvi, Andrea; Natali, Arturo N

2013-03-01

38

Spontaneous talar and calcaneal fracture in rheumatoid arthritis: a case report  

PubMed Central

Rheumatoid arthritis (RA) leads to a progressive weakening of the skeleton which may result in bone fractures. However, spontaneous fractures (exclusive of stress fractures, vertebral collapse, and superficial articular fragmentation) in patients with rheumatoid arthritis have been only occasionally reported in the medical literature. A case of spontaneous talar and calcaneal fracture in rheumatoid arthritis is described. Bone lesions were identified on radiographs, MR images and scintigraphy in a patient with right ankle pain. The absence of episodes of acute trauma, and the presence of acute clinical manifestations should guide the clinical suspicion. PMID:22470803

Spina, Antonio; Clemente, Alberto; Vancini, Chiara; Fejzo, Majlinda; Campioni, Paolo

2011-01-01

39

Regional plantar foot pressure distributions on high-heeled shoes-shank curve effects  

NASA Astrophysics Data System (ADS)

Forefoot pain is common in high-heeled shoe wearers due to the high pressure caused by the center of body mass moving forward and the increased arch height with heel elevation. Sufficient arch support could reduce the high pressure over forefoot. However, too much arch support could lead to abnormal foot alignment and pain over midfoot. Little information is reported on the relationship among plantar arch height, shank curve design and plantar pressure. This study aimed at quantifying the plantar arch height changes at different heel heights and investigating the effect of shank curve on plantar pressure distribution. The plantar arch height increased to (7.6±1.3)mm at heel height of 75 mm. The Chinese standard suggests the depth of last should be 8.5mm for heel height of 75 mm. When a shank curve with higher depth of last (11 mm) was used, the peak pressure over forefoot further decreased in midstance phase, which might ease the forefoot problems, while the peak pressure over midfoot increased but not exceeded the discomfort pressure thresholds. To achieve a more ideal pressure distribution in high-heeled shoes, a higher than expected depth of last would be suggested that would not cause discomfort over midfoot.

Cong, Yan; Lee, Winson; Zhang, Ming

2011-12-01

40

The use of a kickstand modification for the prevention of heel decubitus ulcers in trauma patients with lower extremity external fixation.  

PubMed

External fixation is frequently used to manage patients with lower extremity trauma. Excessive pressure from contact surfaces must be avoided to prevent added morbidity from heel ulcers. The purpose of this article is to present a simple solution to off-load the heel by adding a "kickstand" to the external fixator. The kickstand modification is designed to prevent breakdown of the soft tissue covering of the heel that can complicate the treatment of the initial injury and may also result in calcaneal osteomyelitis. By preventing such damage, the kickstand modification may also help to avoid radical procedures for soft tissue coverage, prolonged treatment times, and, ultimately, amputations. The kickstand device is made by adapting 2 extra rods and clamps to the primary external fixator to obtain proper clearance of the heel when the foot is resting over a surface. In cases where traditional off-loading devices are difficult to apply and can interfere with proper wound care, the kickstand might provide a useful preventive solution. From January to August 2006, we applied this technique in 10 patients with lower extremity trauma (11 fractures) and have seen no heel ulcers or other complications as per the staging system from the National Pressure Ulcer Advisory Panel. PMID:19169108

Castro-Aragon, Oscar E; Rapley, Jay H; Trevino, Saul G

2009-02-01

41

A retrospective comparison of percutaneous plantar fasciotomy and open plantar fasciotomy with heel spur resection.  

PubMed

Minimally invasive surgery for the treatment of recalcitrant heel pain is a relatively new approach. To compare the 2 approaches, a retrospective chart review was conducted of 53 patients (55 feet) who had undergone surgical treatment of plantar fasciitis by either open fasciotomy with heel spur resection or percutaneous medial fascial release. The outcomes measures included perioperative pain and the interval to return to full activity. Pain was measured on a subjective 10-point visual analog scale. Of the 55 fasciotomies performed, 23 were percutaneous and 32 were open, with adjunctive heel spur resection. The percutaneous group experienced a mean pain reduction of 5.69 points at the first postoperative visit, whereas open fasciotomy group experienced a mean pain reduction of 3.53 points. At 12 months postoperatively, no statistically significant difference was found in the pain levels between the 2 groups. The results also showed that the percutaneous group returned to normal activity an average of 2.82 weeks (p < .001) faster than the open group. In the patient cohorts studied, percutaneous medial fascial release was as effective at resolving recalcitrant plantar fasciitis pain as the open procedure and involved less postoperative pain and a faster return to full activity. PMID:23473671

Fallat, Lawrence M; Cox, J Todd; Chahal, Ruby; Morrison, Pamela; Kish, John

2013-01-01

42

Buy good shoes that fit well. Shoes should fit snugly in the heel so that the foot does not slide back and forth  

E-print Network

Buy good shoes that fit well. Shoes should fit snugly in the heel so that the foot does not slide drug store. Bring some to school with you. 3. Seek medical help early for problems. Redness, heat, pain

Virginia Tech

43

Criss Cross Heel and Toe Touch  

E-print Network

-a-Picture/Perspectives Duct Tape Adventure Egg Drop Electric Fence Escape from the Planet "What" Eyes Voice Body Fire Fighting1 GAMES BOOK Stretches All Over Criss Cross Crow Hop Fried Egg Heel and Toe Touch Heel Clicker Hop Clam Free Clock Dead Ant Tag Dragon Tail Tag Drip Drip Drop Earth Air Water Fire (E) Ecological Values

Royer, Dana

44

Fibrolipomatous hamartoma of the inferior calcaneal nerve (Baxter nerve).  

PubMed

Fibrolipomatous hamartoma (FLH) is a rare, benign lesion of the peripheral nerves most frequently involving the median nerve and its digital branches (80 %). Pathognomonic MR features of FLH such as coaxial-cable-like appearance on axial planes and a spaghetti-like appearance on coronal planes have been described by Marom and Helms, obviating the need for diagnostic biopsy. We present a case of fibrolipomatous hamartoma of the inferior calcaneal nerve (Baxter nerve) with associated subcutaneous fat proliferation. PMID:22526881

Zeng, Rong; Frederick-Dyer, Katherine; Ferguson, N Lynn; Lewis, James; Fu, Yitong

2012-09-01

45

Surgical Treatment of Calcaneal Fractures of Sanders Type II and III by a Minimally Invasive Technique Using a Locking Plate.  

PubMed

The aim of the present study was to investigate the outcomes of surgical treatment of calcaneal fractures of Sanders type II and III using a minimally invasive technique and a locking plate. We reviewed 33 feet in 33 consecutive patients with Sanders type II and III calcaneal fractures who had undergone a minimally invasive technique using percutaneous reduction and locking plates. All operations were performed by the same surgeons. The postoperative evaluation included radiographs, determination of restoration of Böhler's angle and Gissane's angle, and administration of the American Orthopaedic Foot and Ankle Society ankle-hind foot scale, Maryland Foot Score, and visual analog scale of pain. The mean visual analog scale score was 1.6 ± 1.4 when radiographic fracture healing was observed. The median functional score of the 33 patients (33 feet) reached 82 (interquartile range 80 to 99) at the last follow-up evaluation according to the American Orthopaedic Foot and Ankle Society ankle-hind foot scale and 89 (interquartile range 80 to 99) according to Maryland Foot Score. All cases achieved restoration of a normal Böhler's angle and Gissane's angle. Postoperative superficial infections occurred in 2 patients, subtalar arthritis developed in 2, and no soft tissue necrosis was observed. For Sanders type II and III fractures of the calcaneus bone, treatment with a minimally invasive technique combining percutaneous reduction and locking plate fixation provided satisfactory clinical results, with a lower incidence of complications. However, longer term studies with a larger sample size and more randomized controlled trials are required to define the superiority of our minimally invasive technique compared with conventional surgical treatment of calcaneal fractures. PMID:25441282

Cao, Liehu; Weng, Weizong; Song, Shaojun; Mao, Ningfang; Li, Haihang; Cai, Yuanqi; Zhou, Qirong; Su, Jiacan

2015-01-01

46

Pain.  

PubMed

Invasive stimulation of the motor (precentral) cortex using surgically implanted epidural electrodes is indicated for the treatment of neuropathic pain that is refractory to medical treatment. Controlled trials have demonstrated the efficacy of epidural motor cortex stimulation (MCS), but MCS outcome remains variable and validated criteria for selecting good candidates for implantation are lacking. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach that could be used as a preoperative tool to predict MCS outcome and also could serve as a therapeutic procedure in itself to treat pain disorders. This requires repeated rTMS sessions and a maintenance protocol. Other studies have also demonstrated the efficacy of transcranial direct current stimulation (tDCS) in relieving chronic pain syndromes. The most studied target is the precentral cortex, but other targets, such as the prefrontal and parietal cortices, could be of interest. The analgesic effects of cortical stimulation relate to the activation of various circuits modulating neural activities in remote structures, such as the thalamus, limbic cortex, insula, or descending inhibitory controls. In addition to the treatment of refractory neuropathic pain by epidural MCS, new developments of this type of strategy are ongoing, for other types of pain syndrome and stimulation techniques. PMID:24112914

Lefaucheur, Jean-Pascal

2013-01-01

47

The role of the calcanealheel’ as a propulsive lever in basal archosaurs and extant monitor lizards  

Microsoft Academic Search

The structurally complex ankles of Triassic archosaurs (Reptilia: Diapsida) have been repeatedly described, and tarsal characters have played an important role in analyses of archosaur phylogeny. Morphological variations in the ankle joint undoubtedly had a major impact on locomotion, but the functional implications of many ankle features remain poorly understood. This paper investigates the function of one such structure, the

CORWIN SULLIVAN

2010-01-01

48

Evolution and Allometry of Calcaneal Elongation in Living and Extinct Primates  

PubMed Central

Specialized acrobatic leaping has been recognized as a key adaptive trait tied to the origin and subsequent radiation of euprimates based on its observed frequency in extant primates and inferred frequency in extinct early euprimates. Hypothesized skeletal correlates include elongated tarsal elements, which would be expected to aid leaping by allowing for increased rates and durations of propulsive acceleration at takeoff. Alternatively, authors of a recent study argued that pronounced distal calcaneal elongation of euprimates (compared to other mammalian taxa) was related primarily to specialized pedal grasping. Testing for correlations between calcaneal elongation and leaping versus grasping is complicated by body size differences and associated allometric affects. We re-assess allometric constraints on, and the functional significance of, calcaneal elongation using phylogenetic comparative methods, and present an evolutionary hypothesis for the evolution of calcaneal elongation in primates using a Bayesian approach to ancestral state reconstruction (ASR). Results show that among all primates, logged ratios of distal calcaneal length to total calcaneal length are inversely correlated with logged body mass proxies derived from the area of the calcaneal facet for the cuboid. Results from phylogenetic ANOVA on residuals from this allometric line suggest that deviations are explained by degree of leaping specialization in prosimians, but not anthropoids. Results from ASR suggest that non-allometric increases in calcaneal elongation began in the primate stem lineage and continued independently in haplorhines and strepsirrhines. Anthropoid and lorisid lineages show stasis and decreasing elongation, respectively. Initial increases in calcaneal elongation in primate evolution may be related to either development of hallucal-grasping or a combination of grasping and more specialized leaping behaviors. As has been previously suggested, subsequent increases in calcaneal elongation are likely adaptations for more effective acrobatic leaping, highlighting the importance of this behavior in early euprimate evolution. PMID:23844094

Boyer, Doug M.; Seiffert, Erik R.; Gladman, Justin T.; Bloch, Jonathan I.

2013-01-01

49

Longitudinal changes in calcaneal quantitative ultrasound measures during childhood  

PubMed Central

Summary This longitudinal study examined how calcaneal quantitative ultrasound (QUS) measures change during childhood while taking into account skeletal maturation, body mass index (BMI), and physical activity. The study reported sex differences in QUS growth curves and an inverse relationship between BMI and speed of sound (SOS) measures. Introduction The aim of this study was to examine how calcaneal QUS parameters change over time during childhood and to determine what factors influence these changes. Methods The study sample consisted of a total of 192 Caucasian children participating in the Fels Longitudinal Study. A total of 548 calcaneal broadband ultrasound attenuation (BUA) and SOS observations were obtained between the ages of 7.6 and 18 years. The best fitting growth curves were determined using statistical methods for linear mixed effect models. Results There are significant sex differences in the pattern of change in QUS parameters (p<0.05). The relationship between QUS measures and skeletal age is best described by a cubic growth curve in boys and a linear pattern among girls. Boys experience their most rapid growth in BUA and SOS in early and late adolescence, while girls experience constant growth throughout childhood. Adiposity levels were significantly associated with the changes in SOS among boys (p<0.001) and girls (p<0.01), indicating that children with higher BMI are likely to have lower SOS over time compared to children with lower BMI. For girls, physical activity levels showed positive associations with changes in QUS measures (p<0.05). Conclusion This study documents significant sex differences in the pattern of change in QUS measures over childhood and adolescence. Our study also shows significant influences of adiposity and physical activity on the pattern of change in QUS measures during childhood. PMID:20976593

Nahhas, R. W.; Choh, A. C.; Demerath, E. W.; Duren, D. L.; Chumlea, W. C.; Sherwood, R. J.; Towne, B.; Siervogel, R. M.; Czerwinski, S. A.

2014-01-01

50

Ergonomic procedure for heel sticks and shots in Kangaroo Care (skin-to-skin) position.  

PubMed

Kangaroo Care (KC) has been recommended as a pain-reducing strategy in neonates; however, KC has not been widely used to minimize procedural pain caused in part by nurses'/phlebotomists' discomfort when positioning themselves and the infant for blood drawing and injections. Therefore, an ergonomically designed setup incorporating the use of KC was introduced into clinical practice to facilitate blood draws and injections. The step-by-step procedure used for heel sticks and injections is presented in this manuscript. After implementing the ergonomic step-by-step protocol, complaints of discomfort by nurses and phlebotomists ceased, and an additional benefit was that infant pain responses were significantly reduced. PMID:23985473

Cong, Xiaomei; Ludington-Hoe, Susan; Vazquez, Victoria; Zhang, Di; Zaffetti, Sharon

2013-01-01

51

[Osteochondritis Dissecans of the Talus with Hindfoot Malalignment - Autologous Matrix-Induced Chondrogenesis with Lateral Calcaneal Distraction Osteotomy in an Internationally Successful Young Female Ski Racer.  

PubMed

Background: Osteochondritis dissecans of the talus (ODT) describes a special entity of osteochondral lesions of the talus (OLT). In the case of an advanced stage or failure of conservative treatment, a wide variety of surgical treatment strategies for osteochondral defects of the ankle have been described. In most cases, the ODT leads to a loss in sports time and competition. Material and Methods: In the following case report we describe a case dealing with a young alpine ski racer who competes in international races. An osteochondritis dissecans of the talus was observed and led to pain and loss of sports function. We decided for an operative treatment with an autologous matrix-associated chondrogenesis (AMIC). In addition to the AMIC we performed a lateral calcaneal distraction osteotomy, based on the findings of a flatfoot in order to correct the hindfoot malalignment. Results: At an early time pain relief could be detected. Step by step, the presented ski racer could increase the intensity of training sessions. Based on the findings in the MRI at the follow-up, an integrated repair tissue could be detected. Conclusions: The following case report describes a positive course after an autologous matrix-associated chondrogenesis (AMIC) combined with a lateral calcaneal distraction osteotomy. At this time the athlete is reintegrated in elite sports and takes part in the normal training programmes. PMID:25211309

Hotfiel, T; Engelhardt, M

2014-09-11

52

Plantar foot pressures during treadmill walking with high-heel and low-heel shoes.  

PubMed

The effect of walking with high-heel shoes on plantar foot pressure distribution was investigated. Ten normal women walking in shoes with low heels were compared to women walking in high-heel shoes. It was shown that high-heel shoes increased the load on the forefoot and relieved it on the hindfoot. The load passed toward the medial forefoot and the hallux. The lateral side of the forefoot showed a decrease in contact area, reduced forces, and peak pressures. The medial side of the forefoot had a higher force-time and pressure-time integral. It is suggested that these higher loads on the medial forefoot may aggravate symptoms in patients with hallux valgus deformity. PMID:8946179

Nyska, M; McCabe, C; Linge, K; Klenerman, L

1996-11-01

53

Analysis of heel pad tissues mechanics at the heel strike in bare and shod conditions.  

PubMed

A combined experimental and numerical approach is used to investigate the interaction phenomena occurring between foot and footwear during the heel strike phase of the gait. Two force platforms are utilised to evaluate the ground reaction forces of a subject in bare and shod walking. The reaction forces obtained from the experimental tests are assumed as loading conditions for the numerical analyses using three dimensional models of the heel region and of the running shoe. The heel pad region, as fat and skin tissues, is described by visco-hyperelastic and fibre-reinforced hyperelastic formulations respectively and bone region by a linear orthotropic formulation. Different elastomeric foams are considered with regard to the outsole, the midsole and the insole layers. The mechanical properties are described by a hyperfoam formulation. The evaluation of the mechanical behaviour of the heel pad tissues at the heel strike in bare and shod conditions is performed considering different combinations of materials for midsole and insole layers. Results allow for the definition of the influence of different material characteristics on the mechanical response of the heel pad region, in particular showing the compressive stress differentiation in the bare and shod conditions. PMID:22789809

Fontanella, C G; Forestiero, A; Carniel, E L; Natali, A N

2013-04-01

54

Bone health comparison in seven Asian countries using calcaneal ultrasound  

PubMed Central

Background Bone density measurements by DXA are not feasible for large population studies, whereas portable ultrasound heel scanners can provide a practical way of assessing bone health status. The purpose of this study was to assess bone health in seven Asian countries using heel ultrasound. Methods Stiffness index (SI) was measured and T-scores generated against an Asian database were recorded for 598,757 women and 173,326 men aged over 21 years old using Lunar Achilles (GE Healthcare) heel scanners. The scanners were made available in public centres in Singapore, Vietnam, Malaysia, Taiwan, Thailand, Indonesia and the Philippines. Results The mean SI was higher for men than women. In women SI as well as T-scores declined slowly until approximately 45 years of age, then declined rapidly to reach a mean T-score of?80 years. Conclusions The heel scan data shows a high degree of poor bone health in both men and women in Asian countries, raising concern about the possible increase in fractures with ageing and the expected burden on the public health system. PMID:23497143

2013-01-01

55

Calcaneal Osteotomy Preoperative Planning System with 3D Full-Sized Computer-Assisted Technology  

Microsoft Academic Search

In this study, we developed a CT-based computer-assisted pre-operative planning and simulating system for the calcaneal osteotomy\\u000a by integrating different software’s function. This system uses the full-scaled 3D reverse engineering technique in designing\\u000a and developing preoperative planning modules for the calcaneal osteotomy surgery. The planning system presents a real-sized\\u000a three-dimensional image of the calcaneus, and provides detailed interior measurements of

Yi-Jiun Chou; Shuh-Ping Sun; Hsin-Hua Liu

56

Reductions in heel bone quality across gestation are attenuated in pregnant adolescents with higher prepregnancy weight and greater increases in PTH across gestation.  

PubMed

Few studies have examined the effect of maternal calcium intake and vitamin D status on bone health across gestation in pregnant adolescents. This study aimed to characterize maternal bone quality and determinants of bone-quality change across gestation in pregnant adolescents. Healthy pregnant adolescents (n?=?156; aged 13 to 18 years) with singleton pregnancies and at 12 to 30 weeks gestation at enrollment were recruited from two urban maternity clinics in Baltimore, MD, and Rochester, NY, for this prospective longitudinal study. Maternal serum was collected at midgestation and at delivery for assessment of bone biomarkers and calcitropic hormones. Maternal bone quality (assessed by heel ultrasound) and sonographic fetal biometry were measured up to three times across pregnancy. Racially diverse teens (64.7% African American, 35.3% white) were followed from 21.0 (interquartile range [IQR] 17.3, 27.0) weeks of gestation until delivery at 40.0 (IQR 39.0, 40.7) weeks. Significant decreases in calcaneal speed of sound (SOS), broadband ultrasound attenuation (BUA), and quantitative ultrasound index (QUI) (-9.2?±?16.1?m/s, -3.2 (-8.0, 2.1) dB/MHz and -5.3?±?8.8, respectively) were evident across pregnancy. Multivariate analysis controlling for baseline measures and measurement intervals was used to identify independent predictors of normalized (per week) calcaneal bone loss. Weekly decreases in bone quality were not significantly associated with maternal calcium intake or 25(OH)D concentration. Greater weekly reductions in calcaneal bone quality were evident in teens with lower prepregnancy weight (BUA, p?=?0.006 and QUI, p?=?0.012) and among those with lower weekly increase in PTH (SOS, p?=?0.046). Overall, significant decreases in calcaneal bone quality occurred across pregnancy in adolescents, but the magnitude of this loss was attenuated in those with greater prepregnancy weight and weekly increases in PTH. Further studies are needed to understand the role of elevated PTH and greater prepregnancy weight in preserving adolescent bone during pregnancy. PMID:24676885

Whisner, Corrie M; Young, Bridget E; Witter, Frank R; Harris, Zena Leah; Queenan, Ruth A; Cooper, Elizabeth M; O'Brien, Kimberly O

2014-09-01

57

Waste Tank Heel Chemical Cleaning Summary  

SciTech Connect

At the Savannah River Site in Aiken, South Carolina, there are approximately 40 million gallons of legacy High Level Waste stored in large capacity sub-surface tanks. Twelve of these tanks are single-containment, non-conforming tanks with leaks. These tanks were built in the 1950s. Some of these tanks contain sludge heels and are being considered for near-term removal efforts and vitrification. Currently, only mechanical methods (i.e., pumps) are used to remove the sludge waste with varying degrees of success. To provide for additional levels of removal, chemically-aided techniques are being considered. The objective of the was to collect and evaluate information available on chemical-based methods for removing residual solids from the Site's waste tanks. As part of this study, the team was requested to develop recommendations for chemical treatments to remove residual heels (primarily sludge). Ideally, one agent alone would be efficient at dissolving all residual tank heels and yet satisfy all safety and process concerns. No such chemical cleaning agent was found. The cleaning agents identified from the literature, included oxalic acid, a mixture of oxalic acid and citric acid, a combination of oxalic acid with hydrogen peroxide, nitric acid, formic acid, and organics. A criteria matrix for evaluating the various cleaning agents was developed. The results of the evaluation conclusively support oxalic acid as the cleaning agent of choice for the immediate future. Oxalic acid scored nearly double the next closest cleaning agent. Nitric acid, formic acid, and oxalic acid with hydrogen peroxide were all closely grouped for the next best choice. The mixture of oxalic acid and citric acid rated poorly. Organics rated even more poorly due to large uncertainties in performance and downstream impacts.

Barnes, M.J.

2003-12-02

58

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Calculation of wind heeling moment (Hm). 174...Special Rules Pertaining to Mobile Offshore Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of a...

2012-10-01

59

Complex heel reconstruction with a sural fasciomyocutaneous perforator flap.  

PubMed

Reconstruction of weight-bearing surfaces at the foot and ankle is controversial. Free tissue transfer and local fasciocutaneous perforator flaps are preferred for plantar reconstruction, but high rates of flap breakdown and ulceration have caused unsatisfactory functional outcomes. We present a modified "sural fasciomyocutaneous perforator flap" and its functional outcome. Between January 2007 and September 2010, 19 patients were treated for soft-tissue defects in the weight-bearing area with sural fasciomyocutaneous perforator flaps. The gastrocnemius, preserved in the base of the flap, was applied as padding under the calcaneus. In follow-up from 9 to 25 months (mean 13.8 months), each patient's pain score, defect size, ulcer formation, protective sensation recovery, and normal footwear were analyzed. The majority of the flaps survived with satisfactory aesthetic and functional results. One case of partial flap loss and one case of delayed ulceration were noted. With partial weight bearing at 4 weeks, satisfactory gait recovery was obtained at 5 to 8 months (in conjunction with protective sensation recovery). Sural fasciomyocutaneous perforator flap is a reliable modality in heel construction, showing advantages of low ulceration rate, durability, and good protective sensation recovery compared with conventional free tissue transfer and local fasciocutaneous perforator flap. PMID:24163225

Lu, Shengdi; Chai, Yimin; Wang, Chunyang; Wen, Gen

2014-02-01

60

On muscle, tendon and high heels.  

PubMed

Wearing high heels (HH) places the calf muscle-tendon unit (MTU) in a shortened position. As muscles and tendons are highly malleable tissues, chronic use of HH might induce structural and functional changes in the calf MTU. To test this hypothesis, 11 women regularly wearing HH and a control group of 9 women were recruited. Gastrocnemius medialis (GM) fascicle length, pennation angle and physiological cross-sectional area (PCSA), the Achilles' tendon (AT) length, cross-sectional area (CSA) and mechanical properties, and the plantarflexion torque-angle and torque-velocity relationships were assessed in both groups. Shorter GM fascicle lengths were observed in the HH group (49.6+/-5.7 mm vs 56.0+/-7.7 mm), resulting in greater tendon-to-fascicle length ratios. Also, because of greater AT CSA, AT stiffness was higher in the HH group (136.2+/-26.5 N mm(-1) vs 111.3+/-20.2 N mm(-1)). However, no differences in the GM PCSA to AT CSA ratio, torque-angle and torque-velocity relationships were found. We conclude that long-term use of high-heeled shoes induces shortening of the GM muscle fascicles and increases AT stiffness, reducing the ankle's active range of motion. Functionally, these two phenomena seem to counteract each other since no significant differences in static or dynamic torques were observed. PMID:20639419

Csapo, R; Maganaris, C N; Seynnes, O R; Narici, M V

2010-08-01

61

Comparison of open reduction internal fixation and conservative treatment plus open reduction internal fixation for calcaneal fractures  

PubMed Central

To compare the effect of open reduction internal fixation and conservative treatment combined with open reduction internal fixation for subjects with calcaneal fractures, 130 patients with calcaneal fractures were divided into observation group and control group. Observation group were treated with open reduction internal fixation and conservative treatment, control group treated as open reduction internal fixation. The healing related indicators, daily life activities ability score of observation group after treatment 6 months were significantly higher than that of the control group, there was no significant difference for the healing rate of excellent and good rate, the daily life activities ability score after one and three year between two groups. Open reduction internal fixation combined with conservative treatment in treatment of calcaneal fractures can clear anatomic structure and have fast function recovery. Thus, it should be as the preferred method for the treatment of calcaneal fractures. PMID:25550973

Pan, Yongmiao; Yuan, Linyi; Ye, Chengfeng

2014-01-01

62

Human touch effectively and safely reduces pain in the newborn intensive care unit.  

PubMed

This was a feasibility pilot study to evaluate the efficacy of the nonpharmacologic pain management technique of gentle human touch (GHT) in reducing pain response to heel stick in premature infants in the neonatal intensive care unit (NICU). Eleven premature infants ranging from 27 to 34 weeks' gestational age, in a level III NICU in a teaching hospital, were recruited and randomized to order of treatment in this repeated-measures crossover-design experiment. Containment with GHT during heel stick was compared with traditional nursery care (side lying and "nested" in an incubator). Heart rate, respiratory rate, oxygen saturation, and cry were measured continuously beginning at baseline and continuing through heel warming, heel stick, and recovery following the heel stick. Infants who did not receive GHT had decreased respiration, increased heart rate, and increased cry time during the heel stick. In contrast, infants who received GHT did not have decreased respirations, elevated heart rates, or increased cry time during the heel stick. No significant differences were noted in oxygen saturation in either group. GHT is a simple nonpharmacologic therapy that can be used by nurses and families to reduce pain of heel stick in premature infants in the NICU. PMID:24602430

Herrington, Carolyn J; Chiodo, Lisa M

2014-03-01

63

Utility of heel ultrasound bone density in men.  

PubMed

In women, heel ultrasound (US) bone mineral density (BMD) has been shown to predict fracture risk, but the usefulness of this screening tool in men is not known. We measured the heel quantitative ultrasound index (QUI( in a convenience sample 185 of men (136 Caucasian, 1 Asian, and 48 African-American) with an average age of 63 yr (range of 25-85) undergoing BMD of the spine and hip by dual X-ray absorptiometry (DXA) to determine whether the heel measurement could predict central BMD. The average DXA T-score was -0.97, -1.20, and -1.61 for the spine, total hip, and femoral neck, respectively. The mean heel US BMD T-score (using the only available T-score, which was defined for Caucasian postmenopausal women) was -0.92. There were significant correlations among the various DXA measurements and the heel US BMD T-score (r = 0.373-0.483, p < 0.001). We defined arbitrarily osteopenia as a spine, total hip, or femoral neck T-score by DXA of < -1.5. We also made two different arbitrary definitions of osteoporosis by DXA: < -2.0 and < -2.5. Using these numbers as disease definitions, we determined the specificity, sensitivity, as well as positive and negative predictive values of using the heel US T-score to predict osteopenia or osteoporosis. Using various cutoffs for the heel T-score, we found that increasing the cutoff toward 0 increased the sensitivity but lowered the specificity. No cutoff was found that provided both good sensitivity and specificity. By analyzing the men by ethnic and age groups, we found that the best set of receiver operating characteristic (ROC) curves was derived from data using heel US to predict osteopenia and osteoporosis in men younger than age 65, although the areas under the ROC curve were approx 0.8. In conclusion, despite a strong correlation between the heel QUI and the spine and hip BMD by DXA, no heel T-score could predict osteopenia or osteoporosis with satisfactory sensitivity and specificity. It is possible that the use of risk factor assessment plus heel QUI might have better predictive value, and further studies are needed to determine whether heel QUI or other US determination is an independent risk factor for fracture in men. PMID:11740064

Adler, R A; Funkhouser, H L; Holt, C M

2001-01-01

64

Preventing heel ulcers: a comparison of prophylactic body-support systems.  

PubMed

Five commercially available body-support systems used in the prevention of decubitus heel ulcers were objectively compared for their capacity to dissipate or decrease pressure concentration at the most prominent posterior aspect of the heel in bedridden, insensate patients. The Foot Drop Stop, a foam heel suspender, completely eliminated contact between the heel and the bed, and it was the most successful in decreasing pressure concentration. The space boot and foam heel protectors were far more successful than sheepskin rugs or polyester heel protectors, which provided little protection to the prominent heel. PMID:2059125

Pinzur, M S; Schumacher, D; Reddy, N; Osterman, H; Havey, R; Patwardin, A

1991-06-01

65

Heel-line hyperpigmentation: a variant of sock-line hyperpigmentation after the use of heel-length socks.  

PubMed

Two infants developed hyperpigmented curvilinear patches on the posterior heel after wearing heel-length socks. Both of the patient's lesions improved after discontinuing the use of the heel-length socks. Hyperpigmented patches called sock-line or mitten-line hyperpigmentation have been reported at sites of tight elastic bands from socks or mittens in infants on the calves and wrists. Recognizing this clinical entity is important to differentiate it from other causes of linear lesions such as child abuse or amniotic band syndrome. PMID:23432211

Ciliberto, Heather; Berk, David; Salphale, Pankaj; Bayliss, Susan

2013-01-01

66

Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach  

Microsoft Academic Search

The objective of this study was to evaluate the outcome of semi-open reduction and minimal internal fixation through a single\\u000a small lateral approach as a minimally invasive technique for treatment of displaced intra-articular calcaneal fractures. This\\u000a prospective study was conducted on eighteen patients (16 men and 2 women). The average age was 37.7 (22–55). The most common\\u000a cause of injury was

Mohamed F. Mostafa; Gamal El-Adl; Ehab Y. Hassanin; M-Serry Abdellatif

2010-01-01

67

The mineralized collagen for the reconstruction of intra-articular calcaneal fractures with trabecular defects  

PubMed Central

Background: In cases of severe subversion of the morphology of calcaneal fractures with trabecular defects, bone graft is often necessary to provide a mechanical buttress. The mineralized collagen (MC) is a novel bone substitute that is developed by biomimetic synthesis strategy that mimics the extracellular matrix (ECM) of natural bone in structure and chemical composition. It can avoid donor site morbidity and complications associated with harvesting autologous bone graft. Objective: In this study, we conducted a retrospective matched-pair analysis to assess the clinical and radiological performances of MC as a bone graft substitute in intra-articular calcaneal fractures with trabecular defects. Methods: 24 pairs of intra-articular calcaneal fractures with trabecular defects were treated with open reduction, internal fixation, and grafting either with MC or autograft. Patient demographics, medical history, and CT fracture classification were matched. Fractures were monitored 6 weeks, 12 weeks, 6 months, and 1 year postoperatively for healing and postoperative complications and results were analyzed. Results: All patients had follow-up at a minimum of 12 months after surgery with a mean follow-up time of 17 months. All fractures were healed; there were no significant differences in the meantime to union and clinical between the two groups. The radiographic evaluation confirmed that a significant improvement in the mean Böhler’s angle, Gissane’s angle and the calcaneus height was observed in all patients in both treatment groups. A total of 29% (7/24) of patients suffered from harvest-site morbidity at 12 months in the autograft group. In contrast, all patients were free from postoperative local complications in the iliac region and no patient developed adverse reactions attributable to MC in the MC group. Conclusion: These results justify and favor the use of MC as a good autograft alternative in displaced intra-articular calcaneal fractures with trabecular defects. PMID:24270815

Lian, Kai; Lu, Hong; Guo, Xiaodong; Cui, Fuzhai; Qiu, Zhiye; Xu, Shuyun

2013-01-01

68

Does Plasmodium falciparum have an Achilles' heel?  

E-print Network

Plasmodium falciparum is the parasite that causes the most severe form of malaria. Currently, science has been established about its cellular structures, its metabolic processes, and even the molecular structures of its intrinsic membrane proteins responsible for transporting water, nutrient, and waste molecules across the parasite plasma membrane (PPM). I hypothesize that Plasmodium falciparum has an Achilles' heel that can be attacked with erythritol, the well-known sweetener that is classified as generally safe. Most organisms have in their cell membrane two types of water-channel proteins: aquaporins to maintain hydro-homeostasis across the membrane and aquaglyceroporins to uptake glycerols etc. In contrast, P. falciparum has only one type of such proteins---the multi-functional aquaglyceroporin (PfAQP) expressed in the PPM---to do both jobs. Moreover, the parasite also uses PfAQP to excrete its metabolic wastes (ammonia included) produced at a very high rate in the blood stage. This extremely high efficiency of the bug using one protein for multiple essential tasks makes the parasite fatally vulnerable. Erythritol in the blood stream can kill the parasite by clogging up its PfAQP channel that needs to be open for maintaining hydro-homeostasis and for excreting toxic wastes across the bug's PPM. In vitro tests are to measure the growth/death rate of P. falciparum in blood with various erythritol concentrations. In vivo experiments are to administer groups of infected mice with various doses of erythritol and monitor the parasite growth levels from blood samples drawn from each group. Clinic trials can be performed to observe the added effects of administering to patients erythritol along with the known drugs because erythritol was classified as a safe food ingredient.

Liao Y Chen

2013-05-21

69

Does Plasmodium falciparum have an Achilles’ heel?  

PubMed Central

Background Plasmodium falciparum is the parasite that causes the most severe form of malaria responsible for nearly a million deaths a year. Currently, science has been established about its cellular structures, its metabolic processes, and even the molecular structures of its intrinsic membrane proteins responsible for transporting water, nutrient, and waste molecules across the parasite plasma membrane (PPM). Presentation of the hypothesis I hypothesize that Plasmodium falciparum has an Achilles’ heel that can be attacked with erythritol, the well-known sweetener that is classified as generally safe. This hypothesis is based on the molecular structure of the parasite’s membrane and the quantitative mechanics of how erythritol interacts with the multi-functional channel protein expressed in the PPM. Most organisms have in their cell membrane two types of water-channel proteins: aquaporins to maintain hydro-homeostasis across the membrane and aquaglyceroporins to uptake glycerols etc. In contrast, P. falciparum has only one type of such proteins---the multi-functional aquaglyceroporin (PfAQP) expressed in the PPM---to do both jobs. Moreover, the parasite also uses PfAQP to excrete its metabolic wastes (ammonia included) produced at a very high rate in the blood stage. This extremely high efficiency of the bug using one protein for multiple essential tasks makes the parasite fatally vulnerable. Erythritol in the blood stream can kill the parasite by clogging up its PfAQP channel that needs to be open for maintaining hydro-homeostasis and for excreting toxic wastes across the bug’s PPM. Testing the hypothesis In vitro tests are to measure the growth/death rate of P. falciparum in blood with various erythritol concentrations. In vivo experiments are to administer groups of infected mice with various doses of erythritol and monitor the parasite growth levels from blood samples drawn from each group. Clinic trials can be performed to observe the added effects of administering to patients erythritol along with the known drugs because erythritol was classified as a safe food ingredient. Implications of the hypothesis If proven true, erythritol will cure the most severe form of malaria without significant side effects. PMID:25346857

Chen, Liao Y.

2014-01-01

70

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

Code of Federal Regulations, 2013 CFR

...SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO SPECIFIC VESSEL TYPES Special Rules Pertaining to Mobile Offshore Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of...

2013-10-01

71

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

...SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO SPECIFIC VESSEL TYPES Special Rules Pertaining to Mobile Offshore Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of...

2014-10-01

72

46 CFR 174.055 - Calculation of wind heeling moment (Hm).  

Code of Federal Regulations, 2011 CFR

...SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO SPECIFIC VESSEL TYPES Special Rules Pertaining to Mobile Offshore Drilling Units § 174.055 Calculation of wind heeling moment (Hm). (a) The wind heeling moment (Hm) of...

2011-10-01

73

Monarthritis of the ankle as manifestation of a calcaneal metastasis of bronchogenic carcinoma.  

PubMed

We report a case of bronchiogenic carcinoma metastasizing to the calcaneus and clinically manifesting itself as a therapy-refractory monarthritis in the right ankle. There is a wide spectrum of possible diagnoses of acute ankle monarthritis including different forms of inflammatory rheumatic diseases, sarcoidosis, osteoarthritis, or septic arthritis. Primary or metastatic malignancies of the hand or foot bones are considered to be rare. Persistent monarthritis as a sole symptom of a calcaneal metastasis has never been reported. This case demonstrates possible difficulties in the early differential diagnosis of acute monarthritis, and will be discussed with respect to the few reports on foot acrometastases. PMID:11846057

Kaufmann, J; Schulze, E; Hein, G

2001-01-01

74

Nuclear mitochondrial DNA: an Achilles' heel of molecular systematics, phylogenetics,  

E-print Network

Nuclear mitochondrial DNA: an Achilles' heel of molecular systematics, phylogenetics-like DNA (numt) has been found in a variety of insect species. In this work, our objective was to create. This led us to infer that M. capixaba has numts. A phylogenetic analysis which included COI sequences

75

An unusual cause of a painful plantar mass  

Microsoft Academic Search

Anomalous or accessory muscles in and around the foot and ankle have been reported in 8% of the population. Quadratus plantae muscle is one of the medial anomalous muscles in the foot and is a rare cause of heel pain or mass. This muscle has been implicated in tarsal tunnel syndrome. There is exiguous radiological description of quadratus plantae muscle

Suchi Gaba; Michael Allen; Raj Bhatt

2008-01-01

76

Back to School Foot Pain (Flip-Flops)  

MedlinePLUS

... ankles, broken or sprained toes, cuts and scrapes, plantar warts, Athlete's foot, and callus build-up on the heels and toes. Foot and ankle surgeons can usually reduce or eliminate students' foot pain with simple treatment methods including stretching exercises, ice ...

77

Heel and toe driving on fuel cell vehicle  

DOEpatents

A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

Choi, Tayoung; Chen, Dongmei

2012-12-11

78

Groin pain  

MedlinePLUS

Pain - groin; Lower abdominal pain; Genital pain; Perineal pain ... Common causes of groin pain include: Pulled muscle, tendon, or ligaments in the leg. This problem often occurs in people who play sports such as ...

79

THE COMBINED EFFECTS OF HEEL HEIGHT AND LOAD CARRIAGE ON POSTURE DURING GAIT: A PILOT STUDY  

Microsoft Academic Search

INTRODUCTION: It is very common for women to walk in high-heeled shoes and carry a bag at the same time. These disturbances are combined and reduce stability during gait. Studies on gait pattern with high-heeled shoes report decrease in trunk flexion angle and increase in plantarflexion angle. High-heeled shoes shift the center of gravity of the subject anteriorly resulting in

Soul Lee; Jing Xian Li

2008-01-01

80

Surgical treatment of intra-articular calcaneal fractures: description of a technique using an adjustable uniplanar external fixator.  

PubMed

Several surgical techniques are available for the treatment of intra-articular calcaneal fractures. The use of a uniplanar external fixator is an option for the treatment of fractures classified as Sanders types 2 and 3. Satisfactory reduction and stabilisation of the fracture are achieved by means of mini-incisions and fixator adjustment. The advantages of this technique include less soft-tissue damage, avoidance of internal implants and early weight-bearing with the potential to improve postoperative recovery. PMID:25540120

Ramos, Randal Rudge; de Castro Filho, Carlos Daniel Candido; Ramos, Roger Rudge; Bittar, Cíntia Kelly; de Cillo, Mario Sérgio Paulilo; de Mattos, Carlos Augusto; Zabeu, José Luís Amim; Mazzuia, Antenor Rafael

2014-11-01

81

Mid-Term Follow Up Results of Subtalar Distraction Arthrodesis Using a Double Bone-Block for Calcaneal Malunion  

PubMed Central

Purpose This study was designed to evaluate the mid-term results and efficacy of subtalar distraction double bone-block arthrodesis for calcaneal malunion. Materials and Methods From January 2004 to June 2007, we operated on 6 patients (10 cases). There were 5 males (9 cases) and 1 female (1 case), four of which presented with bilateral calcaneal malunion. Seven cases were operated on initially. The period between initial injury and arthrodesis was 23 months, and the average follow up period was 58 months. In operation, we applied an extensile lateral approach and arthrodesis was performed through a tricortical double bone-block and cannulated screws. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined to assess union and various parameters. Results The mean age of the patients was 41 years. All cases achieved radiologic union at the final follow-up. The mean AOFAS Ankle-Hindfoot scale (maximum of 94 points) increased from 43.3 points preoperatively to 85.4 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographs showed improvements of 5.6 mm in talo-calcaneal height, 1.8° in talocalcaneal angle, 5.1° in talar declination angle and 5.3° in talo-first metatarsal angle. Conclusion Subtalar distraction two bone-block arthrodesis provides overall good results not only in the short term but also the mid-term with significant improvement in clinical and radiologic outcomes. This procedure warrants consideration for managing calcaneal malunion with loss of height and subtalar arthritis. PMID:24954341

Chung, Hyung-Jin; Choo, Ji-Woong

2014-01-01

82

Abdominal pain  

MedlinePLUS

Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

83

Flank pain  

MedlinePLUS

Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. However, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...

84

Hybrid toe and heel joints for biped\\/humanoid robots for natural gait  

Microsoft Academic Search

A biped\\/humanoid robot with toe and heel joints is capable of more natural locomotion due to the additional degrees of freedom available. Though passive spring loaded joints can help to some extent, they introduce constraints between the joint torque and the joint angular displacement. In this paper, we propose to use hybrid active\\/passive toe and heel joints in order to

R Prasanth KumarI; Nandha Handharu; Jungwon Yoon; Gap-soon Kim

2007-01-01

85

Reliability of the Kinetic Measures under Different Heel Conditions during Normal Walking  

ERIC Educational Resources Information Center

The purpose of this study was to determine and compare the reliability of 3 dimension reaction forces and impulses in walking with 3 different heel shoe conditions. These results suggest that changing the height of the heels affects mainly the reliability of the ground reaction force and impulse measures on the medial and lateral dimension and not…

Liu, Yuanlong; Wang, Yong Tai

2004-01-01

86

Strength evaluation of lateral calcaneal wall with circular external fixation application in cadaveric specimens.  

PubMed

Circular external fixation is a useful treatment option for the correction of complex trauma, extremity deformity, osteomyelitis, and reconstruction of the foot and ankle. The goal of the present study was to determine the degrees of bolt rotation required to create enough wire tension to cause structural failure of the lateral calcaneal wall when stressed with both olive and smooth wires in a cadaveric model. Ten fresh, thawed, below-the-knee specimens were tested at the San Diego Cadaveric Academic Research Symposium. The mean bolt rotation required to pull an olive wire through the lateral wall of the calcaneus was 79.8° ± 32.81°, and the mean bolt rotation required to "walk" a skinny wire (narrow diameter) and create 1 mm of cortical bone failure was 50.5° ± 30.91°. The results of the present investigation further define and elucidate the appropriate "Russian tensioning" technique applicable for external fixation of the calcaneus using olive or skinny wires in the case of fracture repair or compression arthrodesis. PMID:23253879

Bussewitz, Bradly W; Scott, Ryan T; Hyer, Christopher F; Philbin, Terrence M

2013-01-01

87

The influence of heel height on utilized coefficient of friction during walking.  

PubMed

Wearing high heel shoes has been associated with an increased potential for slips and falls. The association between wearing high heels and the increased potential for slipping suggests that the friction demand while wearing high heels may be greater when compared to wearing low heel shoes. The purpose of this study was to determine if heel height affects utilized friction (uCOF) during walking. A secondary purpose of this study was to compare kinematics at the ankle, knee, and hip that may explain uCOF differences among shoes with varied heel heights. Fifteen healthy women (mean age 24.5±2.5yrs) participated. Subjects walked at self-selected velocity under 3 different shoe conditions that varied in heel height (low: 1.27cm, medium: 6.35cm, and high: 9.53cm). Ground reaction forces (GRFs) were recorded using a force platform (1560Hz). Kinematic data were obtained using an 8 camera motion analysis system (120Hz). Utilized friction was calculated as the ratio of resultant shear force to vertical force. One-way repeated measures ANOVAs were performed to test for differences in peak uCOF, GRFs at peak uCOF and lower extremity joint angles at peak uCOF. On average, peak uCOF was found to increase with heel height. The increased uCOF observed in high heel shoes was related to an increase in the resultant shear force and decrease in the vertical force. Our results signify the need for proper public education and increased footwear industry awareness of how high heel shoes affect slip risk. PMID:21536444

Blanchette, Mark G; Brault, John R; Powers, Christopher M

2011-05-01

88

Osteochondrosis: common causes of pain in growing bones.  

PubMed

Osteochondrosis is a term used to describe a group of disorders that affect the growing skeleton. These disorders result from abnormal growth, injury, or overuse of the developing growth plate and surrounding ossification centers. The exact etiology of these disorders is unknown, but genetic causes, repetitive trauma, vascular abnormalities, mechanical factors, and hormonal imbalances may all play a role. Legg-Calvé-Perthes disease is a hip disorder that causes hip pain, an atraumatic limp, and knee pain. Osgood-Schlatter and Sinding-Larsen-Johannson diseases are common causes of anterior knee pain that is aggravated by jumping activities and kneeling. Sever disease causes heel pain that is exacerbated by activity and wearing cleats. It often mimics Achilles tendinitis and is treated with activity and shoe modifications, heel cups, and calf stretches. Freiberg disease and Köhler bone disease often cause foot pain and are disorders of the metatarsal head and navicular bone, respectively. Radiographs show sclerosis, flattening, and fragmentation of bone in both diseases. Elbow pain can be caused by medial epicondyle apophysitis or Panner disease. Medial epicondyle apophysitis is exacerbated by frequent throwing and is treated with throwing cessation and acetaminophen or nonsteroidal anti-inflammatory drugs. Panner disease is the most common cause of lateral-sided elbow pain in children younger than 10 years. It may or may not be associated with frequent throwing, and it resolves spontaneously. Scheuermann disease causes back pain and a humpback deformity from vertebral bone anterior wedging. PMID:21302869

Atanda, Alfred; Shah, Suken A; O'Brien, Kathleen

2011-02-01

89

Influence of the calcaneus shape on the risk of posterior heel ulcer using 3D patient-specific biomechanical modeling  

E-print Network

for the prevention of heel ulcer when coupled with a pressure sensor. Key terms: posterior heel ulcer prevention sensitivity. Three mechanisms, at least, are recognized as leading to pressure ulcerations (Mueller4 of inactivity and prolonged time lying down on the back. They appear when pressures applied on the heel create

Payan, Yohan

90

Backwards in High Heels: Getting Women Elected, 1842-1990  

NSDL National Science Digital Library

Incorporated as the capital of the Republic of Texas in 1839, Austin didnâÂÂt elect its first female council woman until the middle of the 20th century. The first female legislators didnâÂÂt find their way into office until the 1970s, and it wasnâÂÂt until 1990 that Texas elected a female governor. This exhibit by AustinâÂÂs Public Library tells the story of women in the cityâÂÂs politics through photographs, essays, and old newspaper clippings. Categories include WomenâÂÂs Work, Political Pioneers, and A Foot in the Door, among many others. Of particular interest, the biography of Ann Richards, the former governor of Texas, contextualizes her famous quote: âÂÂGinger Rogers did everything that Fred Astaire did. She just did it backwards and in high heels.âÂÂ

2014-02-25

91

Wrist pain  

MedlinePLUS

Pain - wrist ... Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome . You may feel aching, ... become weak, making it difficult to grasp things. Pain may extend up to your elbow. Carpal tunnel ...

92

Ankle pain  

MedlinePLUS

Pain - ankle ... Ankle pain is often due to an ankle sprain. An ankle sprain is an injury to the ligaments, which ... the joint. In addition to ankle sprains, ankle pain can be caused by: Damage or swelling of ...

93

Elbow pain  

MedlinePLUS

Pain - elbow ... Elbow pain can be caused by a variety of problems. A common cause in adults is tendinitis , an inflammation ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

94

Foot pain  

MedlinePLUS

Pain - foot ... Foot pain may be due to: Aging Being on your feet for long periods of time Being overweight A ... other sports activity The following can cause foot pain: Arthritis and gout : Common in the big toe, ...

95

Neck Pain  

MedlinePLUS

... Pregnancy and Rheumatic Disease Sex and Arthritis Neck Pain PRINT Download PDF Description Saying, “It’s a pain ... requires expensive or uncomfortable tests. What is neck pain? Acute strain may occur after sleeping in an ...

96

Pain Relievers  

MedlinePLUS

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There ... also have a slightly different response to a pain reliever. Over-the-counter (OTC) medicines are good for ...

97

Depression, Pain, and Pain Behavior.  

ERIC Educational Resources Information Center

Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…

Keefe, Francis J.; And Others

1986-01-01

98

Effectiveness of a heel cup with an arch support insole on the standing balance of the elderly  

PubMed Central

Background The use of insoles may enhance postural stability and prevent falls. The aim of this study was to design a new insole and to explore the effectiveness of the insole on the standing balance of the healthy elderly. Methods The study was conducted at a community hospital. Patients older than 65 years at an outpatient clinic without abnormal gait patterns, lower limb deformities, or foot pain were enrolled. The participants were assigned to good- and poor-stability groups on the basis of the stability index (SI), using the Biodex® Balance System. A heel cup with an arch support insole was provided. Participants wore the insole for 8 weeks for a minimum of 4 hours/day. A static balance test for SI was performed at the initial meeting and 8 weeks after the assigned insoles were worn for each participant. Results Five participants (10.0%) of 50 total did not finish the study. There were 25 patients in the good-stability group and 20 in the poor-stability group. The SI, before and after intervention, was significantly different for all 45 participants (3.244±0.688 versus 3.064±0.671; P<0.001). The differences in SI before and after the intervention both in the good-stability group (2.764±0.546 versus 2.592±0.538) and the poor-stability group (3.845±0.188 versus 3.655±0.128) were statistically significant (P<0.001). No statistically significant difference on changes of SI were seen between the two groups. Conclusion The results suggest a heel cup with arch support insole is effective in enhancing the standing balance of the elderly. This may be of benefit in preventing falls. PMID:24600215

Chen, Tzu-Hsuan; Chou, Li-Wei; Tsai, Mei-Wun; Lo, Ming-Jor; Kao, Mu-Jung

2014-01-01

99

Analysis of muscular fatigue and foot stability during high-heeled gait  

Microsoft Academic Search

Plantar pressure measurements and surface electromyography (EMG) were used to determine the effects of muscular fatigue induced by high-heeled gait. The medio-lateral (M\\/L) stability of the foot was characterized by measuring the M\\/L deviations of the center of pressure (COP) and correlating these data with fatigue of lower-limb muscles seen on EMG. EMG measurements from habitual high-heeled shoe wearers demonstrated

Amit Gefen; M. Megido-Ravid; Y. Itzchak; M. Arcan

2002-01-01

100

Foot-Ankle RollOver Characteristics in Different Heel Heights during Walking  

Microsoft Academic Search

In this study, a feasibility study was performed for biomechanical applications of foot-ankle roll-over characteristics in different heel height shoes during walking. Five nondisabled female volunteers were participated in gait experiments, wearing four pairs of shoes with different heel heights. Roll-over shapes of the foot-ankle systems were obtained using trajectories of ankle, knee and the center of pressure between initial

H. S. Choi; H. L. Park; Y. H. Kim

2005-01-01

101

Study on lumbar kinematics and the risk of low back disorder in female university students by using shoes of different heel heights.  

PubMed

The study was taken up to investigate the effects of heel heights on lumbar kinematics and the risk of Low Back Disorder (LBD) in females. Nineteen female university students (24.5 ± 3.36 yrs) volunteered in the study. Lumbar kinematics was measured by using Industrial Lumbar Motion Monitor (iLMM). The volunteers were asked to walk for a distance of 50 meters in 3 different given conditions i.e bare foot (Heel 0), with flat heels (Heel 1) and with high heels (Heel 2). Heights of Heel 1 and Heel 2 were 1.5 ± 0.84 cm and 5.5 ± 1.70 cm respectively. The Lumbar kinematic parameters studied were- Average Twisting Velocity (ATV), Maximum Sagital Flexion (MSF) and Maximum Lateral Velocity (MLV). It was observed that all the above mentioned Lumbar kinematics - ATV, MSF and MLV increases with increase of heel heights, which in turn increases the risk of LBD. As a result of increase in Lumbar kinematic values with increase in heel heights, LBD risk has also increased. Mean and SD of the LBD risk with Heel 0, Heel 1 and Heel 2 were 16.79 ± 6.04%, 19.00 ± 7.38% and 22.11 ± 6.98% respectively. Lower stature with high heels showed higher risk of LBD than the higher stature with high heels. PMID:22317099

Iqbal, Rauf; De, Amitabha; Mishra, Wricha; Maulik, Shreya; Chandra, A M

2012-01-01

102

Interference of high-heeled shoes in static balance among young women.  

PubMed

The aim of the present study was to assess the effect of the use of high-heeled shoes on static balance in young adult women. Fifty-three women between 18 and 30 years of age and accustomed to wearing high-heeled shoes participated in the study. None of the participants had any orthopedic or neurologic alterations. Static balance was assessed using a force plate. Oscillations from the center of pressure in the mediolateral and anteroposterior directions were measured both when barefoot and when wearing high-heeled shoes [7 centimeters (cm) in height and 1cm in diameter] under the conditions of eyes open and eyes closed. Two-way analysis of variance was employed for the statistical analysis, with the level of significance set at 5% (p<.05). The results revealed statistically significant differences between tests when barefoot and when wearing high-heeled shoes as well as with eyes open and eyes closed (p<.01). With the use of high-heeled shoes, there was a significant increase in mediolateral oscillation with eyes closed (p<.01). The present study demonstrates that the use of seven-cm high heels altered static balance in the healthy young women analyzed, increasing the oscillation of the center of pressure, regardless of visual restriction. PMID:22742722

Gerber, Susana Bacelete; Costa, Rafael Vital; Grecco, Luanda André Collange; Pasini, Hugo; Marconi, Nádia Fernanda; Oliveira, Claudia Santos

2012-10-01

103

Thinking while walking: experienced high-heel walkers flexibly adjust their gait.  

PubMed

Theories of motor-skill acquisition postulate that attentional demands of motor execution decrease with practice. Hence, motor experts should experience less attentional resource conflict when performing a motor task in their domain of expertise concurrently with a demanding cognitive task. We assessed cognitive and motor performance in high-heel experts and novices who were performing a working memory task while walking in gym shoes or high heels on a treadmill. Surprisingly, neither group showed lower working memory performance when walking than when sitting, irrespective of shoe type. However, high-heel experts adapted walking regularity more flexibly to shoe type and cognitive load than novices, by reducing the variability of time spent in the single-support phase of the gait cycle in high heels when cognitively challenged. We conclude that high-heel expertise is associated with more flexible adjustments of movement patterns. Future research should investigate whether a more demanding walking task (e.g., wearing high heels on uneven surfaces and during gait perturbations) results in expertise-related differences in the simultaneous execution of a cognitive task. PMID:23760158

Schaefer, Sabine; Lindenberger, Ulman

2013-01-01

104

Pelvic Pain  

MedlinePLUS

Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

105

Back Pain  

MedlinePLUS

NINDS Back Pain Information Page Condensed from Low Back Pain Fact Sheet Table of Contents (click to jump to sections) ... Trials Organizations Additional resources from MedlinePlus What is Back Pain? Acute or short-term low back pain generally ...

106

Vascular access in haemodialysis: strengthening the Achilles' heel.  

PubMed

Despite all the progress achieved since Scribner first introduced the arteriovenous (AV) shunt in 1960 and Cimino and Brescia introduced the native AV fistula in 1962, we have continued to face a conundrum in vascular access for dialysis, in that dialysis vascular access is at the same time both the 'lifeline' and the 'Achilles' heel' of haemodialysis. Indeed, findings from a multitude of published articles in this area, unfortunately mainly observational studies, reflect both our frustration and our limited knowledge in this area. Despite improved understanding of the pathophysiology of stenosis and thrombosis of the vascular access, we have unfortunately not been very successful in translating these advances into either improved therapies or a superior process of care. As a result, we continue to face an epidemic of arteriovenous fistula (AVF) maturation failure, a proliferation of relatively ineffective interventions such as angioplasty and stent placement, an extremely high incidence of catheter use, and more doubts rather than guidance with regard to the role (or lack thereof) of surveillance. An important reason for these problems is the lack of focused translational research and robust randomized prospective studies in this area. In this Review, we will address some of these critical issues, with a special emphasis on identifying the best process of care pathways that could reduce morbidity and mortality. We also discuss the potential use of novel therapies to reduce dialysis vascular access dysfunction. PMID:23591442

Riella, Miguel C; Roy-Chaudhury, Prabir

2013-06-01

107

Cancer Pain  

Microsoft Academic Search

Cancer pain remains undertreated. Pain occurs in over three-quarters of cancer patients and remains one of the most feared\\u000a aspects of this illness despite the excellent therapies that are available. Cancer pain commonly results from tumor compressing\\u000a or invading soft tissue, bone, or nerves or from diagnostic or therapeutic endeavors. Optimal pain management involves determining\\u000a pain intensity, evaluating the etiology

Suzanne A. Nesbit

108

Heel effect adaptive flat field correction of digital x-ray detectors  

SciTech Connect

Purpose: Anode heel effect renders large-scale background nonuniformities in digital radiographs. Conventional offset/gain calibration is performed at mono source-to-image distance (SID), and disregards the SID-dependent characteristic of heel effect. It results in a residual nonuniform background in the corrected radiographs when the SID settings for calibration and correction differ. In this work, the authors develop a robust and efficient computational method for digital x-ray detector gain correction adapted to SID-variant heel effect, without resorting to physical filters, phantoms, complicated heel effect models, or multiple-SID calibration and interpolation.Methods: The authors present the Duo-SID projection correction method. In our approach, conventional offset/gain calibrations are performed only twice, at the minimum and maximum SIDs of the system in typical clinical use. A fast iterative separation algorithm is devised to extract the detector gain and basis heel patterns from the min/max SID calibrations. The resultant detector gain is independent of SID, while the basis heel patterns are parameterized by the min- and max-SID. The heel pattern at any SID is obtained from the min-SID basis heel pattern via projection imaging principles. The system gain desired at a specific acquisition SID is then constructed using the projected heel pattern and detector gain map.Results: The method was evaluated for flat field and anatomical phantom image corrections. It demonstrated promising improvements over interpolation and conventional gain calibration/correction methods, lowering their correction errors by approximately 70% and 80%, respectively. The separation algorithm was able to extract the detector gain and heel patterns with less than 2% error, and the Duo-SID corrected images showed perceptually appealing uniform background across the detector.Conclusions: The Duo-SID correction method has substantially improved on conventional offset/gain corrections for digital x-ray imaging in an SID-variant environment. The technique is relatively simple, and can be easily incorporated into multiple-point gain calibration/correction techniques. It offers a potentially valuable tool for preprocessing digital x-ray images to boost image quality of mammography, chest and cardiac radiography, as well as automated computer aided diagnostic radiology.

Yu, Yongjian [X-ray Products, Varian Medical Systems Inc., Liverpool, New York 13088 (United States)] [X-ray Products, Varian Medical Systems Inc., Liverpool, New York 13088 (United States); Wang, Jue [Department of Mathematics, Union College, Schenectady, New York 12308 (United States)] [Department of Mathematics, Union College, Schenectady, New York 12308 (United States)

2013-08-15

109

Treatment of displaced intraarticular calcaneal fractures with or without bone grafts: A systematic review of the literature  

PubMed Central

Background: The necessity of bone grafts in the treatment of intraarticular calcaneal fractures continues to be one of the most debated topics in foot and ankle surgery. The purpose of this study was to determine whether there are sufficient objective cumulative data in the literature to compare the two methods and if the bone graft was needed in surgical treatment of intraarticular calcaneal fractures. Materials and Methods: A comprehensive search of all relevant articles from 1990 to 2010 was conducted. Two reviewers evaluated each study to determine its suitability for inclusion and collected the data of interest. Meta-analytic pooling of group results across studies was performed for the two treatment methods. Results: The systematic review identified 32 primary studies with 1281 fractures, which contained 4 comparative studies, 13 with bone grafts, and 15 without bone grafts in treatment methods. The infection rate in bone graft group was higher through statistically insignificant than in non-graft group (8.3% vs. 6.3%) No significant difference was found between good reduction rate, postoperative osteoarthritis rate, and subtalar fusion rate. The average full weight-bearing time in bone graft group was significantly lower (5.4 months) than in non-graft group (10.5 months). The mean postoperative Böhler's angle was significantly higher in bone graft group (lose due to collapse was significancy less). For the efficacy outcomes, the bone graft group had a lower American Orthopaedic Foot and Ankle Society Score (AOFAS) (71.4 points vs. 80.5 points) but a higher Creighton score (89.9 points vs. 81.0 points) compared with non-graft group. Pooled mean results showed 35% of the patients in bone graft group had an excellent result, 40% had a good result, 21% had a fair result, and 4% had a poor result. In the non-graft group, the corresponding values were 34, 42, 14, and 10%, respectively. Conclusions: The operative treatment of intraarticular calcaneal fractures with bone grafts could restore the Böhler's angle better and the patients could return to full weight bearing earlier. However, the functional and efficacy outcomes appear to be similar between the two treatment groups. There were more joint depression and comminuted fractures in the bone graft group, and the mean followup time was shorter. Large sample comparative studies are still needed. PMID:22448049

Yang, Yunfeng; Zhao, Hongmou; Zhou, Jiaqian; Yu, Guangrong

2012-01-01

110

Early minimally invasive percutaneous fixation of displaced intra-articular calcaneal fractures with a percutaneous angle stable device.  

PubMed

The Minimally Invasive Reduction and Osteosynthesis System(®) (MIROS) is a percutaneous angle stable device for the treatment of fractures. The aim of the present study was to evaluate the clinical and radiographic results of an early minimally invasive osteosynthesis with the MIROS device. A total of 40 consecutive patients were treated for an intra-articular fracture of the calcaneus. We evaluated the clinical and radiographic outcomes after treatment of intra-articular calcaneal fractures with the MIROS hardware. Soft tissue damage was noted. The patients completed the American Orthopaedic Foot and Ankle Society survey at 12 and 24 months and underwent radiologic evaluations. A statistically significant association between the American Orthopaedic Foot and Ankle Society score and type of soft tissue lesion. A Sanders type II, III, and IV fracture was found in 15, 20, and 15 of 50 fractures, respectively. Postoperatively, restoration of the posterior facet was reached in 13 of 15, 18 of 20, and 11 of 15 with a type II, III, and IV fracture, respectively. The American Orthopaedic Foot and Ankle Society scale mean score was 85 at the final follow-up visit. No significant association was found between the score and the preoperative variables (p > .09), although patients with bilateral fractures had a significantly lower score. The MIROS device for early treatment of intra-articular calcaneus fractures resulted in excellent clinic and radiologic results. The standardized technique we have reported, with the elastic wires acting as a girder for the fractured and displace subtalar joint and the collapsed lateral calcaneal wall, has permitted early weightbearing with positive stimuli for the bone healing. The drainage effect of the percutaneous wires likely prevented compartment syndrome when applied within the first hours after the trauma. PMID:25441275

Battaglia, Alberto; Catania, Pompeo; Gumina, Stefano; Carbone, Stefano

2015-01-01

111

Low back pain - acute  

MedlinePLUS

Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term; Back strain - new ... back supports most of your body's weight. Low back pain is the number two reason that Americans see ...

112

Ribcage pain  

MedlinePLUS

... not cause the pain in those who have pleurisy (swelling of the lining of the lungs) or ... Inflammation of cartilage near the breastbone ( costochondritis ) Osteoporosis Pleurisy (the pain is worse when breathing deeply)

113

Back Pain  

MedlinePLUS

... Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, ... 10 people at some point during their lives. Back pain can range from a dull, constant ache to ...

114

Back Pain  

MedlinePLUS

Back Pain The Centers for Disease Control and Prevention’s 2008 Health Report states that over 27% of the ... States population age 18 and older have active back pain. As many as 80-90% of Americans will ...

115

Neck pain  

MedlinePLUS

Pain - neck; Neck stiffness ... this as having a stiff neck. If neck pain involves nerves, you may feel numbness, tingling, or ... A common cause of neck pain is muscle strain or tension. Usually, ... Such activities include: Bending over a desk for hours Poor ...

116

Geriatric pain  

Microsoft Academic Search

Geriatric pain will be a significant health care problem in the next millennium. Pain can be acute due to trauma or surgery,\\u000a and chronic due to medical illnesses and their sequels. In this article, management of geriatric chronic pain is discussed.

Daniel Lynch

1999-01-01

117

Chronic Pain  

Microsoft Academic Search

The primary purposes of acute pain and the reason it is noxious are to interrupt ongoing activity in order to warn the sufferer of tissue damage, to discourage movement that might exacerbate injury or prevent healing, and to teach the organism to avoid the pain-producing circumstances. Therefore, it is no wonder that when pain persists to become chronic, many sufferers

Malcolm H. Johnson

118

Correlation of Femoral and Lumbar DXA and Calcaneal Ultrasound, Measured In Situ with Intact Soft Tissues, with the In Vitro Failure Loads of the Proximal Femur  

Microsoft Academic Search

:   The objective of this study was to determine experimentally the sex-specific correlation of femoral and lumbar DXA and calcaneal\\u000a ultrasound, measured in situ, with the in vitro failure loads of the proximal femur. Fifty-eight cadavers with intact skin\\u000a and soft tissues (34 male, aged 81.2 ± 8.7 years; 24 female, aged 83.7 ± 10.6 years) were examined. The bone

E.-M. Lochmüller; J.-B. Zeller; D. Kaiser; F. Eckstein; J. Landgraf; R. Putz; R. Steldinger

1998-01-01

119

Low back pain - chronic  

MedlinePLUS

Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... waist, leads to pain. Many people with chronic back pain have arthritis. Or they may have extra wear ...

120

Neuropathic Pain  

PubMed Central

Neuropathic pain is triggered by lesions to the somatosensory nervous system that alter its structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are pathologically amplified. The pain is an expression of maladaptive plasticity within the nociceptive system, a series of changes that constitute a neural disease state. Multiple alterations distributed widely across the nervous system contribute to complex pain phenotypes. These alterations include ectopic generation of action potentials, facilitation and disinhibition of synaptic transmission, loss of synaptic connectivity and formation of new synaptic circuits, and neuroimmune interactions. Although neural lesions are necessary, they are not sufficient to generate neuropathic pain; genetic polymorphisms, gender, and age all influence the risk of developing persistent pain. Treatment needs to move from merely suppressing symptoms to a disease-modifying strategy aimed at both preventing maladaptive plasticity and reducing intrinsic risk. PMID:19400724

Costigan, Michael; Scholz, Joachim; Woolf, Clifford J.

2009-01-01

121

Cancer Pain  

Microsoft Academic Search

The effectiveness of cancer pain therapy is influenced by the attitudes and knowledge of the treating physicians. As part of a quality improvement project in the management of cancer pain, a survey of 236 medical practitioners was conducted. One hundred seventy-six respondents (74.5%) completed the survey. Fifty-two percent treated patients with cancer pain several times a week or more. Whereas

Rama Sapir; Raphael Catane; Nurith Strauss-Liviatan; Nathan I. Cherny

1999-01-01

122

Central pain.  

PubMed

Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed. PMID:25295639

Singh, Supreet

2014-12-01

123

PAIN SCALES (ATTACHMENT A)  

E-print Network

PAIN SCALES (ATTACHMENT A) 0-10 NUMERIC PAIN INTENSITY SCALE 0 1 2 3 4 5 6 7 8 9 10 NO PAIN MODERATE WORST PAIN PAIN #12;PAIN SCALES (ATTACHMENT A) FLACC PAIN SCALE The FLACC is a behavioral pain assessment scale for use in non-verbal patients unable to provide numeric reports of pain. SCORING Categories

Oliver, Douglas L.

124

Implementation guide for Hanford Tanks Initiative C-106 heel retrieval contract management HNF-2511  

SciTech Connect

This report is an Implementation Guide for Hanford Tanks Initiative C-106 heel retrieval contract management HNF-2511 to provide a set of uniform instructions for managing the two contractors selected. The primary objective is to produce the necessary deliverables and services for the HTI project within schedule and budget.

McDaniel, L.B.

1998-04-17

125

Beyond pain  

Microsoft Academic Search

The purpose of the present article is to provide unification to a number of somewhat disparate themes in the chronic pain and phobia literature. First, we present a summary review of the early writings and current theoretical perspectives regarding the role of avoidance in the maintenance of chronic pain. Second, we present an integrative review of recent empirical investigations of

Gordon J. G Asmundson; Peter J Norton; G. Ron Norton

1999-01-01

126

Pain frequency moderates the relationship between pain catastrophizing and pain  

PubMed Central

Background: Pain frequency has been shown to influence sensitization, psychological distress, and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method: A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale (PCS), Beck Depression Inventory, and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency. Results: In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed. Conclusions: This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations. PMID:25646089

Kjøgx, Heidi; Zachariae, Robert; Pfeiffer-Jensen, Mogens; Kasch, Helge; Svensson, Peter; Jensen, Troels S.; Vase, Lene

2014-01-01

127

Work- and Travel-related Physical Activity and Alcohol Consumption: Relationship With Bone Mineral Density and Calcaneal Quantitative Ultrasonometry.  

PubMed

A number of healthy workers rarely exercise because of a lack of time or resources. Physical activity related to work and everyday travel may be more feasible, but evidence of its beneficial effect on bone health is scarce. We assessed if this form of physical activity was associated with higher bone mineral density (BMD) and stiffness index (SI) when adjusted for recreational physical activity, age, body mass index, smoking, alcohol consumption, education, and serum level of 25-hydroxyvitamin D. Healthy workers, aged 25-54 yr, of the Electricity Generating Authority of Thailand were surveyed. The outcomes were BMD (lumbar spine, femoral neck, and total hip) and calcaneal SI. Physical activity was estimated using the global physical activity questionnaire and considered active when >600 metabolic equivalent tasks (min). Of 2268 subjects, 74% were men. Active male subjects had significantly higher BMD at the femoral neck and total hip (p < 0.005). However, the association was not significant with male lumbar spine BMD, male SI, or any bone parameters in women (p > 0.05). In men, work and travel physical activity seems beneficial to male bone health; hence, it should be encouraged. Furthermore, smoking appeared harmful while moderate alcohol consumption was beneficial. PMID:24878331

Sritara, Chanika; Thakkinstian, Ammarin; Ongphiphadhanakul, Boonsong; Pornsuriyasak, Prapaporn; Warodomwichit, Daruneewan; Akrawichien, Tawatchai; Vathesatogkit, Prin; Sritara, Piyamitr

2015-01-01

128

Developmental changes in the responses of preterm infants to a painful stressor  

Microsoft Academic Search

The purpose of this investigation was to examine longitudinally gestational age and developmental differences in preterm infants’ self-regulatory abilities in response to a painful stressor, as well as associations between behavioral and cardiovascular responses. Participants included 49 healthy premature infants. Behavioral and cardiovascular responses to a heel stick blood draw were compared between infants of 28–31 and 32–34 weeks’ gestation

Rachel Lucas-Thompson; Elise L. Townsend; Megan R. Gunnar; Michael K. Georgieff; Sixto F. Guiang; Raul F. Ciffuentes; Richard C. Lussky; Elysia Poggi Davis

2008-01-01

129

What a Pain! Kids and Growing Pains  

MedlinePLUS

... Main Page The Pink Locker Society What a Pain! Kids and Growing Pains KidsHealth > Kids > Illnesses & Injuries > Aches, Pains & Injuries > What ... something doctors call growing pains . What Are Growing Pains? Growing pains aren't a disease. You probably ...

130

Reproducibility of pain measurement and pain perception  

Microsoft Academic Search

The reproducibility of both the conscious experience of pain and the reproducibility of psychophysical assessments of pain remain critical, yet poorly characterized factors in pain research and treatment. To assess the reproducibility of both the pain experience and two methods of pain assessment, 15 subjects evaluated experimental heat pain during four weekly sessions. In each session, both brief (5s) and

Elisa M. Rosier; Michael J. Iadarola; Robert C. Coghill

2002-01-01

131

Breast pain  

MedlinePLUS

... breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some amount ... unless a woman is taking hormone replacement therapy) Menstruation and premenstrual syndrome (PMS) Pregnancy -- breast tenderness tends ...

132

Penis pain  

MedlinePLUS

Pain - penis; Priapism ... Bladder stone Bites, either human or insect Cancer of the penis Erection that does not go away (priapism) Genital herpes Infected hair follicles Infected prosthesis of the penis Infection under the ...

133

Cyclic impacts on heel strike: A possible biomechanical factor in the etiology of degenerative disease of the human locomotor system  

Microsoft Academic Search

The cyclic impacts induced by heel strike when walking were studied using both a high-resonance-frequency force plate and a low-mass skin-mounted accelerometer. The data were computer analyzed. The results showed that during normal human walking, the locomotor system is subjected to repetitive impact loads at heel strike, lasting about 5 ms and consisting of frequency spectra up to and above

Yoram Folman; Joseph Wosk; Arkady Voloshin; Shimon Liberty

1986-01-01

134

The effects of isolation on the mechanics of the human heel pad.  

PubMed Central

In previous studies on the mechanical properties of the human heel pad (Bennett & Ker, 1990; Aerts et al. 1995) the fat pad and part of the calcaneus was removed from amputated test specimens. The present study tested whether this procedure influences the mechanical behaviour of the sample. Intact amputated feet were therefore mounted on steel rods driven through the calcaneus and placed in a mechanical test situation (pendulum or servohydraulic material tester). The mechanical properties of the pad were determined for a series of experiments in which the pad was gradually freed from the foot in the way done by Bennett & Ker (1990) and Aerts et al. (1995). The results showed no observable differences in the mechanics of the pad by isolating it from the rest of the foot. Thus, in relation to human locomotion, the load-deformation relation of heel pads as described by Aerts et al. (1995) is the most appropriate to date. PMID:8621341

Aerts, P; Ker, R F; de Clercq, D; Ilsley, D W

1996-01-01

135

Influence of in-shoe heel lifts on plantar pressure and center of pressure in the medial-lateral direction during walking.  

PubMed

The aim of this study was to investigate how the height and material of in-shoe heel lifts affect plantar pressure and center of pressure (COP) trajectory in the medial-lateral direction during walking. Seventeen healthy young male adults were asked to walk along an 8m walkway while wearing a high-cut flat shoe and 5 different heel lifts. Peak pressure (PP), pressure-time integral (PTI) and contact area (CA) were measured by Pedar insole system for three foot regions: forefoot, midfoot and heel. Range and velocity of medial-lateral (ML) COP during forefoot contact phase (FFCP) and foot flat phase (FFP) were collected using Footscan pressure plate. Forefoot pressure and ML-COP parameters increased as the heel was elevated. Statistically significant attenuation of heel peak plantar pressure was provided by all heel lifts except for the hard lift. Post hoc tests suggest that material had a greater influence on the range and velocity of ML-COP during FFCP than heel height, while during FFP, heel height seemed to affect these parameters more. The findings from this study suggest that thick heel lifts should be used with caution, and that a heel lift made of materials with good support and elastic properties might be more appropriate to improve footwear comfort and medial-lateral motion control. PMID:24440428

Zhang, Xianyi; Li, Bo

2014-04-01

136

The Effects of Lower Extremity Angle According to Heel-height Changes in Young Ladies in Their 20s during Gait  

PubMed Central

[Purpose] The purpose of this study was to compare the effects of heel-height changes on the low joint angles of the lower extremities of women in their 20s during gait. [Subjects and Methods] Qualisys Track Manager Software ver. 2.8 (Qualisys, Sweden) was used to perform measurements on 14 female university students in their 20s. To measure movements, the subjects were asked to walk while wearing high-heeled shoes and reflective stickers on their hip joints, knee joints, and ankle joints, the changes in joint angles were measured at heel strike, foot flat, and toe off. [Results] Analysis of the amount of change according to heel height changes during gait showed that the angle of the hip joints was reduced with an increase in heel-height. Although the changes were not significant, the angle of the knee joints was reduced during heel strike, foot flat, and midstance, and it was increased during toe off. In contrast, the angle of the ankle joints was increased by a significant amount during heel strike, foot flat, midstance, and toe off. [Conclusions] During gait with high heels, the movements of the lower extremities of women in their 20s were reduced significantly with an increase in heel height. Therefore, it is concluded that the restrictions on gait can only be reduced by wearing low-heeled shoes. PMID:25140096

Lee, ChangRyeol

2014-01-01

137

Lower Limb Muscles SEMG Activity during High-Heeled Latin Dancing  

Microsoft Academic Search

\\u000a aim of this study is to provide information about surface electromyography (SEMG) activity pattern in lower limb muscles during\\u000a Latin dancing with different heel height shoes. SEMG signals from tibialis anterior, medial and lateral sides of gastrocnemius,\\u000a soleus and biceps femoris of ten professional female dancers were recorded. All the muscles average EMG (aEMG) values except\\u000a biceps femoris were significantly

Y. D. Gu; J. S. Li; G. Q. Ruan; Y. C. Wang; M. J. Lake; X. J. Ren

138

Relation between heel position and the distribution of forefoot plantar pressures and skin callosities in rheumatoid arthritis.  

PubMed Central

OBJECTIVE: To investigate the relation between the position of the rearfoot and the distribution of forefoot plantar pressures and skin callosities in rheumatoid arthritis. METHOD: Plantar pressures and callosity patterns were measured in 102 rheumatoid arthritis patients (120 feet with normal heel alignment and 84 feet with valgus heel alignment measured by goniometry) and in 42 (84 feet) age matched healthy adults. Peak pressures (kPa) were measured across the metatarsal heads in-shoe using an FScan system and the distribution of plantar callosities was visually mapped for each foot. RESULTS: Peak pressures were significantly greater at all but the first metatarsal head in the rheumatoid normal heel alignment and healthy adult groups than in the rheumatoid valgus heel group. The feet of both the rheumatoid normal heel group and the healthy adult group behaved the same, the highest peak pressures registering on the central metatarsal heads. However, only in the rheumatoid group were plantar callosities found at these sites. In the rheumatoid valgus heel group, lateral metatarsal heads were frequently non-weightbearing, producing gross loading patterns with a dominant medial distribution. Peak pressures were shifted to the medial fore-foot accompanied by a higher prevalence of callosities. The results, however, failed to establish clearly an association between peak pressures and callus formation. CONCLUSIONS: In rheumatoid arthritis there is an important interrelation between the rearfoot position and forefoot pressure sites. PMID:8976636

Woodburn, J; Helliwell, P S

1996-01-01

139

The X-ray attenuation characteristics and density of human calcaneal marrow do not change significantly during adulthood  

NASA Technical Reports Server (NTRS)

Changes in the material characteristics of bone marrow with aging can be a significant source of error in measurements of bone density when using X-ray and ultrasound imaging modalities. In the context of computed tomography, dual-energy computed techniques have been used to correct for changes in marrow composition. However, dual-energy quantitative computed tomography (DE-QCT) protocols, while increasing the accuracy of the measurement, reduce the precision and increase the radiation dose to the patient in comparison to single-energy quantitative computed tomography (SE-QCT) protocols. If the attenuation properties of the marrow for a particular bone can be shown to be relatively constant with age, it should be possible to use single-energy techniques without experiencing errors caused by unknown marrow composition. Marrow was extracted by centrifugation from 10 mm thick frontal sections of 34 adult cadaver calcanei (28 males, 6 females, ages 17-65 years). The density and energy-dependent linear X-ray attenuation coefficient of each marrow sample were determined. For purposes of comparing our results, we then computed an effective CT number at two GE CT/i scan voltages (80 and 120 kVp) for each specimen. The coefficients of variation for the density, CT number at 80 kVp and CT number at 120 kVp were each less than 1%, and the parameters did not change significantly with age (p > 0.2, r2 < 0.02, power > 0.8 where the minimum acceptable r2 = 0.216). We could demonstrate no significant gender-associated differences in these relationships. These data suggest that calcaneal bone marrow X-ray attenuation properties and marrow density are essentially constant from the third through sixth decades of life.

Les, C. M.; Whalen, R. T.; Beaupre, G. S.; Yan, C. H.; Cleek, T. M.; Wills, J. S.

2002-01-01

140

Effect of Aloe vera application on the content and molecular arrangement of glycosaminoglycans during calcaneal tendon healing.  

PubMed

Although several treatments for tendon lesions have been proposed, successful tendon repair remains a great challenge for orthopedics, especially considering the high incidence of re-rupture of injured tendons. Our aim was to evaluate the pharmacological potential of Aloe vera on the content and arrangement of glycosaminoglycans (GAGs) during tendon healing, which was based on the effectiveness of A. vera on collagen organization previously observed by our group. In rats, a partial calcaneal tendon transection was performed with subsequent topical A. vera application at the injury site. The tendons were treated with A. vera ointment for 7 days and excised on the 7(th) , 14(th) , or 21(st) day post-surgery. Control rats received ointment without A. vera. A higher content of GAGs and a lower amount of dermatan sulfate were detected in the A. vera-treated group on the 14(th) day compared with the control. Also at 14 days post-surgery, a lower dichroic ratio in toluidine blue stained sections was observed in A. vera-treated tendons compared with the control. No differences were observed in the chondroitin-6-sulfate and TGF-?1 levels between the groups, and higher amount of non-collagenous proteins was detected in the A. vera-treated group on the 21(st) day, compared with the control group. No differences were observed in the number of fibroblasts, inflammatory cells and blood vessels between the groups. The application of A. vera during tendon healing modified the arrangement of GAGs and increased the content of GAGs and non-collagenous proteins. Microsc. Res. Tech. 77:964-973, 2014. © 2014 Wiley Periodicals, Inc. PMID:25147000

De Aro, Andrea Aparecida; Esquisatto, Marcelo Augusto Marretto; Nishan, Umar; Perez, Mylena Oliveira; Rodrigues, Rodney Alexandre Ferreira; Foglio, Mary Ann; De Carvalho, João Ernesto; Gomes, Laurecir; Vidal, Benedicto De Campos; Pimentel, Edson Rosa

2014-12-01

141

Influence of shoes and heel strike on the loading of the hip joint.  

PubMed

The forces and moments acting at the hip joint influence the long-term stability of the fixation of endoprostheses and the course of coxarthrosis. These loads may depend on the kind of footwear and the walking or running style. These factors were investigated in a patient with instrumented hip implants. He wore different sports shoes, normal leather shoes, hiking boots and clogs and walked barefoot with soft, normal and hard heel strikes. The loads were lowest while walking and jogging without shoes. All shoes increased the joint force and the bending moment at the implant slightly but the torsional moment rose by up to 50%. No relation was found between the different type of shoes and the load increase, only shoes with very hard soles were clearly disadvantageous. Soft heels, soles or insoles did not offer advantages. Gait stability seems to play the most important role in increasing the joint loading and should be the criterion for the choice of footwear. Smooth gait patterns with soft heel strikes are the only means to reduce joint loading during slow jogging. PMID:7657680

Bergmann, G; Kniggendorf, H; Graichen, F; Rohlmann, A

1995-07-01

142

Design and Reliability of a Novel Heel Rise Test Measuring Device for Plantarflexion Endurance  

PubMed Central

Background. Plantarflexion results from the combined action of the soleus and gastrocnemius muscles in the calf. The heel rise test is commonly used to test calf muscle endurance, function, and performance by a wide variety of professionals; however, no uniform description of the test is available. This paper aims to document the construction and reliability of a novel heel rise test device and measurement protocol that is suitable for the needs of most individuals. Methods. This device was constructed from compact and lightweight materials and is fully adjustable, enabling the testing of a wide variety of individuals. It is easy to assemble and disassemble, ensuring that it is portable for use in different settings. Findings. We tested reliability on 40 participants, finding excellent interrater reliability (ICC2,1 0.97, 95% CI: 0.94 to 0.98). Limits of agreement were less than two repetitions in 90% of cases and the Bland-Altman plot showed no bias. Interpretation. We have designed a novel, standardized, simple, and reliable device and measurement protocol for the heel rise test which can be used by researchers and clinicians in a variety of settings. PMID:24877089

Sman, Amy D.; Hiller, Claire E.; Ocsing, Aldrin; Refshauge, Kathryn M.

2014-01-01

143

Chronic Achilles TendinopathyA Prospective Randomized Study Comparing the Therapeutic Effect of Eccentric Training, the AirHeel Brace, and a Combination of Both  

Microsoft Academic Search

Background: Previous studies have shown that eccentric training has a positive effect on chronic Achilles tendinopathy. A new strategy for the treatment of chronic Achilles tendinopathy is the AirHeel brace.Hypothesis: AirHeel brace treatment improves the clinical outcome of patients with chronic Achilles tendinopathy. The combination of the AirHeel brace and an eccentric training program has a synergistic effect.Study Design: Randomized

Wolf Petersen; Robert Welp; Dieter Rosenbaum

2007-01-01

144

Methods for Heel Retrieval for Tanks C-101, C-102, and C-111 at the Hanford Site - 13064  

SciTech Connect

The purpose of this paper is to evaluate the prospects of using bulk waste characteristics to determine the most appropriate heel retrieval technology. If the properties of hard to remove heels can be determined before bulk retrieval, then a heel retrieval technology can be selected before bulk retrieval is complete. This would save substantially on sampling costs and would allow the deployment of the heel retrieval technology immediately after bulk retrieval. The latter would also accelerate the heel removal schedule. A number of C-farm retrievals have been fully or partially completed at the time of this writing. Thus, there is already substantial information on the success of different technologies and the composition of the heels. There is also substantial information on the waste types in each tank based on historical records. Therefore, this study will correlate the performance of technologies used so far and compare them to the known waste types in the tanks. This will be used to estimate the performance of future C Farm heel retrievals. An initial decision tree is developed and employed on tanks C-101, C-102, and C 111. An assumption of this study is that no additional characterization information would be available, before or after retrieval. Note that collecting additional information would substantially increase the probability of success. Deploying some in-situ testing technologies, such as a water lance or an in-situ Raman probe, might substantially increase the probability of successfully selecting the process conditions without having to take samples from the tanks for laboratory analysis. (authors)

Sams, T.L.; Kirch, N.W.; Reynolds, J.H. [Washington River protection Solutions, Richland, WA 99352 (United States)] [Washington River protection Solutions, Richland, WA 99352 (United States)

2013-07-01

145

Methods for heel retrieval for tanks C-101, C-102, and C-111 at the Hanford Site  

SciTech Connect

The purpose of this paper is to evaluate the prospects of using bulk waste characteristics to determine the most appropriate heel retrieval technology. If the properties of hard to remove heels can be determined before bulk retrieval, then a heel retrieval technology can be selected before bulk retrieval is complete. This would save substantially on sampling costs and would allow the deployment of the heel retrieval technology immediately after bulk retrieval. The latter would also accelerate the heel removal schedule. A number of C-farm retrievals have been fully or partially completed at the time of this writing. Thus, there is already substantial information on the success of different technologies and the composition of the heels. There is also substantial information on the waste types in each tank based on historical records. Therefore, this study will correlate the performance of technologies used so far and compare them to the known waste types in the tanks. This will be used to estimate the performance of future C Farm heel retrievals. An initial decision tree is developed and employed on tanks C-101, C-102, and C 111. An assumption of this study is that no additional characterization information would be available, before or after retrieval. Note that collecting additional information would substantially increase the probability of success. Deploying some in-situ testing technologies, such as a water lance or an in-situ Raman probe, might substantially increase the probability of successfully selecting the process conditions without having to take samples from the tanks for laboratory analysis.

Sams, Terry L. [Washington River Protection Solutions, LLC, Richland, WA (United States); Kirch, N. W. [Washington River Protection Solutions, LLC, Richland, WA (United States); Reynolds, Jacob G. [Washington River Protection Solutions, LLC, Richland, WA (United States)

2013-01-11

146

Inflammatory Back Pain vs. Mechanical Back Pain  

MedlinePLUS Videos and Cool Tools

... cause. Specifically, is the back pain inflammatory in nature or mechanical? INFLAMMATORY VS MECHANICAL BACK PAIN VIDEO: ... determing if the back pain is inflammatory in nature and related to a disease such as ankylosing ...

147

Central Pain Syndrome  

MedlinePLUS

NINDS Central Pain Syndrome Information Page Table of Contents (click to jump to sections) What is Central Pain Syndrome? Is there ... being done? Clinical Trials Organizations What is Central Pain Syndrome? Central pain syndrome is a neurological condition ...

148

Somatoform pain disorder  

MedlinePLUS

Pain disorder ... thought to be related to emotional stress. The pain was often said to be "all in their head." However, patients with somatoform pain disorder seem to experience painful sensations in a ...

149

Complex Regional Pain Syndrome  

MedlinePLUS

Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. ... in skin temperature, color, or texture Intense burning pain Extreme skin sensitivity Swelling and stiffness in affected ...

150

Chronic Pain Medicines  

MedlinePLUS

MENU Return to Web version Chronic Pain | Chronic Pain Medicines How is chronic pain treated? Treatment of chronic ... or she tells you how to use your pain medicine. If you have questions about side effects or ...

151

THE INFLUENCE OF HEEL HEIGHT ON VERTICAL GROUND REACTION FORCE DURING LANDING TASKS IN RECREATIONALLY ACTIVE AND ATHLETIC COLLEGIATE FEMALES  

PubMed Central

Purpose: To determine if heel height alters vertical ground reaction forces (vGRF) when landing from a forward hop or drop landing. Background: Increased vGRF during landing are theorized to increase ACL injury risk in female athletes. Methods: Fifty collegiate females performed two single?limb landing tasks while wearing heel lifts of three different sizes (0, 12 & 24 mm) attached to the bottom of a athletic shoe. Using a force plate, peak vGRF at landing was examined. Repeated measures ANOVAs were used to determine the influence of heel height on the dependent measures. Results: Forward hop task? Peak vGRF (normalized for body mass) with 0 mm, 12 mm, and 24 mm lifts were 2.613±0.498, 2.616±0.497 and 2.495±0.518% BW, respectively. Significant differences were noted between 0 and 24 mm lift (p<.001) and 12 and 24 mm lifts (p=.004), but not between the 0 and 12 mm conditions (p=.927). Jump?landing task? No significant differences were found in peak vGRF (p=.192) between any of the heel lift conditions. Conclusions: The addition of a 24 mm heel lift to the bottom of a sneaker significantly alters peak vGRF upon landing from a unilateral forward hop but not from a jumping maneuver. PMID:23439490

Carcia, Christopher R.

2013-01-01

152

Designing and Constructing Blood Flow Monitoring System to Predict Pressure Ulcers on Heel  

PubMed Central

Background: A pressure ulcer is a complication related to the need for the care and treatment of primarily disabled and elderly people. With the decrease of the blood flow caused by the pressure loaded, ulcers are formed and the tissue will be wasted with the passage of time. Objective: The aim of this study was to construct blood flow monitoring system on the heel tissue which was under external pressure in order to evaluate the tissue treatment in the ulcer. Methods: To measure the blood flow changes, three infrared optical transmitters were used at the distances of 5, 10, and 15 mm to the receiver. Blood flow changes in heels were assessed in pressures 0, 30, and 60 mmHg. The time features were extracted for analysis from the recorded signal by MATLAB software. Changes of the time features under different pressures were evaluated at the three distances by ANOVA in SPSS software. The level of significance was considered at 0.05. Results: In this study, 15 subjects, including both male and female, with the mean age of 54±7 participated. The results showed that the signal amplitude, power and absolute signal decreased significantly when pressure on the tissue increased in different layers (p<0.05). Heart rate only decreased significantly in pressures more than 30 mmHg (p=0.02). In pressures more than 30 mmHg, in addition to a decrease in the time features, the pattern of blood flow signal changed and it wasn’t the same as no-load signal. Conclusion: By detecting the time features, we can reach an early diagnosis to prognosticate the degeneration of the tissue under pressure and it can be recommended as a method to predict bedsores in the heel. PMID:25505771

Akbari, H; Younessi Heravi, MA

2014-01-01

153

SLUDGE HEEL REMOVAL BY ALUMINUM DISSOLUTION AT SAVANNAH RIVER SITE 12390  

SciTech Connect

High Level Waste (HLW) at the Savannah River Site (SRS) is currently stored in aging underground storage tanks. This waste is a complex mixture of insoluble solids, referred to as sludge, and soluble salts. Continued long-term storage of these radioactive wastes poses an environmental risk. Operations are underway to remove and disposition the waste, clean the tanks and fill with grout for permanent closure. Heel removal is the intermediate phase of the waste retrieval and tank cleaning process at SRS, which is intended to reduce the volume of waste prior to treatment with oxalic acid. The goal of heel removal is to reduce the residual amount of radioactive sludge wastes to less than 37,900 liters (10,000 gallons) of wet solids. Reducing the quantity of residual waste solids in the tank prior to acid cleaning reduces the amount of acid required and reduces the amount of excess acid that could impact ongoing waste management processes. Mechanical heel removal campaigns in Tank 12 have relied solely on the use of mixing pumps that have not been effective at reducing the volume of remaining solids. The remaining waste in Tank 12 is known to have a high aluminum concentration. Aluminum dissolution by caustic leaching was identified as a treatment step to reduce the volume of remaining solids and prepare the tank for acid cleaning. Dissolution was performed in Tank 12 over a two month period in July and August, 2011. Sample results indicated that 16,440 kg of aluminum oxide (boehmite) had been dissolved representing 60% of the starting inventory. The evolution resulted in reducing the sludge solids volume by 22,300 liters (5900 gallons), preparing the tank for chemical cleaning with oxalic acid.

Keefer, M.

2012-01-12

154

[Shewanella algae infection after surgical treatment of Haglund's heel and rupture of the Achilles tendon.  

PubMed

This is a case report of soft tissue infection with the marine bacterium Shewanella algae that is rare in Denmark. The patient was a 43-year-old male and he was treated surgically for Haglund's heel, a bony protrusion at the calcaneus. After clinical healing the patient suffered a rupture of the Achilles tendon, which was treated surgically as well. The post-operative healing process proved to be protracted with a number of surgical wound revisions being necessary. A microbiology culture showed the presence of S. algae and after proper antibiotic treatment the patient recovered quickly. PMID:25353681

Prischl, Clemens; Bendtsen, Michael Melchior; Laursen, Malene

2014-10-20

155

Solitary erythematous, tender plaque of the heel in a young infant.  

PubMed

Calcinosis cutis is a rare disorder resulting from the precipitation and deposition of insoluble calcium and phosphate salts (hydroxyapatite crystals) in the dermis and subcutaneous tissue. It is generally divided into four main groups on the basis of etiology and pathogenesis. Clinical presentation of cutaneous calcinosis cutis varies according to the diagnosis and the underlying process. We report a case of calcinosis cutis of the heel in which both the extravasation of a calcium gluconate infusion and renal failure could have promoted the development of calcinosis cutis. PMID:24050291

Vaccari, Sabina; Ismaili, Alma; Barisani, Alessia; Neri, Iria; Patrizi, Annalisa

2013-09-01

156

Paining Out: An Integrative Pain Therapy Model  

Microsoft Academic Search

This article describes and evaluates an integrative pain therapy model as a beneficial form of pain-management for chronic\\u000a pain. The author based his model on cognitive-behavioral modalities, progressive relaxation combined with art therapy, sensory\\u000a awareness combined with indirect clinical hypnosis, formal clinical hypnosis and self-hypnosis. Those techniques were applied\\u000a in small group settings to systematically alter pain perception, pain interpretations

Mirko Pavlek

2008-01-01

157

Clinical Issues in Pain Management Clinical Issues in Pain Management  

E-print Network

Example: Chronic low back pain Recurrent acute pain Intermittent episodes of acute pain Chronic becausePain Clinical Issues in Pain Management #12;Clinical Issues in Pain Management: Acute Pain By definition, acute pain goes on for six months or less During acute pain, there is an urgent search for relief

Meagher, Mary

158

Painful hypoadrenalism.  

PubMed

A 61-year-old man presented with diffuse myalgia and arthralgia. The physical examination showed diffuse musculoskeletal tenderness and joint stiffness without the presence of synovitis or arthritis. Nerve conduction study showed combined mild axonal degenerative and demyelinating change. Muscle biopsy analysis showed unspecific mild muscle atrophy with myopathic changes found on electromyography. A diagnosis of isolated adrenocorticotropic hormone deficiency was made on the basis of endocrinological evaluation. The widespread musculoskeletal pain resolved as a result of administration of physiological dose of hydrocortisone replacement. In a patient with unexplained rheumatic symptoms, adrenocortical insufficiency should be considered in the possible aetiology. PMID:22700071

Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

2011-01-01

159

Painful hypoadrenalism  

PubMed Central

A 61-year-old man presented with diffuse myalgia and arthralgia. The physical examination showed diffuse musculoskeletal tenderness and joint stiffness without the presence of synovitis or arthritis. Nerve conduction study showed combined mild axonal degenerative and demyelinating change. Muscle biopsy analysis showed unspecific mild muscle atrophy with myopathic changes found on electromyography. A diagnosis of isolated adrenocorticotropic hormone deficiency was made on the basis of endocrinological evaluation. The widespread musculoskeletal pain resolved as a result of administration of physiological dose of hydrocortisone replacement. In a patient with unexplained rheumatic symptoms, adrenocortical insufficiency should be considered in the possible aetiology. PMID:22700071

Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

2011-01-01

160

When Sex Is Painful  

MedlinePLUS

How common is painful sex? Pain during intercourse is very common—nearly 3 out of 4 women have pain during intercourse at some time during ... a long-term problem. What causes pain during sex? Pain during sex may be a sign of ...

161

Low Back Pain  

MedlinePLUS

MENU Return to Web version Low Back Pain Overview What is low back pain? Low back pain is a common problem for many people. It can be caused by many ... lift and exercise correctly. Symptoms When is low back pain serious? Call your family doctor if: Pain goes ...

162

Bone pain or tenderness  

MedlinePLUS

... cause of the pain, your doctor may prescribe: Antibiotics Anti-inflammatory medicines Hormones Laxatives (if you develop constipation during prolonged bed rest) Pain relievers If pain is related to thinning bones, you may need treatment for osteoporosis .

163

What Is Back Pain?  

MedlinePLUS

... some types of treatments for chronic back pain. Hot or Cold Packs (or Both) Hot or cold packs can soothe sore, stiff backs. ... helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but this ...

164

Prevent Back Pain  

MedlinePLUS

... Everyday Healthy Living > Safety > Prevent Back Pain Prevent Back Pain The Basics Take Action! Ver en español Content ... Basics One of the best ways to prevent back pain is to keep your back muscles strong. Follow ...

165

Medications for back pain  

MedlinePLUS

Your back pain may not go away completely, or it may get more painful at times. Learning to take care ... home and how to prevent repeat episodes of back pain may help you avoid surgery. Different medications can ...

166

Complex Regional Pain Syndrome  

MedlinePLUS

... any treatment? Because there is no cure for CRPS, treatment is aimed at relieving painful symptoms. Doctors may prescribe topical analgesics, antidepressants, corticosteroids, and opioids to relieve pain. ...

167

Foot Kinematics During a Bilateral Heel Rise Test in Participants With Stage II Posterior Tibial Tendon Dysfunction  

PubMed Central

STUDY DESIGN Experimental laboratory study using a cross-sectional design. OBJECTIVES To compare foot kinematics, using 3-dimensional tracking methods, during a bilateral heel rise between participants with posterior tibial tendon dysfunction (PTTD) and participants with a normal medial longitudinal arch (MLA). BACKGROUND The bilateral heel rise test is commonly used to assess patients with PTTD; however, information about foot kinematics during the test is lacking. METHODS Forty-five individuals volunteered to participate, including 30 patients diagnosed with unilateral stage II PTTD (mean ± SD age, 59.8 ± 11.1 years; body mass index, 29.9 ± 4.8 kg/m2) and 15 controls (mean ± SD age, 56.5 ± 7.7 years; body mass index, 30.6 ± 3.6 kg/m2). Foot kinematic data were collected during a bilateral heel rise task from the calcaneus (hindfoot), first metatarsal, and hallux, using an Optotrak motion analysis system and Motion Monitor software. A 2-way mixed-effects analysis of variance model, with normalized heel height as a covariate, was used to test for significant differences between the normal MLA and PTTD groups. RESULTS The patients in the PTTD group exhibited significantly greater ankle plantar flexion (mean difference between groups, 7.3°; 95% confidence interval [CI]: 5.1° to 9.5°), greater first metatarsal dorsiflexion (mean difference between groups, 9.0°; 95% CI: 3.7° to 14.4°), and less hallux dorsiflexion (mean difference, 6.7°; 95% CI: 1.7° to 11.8°) compared to controls. At peak heel rise, hindfoot inversion was similar (P = .130) between the PTTD and control groups. CONCLUSION Except for hindfoot eversion/inversion, the differences in foot kinematics in participants with stage II PTTD, when compared to the control group, mainly occur as an offset, not an alteration in shape, of the kinematic patterns. PMID:19648723

HOUCK, JEFF; NEVILLE, CHRISTOPHER; TOME, JOSHUA; FLEMISTER, ADOLPH

2010-01-01

168

The prevalence of musculoskeletal pain & its associated factors among female Saudi school teachers  

PubMed Central

Objectives: To quantify the prevalence and identify the associated factors of musculoskeletal pain among Saudi female school teachers. Methods: An observational quantitative cross-sectional survey of female Saudi school teachers in five different areas of Saudi Arabia was carried out between August and October 2013. A self-administered questionnaire was used in which the items related to participants’ demographic information and pain information were included. A numeric pain rating scale was used for patient self-reporting of pain. Data analysis was carried out using SPSS Pc+ version 21.0 statistical software. Results: Four hundred and eighty six female school teachers responded to the survey. Severe Low back pain was reported by 38.1% of teacher, followed by knee pain (26.3%), heel (24.1%), shoulder (20.6%), upper back (17.7%), hip joint (16.5%),ankle (12.3%), neck (11.3%). Sever pain of elbow (5.6%) and wrist (7.4%) was the least reported. Pain affected work at school in 46.1% of school teachers. A combination of variables: body mass index, Vitamin D deficiency, teaching level, presence of chronic illness, were found to be significantly associated with musculoskeletal pain. Conclusion: The results of self-reported prevalence of musculoskeletal pain among female Saudi school teachers is useful to educate the school teachers for adequate care so as to prevent these pains. There is a need for the higher authorities to address this issue and implement intervention programs to alleviate the pain and suffering of these school teachers.

Abdulmonem, Alsiddiky; Hanan, Algethami; Elaf, Ahmed; Haneen, Tokhtah; Jenan, Aldouhan

2014-01-01

169

Peripheral Pain Mechanisms in Chronic Widespread Pain  

PubMed Central

Clinical symptoms of chronic widespread pain (CWP) conditions including fibromyalgia (FM), include pain, stiffness, subjective weakness, and muscle fatigue. Muscle pain in CWP is usually described as fluctuating and often associated with local or generalized tenderness (hyperalgesia and/or allodynia). This tenderness related to muscle pain depends on increased peripheral and/or central nervous system responsiveness to peripheral stimuli which can be either noxious (hyperalgesia) or non-noxious (allodynia). For example, patients with muscle hyperalgesia will rate painful muscle stimuli higher than normal controls, whereas patients with allodynia may perceive light touch as painful, something that a “normal” individual will never describe as painful. The pathogenesis of such peripheral and/or central nervous system changes in CWP is unclear, but peripheral soft tissue changes have been implicated. Indirect evidence from interventions that attenuate tonic peripheral nociceptive impulses in patients with CWP syndromes like FM suggest that overall FM pain is dependent on peripheral input. More importantly, allodynia and hyperalgesia can be improved or abolished by removal of peripheral impulse input. Another potential mechanism for CWP pain is central disinhibition. However, this pain mechanism also depends on tonic impulse input, even if only inadequately inhibited. Thus a promising approach to understanding CWP is to determine whether abnormal activity of receptors in deep tissues is fundamental to the development and maintenance of this chronic pain disorder. Conclusions Most CWP patients present with focal tissue abnormalities including myofascial trigger points, ligamentous trigger points, or osteoarthritis of the joints and spine. While not predictive for the development of CWP these changes nevertheless represent important pain generators that may initiate or perpetuate chronic pain. Local chemical mediators, including lactic acid, ATP, and cytokines seem to play an important role in sensitizing deep tissue nociceptors of CWP patients. Thus the combination of peripheral impulse input and increased central pain sensitivity may be responsible for wide-spread chronic pain disorders including FM. PMID:22094192

Staud, Roland

2011-01-01

170

Chronic Pain and Fatigue  

E-print Network

Chronic Pain and Fatigue Research Center Department of Anesthesiology 24 Frank Lloyd Wright Dr, information regarding this condition The UMHS Chronic Pain and Fatigue Research Center (CPFRC) offers of other pain syndromes such as irritable bowel, pelvic pain, and headaches. The FM Workshop is conducted

Shyy, Wei

171

PAIN MEDICINE POSITION PAPER  

Microsoft Academic Search

Current Status Since the 1950s, significant advances in the treatment of pain have resulted in greater relief for an increasing number of patients. However, the quality of pain care delivery in the United States continues to fall remarkably short of the current potential for optimal care. Pain medicine remains fragmented, and the absence of a unified organizational model of pain

Michel Y. Dubois; Rollin M. Gallagher; Philipp M. Lippe

2009-01-01

172

Chronic pelvic pain.  

PubMed

Chronic pelvic pain is pain lasting longer than 6 months and is estimated to occur in 15% of women. Causes of pelvic pain include disorders of gynecologic, urologic, gastroenterologic, and musculoskeletal systems. The multidisciplinary nature of chronic pelvic pain may complicate diagnosis and treatment. Treatments vary by cause but may include medicinal, neuroablative, and surgical treatments. PMID:24280400

Stein, Sharon L

2013-12-01

173

Opioids for neuropathic pain  

Microsoft Academic Search

Whether opioids are effective for neuropathic pain has been a matter of controversy for decades. Within limits, it is clear\\u000a that opioids in general are effective for neuropathic pain. Furthermore, there is no evidence that opioids are any less effective\\u000a for neuropathic pain than for non-neuropathic pain, no evidence that opioids are less effective for neuropathic pain than\\u000a are other

Nathaniel Katz; Christine Benoit

2005-01-01

174

Growing pains in children  

PubMed Central

We review the clinical manifestations of "growing pains", the most common form of episodic childhood musculoskeletal pain. Physicians should be careful to adhere to clear clinical criteria as described in this review before diagnosing a child with growing pain. We expand on current theories on possible causes of growing pains and describe the management of these pains and the generally good outcome in nearly all children. PMID:17550631

Uziel, Yosef; Hashkes, Philip J

2007-01-01

175

Planus Foot Posture and Pronated Foot Function are Associated with Foot Pain: The Framingham Foot Study  

PubMed Central

Objective To examine the associations of foot posture and foot function to foot pain. Methods Data were collected on 3,378 members of the Framingham Study who completed foot examinations in 2002–2008. Foot pain (generalized and at six locations) was based on the response to the question “On most days, do you have pain, aching or stiffness in either foot?” Foot posture was categorized as normal, planus or cavus using static pressure measurements of the arch index. Foot function was categorized as normal, pronated or supinated using the center of pressure excursion index from dynamic pressure measurements. Sex-specific multivariate logistic regression models were used to examine the effect of foot posture and function on generalized and location-specific foot pain, adjusting for age and weight. Results Planus foot posture was significantly associated with an increased likelihood of arch pain in men (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.01 – 1.90), while cavus foot posture was protective against ball of foot pain (OR 0.74, 95% CI 0.55 – 1.00) and arch pain (OR 0.64, 95% CI 0.48 – 0.85) in women. Pronated foot function was significantly associated with an increased likelihood of generalized foot pain (OR 1.28, 95% CI 1.04 – 1.56) and heel pain (OR 1.54, 95% CI 1.04 – 2.27) in men, while supinated foot function was protective against hindfoot pain in women (OR 0.74, 95% CI 0.55 – 1.00). Conclusion Planus foot posture and pronated foot function are associated with foot symptoms. Interventions that modify abnormal foot posture and function may therefore have a role in the prevention and treatment of foot pain. PMID:23861176

Menz, Hylton B.; Dufour, Alyssa B.; Riskowski, Jody L.; Hillstrom, Howard J.; Hannan, Marian T.

2014-01-01

176

Breakthrough pain: characteristics and impact in patients with cancer pain  

Microsoft Academic Search

Few surveys have been performed to define the characteristics and impact of breakthrough pain in the cancer population. In this cross-sectional survey of inpatients with cancer, patients responded to a structured interview (the Breakthrough Pain Questionnaire) designed to characterize breakthrough pain, and also completed measures of pain and mood (Memorial Pain Assessment Card (MPAC)), pain-related interference in function (Brief Pain

Russell K Portenoy; David Payne; Paul Jacobsen

1999-01-01

177

The potential influence of the heel counter on internal stress during static standing: a combined finite element and positional MRI investigation.  

PubMed

Confinement of the heel due to the counter of the shoe is believed to influence heel pad biomechanics. Using a two-dimensional finite element model of the heel pad and shoe during a simulation of static standing, the aim of this study was to quantify the potential effect of confinement on internal heel pad stress. Non-weightbearing MRI and weightbearing MRI with plantar pressure and ground reaction force data were recorded for a single subject. The non-weightbearing MRI was used to create two FE models of the heel pad, using either homogeneous or composite material properties. The composite model included a distinction in material properties between fat pad and skin. Vertical and medial-lateral forces, as measured on the subject's heel, were applied to the models and vertical compressive strains for both models were comparable with those observed by weightbearing MRI. However, only for the composite model was the predicted plantar pressure distribution comparable with measured data. The composite model was therefore used in further analyses. In this composite model, the internal stresses were located mainly in the skin and were predominantly tensile in nature, whereas the stress state in the fat pad approached hydrostatic conditions. A representation of a running shoe, including an insole, midsole and heel counter was then added to the composite heel pad to form the shod model. In order to investigate the counter effect, the load was applied to the shod model with and without the heel counter. The effect of the counter on peak stress was to elevate compression (0-50%), reduce tension (22-34%) and reduce shear (22-28%) in the skin. In addition, the counter reduced both compressive (20-40%) and shear (58-80%) stress in the fat pad and tension in the fat pad remained negligible. Taken together the results indicate that a well-fitted counter works in sympathy with the internal structure of the heel pad and could be an effective reducer of heel pad stress. However, further research needs to be undertaken to assess the long-term effects on the soft-tissues, practicalities of achieving good fit and behavior under dynamic events. PMID:17362970

Spears, I R; Miller-Young, J E; Sharma, J; Ker, R F; Smith, F W

2007-01-01

178

An Introduction Significance of Pain  

E-print Network

Inflammation or nerve damage !!65 -90 million in US !!Arthritis !!Neuropathic pain !!Back pain !!MigraineAn Introduction to: Pain #12;Significance of Pain !!Pain is adaptive !!Alerts us to danger !!Motivates escape and avoidance learning !!Motivates recuperation !!Congenital insensitivity to pain !!Pain

Meagher, Mary

179

The relation between bone mineral density in the heel and pixel intensity in the mandibular jaw bone among elderly women  

PubMed Central

Objectives The purpose of this study was to investigate the correlation between pixel intensity (PI) in digital radiographs of the lower jaw and bone mineral density (BMD) in the heels of post-menopausal women (as measured with DXL, a combination of dual energy X-ray absorptiometry and lasers). Methods Two intraoral periapical digital radiographs were taken in the right and left mandible premolar region, and the digital images were analysed by a computer program (Dimaxis) regarding PI. As the radiographs were taken, the BMD of the patient's left heel was measured via a portable Calscan device. The patient answered a questionnaire concerning risk factors. The correlation between variables was analysed using statistical tests. Results A significant correlation was found between the PI in the left (P = 0.001) and right (P = 0.004) mandible and the BMD of the left heel for the whole group. A pronounced correlation was found to exist for women > 70 years old. Based on a cut-off value of the PI, to differentiate between healthy individuals and those who required further analysis for osteoporosis, the following values were obtained: sensitivity 0.74, specificity 0.50, positive predictive value 0.77 and negative predictive value 0.46. Conclusion A positive correlation was found between PI in digital radiographs of the mandible and the BMD of the heel. The low predictive value does not allow any definite conclusions to be drawn from the present study. A reasonable recommendation could be for future studies to employ a larger study population to explore the effect on this value. PMID:20841458

Hedström, L; Baigi, A; Bergh, H

2010-01-01

180

Central modulation of pain  

PubMed Central

It has long been appreciated that the experience of pain is highly variable between individuals. Pain results from activation of sensory receptors specialized to detect actual or impending tissue damage (i.e., nociceptors). However, a direct correlation between activation of nociceptors and the sensory experience of pain is not always apparent. Even in cases in which the severity of injury appears similar, individual pain experiences may vary dramatically. Emotional state, degree of anxiety, attention and distraction, past experiences, memories, and many other factors can either enhance or diminish the pain experience. Here, we review evidence for “top-down” modulatory circuits that profoundly change the sensory experience of pain. PMID:21041960

Ossipov, Michael H.; Dussor, Gregory O.; Porreca, Frank

2010-01-01

181

Pediatric pain management.  

PubMed

It is now recognized that from the newborn period onwards, children are capable of experiencing pain. This includes the premature infant. The challenge for healthcare providers is to incorporate methods of pain assessment and treatment into their daily practices. The child's understanding of pain closely follows the cognitive and behavioral model developed by Jean Piaget. Based on these developmental stages, pain assessment measures have been developed. Pharmacologic advances have accompanied this improved understanding of infant, child, and adolescent psychology. While acute pain accounts for the majority of children's experiences, recurrent/chronic pain states do occur (e.g. sickle cell related and neuropathic) and can be effectively treated. PMID:9037997

Lederhaas, G

1997-01-01

182

EM-21 ALTERNATIVE ENHANCED CHEMICAL CLEANING PROGRAM FOR SLUDGE HEEL REMOVAL  

SciTech Connect

Preliminary studies in the EM-21 Alternative Chemical Cleaning Program have focused on understanding the dissolution of Hematite (a primary sludge heel phase) in oxalic acid, with a focus on minimizing oxalic acid usage. Literature reviews, thermodynamic modeling, and experimental results have all confirmed that pH control, preferably using a supplemental proton source, is critical to oxalate minimization. With pH control, iron concentrations as high as 0.103 M have been obtained in 0.11 M oxalic acid. This is consistent with the formation of a 1:1 (iron:oxalate) complex. The solubility of Hematite in oxalic acid has been confirmed to increase by a factor of 3 when the final solution pH decreases from 5 to below 1. This is consistent with literature predictions of a shift in speciation from a 1:3 to 1:1 as the pH is lowered. Above a solution pH of 6, little Hematite dissolves. These results emphasize the importance of pH control in optimizing Hematite dissolution in oxalic acid.

Hay, M.; King, W.; Martino, C.

2009-12-18

183

Immunoediting and Antigen Loss: Overcoming the Achilles Heel of Immunotherapy with Antigen Non-Specific Therapies  

PubMed Central

Cancer immunotherapy has emerged as a mainstream therapy option in the battle against cancer. Pre-clinical data demonstrates the ability of immunotherapy to harness the immune system to fight disseminated malignancy. Clinical translation has failed to recapitulate the promising results of pre-clinical studies although there have been some successes. In this review we explore some of the short-comings of cancer immunotherapy that have limited successful clinical translation. We will give special consideration to what we consider the most formidable hurdle to successful cancer immunotherapy: tumor-induced immune suppression and immune escape. We will discuss the need for antigen-specific immune responses for successful immunotherapy but also consider the need for antigen specificity as an Achilles heel of immunotherapy given tumor heterogeneity, immune editing, and antigen loss. Finally, we will discuss how combinatorial strategies may overcome some of the pitfalls of antigen specificity and highlight recent studies from our lab which suggest that the induction of antigen non-specific immune responses may also produce robust anti-tumor effects and bypass the need for antigen specificity. PMID:23898464

Monjazeb, Arta Monir; Zamora, Anthony E.; Grossenbacher, Steven K.; Mirsoian, Annie; Sckisel, Gail D.; Murphy, William J.

2013-01-01

184

EM-31 ALTERNATIVE AND ENHANCED CHEMICAL CLEANING PROGRAM FOR SLUDGE HEEL REMOVAL - 11220  

SciTech Connect

Mixtures of oxalic acid with nitric acid have been shown to be superior to oxalic acid alone for the dissolution of iron-rich High Level Waste sludge heels. Optimized conditions resulting in minimal oxalate usage and stoichiometric iron dissolution (based on added oxalate ion) have been determined for hematite (a primary sludge iron phase) in oxalic/nitric acid mixtures. The acid mixtures performed better than expected based on the solubility of hematite in the individual acids through a synergistic effect in which the preferred 1:1 Fe:oxalate complex is formed. This allows for the minimization of oxalate additions to the waste stream. Carbon steel corrosion rates were measured in oxalic/nitric acid mixtures to evaluate the impacts of chemical cleaning with these solutions on waste tank integrity. Manageable corrosion rates were observed in the concentration ranges of interest for an acid contact timescale of 1 month. Kinetics tests involving hematite and gibbsite (a primary sludge aluminum phase) have confirmed that {ge}90% solids dissolution occurs within 3 weeks. Based on these results, the chemical cleaning conditions recommended to promote minimal oxalate usage and manageable corrosion include: 0.5 wt. % oxalic acid/0.175 M nitric acid mixture, 50 C, 2-3 week contact time with agitation.

King, W.; Hay, M.; Wiersma, B.; Pennebaker, F.

2010-12-10

185

Loin pain hematuria syndrome.  

PubMed

Loin pain hematuria syndrome is a rare disease with a prevalence of ?0.012%. The most prominent clinical features include periods of severe intermittent or persistent unilateral or bilateral loin pain accompanied by either microscopic or gross hematuria. Patients with loin pain hematuria syndrome initially present with hematuria, flank pain, or most often both hematuria and flank pain. Kidney biopsies from patients with loin pain hematuria typically reveal only minor pathologic abnormalities. Further, loin pain hematuria syndrome is not associated with loss of kidney function or urinary tract infections. Loin pain hematuria syndrome-associated hematuria and pain are postulated to be linked to vascular disease of the kidney, coagulopathy, renal vasospasm with microinfarction, hypersensitivity, complement activation on arterioles, venocalyceal fistula, abnormal ureteral peristalsis, and intratubular deposition of calcium or uric acid microcrystals. Many patients with loin pain hematuria syndrome also meet criteria for a somatoform disorder, and analgesic medications, including narcotics, commonly are used to treat loin pain hematuria syndrome-associated pain. Interventional treatments include renal denervation, kidney autotransplantation, and nephrectomy; however, these methods should be used only as a last resort when less invasive measures have been tried unsuccessfully. In this review article, we discuss and critique current clinical practices related to loin pain hematuria syndrome pathophysiology, diagnosis, treatment, and prognosis. PMID:24725981

Taba Taba Vakili, Sahar; Alam, Tausif; Sollinger, Hans

2014-09-01

186

Pain in Parkinson's Disease  

MedlinePLUS

... for increased overall health care costs. A person’s perception of pain can be affected by emotional factors. ... medications such as levodopa can affect a person’s perception of pain. People with Parkinson’s who are in ...

187

Magnets for Pain Relief  

MedlinePLUS

... our disclaimer about external links Menu Magnets for Pain Relief On this page: Introduction Key Points About ... Top What the Science Says About Magnets for Pain Scientific evidence does not support the use of ...

188

Sacroiliac joint pain.  

PubMed

The sacroiliac joint is a source of pain in the lower back and buttocks in approximately 15% of the population. Diagnosing sacroiliac joint-mediated pain is difficult because the presenting complaints are similar to those of other causes of back pain. Patients with sacroiliac joint-mediated pain rarely report pain above L5; most localize their pain to the area around the posterior superior iliac spine. Radiographic and laboratory tests primarily help exclude other sources of low back pain. Magnetic resonance imaging, computed tomography, and bone scans of the sacroiliac joint cannot reliably determine whether the joint is the source of the pain. Controlled analgesic injections of the sacroiliac joint are the most important tool in the diagnosis. Treatment modalities include medications, physical therapy, bracing, manual therapy, injections, radiofrequency denervation, and arthrodesis; however, no published prospective data compare the efficacy of these modalities. PMID:15473677

Dreyfuss, Paul; Dreyer, Susan J; Cole, Andrew; Mayo, Keith

2004-01-01

189

Communicating about Cancer Pain  

Cancer.gov

Patients with cancer may be reluctant to discuss their pain with their doctors for a variety of reasons. NCI sponsors research that examines the barriers that prevent patients from talking about pain.

190

Posttonsillectomy pain in children.  

PubMed

Tonsillectomy, used to treat a variety of pediatric disorders, including obstructive sleep apnea, peritonsillar cellulitis or abscesses, and very frequent throat infection, is known to produce nausea, vomiting, and prolonged, moderate-to-severe pain. The authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions in pain management, recommendations for patient and family teaching regarding pain management, and best practices for improving medication adherence. PMID:24445532

Sutters, Kimberly A; Isaacson, Glenn

2014-02-01

191

Molecular pain, a new era of pain research and medicine  

Microsoft Academic Search

Molecular pain is a relatively new and rapidly expanding research field that represents an advanced step from conventional pain research. Molecular pain research addresses physiological and pathological pain at the cellular, subcellular and molecular levels. These studies integrate pain research with molecular biology, genomics, proteomics, modern electrophysiology and neurobiology. The field of molecular pain research has been rapidly expanding in

Jianguo Gu; Min Zhuo; Michael Caterina; Amy B MacDermott; Annika Malmberg; Volker Neugebauer; Megumu Yoshimura

2005-01-01

192

Definitions and Types of Pain  

MedlinePLUS

... Types of Pain Defining Pain Pain is a perception that signals the individual that tissue damage has ... in the body that are involved in the perception of pain are called "nociception." Basic and clinical ...

193

Pediatric Procedural Pain  

ERIC Educational Resources Information Center

This article reviews the various settings in which infants, children, and adolescents experience pain during acute medical procedures and issues related to referral of children to pain management teams. In addition, self-report, reports by others, physiological monitoring, and direct observation methods of assessment of pain and related constructs…

Blount, Ronald L.; Piira, Tiina; Cohen, Lindsey L.; Cheng, Patricia S.

2006-01-01

194

Chest pain in children.  

PubMed Central

Chest pain is usually a benign symptom in children. The most common identifiable causes are musculoskeletal. Often, no cause can be identified. Cardiac disorders are uncommon causes of chest pain children. Most causes can be diagnosed from history and physical examination. Treatment should be directed at the underlying cause. For idiopathic chest pain, reassurance and regular follow-up examinations are important. PMID:8704491

Leung, A. K.; Robson, W. L.; Cho, H.

1996-01-01

195

Complex Regional Pain Syndrome  

MedlinePLUS

... pain reliever) into certain nerves to block the pain signals. If the injection works, it may be repeated. Physical therapy and psychological counseling are also helpful. However, a treatment that works for ... pain syndrome from getting worse. Sometimes the condition improves. ...

196

Paine Appointed Administrator  

NASA Technical Reports Server (NTRS)

President Richard M. Nixon announcing the appointment of Dr. Thomas O. Paine as Administrator for the National Aeronautics and Space Administration. The ceremony was held at the White House. Paine had been serving as acting administrator. From left to right: President Richard M. Nixon NASA Administrator Dr. Thomas O. Paine Vice President Spiro T. Agnew

1969-01-01

197

Forebrain Pain Mechanisms  

PubMed Central

Emotional-affective and cognitive dimensions of pain are less well understood than nociceptive and nocifensive components, but the forebrain is believed to play an important role. Recent evidence suggests subcortical and cortical brain areas outside the traditional pain processing network contribute critically to emotional-affective responses and cognitive deficits related to pain. These brain areas include different nuclei of the amygdala and certain prefrontal cortical areas. Their roles in various aspects of pain will be discussed. Biomarkers of cortical dysfunction are being identified that may evolve into therapeutic targets to modulate pain experience and improve pain-related cognitive impairment. Supporting data from preclinical studies in neuropathic pain models will be presented. Neuroimaging analysis provides evidence for plastic changes in the pain processing brain network. Results of clinical studies in neuropathic pain patients suggest that neuroimaging may help determine mechanisms of altered brain functions in pain as well as monitor the effects of pharmacologic interventions to optimize treatment in individual patients. Recent progress in the analysis of higher brain functions emphasizes the concept of pain as a multidimensional experience and the need for integrative approaches to determine the full spectrum of harmful or protective neurobiological changes in pain. PMID:19162070

Neugebauer, Volker; Galhardo, Vasco; Maione, Sabatino; Mackey, Sean C.

2009-01-01

198

Cannabinoids in cancer pain  

Microsoft Academic Search

This article of the month presents results of a clinical study conducted in the UK and Romania, which evaluated the efficacy of a THC:CBD cannabis extract (Sativex®) and a THC cannabis ex- tract in the treatment of 177 patients with cancer pain, who experienced inadequate pain reduction despite intake of opioids (Johnson et al. J Pain Symptom Manage, 2010, in

Franjo Grotenhermen

2010-01-01

199

The influence of children's pain memories on subsequent pain experience.  

PubMed

Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. PMID:22560288

Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

2012-08-01

200

Dancing in pain: pain appraisal and coping in dancers.  

PubMed

This study investigated the relationships between the type of pain experienced (performance pain and injury pain), the cognitive appraisal of pain and pain coping styles in dancers. Fifty-one professional ballet and contemporary dancers (17 males and 34 females), with the mean age of 25.9 years, completed a general pain questionnaire, the Pain Appraisal Inventory, the Survey of Pain Attitudes Control Subscale, and the Sports Inventory for Pain. Multivariate analyses of variance indicated that both the cognitive appraisal of the pain and pain coping styles did not differ according to the type of pain experienced or the pain severity. However, it was found that dancers with performance pain of either low or high severity were more likely to dance in pain than dancers experiencing injury pain. Multiple regression analyses indicated that the appraisal of pain as threatening was predictive of the use of avoidance and catastrophizing pain coping styles. Overall, results indicated that dancers may not differentiate between performance pain and injury pain, or modify their appraisal and coping strategies according to the characteristics of the pain experienced. The study highlighted an opportunity for increased education for dancers in recognizing the difference between pain considered to be a routine aspect of training and pain which is a signal of serious injury. PMID:19618573

Anderson, Ruth; Hanrahan, Stephanie J

2008-01-01

201

Cannabinoids for neuropathic pain.  

PubMed

Treatment options for neuropathic pain have limited efficacy and use is fraught with dose-limiting adverse effects. The endocannabinoid system has been elucidated over the last several years, demonstrating a significant interface with pain homeostasis. Exogenous cannabinoids have been demonstrated to be effective in a range of experimental neuropathic pain models, and there is mounting evidence for therapeutic use in human neuropathic pain conditions. This article reviews the history, pharmacologic development, clinical trials results, and the future potential of nonsmoked, orally bioavailable, nonpsychoactive cannabinoids in the management of neuropathic pain. PMID:25160710

Fine, Perry G; Rosenfeld, Mark J

2014-10-01

202

Association of calcaneal quantitative ultrasound parameters with metabolic syndrome in middle-aged and elderly Chinese: a large population-based cross-sectional study  

PubMed Central

Background The possible association between metabolic syndrome (MS) and bone mineral density (BMD) has been highlighted recently. However, the exact effects of MS on calcaneal quantitative ultrasound (QUS) parameters remains uncertain. The aim of this study was to assess the impact of MS states, different componets of MS, as well as the number of MS componets on QUS. Methods A total of 7489 Chinese adults aged 40 years or older in Nanjing were enrolled in this cross-sectional study. MS was defined according to recommendations generated by the International Diabetes Federation (IDF) in 2005. QUS was measured for each participant. Results The prevalence of MS was 34.6% in men and 42.8% in women (over 40 years old). In postmenopausal women with MS, 25-hydroxyvitamin D[25(OH)D], age adjusted quantitative ultrasound index (QUI) and broadband ultrasound attenuation (BUA) were all lower than those without (p?

2014-01-01

203

An equine pain face  

PubMed Central

Objective The objective of this study was to investigate the existence of an equine pain face and to describe this in detail. Study design Semi-randomized, controlled, crossover trial. Animals Six adult horses. Methods Pain was induced with two noxious stimuli, a tourniquet on the antebrachium and topical application of capsaicin. All horses participated in two control trials and received both noxious stimuli twice, once with and once without an observer present. During all sessions their pain state was scored. The horses were filmed and the close-up video recordings of the faces were analysed for alterations in behaviour and facial expressions. Still images from the trials were evaluated for the presence of each of the specific pain face features identified from the video analysis. Results Both noxious challenges were effective in producing a pain response resulting in significantly increased pain scores. Alterations in facial expressions were observed in all horses during all noxious stimulations. The number of pain face features present on the still images from the noxious challenges were significantly higher than for the control trial (p = 0.0001). Facial expressions representative for control and pain trials were condensed into explanatory illustrations. During pain sessions with an observer present, the horses increased their contact-seeking behavior. Conclusions and clinical relevance An equine pain face comprising ‘low’ and/or ‘asymmetrical’ ears, an angled appearance of the eyes, a withdrawn and/or tense stare, mediolaterally dilated nostrils and tension of the lips, chin and certain facial muscles can be recognized in horses during induced acute pain. This description of an equine pain face may be useful for improving tools for pain recognition in horses with mild to moderate pain. PMID:25082060

Gleerup, Karina B; Forkman, Björn; Lindegaard, Casper; Andersen, Pia H

2015-01-01

204

The human foot and heel-sole-toe walking strategy: a mechanism enabling an inverted pendular gait with low isometric muscle force?  

PubMed

Mechanically, the most economical gait for slow bipedal locomotion requires walking as an 'inverted pendulum', with: I, an impulsive, energy-dissipating leg compression at the beginning of stance; II, a stiff-limbed vault; and III, an impulsive, powering push-off at the end of stance. The characteristic 'M'-shaped vertical ground reaction forces of walking in humans reflect this impulse-vault-impulse strategy. Humans achieve this gait by dissipating energy during the heel-to-sole transition in early stance, approximately stiff-limbed, flat-footed vaulting over midstance and ankle plantarflexion (powering the toes down) in late stance. Here, we show that the 'M'-shaped walking ground reaction force profile does not require the plantigrade human foot or heel-sole-toe stance; it is maintained in tip-toe and high-heel walking as well as in ostriches. However, the unusual, stiff, human foot structure--with ground-contacting heel behind ankle and toes in front--enables both mechanically economical inverted pendular walking and physiologically economical muscle loading, by producing extreme changes in mechanical advantage between muscles and ground reaction forces. With a human foot, and heel-sole-toe strategy during stance, the shin muscles that dissipate energy, or calf muscles that power the push-off, need not be loaded at all--largely avoiding the 'cost of muscle force'--during the passive vaulting phase. PMID:22572024

Usherwood, J R; Channon, A J; Myatt, J P; Rankin, J W; Hubel, T Y

2012-10-01

205

Neurological diseases and pain  

PubMed Central

Chronic pain is a frequent component of many neurological disorders, affecting 20–40% of patients for many primary neurological diseases. These diseases result from a wide range of pathophysiologies including traumatic injury to the central nervous system, neurodegeneration and neuroinflammation, and exploring the aetiology of pain in these disorders is an opportunity to achieve new insight into pain processing. Whether pain originates in the central or peripheral nervous system, it frequently becomes centralized through maladaptive responses within the central nervous system that can profoundly alter brain systems and thereby behaviour (e.g. depression). Chronic pain should thus be considered a brain disease in which alterations in neural networks affect multiple aspects of brain function, structure and chemistry. The study and treatment of this disease is greatly complicated by the lack of objective measures for either the symptoms or the underlying mechanisms of chronic pain. In pain associated with neurological disease, it is sometimes difficult to obtain even a subjective evaluation of pain, as is the case for patients in a vegetative state or end-stage Alzheimer's disease. It is critical that neurologists become more involved in chronic pain treatment and research (already significant in the fields of migraine and peripheral neuropathies). To achieve this goal, greater efforts are needed to enhance training for neurologists in pain treatment and promote greater interest in the field. This review describes examples of pain in different neurological diseases including primary neurological pain conditions, discusses the therapeutic potential of brain-targeted therapies and highlights the need for objective measures of pain. PMID:22067541

2012-01-01

206

Pain after earthquake  

PubMed Central

Introduction On 6 April 2009, at 03:32 local time, an Mw 6.3 earthquake hit the Abruzzi region of central Italy causing widespread damage in the City of L Aquila and its nearby villages. The earthquake caused 308 casualties and over 1,500 injuries, displaced more than 25,000 people and induced significant damage to more than 10,000 buildings in the L'Aquila region. Objectives This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009). Methods 958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy. Results A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%). Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions. Conclusions This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations. PMID:22747796

2012-01-01

207

Effects of therapeutic massage on gait and pain after delayed onset muscle soreness  

PubMed Central

Unfamiliar or sudden exercise can induce delayed onset muscle soreness (DOMS) within 12–24 h. So, several researchers have reported various interventions to treat DOMS. Massage is generally known to eliminate muscle fatigue. However, effect of massage after DOMS is still not clear. We investigated whether the massage is effective on pain and gait after DOMS. The participants were divided into a control group (n= 10) with DOMS and an experimental group (n= 11) with the massage treated after DOMS. We induced DOMS by taking isotonic exercise with going up and down 20 times in 5-story building. We applied the massage and assessment on gastrocnemius of dominant foot. The change of gait and pain was assessed using gaitrite and algometer. In the present results, the massage on gastrocnemius after DOMS showed significant difference in pain (P< 0.05). Also, there was a significant difference in gait (P< 0.05), especially, spatial parameters (distance, step length, stride length) and temporal parameters (ambulation, heel on off time, stride velocity). Moreover, the pain relief after massage-treated in DOMS correlated with gait. These results suggest that the massage on gastrocnemius after DOMS has influence on pain and gait performance. Therefore, massage can be applied as intervention for delayed onset muscle soreness. PMID:24877051

Han, Jun-Ho; Kim, Min-Jeong; Yang, Hyuk-Jin; Lee, Yu-Jin; Sung, Yun-Hee

2014-01-01

208

Heart Rate Variability in Response to Pain Stimulus in VLBW Infants Followed Longitudinally During NICU Stay  

PubMed Central

The objective of this longitudinal study, conducted in a neonatal intensive care unit, was to characterize the response to pain of high-risk very low birth weight infants (< 1500 g) from 23 through 38 weeks post-menstrual age (PMA) by measuring heart rate variability (HRV). Heart period data were recorded before, during, and after a heel lanced or wrist venipunctured blood draw for routine clinical evaluation. Pain response to the blood draw procedure and age-related changes of HRV in low-frequency and high-frequency bands were modeled with linear mixed-effects models. HRV in both bands decreased during pain, followed by a recovery to near-baseline levels. Venipuncture and mechanical ventilation were factors that attenuated the HRV response to pain. HRV at the baseline increased with post-menstrual age but the growth rate of high-frequency power was reduced in mechanically ventilated infants. There was some evidence that low-frequency HRV response to pain improved with advancing PMA. PMID:19739134

Padhye, Nikhil S; Williams, Amber L; Khattak, Asif Z; Lasky, Robert E

2009-01-01

209

Preliminary study report: topological texture features extracted from standard radiographs of the heel bone are correlated with femoral bone mineral density  

NASA Astrophysics Data System (ADS)

With the growing number of eldery patients in industrialized nations the incidence of geriatric, i.e. osteoporotic fractures is steadily on the rise. It is of great importance to understand the characteristics of hip fractures and to provide diagnostic tests for the assessment of an individual's fracture-risk that allow to take preventive action and give therapeutic advice. At present, bone-mineral-density (BMD) obtained from DXA (dual-energy x-ray-absorptiometry) is the clinical standard of reference for diagnosis and follow-up of osteoporosis. Since availability of DXA - other than that of clinical X-ray imaging - is usually restricted to specialized medical centers it is worth trying to implement alternative methods to estimate an individual's BMD. Radiographs of the peripheral skeleton, e.g. the ankle, range among the most ordered diagnostic procedures in surgery for exclusion or confirmation of fracture. It would be highly beneficial if - as a by-product of conventional imaging - one could obtain a quantitative parameter that is closely correlated with femoral BMD in addition to the original diagnostic information, e.g. fracture status at the peripheral site. Previous studies could demonstrate a correlation between calcaneal BMD and osteoporosis. The objective of our study was to test the hypothesis that topological analysis of calcaneal bone texture depicted by a lateral x-ray projection of the ankle allows to estimate femoral BMD. Our analysis on 34 post-menopausal patients indicate that texture properties based on graylevel topology in calcaneal x-ray-films are closely correlated with BMD at the hip and may qualify as a substitute indicator of femoral fracture risk.

Boehm, H. F.; Lutz, J.; Koerner, M.; Notohamiprodjo, M.; Reiser, M.

2009-02-01

210

Abdominal pain - children under age 12  

MedlinePLUS

Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can ... kinds of pain: Generalized pain or pain over more than half ...

211

Pain Management in Newborns.  

PubMed

As a standard of care for preterm/term newborns effective pain management may improve their clinical and neurodevelopmental outcomes. Neonatal pain is assessed using context-specific, validated, and objective pain methods, despite the limitations of currently available tools. Therapeutic approaches reducing invasive procedures and using pharmacologic, behavioral, or environmental measures are used to manage neonatal pain. Nonpharmacologic approaches like kangaroo care, facilitated tucking, non-nutritive sucking, sucrose, and others can be used for procedural pain or adjunctive therapy. Local/topical anesthetics, opioids, NSAIDs/acetaminophen and other sedative/anesthetic agents can be incorporated into NICU protocols for managing moderate/severe pain or distress in all newborns. PMID:25459780

Hall, Richard W; Anand, Kanwaljeet J S

2014-12-01

212

Pain and functional imaging.  

PubMed Central

Functional neuroimaging has fundamentally changed our knowledge about the cerebral representation of pain. For the first time it has been possible to delineate the functional anatomy of different aspects of pain in the medial and lateral pain systems in the brain. The rapid developments in imaging methods over the past years have led to a consensus in the description of the central pain responses between different studies and also to a definition of a central pain matrix with specialized subfunctions in man. In the near future we will see studies where a systems perspective allows for a better understanding of the regulatory mechanisms in the higher-order frontal and parietal cortices. Also, pending the development of experimental paradigms, the functional anatomy of the emotional aspects of pain will become better known. PMID:10466155

Ingvar, M

1999-01-01

213

Treatment of myofascial pain.  

PubMed

SUMMARY The objective of this article was to perform a narrative review regarding the treatment of myofascial pain syndrome and to provide clinicians with treatment recommendations. This paper reviews the efficacy of various myofascial pain syndrome treatment modalities, including pharmacological therapy, injection-based therapies and physical therapy interventions. Outcomes evaluated included pain (visual analog scale), pain pressure threshold and range of motion. The evidence found significant benefit with multiple treatments, including diclofenac patch, thiocolchicoside and lidocaine patches. Trigger point injections, ischemic compression therapy, transcutaneous electrical nerve stimulation, spray and stretch, and myofascial release were also efficacious. The authors recommend focusing on treating underlying pathologies, including spinal conditions, postural abnormalities and underlying behavioral issues. To achieve maximum pain reduction and improve function, we recommend physicians approach myofascial pain syndrome with a multimodal plan, which includes a combination of pharmacologic therapies, various physical therapeutic modalities and injection therapies. PMID:24645933

Desai, Mehul J; Bean, Matthew C; Heckman, Thomas W; Jayaseelan, Dhinu; Moats, Nick; Nava, Andrew

2013-01-01

214

Neonatal pain management  

PubMed Central

The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

Bhalla, Tarun; Shepherd, Ed; Tobias, Joseph D.

2014-01-01

215

Gender role expectations of pain: relationship to experimental pain perception  

Microsoft Academic Search

The primary purpose of this study was to investigate the influence of an individual's Gender Role Expectations of Pain (GREP) on experimental pain report. One hundred and forty-eight subjects (87 females and 61 males) subjects underwent thermal testing and were asked to report pain threshold, pain tolerance, VAS ratings of pain intensity and unpleasantness, and a computerized visual analogue scales

Emily A Wise; Donald D Price; Cynthia D Myers; Marc W Heft; Michael E Robinson

2002-01-01

216

Loin pain haematuria syndrome: distress resolved by pain relief  

Microsoft Academic Search

Loin pain haematuria syndrome (LPHS) is a syndrome of severe chronic pain of unknown aetiology. This study assessed pain, mood variables and psychiatric status in patients (n=26) with LPHS. Patients were assessed before and after treatment with capsaicin. Assessment inventories used were the McGill Pain Questionnaire, the Pain Discomfort Scale, the General Health Questionnaire and the Hospital Anxiety and Depression

Matthew Bultitude; John Young; Michael Bultitude; James Allan

1998-01-01

217

Comparative Pain Scale 0 No pain. Feeling perfectly normal.  

E-print Network

pain, such as a sprained ankle when you stand on it wrong or mild back pain. Not only do you notice-migraine headache combined with several bee stings, or a bad back pain. Severe Unable to engage in normal activitiesComparative Pain Scale 0 No pain. Feeling perfectly normal. Minor Does not interfere with most

Kay, Mark A.

218

Complex regional pain syndrome.  

PubMed

Complex regional pain syndrome is a chronic pain syndrome that is often instigated by postoperative or post-traumatic events. The disease process can progress through three stages, the first of which tends to respond best to treatment. A review of the literature is presented, followed by a report of a patient who developed symptoms of complex regional pain syndrome following a water-skiing accident. PMID:10546427

Hernandez, W; Raja, A; Capuano, C

1999-10-01

219

Esophageal Chest Pain  

Microsoft Academic Search

\\u000a Esophageal chest pain has come under critical scrutiny recently [1]. Motility disorders in particular have fallen out of favor as a cause of chest pain [1–3], to the extent that chest pain of uncertain origin has now become a rare indication for esophageal manometry in the United\\u000a States [4]. The reasons for this include changing perceptions about the relevance of

John S de Caestecker

220

Painful Peripheral Neuropathies  

PubMed Central

Peripheral neuropathies are a heterogeneous group of diseases affecting peripheral nerves. The causes are multiple: hereditary, metabolic, infectious, inflammatory, toxic, traumatic. The temporal profile includes acute, subacute and chronic conditions. The majority of peripheral neuropathies cause mainly muscle weakness and sensory loss, positive sensory symptoms and sometimes pain. When pain is present, however, it is usually extremely intense and among the most disabling symptoms for the patients. In addition, the neurological origin of the pain is often missed and patients receive inadequate or delayed specific treatment. Independently of the disease causing the peripheral nerve injury, pain originating from axonal pathology or ganglionopathy privileges neuropathies affecting smaller fibres, a clinical observation that points towards abnormal activity within nociceptive afferents as a main generator of pain. Natural activation of blood vessels or perineurial nociceptive network by pathology also causes intense pain. Pain of this kind, i.e. nerve trunk pain, is among the heralding symptoms of inflammatory or ischemic mononeuropathy and for its intensity represents itself a medical emergency. Neuropathic pain quality rekindles the psychophysical experience of peripheral nerves intraneural microstimulation i.e. a combination of large and small fibres sensation temporally distorted compared to physiological perception evoked by natural stimuli. Pins and needles, burning, cramping mixed with numbness, and tingling are the wording most used by patients. Nociceptive pain instead is most often described as aching, deep and dull. Good command of peripheral nerve anatomy and pathophysiology allows timely recognition of the different pain components and targeted treatment, selected according to intensity, type and temporal profile of the pain. PMID:18615140

Marchettini, P; Lacerenza, M; Mauri, E; Marangoni, C

2006-01-01

221

SOLID PHASE CHARACTERIZATION OF HEEL SAMPLES FROM TANK 241-C-110  

SciTech Connect

During sluicing operations of tank 241-C-110, a significant amount of solids were unable to be retrieved. These solids (often referred to as the tank 'heel') were sampled in 2010 and chemically and mineralogically analyzed in the 222-S Laboratory. Additionally, dissolution tests were performed to identify the amount of undissolvable material after using multiple water contacts. This report covers the solid phase characterization of six samples from these tests using scanning electron microscopy, polarized light microscopy, and X-ray diffraction. The chemical analyses, particle size distribution analysis, and dissolution test results are reported separately. Two of the samples were from composites created from as-received material - Composite A and Composite B. The main phase in these samples was sodium-fluoride-phosphate hydrate (natrophosphate) - in the X-ray diffraction spectra, this phase was the only phase identifiable. Polarized light microscopy showed the presence of minor amounts of gibbsite and other phases. These phases were identified by scanning electron microscopy - energy dispersive X-ray spectroscopy as sodium aluminosilicates, sodium diuranate, and sodium strontium phosphate hydrate (nastrophite) crystals. The natrophosphate crystals in the scanning electron microscopy analysis showed a variety of erosive and dissolution features from perfectly shaped octahedral to well-rounded appearance. Two samples were from water-washed Composites A and B, with no change in mineralogy compared to the as-received samples. This is not surprising, since the water wash had only a short period of water contact with the material as opposed to the water dissolution tests. The last two samples were residual solids from the water dissolution tests. These tests included multiple additions of water at 15 C and 45 C. The samples were sieved to separate a coarser fraction of > 710 {mu}m and a finer fraction of < 710 {mu}m. These two fractions were analyzed separately. The coarser fraction contained mostly gibbsite with minor amounts of sodium aluminosilicates (cancrinite) and bismuth aluminum-rich phases. The finer fraction was mostly composed of gibbsite, the sodium alumino silicate phase, cancrinite, and a poorly crystalline to non-crystalline phase containing varying amounts of iron, bismuth, aluminum, and phosphorus.

PAGE JS; COOKE GA; PESTOVICH JA; HUBER HJ

2011-12-01

222

Ketamine in pain management.  

PubMed

For ketamine's fiftieth birthday, a narrative review of this unique drug in pain management is presented. Its history is traced from its conception, and its heritage, as a phencyclidine offspring, delineated. The earliest roots of the conceptions concerning the mechanisms of action are sought, and then followed in preclinical as well as clinical research. The major proposed mechanisms in the literature are commented on and evaluated. The growth of the clinical evidence for perioperative pain, acute pain, and chronic pain is followed from early attempts to systematic reviews. Finally, an attempt is made to foresee what the next 50 years might hold in store for our 50 years old. PMID:23663314

Persson, Jan

2013-06-01

223

Personalized treatment of pain.  

PubMed

Despite advances made in its understanding and treatment, chronic pain remains an unsolved and all too common problem. One of the main obstacles to successful management of pain is the high variability of many patients regarding both response to treatment and susceptibility to adverse effects, which curtails the utility of therapeutic intervention. Understanding the causes of this variability is an important challenge which may lead to a new era in rational pain management. As described in this review, however, there currently seems to be more than one possible explanation of this variability. Rational personalized pain management must take into consideration both ever-increasing knowledge of pharmacogenetics and pharmacokinetics and a broad, clinically based attitude incorporating co-morbidities, both physical and psychiatric, and concomitant medications. Novel models for testing in-vivo pain processing, for example assessment of conditioned pain modulation (CPM), are also promising approaches to use of rational data for empirical treatment of pain. Last, listening to the patient and understanding the context in which pain has affected his or her life is an important part of maintaining the personal nature of therapeutic interaction with patients suffering from pain. PMID:23292814

Ablin, Jacob N; Buskila, Dan

2013-01-01

224

Tinnitus and pain.  

PubMed

Tinnitus has many similarities with the symptoms of neurological disorders such as paresthesia and central neuropathic pain. There is considerable evidence that the symptoms and signs of some forms of tinnitus and central neuropathic pain are caused by functional changes in specific parts of the central nervous system and that these changes are caused by expression of neural plasticity. The changes in the auditory nervous system that cause tinnitus and the changes in the somatosensory systems that cause central neuropathic pain may have been initiated from the periphery, i.e. the ear or the auditory nerve for tinnitus and receptors and peripheral nerves in the body for pain. In the chronic condition of tinnitus and pain, abnormalities in the periphery may no longer play a role in the pathology, but the tinnitus is still referred to the ear and central neuropathic pain is still referred to the location on the body of the original pathology. In this chapter we will discuss specific similarities between tinnitus and pain, and compare tinnitus with other phantom disorders. Since much more is known about pain than about tinnitus, it is valuable to take advantage of the knowledge about pain in efforts to understand the pathophysiology of tinnitus and find treatments for tinnitus. PMID:17956770

Møller, A R

2007-01-01

225

Enhanced kangaroo mother care for heel lance in preterm neonates: a crossover trial  

Microsoft Academic Search

Objective:To test if enhancing maternal skin-to-skin contact, or kangaroo mother care (KMC) by adding rocking, singing and sucking is more efficacious than simple KMC for procedural pain in preterm neonates.Study Design:Preterm neonates (n=90) between 32 0\\/7 and 36 0\\/7 weeks' gestational age participated in a single-blind randomized crossover design. The infant was held in KMC with the addition of rocking,

C C Johnston; F Filion; M Campbell-Yeo; C Goulet; L Bell; K McNaughton; J Byron

2009-01-01

226

Coping Styles, Pain Expressiveness, and Implicit Theories of Chronic Pain.  

PubMed

ABSTRACT Whereas some individuals use active coping strategies and are able to adaptively cope with their pain, others use passive strategies and catastrophic appraisals, which are often associated with increased displays of pain behavior and negative pain-related outcomes. To investigate attribution-based implicit theories as a potential underlying mechanism that might affect coping success, we hypothesized that pain patients with an incremental implicit theory of pain (i.e., view pain as malleable) would have more active coping strategies, lower levels of pain expressiveness, and better pain-related outcomes than those with an entity implicit theory of pain (i.e., view pain as nonmalleable). Patients with chronic back pain undergoing a functional assessment completed a variety of self-report measures and participated in a pain-inducing physiotherapy procedure. The results revealed those with an incremental theory of pain used more active coping strategies, displayed less pain behavior, and reported better pain-related outcomes (e.g., lower levels of depression) than individuals with an entity theory of pain. The findings suggest implicit theories of pain may represent an underlying social-cognitive mechanism linked to important coping, emotional, and expressive reactions to chronic pain. Identifying such a mechanism may provide valuable information for the assessment and treatment of chronic pain. PMID:25396698

Higgins, N C; Bailey, S Jeffrey; LaChapelle, Diane L; Harman, Katherine; Hadjistavropoulos, Thomas

2014-11-14

227

Molecular pain, a new era of pain research and medicine.  

PubMed

Molecular pain is a relatively new and rapidly expanding research field that represents an advanced step from conventional pain research. Molecular pain research addresses physiological and pathological pain at the cellular, subcellular and molecular levels. These studies integrate pain research with molecular biology, genomics, proteomics, modern electrophysiology and neurobiology. The field of molecular pain research has been rapidly expanding in the recent years, and has great promise for the identification of highly specific and effective targets for the treatment of intractable pain. Although several existing journals publish articles on classical pain research, none are specifically dedicated to molecular pain research. Therefore, a new journal focused on molecular pain research is needed. Molecular Pain, an Open Access, peer-reviewed, online journal, will provide a forum for molecular pain scientists to communicate their research findings in a targeted manner to others in this important and growing field. PMID:15813987

Gu, Jianguo; Zhuo, Min; Caterina, Michael; MacDermott, Amy B; Malmberg, Annika; Neugebauer, Volker; Yoshimura, Megumu

2005-01-01

228

Hypnosis and Clinical Pain  

Microsoft Academic Search

Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute

David R. Patterson; Mark P. Jensen

2003-01-01

229

Shoulder Pain COMMON CAUSES  

E-print Network

-injury. Once initial pain has eased a rehabilitation program of shoulder strengthening exercises and stretching strain. Muscle spasms may develop as strained muscles swell after injury. Rest and gentle stretching Pain See Your Healthcare Provider If Rehabilitation Exercises Patient Information: If you suspect

Virginia Tech

230

Chemical Interventions for Pain.  

ERIC Educational Resources Information Center

Reviews properties and pharmacological effects of medications for pain, including peripherally acting analgesics, centrally acting narcotics, and adjuvant analgesics including antidepressants. Discusses the role of the endogenous opioid system in pain and depression. Explores clinical management issues in both inpatient and outpatient settings,…

Aronoff, Gerald M.; And Others

1986-01-01

231

Sacroiliac joint pain - aftercare  

MedlinePLUS

... Trauma from impact, such as landing hard on buttocks Although, SIJ pain can be caused by trauma, this type of ... doctor may order: An injection to help with pain and inflammation. These injections can be repeated over time if necessary. Medicines ...

232

The pain of altruism.  

PubMed

Sociality and cooperation are benefits to human cultures but may carry unexpected costs. We suggest that both the human experience of pain and the expression of distress may result from many causes not experienced as painful in our close primate relatives, because human ancestors motivated to ask for help survived in greater numbers than either the thick-skinned or the stoic. PMID:25200380

Finlay, Barbara L; Syal, Supriya

2014-12-01

233

Diclofenac Topical (osteoarthritis pain)  

MedlinePLUS

... Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a class of medications called ... area four times a day to treat arthritis pain. Topical diclofenac for ... apply to the knee four times a day. Topical diclofenac for osteoarthritis ...

234

Advances in Cancer Pain  

Microsoft Academic Search

dvances in cancer pain research and management are an example of the advances that have occurred within the field of neuro-oncology, the medical discipline that includes the diagnosis and treatment of primary central nervous system neoplasms, metastatic and nonmetastatic neurological complications of cancer originating outside the ner- vous system, and pain associated with cancer. Progress in the diagnosis and treatment

Kathleen M. Foley

1999-01-01

235

Lower Back Pain  

MedlinePLUS

... If your pain is severe, if you have lost feeling or movement, or if you have lost control of your bladder or bowels, see your ... If your pain is severe, if you have lost feeling or movement, or if you have lost ...

236

Early visceral pain predicts chronic pain after laparoscopic cholecystectomy.  

PubMed

Chronic pain after laparoscopic cholecystectomy is related to postoperative pain during the first postoperative week, but it is unknown which components of the early pain response is important. In this prospective study, 100 consecutive patients were examined preoperatively, 1week postoperatively, and 3, 6, and 12months postoperatively for pain, psychological factors, and signs of hypersensitivity. Overall pain, incisional pain (somatic pain component), deep abdominal pain (visceral pain component), and shoulder pain (referred pain component) were registered on a 100-mm visual analogue scale during the first postoperative week. Nine patients developed chronic unexplained pain 12months postoperatively. In a multivariate analysis model, cumulated visceral pain during the first week and number of preoperative biliary pain attacks were identified as independent risk factors for unexplained chronic pain 12months postoperatively. There were no consistent signs of hypersensitivity in the referred pain area either pre- or postoperatively. There were no significant associations to any other variables examined. The risk of chronic pain after laparoscopic cholecystectomy is relatively low, but significantly related to the visceral pain response during the first postoperative week. PMID:25250720

Blichfeldt-Eckhardt, Morten Rune; Ording, Helle; Andersen, Claus; Licht, Peter B; Toft, Palle

2014-11-01

237

Back Pain and Emotional Distress  

MedlinePLUS

North American Spine Society Public Education Series Back Pain and Emotional Distress Common Reactions to Back Pain Four out of five adults will experience an episode of significant back pain sometime during ...

238

Taking narcotics for back pain  

MedlinePLUS

Narcotics are strong drugs that are sometimes used to treat pain. They are also called opioids. You ... types of pain medicine do not relieve pain. Narcotics can provide short-term relief of severe back ...

239

Easing Back Pain During Pregnancy  

MedlinePLUS

What causes back pain during pregnancy? The following changes during pregnancy can lead to back pain: • Strain on your back muscles • Abdominal ... you exercise. How can pregnancy hormones contribute to back pain? To prepare for the passage of the baby ...

240

[Genetics, pain and analgesia].  

PubMed

Genomic variations influencing nociceptive sensitivity and susceptibility to pain conditions, as well as responses to pharmacotherapy of pain are currently under investigation. Candidate genes involved in pain perception, pain processing and pain management such as (opioid) receptors, transporters and other targets of pharmacotherapy are discussed. Drug metabolizing enzymes represent a further major target of ongoing research in order to identify associations between an individual's genetic profile and drug response (pharmacogenetics). Polymorphisms of the cytochrome P 450 enzymes influence analgesic efficacy of codeine, tramadol and tricyclic antidepressants (CYP2D6). Blood levels of some non-steroidal anti-inflammatory drugs (NSAIDs) are dependent on CYP2C9 activity, whereas opioid receptor polymorphisms are discussed with respect to differences in opioid-mediated analgesia and side-effects. Pharmacogenetics is seen as a potential diagnostic tool for improving patient therapy and care and will contribute to a more individualized drug treatment in the future. PMID:16625360

Stamer, U; Bayerer, B; Stüber, F

2006-07-01

241

An archaeology of pain  

NASA Astrophysics Data System (ADS)

Pain is a discursive construct of science and medicine. Through the discourses of biopower and technoscience pain is used to construct and maintain the social body. Biopower and technoscience are discursive practices that are enveloped within the disciplines of Western society. Specifically, the disciplines of education, science, and medicine use biopower and technoscience to normalize the body and construct binaries which create the abnormal. The cyborg is a discursive practice used to implode the binaries of the disciplines which maintain the social body. Through the implosion of binaries, the binary of mind/body is no longer plausible in the explanation of pain. Neuropathic chronic pain and phantom limb pain become cyborg discourses which operate to deconstruct the pedagogies of science and medicine.

Gruber, Dennis Michael

242

Musculoskeletal chest wall pain  

PubMed Central

The musculoskeletal structures of the thoracic wall and the neck are a relatively common source of chest pain. Pain arising from these structures is often mistaken for angina pectoris, pleurisy or other serious disorders. In this article the clinical features, pathogenesis and management of the various musculoskeletal chest wall disorders are discussed. The more common causes are costochondritis, traumatic muscle pain, trauma to the chest wall, “fibrositis” syndrome, referred pain, psychogenic regional pain syndrome, and arthritis involving articulations of the sternum, ribs and thoracic spine. Careful analysis of the history, physical findings and results of investigation is essential for precise diagnosis and effective treatment. ImagesFig. 3Fig. 4Fig. 5 PMID:4027804

Fam, Adel G.; Smythe, Hugh A.

1985-01-01

243

Basic aspects of musculoskeletal pain: from acute to chronic pain  

PubMed Central

The transition from acute to chronic musculoskeletal pain is not well understood. To understand this transition, it is important to know how peripheral and central sensitization are manifested and how they can be assessed. A variety of human pain biomarkers have been developed to quantify localized and widespread musculoskeletal pain. In addition, human surrogate models may be used to induce sensitization in otherwise healthy volunteers. Pain can arise from different musculoskeletal structures (e.g. muscles, joints, ligaments, or tendons), and differentiating the origin of pain from those different structures is a challenge. Tissue specific pain biomarkers can be used to tease these different aspects. Chronic musculoskeletal pain patients in general show signs of local/central sensitization and spread of pain to degrees which correlate to pain intensity and duration. From a management perspective, it is therefore highly important to reduce pain intensity and try to minimize the duration of pain. PMID:23115471

Arendt-Nielsen, Lars; Fernández-de-las-Peñas, César; Graven-Nielsen, Thomas

2011-01-01

244

Subcalcaneal bursitis with plantar fasciitis treated by arthroscopy.  

PubMed

We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging. PMID:23875139

Yamakado, Kotaro

2013-05-01

245

[Multimodal pain therapy].  

PubMed

Chronic pain has both high prevalence and a significant economic impact in Germany. The most common chronic pain types are low back pain and headache. On the one hand, the management of chronic pain patients is incomplete, yet it is often overtreated in orthopaedic surgical settings with interventional procedures. The reason for this is the structure of outpatient management and the way it is paid for in Germany. Pain management of patients with private insurance cover is no better because of "doctor shopping". Medical guidelines could be of some help in improving the situation, but they are widely unknown, and have still to demonstrate whether they have any impact on GP treatment pathways. The "gold standard" multimodal pain therapy shows significant improvement in many studies compared to monomodal therapy regimes and interventional regimes, but is too rarely recommended by the patients' physicians, whether GPs or specialists. Because of the huge number of institutions nowadays that, for the sake of form, offer such multimodal therapies, these need to be differentiated in terms of their structural and process quality. A first step is the "k edoq" project. It is essential to improve knowledge of the principles of modern pain management. This includes better networking and communication between doctors, physiotherapists and psychologists, and at the grassroots level, providing the public with more detailed and better information. PMID:25000627

Böger, A

2014-06-01

246

Influence of the calcaneus morphology on the risk of posterior heel ulcer creation Vincent Luboz, Antoine Perrier, Marek Bucki, Bruno Diot, Francis Cannard, Nicolas Vuillerme,  

E-print Network

with three compartments of varying stiffness: under the calf, the Achilles tendon, and the heel back.495 for the skin, 30 kPa and 0.49 for the fat, 1 GPa and 0.495 for the tendon, and 60 kPa and 0.495 for the muscles

Payan, Yohan

247

Large heel soft tissue defects managed successfully with reverse medial crural fasciocutaneous flap: A 7-year single-center experience with 21 consecutive cases.  

PubMed

The medial crural fasciocutaneous flap is a reliable cutaneous flap that can be used for soft tissue reconstruction in the extremities. The purpose of this article is to evaluate the application and clinical significance of this surgical technique in the reconstruction of heel soft tissue defects. Twenty-one cases of heel soft tissue defect between March 2005 and March 2012 were included in this study. Wound sizes varied from 5.0 × 5.5 to 7.5 × 10.0 cm. All cases were managed with a reverse medial crural fasciocutaneous flap. Patient demographics and case information were analyzed and are reported. The sizes of the reverse medial crural fasciocutaneous flap varied from 6.5 × 10.0 to 9.0 × 15.0 cm; the average size was 7.7 × 13.8 cm. Out of the 21 consecutive cases, 20 flaps survived intact and one flap underwent partial necrosis. Follow-up observations were conducted for 6-36 months. The cosmetic results were satisfactory, without apparent bulkiness; the weight-bearing outcomes were satisfactory. The donor site can be closed primarily or by skin graft. Reverse medial crural fasciocutaneous flap transfer is appropriate for the reconstruction of heel soft tissue defects. The method is safe and can cover large heel defects. PMID:25448373

Jing-Chun, Zhao; Kai, Shi; Jia-Ao, Yu; Chun-Jing, Xian; Lai-Jin, Lu; Chun-Hui, Xie

2015-01-01

248

Discriminative Ability of Heel Quantitative Ultrasound in Postmenopausal Women With Prevalent Low-Trauma Fractures: Application of Optimal Threshold Cutoff Values Using CART Models  

Microsoft Academic Search

Quantitative ultrasound (QUS) of the heel has been proposed as a screening tool to evaluate the bone status and risk of osteoporotic fragility fractures. The aim of this study was to define threshold values of QUS that would maximize the predictive ability of this technique to discriminate subjects with fragility fractures. A cross-sectional analysis was made of a cohort of

María del Carmen Navarro; Pedro Saavedra; María Jesús Gómez-de-Tejada; Mercedes Suárez; Diego Hernández; Manuel Sosa

2011-01-01

249

The Daily Tar Heel URL: http://www.dailytarheel.com/index.php/article/2010/09/grant_money_to_help_scholars  

E-print Network

The Daily Tar Heel URL: http://www.dailytarheel.com/index.php/article/2010/09/grant_money_to_help_scholars Current Date: Sun, 26 Sep 2010 13:05:26 -0400 Grant money to help scholars To benefit biomedical students in biology, physics and chemistry, as well as high-level math and applied sciences courses. The grant money

Sekelsky, Jeff

250

Nonspecific Arm Pain  

PubMed Central

Nonspecific activity-related arm pain is characterized by an absence of objective physical findings and symptoms that do not correspond with objective pathophysiology. Arm pain without strict diagnosis is often related to activity, work-related activity in particular, and is often seen in patients with physically demanding work. Psychological factors such as catastrophic thinking, symptoms of depression, and heightened illness concern determine a substantial percentage of the disability associated with puzzling hand and arm pains. Ergonomic modifications can help to control symptoms, but optimal health may require collaborative management incorporating psychosocial and psychological elements of illness. PMID:25207288

Moradi, Ali; Ebrahimzadeh, Mohammad H; Ring, David

2013-01-01

251

Low Pain vs No Pain Multi-core Haskells  

E-print Network

Chapter 1 Low Pain vs No Pain Multi-core Haskells M. KH. Aswad , P. W. Trinder, A. D. Al Zain, G. J uses 15 'typical' programs to compare a 'no pain', i.e. entirely implicit, parallel language with three 'low pain', i.e. semi-explicit languages. The parallel Haskell implementations use different versions

Trinder, Phil

252

PAIN MEDICINE Neural Correlates of Chronic Low Back Pain Measured  

E-print Network

PAIN MEDICINE Neural Correlates of Chronic Low Back Pain Measured by Arterial Spin Labeling Ajay D of the CP exacerba- tions for each back pain subject. Results: The clinically significant worsening.D., Randy L. Gollub, M.D., Ph.D.# ABSTRACT Background: The varying nature of chronic pain (CP) is difficult

Napadow, Vitaly

253

Pain Control: Support for People with Cancer  

MedlinePLUS

Español Pain Control: Support for People With Cancer Pain Control is for people who have pain from cancer or from its ... health care team How to make your pain control plan work for you Pain control medicines and ...

254

Managing Cancer Pain  

PubMed Central

Despite the existence of effective analgesic drugs, many cancer patients live and die with ineffective pain control. The control of cancer pain is largely achievable with the appropriate use of available analgesics and co-analgesics. It requires attention to detail by a sympathetic physician who will treat the patient as a whole person. The support of knowledgeable nursing, social work, and chaplaincy staff in hospital and at home is essential to the on-going care of these patients. The major obstacles to the control of cancer pain are the physician's lack of detailed inquiry and attention, combined with the inappropriate and inadequate use of analgesics. The misinformation, prejudice and fear surrounding narcotic analgesics are largely unfounded in treating this group of patients. This article addresses issues of management and details a logical approach to analgesic use in patients with cancer pain. PMID:21279022

Latimer, Elizabeth

1984-01-01

255

Magnets for Pain Relief  

MedlinePLUS

Magnets for Pain Relief On this page: Introduction Key Points About Magnets Safety and Side Effects What ... help ensure coordinated and safe care. Top About Magnets A magnet produces a measurable force called a ...

256

Pain Management Programs  

MedlinePLUS

... care providers working directly with the person with pain with a variety of measurement, interventions, and strategies for self-management designed to offer a complete program from assessment, ...

257

Pain medications - narcotics  

MedlinePLUS

... than 3 to 4 months. NAMES OF NARCOTICS Codeine Fentanyl (Duragesic) -- available as a patch Hydrocodone ( Vicodin) ... specialist to help you manage long-term pain. SIDE EFFECTS OF NARCOTICS Drowsiness and impaired judgment often occur ...

258

Palliative care - managing pain  

MedlinePLUS

... Advil, Motrin), diclofenac Narcotics or opioids , such as codeine, morphine, oxycodone, or fentanyl Medicines that work on ... relieve your pain, a different one may help. Side effects, like drowsiness, may get better over time. Other ...

259

Pain management after craniotomy.  

PubMed

Fear of the side effects of analgesic drugs frequently leads to the under-treatment of post-craniotomy pain. Nevertheless, this pain continues to be commonly observed, is frequently severe, and, if unrelieved, may cause distress for the neurosurgical patient and serious complications for the operative brain. We review recent evidence-based data on pain therapy after intracranial surgery. Especially when performed at the end of surgery, local anaesthetic scalp infiltration provides adequate, short-term postoperative pain relief. Opioids, such as morphine or oxycodone, may be used in the early period after craniotomy. If titrated properly, opioids do not increase serious side effects as compared with codeine. The non-narcotics ketoprofen, tramadol, and paracetamol may be useful as supplemental, opioid-sparing drugs. There is a need for larger trials to delineate safety and efficacy of analgesic therapies with a focus on short- and long-term outcomes. PMID:18286837

Nemergut, Edward C; Durieux, Marcel E; Missaghi, Nizam B; Himmelseher, Sabine

2007-12-01

260

Patellofemoral Pain Syndrome  

MedlinePLUS

... on nonimpact elliptical trainers, which are popular at gyms. Because these machines support your body weight, they ... What kind of exercise should I do? Bibliography Management of Patellofemoral Pain Syndrome by S Dixit, M.D., ...

261

Pain: Hope through Research  

MedlinePLUS

... and tumors associated with neurofibromatosis , a neurogenetic disorder. Sports injuries are common. Sprains, strains, bruises, dislocations, and ... all well-known words in the language of sports. Pain is another. In extreme cases, sports injuries ...

262

Complex Regional Pain Syndrome  

MedlinePLUS

... aspartate (NMDA) receptor antagonists such as dextromethorphan and ketamine nasal calcitonin, especially for deep bone pain, and ... involving individuals with acute-phase CRPS is planned. Ketamine . Investigators are using low doses of ketamine—a ...

263

Mechanisms of Neuropathic Pain  

PubMed Central

Neuropathic pain refers to pain that originates from pathology of the nervous system. Diabetes, infection (herpes zoster),nerve compression, nerve trauma, “channelopathies,” and autoimmune disease are examples of diseases that maycause neuropathic pain. The development ofbothanimal models and newer pharmacological strategies has led to an explosion of interest in the underlying mechanisms. Neuropathic pain reflects both peripheral and central sensitization mechanisms. Abnormal signals arise not only from injured axons but also from the intact nociceptors that share the innervation territory of the injured nerve. This review focuses on how both human studies and animal models are helping to elucidate the mechanisms underlying these surprisingly common disorders. The rapid gain in knowledge about abnormal signaling promises breakthroughs in the treatment of these often debilitating disorders. PMID:17015228

Campbell, James N.; Meyer, Richard A.

2007-01-01

264

American Pain Society  

MedlinePLUS

... Interest Policy Code of Ethics Awards and Grants Annual Reports Press Room Membership Member Benefits/Join APS Join/ ... Bulletin Archives APS E-News Clinical Practice Guidelines Annual Reports Online Store Advocacy Pain Care Coalition Washington Wire ...

265

Greater trochanteric pain syndrome.  

PubMed

Pain around the greater trochanter is still a common clinical problem that may be secondary to a variety of either intra-articular or periarticular pathologies. Gluteal tendon pathologies are one of the primary causes of greater trochanteric pain, with attrition of the fasciae latae against the gluteus medius and minimus tendons, and the trochanteric bursa being possible causes. Key sonographic findings of gluteal tendinopathy, bursitis, and differential diagnosis are described in this overview. Clinical diagnosis and treatment of greater trochanteric pain syndrome is still challenging; therefore ultrasound is helpful to localize the origin of pain, determine underlying pathology, and, based on these findings, to guide local aspiration and/or injection in cases of tendinopathy and/or bursitis. PMID:23487333

Klauser, Andrea S; Martinoli, Carlo; Tagliafico, Alberto; Bellmann-Weiler, Rosa; Feuchtner, Gudrun M; Wick, Marius; Jaschke, Werner R

2013-02-01

266

Cognitive Hypnotherapy for Pain Management  

Microsoft Academic Search

Pain is a serious health care problem and there is growing evidence to support the use of hypnosis and cognitive-behavioral interventions for pain management. This article reviews clinical techniques and methods of cognitive hypnotherapy for pain management. Current research with emphasis given to randomized, controlled trials is presented and the efficacy of hypnotherapy for pain management is discussed. Evidence for

Gary Elkins; Aimee Johnson; William Fisher

2012-01-01

267

Low Back Pain COMMON CAUSES  

E-print Network

Low Back Pain COMMON CAUSES: Low back pain may be triggered by a specific event, such improper are known to increase risk for potential injury, but often back pain occurs after a seemingly innocent task, like bending over to pick up something from the floor. Sufferers frequently complain that back pain

Virginia Tech

268

MRI and low back pain  

MedlinePLUS

Back pain and sciatica are common health complaints. Almost everyone has back pain at some time in their life. Most of ... DANGER SIGNS AND BACK PAIN Both you and your doctor may be worried that something serious is causing your low back pain. Could your ...

269

Back Pain - How to Prevent  

MedlinePLUS

How to Prevent Back Pain Introduction Back pain is one of the most common medical problems people have. It affects most people at least ... doctor or healthcare professional or a Causes of Back Pain The most common cause of back pain is ...

270

Upper Back Pain COMMON CAUSES  

E-print Network

Upper Back Pain COMMON CAUSES: Upper back pain may be triggered by a specific event of the computer can innocently strain muscles of the upper back. Long term back problems are more likely when pain develops gradually or discomfort is recurrent over a period of time. Chronic back pain is often triggered

Virginia Tech

271

What's wrong with pain?  

E-print Network

seriously we should take instances of pain in these animals from an ethical perspective. Though I do not have the space to adequately consider other marginal cases, the analysis in this thesis will provide some useful new guideposts to look for when... considering these other cases. Along the way of analyzing whether nonhuman pains should be considered morally relevant, difficult ethical questions will arise. In particular, any argument for taking others? interests seriously will have to provide some...

Shriver, Adam Joseph

2006-10-30

272

Post Vasectomy Pain Syndrome  

Microsoft Academic Search

Although the prevalence of post vasectomy pain syndrome is unknown, it is certain that the incidence of this uncommon complication\\u000a will increase because of the continued popularity of vasectomy as a highly effective and economic means of contraception.\\u000a This chapter covers the evaluation of and treatment options available for the sequelae of symptoms associated with post vasectomy\\u000a pain syndrome and

Jeannette M. Potts

273

Functional Abdominal Pain  

Microsoft Academic Search

Functional abdominal pain syndrome (FAPS) is a relatively less common functional gastrointestinal (GI) disorder defined by\\u000a the presence of constant or frequently recurring abdominal pain that is not associated with eating, change in bowel habits,\\u000a or menstrual periods (Drossman Gastroenterology 130:1377–1390, 2006), which points to a more centrally targeted (spinal and supraspinal) basis for the symptoms. However, FAPS is frequently

Madhusudan Grover; Douglas A. Drossman

2010-01-01

274

Sodium channelopathies and pain  

Microsoft Academic Search

Chronic pain often represents a severe, debilitating condition. Up to 10% of the worldwide population are affected, and many\\u000a patients are poorly responsive to current treatment strategies. Nociceptors detect noxious conditions to produce the sensation\\u000a of pain, and this signal is conveyed to the CNS by means of action potentials. The fast upstroke of action potentials is mediated\\u000a by voltage-gated

Angelika Lampert; Andrias O. O’Reilly; Peter Reeh; Andreas Leffler

2010-01-01

275

Management of Foot Pain  

PubMed Central

This paper deals chiefly with the young adult foot, the older adult foot, and pain of mechanical origin. It does not discuss treatment by surgical methods, but rather by the use of exercises, foot supports and shoe corrections. Foot pain resulting from mechanical disorders can be treated effectively by determination of the biomechanical causative factors, usually by simple physical examination. Relief can often be gained with simple mechanical devices, provided at low cost. ImagesFigure 1Figure 2Figure 4 PMID:21263862

Godfrey, Charles M.

1987-01-01

276

Low Back Pain  

PubMed Central

Low back pain is one of the most common and costly afflictions of our Society. The majority of adults will have at least one episode of acute low back pain that will likely resolve regardless of treatment. Lumbar spine radiographs are overused and there is little scientific support for many of the therapeutic interventions advocated. Even for those patients with symptomatic herniated disc, only a small fraction will ultimately require surgical intervention. PMID:2930949

Reuler, James B.

1985-01-01

277

Mechanisms of Myofascial Pain  

PubMed Central

Myofascial pain syndrome is an important health problem. It affects a majority of the general population, impairs mobility, causes pain, and reduces the overall sense of well-being. Underlying this syndrome is the existence of painful taut bands of muscle that contain discrete, hypersensitive foci called myofascial trigger points. In spite of the significant impact on public health, a clear mechanistic understanding of the disorder does not exist. This is likely due to the complex nature of the disorder which involves the integration of cellular signaling, excitation-contraction coupling, neuromuscular inputs, local circulation, and energy metabolism. The difficulties are further exacerbated by the lack of an animal model for myofascial pain to test mechanistic hypothesis. In this review, current theories for myofascial pain are presented and their relative strengths and weaknesses are discussed. Based on new findings linking mechanoactivation of reactive oxygen species signaling to destabilized calcium signaling, we put forth a novel mechanistic hypothesis for the initiation and maintenance of myofascial trigger points. It is hoped that this lays a new foundation for understanding myofascial pain syndrome and how current therapies work, and gives key insights that will lead to the improvement of therapies for its treatment.

Jafri, M. Saleet

2014-01-01

278

Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete  

PubMed Central

Summary Plantar fasciitis can be a chronic and debilitating condition affecting athletes of all levels. The aim of this study is to compare treatment outcomes for the treatment of chronic plantar fasciitis in athletes, comparing focused extra corporeal sound wave therapy (ESWT) and the surgical endoscopic plantar fasciotomy (EPF). A total of 37 eligible patients were enrolled in the study between May 2006 and December 2008 at a single institution. Patients were either enrolled in the surgical group, or to the ESWT group which included a placebo controlled, randomized group (P-ESWT). Pre and post Visual Analog Scores (VAS) and Roles and Maudlsey (RM) scores were recorded and compared between the three groups. The patient’s return to activity (RTA) was also documented. The results showed statistical improvement within the EPF and ESWT groups with both VAS & RM scores, with EPF being significantly better than both ESWT and P-ESWT in terms of treatment outcomes. Patients enrolled in the ESWT were able though to continue with their exercise regimen, while the EPF group was able to return to their athletic activity in an average of 2.8 months. In conclusion, EPF and ESWT are both effective forms of treatment for chronic plantar fasciitis; EPF being superior in outcomes yet ESWT treatment could be preferable since the athlete can remain active during treatment. Level of Evidence: II PMID:23738317

Saxena, Amol; Fournier, Magali; Gerdesmeyer, Ludger; Gollwitzer, Hans

2012-01-01

279

Pain management in the elderly.  

PubMed

Assessment and management of pain are among the skills that perianesthesia nurses need to deliver safe and effective care. The principles of pain management remain fairly consistent across all age groups. However, managing the pain of elderly surgical patients presents unique challenges. Many elderly people have painful chronic conditions. Consequently, during the perioperative period, the nurse must manage both the patient's chronic and acute pain. As a group, the elderly are more vulnerable to inadequate pain assessment and treatment and are more likely to have serious side effects of analgesic therapy. Therefore, this report highlights the unique aspects of pain management in elderly patients. PMID:10839075

Gordon, D B

1999-12-01

280

Evaluation of Pain in Healthy Newborns and in Newborns with Developmental Problems (Down Syndrome).  

PubMed

Newborns are often subjected to invasive and painful medical procedures. This happens even more frequently when they require hospitalization. The aim of this paper was to evaluate pain in healthy newborns and in newborns with Down syndrome (DS). We performed a prospective cohort study in the neonatal service of the San Cecilio University Hospital in Granada (Spain) from January 2008 to September 2013. The universe of our study comprised a study group of 20 newborns with DS and a control group of 20 newborns without DS. All of the infants were hospitalized, and thus had to undergo painful medical procedures. The variables studied were basal recovery time (as reflected in crying and the normalization of biological constants), number of punctures, oxygen saturation, heartbeat, blood pressure, response to skin-to-skin contact, and gestational age. The evaluation was performed during blood extraction, vein canalization, and heel puncture. The significant differences in the basal recovery time between the two groups of newborns indicated that those with DS were slower to express pain, and when they did, their response was not as clearly defined as that of babies without DS. The oxygen saturation in babies with DS after the puncture was found to be significantly lower than that of the control group (p < .001). The results of this study revealed that babies with DS were not as quick to perceive pain after a puncture. However, when pain was finally perceived, it persisted for a longer time. This situation should be taken into account in the design of pharmacologic and nonpharmacologic therapies. PMID:25439126

Aguilar Cordero, Maria José; Mur Villar, Norma; García García, Inmaculada

2014-11-01

281

Effects of white noise and holding on pain perception in newborns.  

PubMed

This experimental study on newborns was conducted to compare the effects of various atraumatic care procedures during an infant's crying response to pain. Included in this study were 120 newborns chosen from among healthy infants admitted to the Obstetrics Department of Çanakkale State Hospital between April 2010 and June 2010. The patients were divided into three physically homogeneous groups. Infants in group 1 were held on the mothers' laps, infants in group 2 were held on the mother's laps and listened to white noise, and infants in group 3 lay in their cribs and listened to white noise while undergoing a painful procedure. Data collection included the Neonatal Infant Pain Scale, which was used to evaluate the behavioral responses to pain during a heel prick blood draw and a newborn information sheet developed by the researcher. Changes in cardiac and respiratory rates recorded during the invasive procedure were statistically significant among the three groups (p < .05). The shortest crying period and the lowest behavioral reactions were among those infants lying in their cribs and listening to white noise. This group was then followed by the infants who listened to white noise while being held by their mothers. The highest behavioral reaction was reported by those infants who were held by their mothers but did not listen to white noise. According to the results, white noise is an effective nonpharmacologic method to control pain, reduce crying time, and positively effect vital signs. Therefore, it is recommended that the use of white noise be practiced on newborns when they undergo painful procedures. PMID:24559599

Karakoç, Ayse; Türker, Funda

2014-12-01

282

The effects of custom-made foot orthosis using the Central Stabilizer Element on foot pain.  

PubMed

Background:Foot orthoses have been applied for the management of lower limb disorders, mainly for those who develop foot pain. The Central Stabilizer Element (CSE) is a new element that contains the midfoot laterally when a plantar insole is manufactured.Objectives:To determine the effect on foot pain of adding the Central Stabilizer Element during the manufacturing process of foot orthosis, and to describe the proportions of Central Stabilizer Element in terms of width and length of this element.Study design:A clinical study.Methods:A sample comprising 130 patients (57 males and 73 females) with foot pain was recruited for this study, with the patients having supinated, neutral, pronated and overpronated feet. All the patients received a custom-made foot orthosis with the Central Stabilizer Element. The Central Stabilizer Element was made of resins of polyvinyl chloride, and is a device insert in foot orthosis that contains the midfoot laterally to control pronation and supination movements. Perceived patient's foot pain was collected using a Visual Analog Scale at baseline, 15, 60 and 90 days after treatment.Results:A statistically significant decrease was found after foot orthosis application at all times in all foot types. There was a statistically significant correlation between all the ratio proportions according to foot posture (Foot Posture Index scores), except for heel length proportion.Conclusions:The Central Stabilizer Element, applied at midfoot level of a custom-made foot orthoses through a directly mould technique, can reduce foot pain, when a previous foot posture status is considered.Clinical relevanceThe Central Stabilizer Element can be of interest for those professionals who are involved in the manufacturing process of foot orthosis, throughout the control of an excesive pronated or a supinated foot condition that is provoking foot pain. PMID:24812119

Gijon-Nogueron, Gabriel; Cortes-Jeronimo, Encarnacion; Cervera-Marin, Jose Antonio; Diaz-Mohedo, Esther; Lopezosa-Reca, Eva; Fernandez-Sanchez, Manuel; Luque-Suarez, Alejandro

2014-05-01

283

Pain as social glue: shared pain increases cooperation.  

PubMed

Even though painful experiences are employed within social rituals across the world, little is known about the social effects of pain. We examined the possibility that painful experiences can promote cooperation within social groups. In Experiments 1 and 2, we induced pain by asking some participants to insert their hands in ice water and to perform leg squats. In Experiment 3, we induced pain by asking some participants to eat a hot chili pepper. Participants performed these tasks in small groups. We found evidence for a causal link: Sharing painful experiences with other people, compared with a no-pain control treatment, promoted trusting interpersonal relationships by increasing perceived bonding among strangers (Experiment 1) and increased cooperation in an economic game (Experiments 2 and 3). Our findings shed light on the social effects of pain, demonstrating that shared pain may be an important trigger for group formation. PMID:25193943

Bastian, Brock; Jetten, Jolanda; Ferris, Laura J

2014-11-01

284

Conditioned pain modulation in temporomandibular disorders (TMD) pain patients.  

PubMed

The aims were to investigate (1) if temporomandibular disorders (TMD) patients with temporomandibular joint (TMJ) pain had different conditioned pain modulation (CPM) compared with healthy subjects and, (2) if clinical pain characteristics influenced CPM. Sixteen TMD pain patients and 16 age-matched healthy subjects were participated. A mechanical conditioning stimulus (CS) was applied to pericranial muscles provoking a pain intensity of 5/10 on a visual analogue scale. Pressure pain thresholds (PPT) and pressure pain tolerance thresholds (PPTol) were assessed at masseter, forearm and painful TMJ (only PPT) before, during, and 20 min after CS. Data were analyzed with ANOVAs. The correlations between CPM effect and ratings of TMD pain intensity on a numerical rating scale (NRS) or the pain duration were calculated (correlation coefficient; R). The relative PPT and PPTol increases (mean for the three assessment sites) during CS were significantly higher than baseline in healthy subjects (43.0 ± 3.6, 33.0 ± 4.0 %; P < 0.001, P < 0.001) but not in the TMD pain patients (4.9 ± 2.7, -1.4 ± 4.1 %; P = 0.492, P = 1.000) with significant differences between groups (P < 0.001). In the patients, the relative PPT changes during CS were not significantly higher than baseline at TMJ (5.3 ± 3.8 %, P = 0.981) and masseter (-2.8 ± 4.8 %, P = 1.000) but significantly higher at forearm (12.3 ± 4.7 %, P = 0.039). No correlation was detected between TMD pain intensity and CPM effect (R = -0.261; P = 0.337) or between pain duration and CPM effect (R = -0.423; P = 0.103) at painful TMJ. These findings indicate that CPM is impaired in TMD pain patients especially at sites with chronic pain but not at pain-free sites and that the clinical pain characteristics do not influence CPM. PMID:24897946

Oono, Yuka; Wang, Kelun; Baad-Hansen, Lene; Futarmal, Simple; Kohase, Hikaru; Svensson, Peter; Arendt-Nielsen, Lars

2014-10-01

285

Functional abdominal pain  

PubMed Central

Functional abdominal pain or functional abdominal pain syndrome (FAPS) is an uncommon functional gut disorder characterised by chronic or recurrent abdominal pain attributed to the gut but poorly related to gut function. It is associated with abnormal illness behaviour and patients show psychological morbidity that is often minimised or denied in an attempt to discover an organic cause for symptoms. Thus the conventional biomedical approach to the management of such patients is unhelpful and a person's symptom experience is more usefully investigated using a biopsychosocial evaluation, which necessarily entails a multidisciplinary system of healthcare provision. Currently the pathophysiology of the disorder is poorly understood but is most likely to involve a dysfunction of central pain mechanisms either in terms of attentional bias, for example, hypervigilance or a failure of central pain modulation/inhibition. Although modern neurophysiological investigation of patients is promising and may provide important insights into the pathophysiology of FAPS, current clinical management relies on an effective physician-patient relationship in which limits on clinical investigation are set and achievable treatment goals tailored to the patient's needs are pursued. PMID:15998821

Matthews, P; Aziz, Q

2005-01-01

286

Positive Traits Linked to Less Pain through Lower Pain Catastrophizing  

PubMed Central

The present study examined the association between positive traits, pain catastrophizing, and pain perceptions. We hypothesized that pain catastrophizing would mediate the relationship between positive traits and pain. First, participants (n = 114) completed the Trait Hope Scale, the Life Orientation Test- Revised, and the Pain Catastrophizing Scale. Participants then completed the experimental pain stimulus, a cold pressor task, by submerging their hand in a circulating water bath (0º Celsius) for as long as tolerable. Immediately following the task, participants completed the Short-Form McGill Pain Questionnaire (MPQ-SF). Pearson correlation found associations between hope and pain catastrophizing (r = ?.41, p < .01) and MPQ-SF scores (r = ?.20, p < .05). Optimism was significantly associated with pain catastrophizing (r = ?.44, p < .01) and MPQ-SF scores (r = ?.19, p < .05). Bootstrapping, a non-parametric resampling procedure, tested for mediation and supported our hypothesis that pain catastrophizing mediated the relationship between positive traits and MPQ-SF pain report. To our knowledge, this investigation is the first to establish that the protective link between positive traits and experimental pain operates through lower pain catastrophizing. PMID:22199416

Hood, Anna; Pulvers, Kim; Carrillo, Janet; Merchant, Gina; Thomas, Marie

2011-01-01

287

Low back pain.  

PubMed Central

The studies reviewed here show that the duration and severity of individual episodes of back pain can be lessened, reducing recurrences and their cost in terms of suffering and lost work. Frank examines differential diagnosis; acute, chronic, and intractable pain; and service implications. Modern management emphasises self care, and bed rest should usually not be longer than 48 hours. A return to physical fitness and other activities, including employment, is actively encouraged. Medication has a role in facilitating these objectives. Two points are especially emphasised: strategies to manage low back pain must be long term and preventive; and the responsibility to keep fit, maintain an exercise programme, and remain relaxed so as to avoid physically stressing the spine is that of the individual, not of the professionals. Images FIG 2 PMID:8347190

Frank, A

1993-01-01

288

Pain pharmacology: focus on opioids  

PubMed Central

Summary The incidence of chronic pain is estimated to be 20–25% worldwide. Although major improvements in pain control have been obtained, more than 50% of the patients reports inadequate relief. It is accepted that chronic pain, if not adequately and rapidly treated, can become a disease in itself, often intractable and maybe irreversible. This is mainly due to neuroplasticity of pain pathways. In the present review I will discuss about pain depicting the rational for the principal pharmacological interventions and finally focusing on opioids, that represent a primary class of drug to treat pain. PMID:25568646

Fornasari, Diego

2014-01-01

289

Schmidt Sting Pain Index  

NSDL National Science Digital Library

This Wikipedia page has the cleanest version of the Schmidt Sting Pain Index I've seen online. Justin O. Schmidt created this index after years of work with Hymenoptera, and relates his vast experience with their venom to a scale that can be understood by all. The page has only a few references, but one of those will take you to Christ Starr's four stage sting pain scale. At the top of the scale are bullet ants, and pepsis wasps, at the bottom are sweat bees and fire ants.

0002-11-30

290

Atazanavir and chest pain.  

PubMed

We present a case of a 41-year-old man complaining of chest pain, which he directly attributed to his antiretrovirals, specifically atazanavir and ritonavir. The chest pain resolved on stopping the treatment, and recurred when atazanavir was restarted, again resolving on discontinuation. Cardiovascular risk factors are an important consideration with any antiretroviral therapy but particularly with protease inhibitors. The association between atazanavir and cardiac arrhythmias has been reported elsewhere including the British National Formulary, and it may be good practice to perform electrocardiogram assessments in patients commencing and using atazanavir-based regimens. PMID:24108452

Phillips, Matthew; Saxon, Cara; Lee, Vincent

2014-05-01

291

Myofascial pain syndrome treatments.  

PubMed

Myofascial pain syndrome (MPS) is a regional pain disorder caused by taut bands of muscle fibers in skeletal muscles called myofascial trigger points. MPS is a common disorder, often diagnosed and treated by physiatrists. Treatment strategies for MPS include exercises, patient education, and trigger point injection. Pharmacologic interventions are also common, and a variety of analgesics, antiinflammatories, antidepressants, and other medications are used in clinical practice. This review explores the various treatment options for MPS, including those therapies that target myofascial trigger points and common secondary symptoms. PMID:24787338

Borg-Stein, Joanne; Iaccarino, Mary Alexis

2014-05-01

292

Evaluating anterior knee pain.  

PubMed

Musculoskeletal complaints account for about 20% to 30% of all primary care office visits; of these visits, discomfort in the knee, shoulder, and back are the most prevalent musculoskeletal symptoms. Having pain or dysfunction in the front part of the knee is a common presentation and reason for a patient to see a health care provider. There are a number of pathophysiological etiologies to anterior knee pain. This article describes some of the common and less common causes, and includes sections on diagnosis and treatment for each condition as well as key points. PMID:24994047

Hong, Engene; Kraft, Michael C

2014-07-01

293

Individualized pain medicine  

PubMed Central

Since the first draft of the human genome was published 10 years ago, scientists have tried to develop new treatment strategies for various types of diseases based on individual genomes. It is called personalized (or individualized) medicine and is expected to increase efficacy and reduce adverse reactions of drugs. Much progress has been made with newly developed technologies, though individualized pain medicine is still far from realization. Efforts on the integrative genomic analyses along with understandings of interactions between other related factors such as environment will eventually translate complex genomic information into individualized pain medicine. PMID:21399745

Kim, Hyungsuk; Dionne, Raymond A.

2010-01-01

294

Complex regional pain syndrome  

PubMed Central

Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy is a chronic neurological disorder involving the limbs characterized by disabling pain, swelling, vasomotor instability, sudomotor abnormality, and impairment of motor function. CRPS is not uncommon after hand surgery and may complicate post-operative care. There is no specific diagnostic test for CRPS and the diagnosis is based on history, clinical examination, and supportive laboratory findings. Recent modifications to diagnostic criteria have enabled clinicians to diagnose this disease more consistently. This review gives a synopsis of CRPS and discusses the diagnosis, pathophysiology, and treatment options based on the limited evidence in the literature. PMID:22022040

Sebastin, Sandeep J

2011-01-01

295

Reward and motivation in pain and pain relief.  

PubMed

Pain is fundamentally unpleasant, a feature that protects the organism by promoting motivation and learning. Relief of aversive states, including pain, is rewarding. The aversiveness of pain, as well as the reward from relief of pain, is encoded by brain reward/motivational mesocorticolimbic circuitry. In this Review, we describe current knowledge of the impact of acute and chronic pain on reward/motivation circuits gained from preclinical models and from human neuroimaging. We highlight emerging clinical evidence suggesting that anatomical and functional changes in these circuits contribute to the transition from acute to chronic pain. We propose that assessing activity in these conserved circuits can offer new outcome measures for preclinical evaluation of analgesic efficacy to improve translation and speed drug discovery. We further suggest that targeting reward/motivation circuits may provide a path for normalizing the consequences of chronic pain to the brain, surpassing symptomatic management to promote recovery from chronic pain. PMID:25254980

Navratilova, Edita; Porreca, Frank

2014-10-01

296

Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury  

MedlinePLUS

... this flexibility makes the neck very susceptible to pain and injury. The neck’s susceptibility to injury is ... normal aging, and everyday wear and tear. Neck pain can be very bothersome, and it can have ...

297

Pain Catastrophizing in Youths With Physical Disabilities and Chronic Pain  

PubMed Central

Objective?The current study examined the associations between catastrophizing and pain intensity, psychological adjustment, functional ability, and community participation in youths with physical disability and chronic pain.?Methods?Participants consisted of 80 youths, aged 8–20 years, with cerebral palsy (n = 34), neuromuscular disease (n = 22), or spina bifida (n = 24). Measures from a cross-sectional survey included demographic, pain, and disability information, the Pain Catastrophizing Scale, the Child Health Questionnaire, and the Functional Disability Inventory.?Results?Results suggested that catastrophizing was significantly associated with pain intensity and psychological adjustment; however, catastrophizing did not demonstrate significant associations with functional ability or community participation.?Conclusions?The study extends previous findings of significant associations between catastrophizing and both pain intensity and psychological adjustment to samples of youths with chronic pain and disabilities not previously examined. Further research that examines the causal association between catastrophizing and outcomes in youths with chronic pain and physical disability is warranted. PMID:23033363

Engel, Joyce M.; Wilson, Sylia; Tran, Susan T.; Jensen, Mark P.; Ciol, Marcia A.

2013-01-01

298

Heel-strike in walking: assessment of potential sources of intra- and inter-subject variability in the activation patterns of muscles stabilizing the knee joint.  

PubMed

The electromyographic (EMG) signal is known to show large intra-subject and inter-subject variability. Adaptation to, and preparation for, the heel-strike event have been hypothesized to be major sources of EMG variability in walking. The aim of this study was to assess these hypotheses using a principal component analysis (PCA). Two waveform shapes with distinct characteristic features were proposed based on conceptual considerations of how the neuro-muscular system might prepare for, or adapt to, the heel-strike event. PCA waveforms obtained from knee muscle EMG signals were then compared with the predicted characteristic features of the two proposed waveforms. Surface EMG signals were recorded for ten healthy adult female subjects during level walking at a self-selected speed, for the following muscles; rectus femoris, vastus medialis, vastus lateralis, semitendinosus, and biceps femoris. For a period of 200 ms before and after heel-strike, EMG power was extracted using a wavelet transformation (19-395 Hz). The resultant EMG waveforms (18 per subject) were submitted to intra-subject and inter-subject PCA. In all analyzed muscles, the shapes of the first and second principal component (PC-) vectors agreed well with the predicted waveforms. These two PC-vectors accounted for 50-60% of the overall variability, in both inter-subject and intra-subject analyses. It was also found that the shape of the first PC-vector was consistent between subjects, while higher-order PC-vectors differed between subjects. These results support the hypothesis that adaptation to, and preparation for, a variable heel-strike event are both major sources of EMG variability in walking. PMID:23518206

Huber, Cora; Federolf, Peter; Nüesch, Corina; Cattin, Philippe C; Friederich, Niklaus F; Tscharner, Vinzenz von

2013-04-26

299

Breastfeeding FAQs: Pain and Discomfort  

MedlinePLUS

Breastfeeding FAQs: Pain and Discomfort KidsHealth > Parents > Pregnancy & Newborn Center > Newborn Care > Breastfeeding FAQs: Pain and Discomfort ... have. Is it normal to have cramps while nursing? Yes. During the first few days to weeks ...

300

Fractions Without Pain! Hugo Rodriguez  

E-print Network

555 Fractions Without Pain! Hugo Rodriguez Member of the Mexican Society of Geography and Statistic: to achieve their people not only learn, but understand mathematics. The Fractions With Out Pain! Workshop

Spagnolo, Filippo

301

Facts and Figures on Pain  

MedlinePLUS

... Center for Health Statistics Report: Health, United States, 2006, Special Feature on Pain ( 6 ) More than one- ... 21%). Back to Top Key Findings from the 2006 Voices of Chronic Pain Survey ( 9 ) A 2006 ...

302

Dyspareunia: Painful Sex for Women  

MedlinePLUS

... part of the genitals can cause pain during sex. Some conditions affect the skin around the vagina. ... types of birth control) does not fit correctly, sex may also be painful. Vaginismus (say: "vag-in- ...

303

Acute pain medicine in anesthesiology  

PubMed Central

The American Academy of Pain Medicine and the American Society for Regional Anesthesia have recently focused on the evolving practice of acute pain medicine. There is increasing recognition that the scope and practice of acute pain therapies must extend beyond the subacute pain phase to include pre-pain and pre-intervention risk stratification, resident and fellow education in regional anesthesia and multimodal analgesia, as well as a deeper understanding of the pathophysiologic mechanisms that are integral to the variability observed among individual responses to nociception. Acute pain medicine is also being established as a vital component of successful systems-level acute pain management programs, inpatient cost containment, and patient satisfaction scores. In this review, we discuss the evolution and practice of acute pain medicine and we aim to facilitate further discussion on the evolution and advancement of this field as a subspecialty of anesthesiology. PMID:24381730

Munro, Anastacia P.; Tighe, Patrick J.

2013-01-01

304

Descending control of pain  

Microsoft Academic Search

Upon receipt in the dorsal horn (DH) of the spinal cord, nociceptive (pain-signalling) information from the viscera, skin and other organs is subject to extensive processing by a diversity of mechanisms, certain of which enhance, and certain of which inhibit, its transfer to higher centres. In this regard, a network of descending pathways projecting from cerebral structures to the DH

Mark J. Millan

2002-01-01

305

Empathy and pain  

NSDL National Science Digital Library

When your parents punish you and say, "this hurts me as much as it hurts you," they might not be making it up. Feeling empathy activates some, but not all, of the pain-processing regions of the human brain, according to a new brain-scan study.

American Association for the Advancement of Science (AAAS;)

2004-02-20

306

Angina (Chest Pain)  

MedlinePLUS

... levels High blood pressure Smoking Diabetes Overweight or obesity Metabolic syndrome Inactivity Unhealthy diet Older age (The risk increases for men after 45 years of age and for women after 55 years of age.) Family history of early heart disease Diagnosis of Angina All chest pain should be ...

307

Painful diabetic neuropathy.  

PubMed

Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease [corrected]. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined. PMID:24803311

Peltier, Amanda; Goutman, Stephen A; Callaghan, Brian C

2014-01-01

308

Pain and microcrystalline arthritis.  

PubMed

Microcrystals are responsible for some of the most common and complex arthropathies which are often accompanied by intense, severe pain and inflammatory reactions. The main pathogens are crystals of monosodium urate (MSU), responsible for the gout, calcium pyrophosphate (CPP), which deposits also in various clinical forms of arthopathies, and basic calcium phosphate associated with osteoarthritis. In this context, the microcrystal arthritis is characterized by multiple, acute attacks followed by chronic pain, disability, impaired quality of life, and increased mortality. Given their chronic nature, they represent an ever more urgent public health problem. MSU and CPP crystals are also able to activate nociceptors. The pain in mycrocrystalline arthritis (MCA) is an expression of the inflammatory process. In the course of these diseases there is an abundant release of inflammatory molecules, including prostaglandins 2 and kinins. Interleukin-1 represents the most important cytokine released during the crystal-induced inflammatory process. Therefore, clinically, pain is the most important component of MCA, which lead to functional impairment and disability in a large proportion of the population. It is fundamental to diagnose these diseases as early as possible, and to this aim, to identify appropriate and specific targets for a timely therapeutic intervention. PMID:24938197

Ramonda, R; Frallonardo, P; Oliviero, F; Lorenzin, M G; Ortolan, A; Scanu, A; Punzi, L

2014-01-01

309

PainPsychologist  

Cancer.gov

The Departments of Psychiatry and Anesthesiology, Boston Children’s Hospital are seeking a pediatric psychologist for a full time position in the Pediatric Pain Rehabilitation Center at Boston Children’s Hospital Waltham. This is a primarily clinical position with opportunities to participate in ongoing clinical research within this innovative program and potential to develop independent research projects.

310

Pharmacologic treatment of neuropathic pain  

Microsoft Academic Search

Neuropathic pain, or pain after nervous system injury, can be very refractory to pharmacologic interventions. Through a better\\u000a understanding of the pathophysiology of neuropathic pain, it has been suggested that nonopioid agents, such as antidepressants\\u000a and anticonvulsants, may be more efficacious in the treatment of neuropathic pain than common analgesics, such as opioids\\u000a or nonsteroidal anti-inflammatory drugs. However, this has

Mark S. Wallace

2001-01-01

311

The Neuromodulation of Neuropathic Pain by Measuring Pain Response Rate and Pain Response Duration in Animal  

PubMed Central

Objective Neuropathic pain causes patients feel indescribable pain. Deep Brain Stimulation (DBS) is one of the treatment methods in neuropathic pain but the action mechanism is still unclear. To study the effect and mechanism of analgesic effects from DBS in neuropathic pain and to enhance the analgesic effect of DBS, we stimulated the ventral posterolateral nucleus (VPL) in rats. Methods To observe the effect from VPL stimulation, we established 3 groups : normal group (Normal group), neuropathic pain group (Pain group) and neuropathic pain+DBS group (DBS group). Rats in DBS group subjected to electrical stimulation and the target is VPL. Results We observed the behavioral changes by DBS in VPL (VPL-DBS) on neuropathic pain rats. In our study, the pain score which is by conventional test method was effectively decreased. In specific, the time of showing withdrawal response from painful stimulation which is not used measuring method in our animal model was also decreased by DBS. Conclusion The VPL is an effective target on pain modulation. Specifically we could demonstrate changes of pain response duration which is not used, and it was also significantly meaningful. We thought that this study would be helpful in understanding the relation between VPL-DBS and neuropathic pain. PMID:25674337

Kim, Jinhyung; Lee, Sung Eun; Shin, Jaewoo; Jung, Hyun Ho; Kim, Sung June

2015-01-01

312

Over-the-counter pain relievers  

MedlinePLUS

... Analgesics; Acetaminophen; NSAID; Non-steroidal anti-inflammatory drug; Pain medicine - over-the-counter; Pain medicine - OTC ... Pain medicines are also called analgesics. Each kind of pain medicine has benefits and risks. Some types of ...

313

Cognitive behavioral therapy for back pain  

MedlinePLUS

... CBT) can help many people deal with chronic back pain. ... Nonspecific back pain - cognitive behavioral; Backache - chronic - cognitive behavioral; Lumbar pain - chronic - cognitive behavioral; Pain - back - chronic - cognitive behavioral; Chronic ...

314

Usefulness of pain drawings in identifying real or imagined pain: Accuracy of pain professionals, nonprofessionals, and a decision model  

Microsoft Academic Search

The aim of this study was to determine the accuracy of pain specialists, nonprofessionals, and a decision model in judging whether a pain diagram was marked by a patient with chronic pain or by a healthy volunteer. Two hundred twenty-eight pain drawings were shown in random order to 10 pain medicine physicians, 10 pain medicine fellows, 10 nonphysician specialists, and

Robert N. Jamison; Gilbert J. Fanciullo; John C. Baird

2004-01-01

315

Cortical pathophysiology of chronic pain  

E-print Network

Cortical pathophysiology of chronic pain A. Vania Apkarian Department of Physiology multiple non-invasive brain imaging techniques to study the characteristics of patients with chronic pain in chronic pain are summarized, emphasizing the unique role of the prefrontal cortex in chronic, especially

Apkarian, A. Vania

316

Pain relief after cesarean section  

Microsoft Academic Search

Management of acute pain after cesarean section has evolved considerably over the past decade. In many institutions, intravenous patient-controlled analgesia and neuraxial opioids have replaced traditional intramuscular opioid injections. The general approach to pain after cesarean section is changing, shifting away from traditional opioid-based therapy toward a ?multimodal” or ?balanced” approach. Multimodal pain therapy involves the use of a potent

Pamela Angle; Vivien Walsh

2001-01-01

317

Scrotal pain: Evaluation and management  

PubMed Central

Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia.

Gordhan, Chirag G

2015-01-01

318

INTERVENTIONAL PAIN FOR MORE INFORMATION  

E-print Network

suffering from chronic low back and neck pain will be reviewed. The technical skills of common:20 "Physical Therapy of Chronic Low Back Pain"- Mohan Radhakrishana 15:20 - 15:40 Post Test - Arsenio Avila 15INTERVENTIONAL PAIN FOR MORE INFORMATION Sinead Irvine, Event Coordinator Continuing Health

Haykin, Simon

319

Radiographic Assessment for Back Pain  

MedlinePLUS

Radiographic Assessment for Back Pain What are Radiographic Assessments? When Should I get an X-ray for Low Back Pain? Other Reasons for Having an X-ray What ... What are Radiographic Assessments? Radiographic assessments for low back pain involve the use of X-rays to determine ...

320

The heel and toe of the cell's foot: a multifaceted approach for understanding the structure and dynamics of focal adhesions.  

PubMed

Focal adhesions (FAs) are large clusters of transmembrane receptors of the integrin family and a multitude of associated cytoplasmic "plaque" proteins, which connect the extracellular matrix-bound receptors with the actin cytoskeleton. The formation of nearly stationary FAs defines a boundary between the dense and highly dynamic actin network in lamellipodium and the sparser and more diverse cytoskeletal organization in the lamella proper, creating a template for the organization of the entire actin network. The major "mechanical" and "sensory" functions of FAs; namely, the nucleation and regulation of the contractile, myosin-II-containing stress fibers and the mechanosensing of external surfaces depend, to a major extent, on the dynamics of molecular components within FAs. A central element in FA regulation concerns the positive feedback loop, based on the most intriguing feature of FAs; that is, their dependence on mechanical tension developing by the growing stress fibers. FAs grow in response to such tension, and rapidly disassemble upon its relaxation. In this article, we address the mechanistic relationships between the process of FA development, maturation and dissociation and the dynamic molecular events, which take place in different regions of the FA, primarily in the distal end of this structure (the "toe") and the proximal "heel," and discuss the central role of local mechanical forces in orchestrating the complex interplay between FAs and the actin system. PMID:19598236

Wolfenson, Haguy; Henis, Yoav I; Geiger, Benjamin; Bershadsky, Alexander D

2009-11-01

321

Biopsychosocial Profiles of Different Pain Diagnostic Groups  

Microsoft Academic Search

Different pain diagnoses have been examined separately in various research studies. The major aim of the present investigation was to add to the current understanding of the various groups of patients who make up the chronic pain population. This study expanded the research literature by including 7 different predominantly chronic pain syndromes (fibromyalgia, upper extremity pain, cervical pain, thoracic pain,

Skye Porter-Moffitt; Robert J. Gatchel; Richard C. Robinson; Martin Deschner; Mette Posamentier; Peter Polatin; Leland Lou

2006-01-01

322

Topical analgesics in neuropathic pain.  

PubMed

Neuropathic pain can be difficult to treat clinically, as current therapies involve partial effectiveness and significant adverse effects. Following the development of preclinical models for neuropathic pain, significant advances have been made in understanding the neurobiology of neuropathic pain. This includes an appreciation of the molecular entities involved in initiation of pain, the role of particular afferents (small and large diameter, injured and uninjured), and the contribution of inflammation. Currently, topical formulations of capsaicin (cream) and lidocaine (patch) are available for treating neuropathic pain in humans. Preclinical studies provide evidence that peripheral applications of opioids, alpha-adrenergic agents, and antidepressants also may be beneficial in neuropathic pain, and some clinical reports provide support for topical applications of such agents. An appreciation of the ability of drug application, to sites remote from the site of injury, to alleviate aspects of neuropathic pain will provide a significant impetus for the further development of novel topical analgesics for this condition. PMID:16178758

Sawynok, Jana

2005-01-01

323

Beyond pleasure and pain  

Microsoft Academic Search

People approach pleasure and avoid pain. To discover the true nature of approach-avoidance motivation, psy-chologists need to move beyond this hedonic principle to the principles that underlie the different ways that it operates. One such principle is regulatory focus, which distinguishes self-regulation with a promotion focus (ac-complishments and aspirations)from self-regulation with a prevention focus (safety and responsibilities). This principle is

E. Tory Higgins

1997-01-01

324

pain relief after surgery  

Microsoft Academic Search

Summary A two-phase, double-blind study was performed to assess the efficacy of various drugs in the relief of postoperative pain. Oral analgesia with two compounds (paracetamol 320 mg, caffeine 32 mg, codeine phosphate 8 mg and meprobamate 150 mg (Stopayne; Rio Ethicals) and dipyrone 500 mg, pitofenone hydrochloride 5 mg and fenpiverinium bromide 0,1 mg (Baralgan HS; Albert» was found

B. BLOCH; ELSABE SMYTHE

325

Functional Abdominal Pain  

Microsoft Academic Search

\\u000a Functional abdominal pain (FAP) is a frequent complaint seen in the pediatric primary care setting. Current diagnostic criteria\\u000a for functional gastrointestinal disorders (FGIDs) are defi ned in the Rome III criteria, which outline a positive symptom\\u000a profi le for diagnosis. In addition, clinicians should be aware of specifi c “red fl ag ” rule-out symptoms that may suggest\\u000a organic disease

Lisa Scharff; Laura E. Simons

326

[Painful cutaneous leiomyosarcoma].  

PubMed

Leiomyosarcomas are derived from smooth muscles and only rarely involve the skin. A 73-year-old male presented with progressive tumor painful on the chest which had been present for 3 years and was tender to palpation, a finding more often associated with benign leiomyomas. immunohistochemical staining demonstrated multiple nerve fibers entrapped by atypical myofibrils, perhaps explaining the tenderness. Since 1996, we have excised five painless cutaneous leiomyosarcomas, in which entrapped nerves could not be demonstrated. PMID:16049702

Mitteldorf, C; Bertsch, H P; Kretschmer, L

2006-07-01

327

Neuropathic pain: emerging treatments  

Microsoft Academic Search

Neuropathic pain remains one of the most challenging of all neurological diseases and presents a large unmet need for improved therapies. Many mechanistic details are still lacking, but greater knowledge of overlapping mechanisms and disease comorbidities has highlighted key areas for intervention. These include peripheral and central hyperexcitability. Among the mole- cular drivers are ion channels (Nav1.7, Nav1.8, Nav1.3, Cav2.2,

A. Dray

2008-01-01

328

Cross-cultural conceptions of pain and pain control  

PubMed Central

Pain is a ubiquitous feature of the human experience. This paper presents an anthropology of pain. Anthropology is defined as the cross-cultural and comparative study of human behavior. Pain can be acute and episodic, and pain can be constant and uninterrupted. Acute pain, lasting for minutes or hours, is reported at some time by virtually all adults and by most juveniles and is indicated by the cries and facial expressions of toddlers and infants. This universality of pain as a part of the human condition has been established by the research of many biological, physical, and social scientists. Ethnographers, physicians, and public health experts describe pain complaints for a variety of modern, industrial societies and traditional, undeveloped societies. Pain is the most frequent complaint brought to the offices of physicians in North America, and it is a focus of attention in the literate medical traditions of China, India, and Islamic cultures. Hence, the study of pain and the cultural perceptions of pain are prominent foci of anthropologists. Given that the goal of medicine is to offer medical care to all people who seek it, the practice of modern medicine may be assisted by an exploration of the possibility of cultural differences in medical beliefs and practices in the multiethnic and racially diverse patient populations today. PMID:16333427

2002-01-01

329

For the pain in fish(eries) Consequenses of pain perception in fish for catch  

E-print Network

For the pain in fish(eries) Consequenses of pain perception in fish for catch and release fishing 2 DO FISH FEEL PAIN? VIEWS FROM A SCIENTIFIC PERSPECTIVE 4 Sensing pain 4 Experiencing pain 5 Pain could not sense pain (Rowan 1984). Also subsequent philosophers, such as Augustin (354-430) and Aquinas

Bech, Claus

330

Disrupted amygdala connectivity in chronic back pain reflects spontaneous pain perception  

E-print Network

Disrupted amygdala connectivity in chronic back pain reflects spontaneous pain perception 3974 OHBM 2013 INTRODUCTION · Chronic, spontaneous back pain (CBP) is known to engage brain systems involved of chronic pain and immediate pain perception in subacute back pain (SBP) patients who have had back pain

Apkarian, A. Vania

331

Effects of long-term wearing of high-heeled shoes on the control of the body's center of mass motion in relation to the center of pressure during walking.  

PubMed

High-heeled shoes are associated with instability and falling, leading to injuries such as fracture and ankle sprain. This study investigated the effects of habitual wearing of high-heeled shoes on the body's center of mass (COM) motion relative to the center of pressure (COP) during gait. Fifteen female experienced wearers and 15 matched controls walked with high-heeled shoes (7.3cm) while kinematic and ground reaction force data were measured and used to calculate temporal-distance parameters, joint moments, COM-COP inclination angles (IA) and the rate of IA changes (RCIA). Compared with inexperienced wearers, experienced subjects showed significantly reduced frontal IA with increased ankle pronator moments during single-limb support (p<0.05). During double-limb support (DLS), they showed significantly increased magnitudes of the frontal RCIA at toe-off and contralateral heel-strike, and reduced DLS time (p<0.05) but unaltered mean RCIA over DLS. In the sagittal plane experienced wearers showed significantly increased mean RCIA (p<0.05) and significant differences in the RCIA at toe-off and contralateral heel-strike (p<0.05). Significantly increased hip flexor moments and knee extensor moments at toe-off (p<0.05) were needed for forward motion of the trailing limb. The current results identified the change in the balance control in females after long-term use of high-heeled shoes, providing a basis for future design of strategies to minimize the risk of falling during high-heeled gait. PMID:24508016

Chien, Hui-Lien; Lu, Tung-Wu; Liu, Ming-Wei

2014-04-01

332

Increased Anandamide Uptake by Sensory Neurons Contributes to Hyperalgesia in a Model of Cancer Pain  

PubMed Central

Opioids do not effectively manage pain in many patients with advanced cancer. Because anandamide (AEA) activation of cannabinoid type-1 receptors (CB1R) on nociceptors reduces nociception, manipulation of AEA metabolism in the periphery may be an effective alternative or adjuvant therapy in the management of cancer pain. AEA is hydrolyzed by the intracellular enzyme fatty acid amide hydrolase (FAAH), and this enzyme activity contributes to uptake of AEA into neurons and to reduction of AEA available to activate CB1R. We used an in vitro preparation of adult murine dorsal root ganglion (DRG) neurons co-cultured with fibrosarcoma cells to investigate how tumors alter the uptake of AEA into neurons. Evidence that the uptake of [3H]AEA into dissociated DRG cells in the co-culture model mimicked the increase in uptake that occurred in DRG cells from tumor-bearing mice supported the utility of the in vitro model to study AEA uptake. Results with the fluorescent AEA analog CAY10455 confirmed that an increase in uptake in the co-culture model occurred in neurons. One factor that contributed to the increase in [3H]AEA uptake was an increase in total cellular cholesterol in the cancer condition. Treatment with the FAAH inhibitor URB597 reduced CAY10455 uptake in the co-culture model to the level observed in DRG neurons maintained in the control condition (i.e., in the absence of fibrosarcoma cells), and this effect was paralleled by OMDM-1, an inhibitor of AEA uptake, at a concentration that had no effect on FAAH activity. Maximally effective concentrations of the two drugs together produced a greater reduction than was observed with each drug alone. Treatment with BMS309403, which competes for AEA binding to fatty acid binding protein-5, mimicked the effect of OMDM-1 in vitro. Local injection of OMDM-1 reduced hyperalgesia in vivo in mice with unilateral tumors in and around the calcaneous bone. Intraplantar injection of OMDM-1 (5 µg) into the tumor-bearing paw reduced mechanical hyperalgesia through a CB1R-dependent mechanism and also reduced a spontaneous nocifensive behavior. The same dose reduced withdrawal responses evoked by suprathreshold mechanical stimuli in naive mice. These data support the conclusion that OMDM-1 inhibits AEA uptake by a mechanism that is independent of inhibition of FAAH and provide a rationale for the development of peripherally restricted drugs that decrease AEA uptake for the management of cancer pain. PMID:23644187

Khasabova, Iryna A.; Holman, Michelle; Morse, Tim; Burlakova, Natalya; Coicou, Lia; Harding-Rose, Catherine; Simone, Don A.; Seybold, Virginia S.

2013-01-01

333

Opioidergic activation in the medial pain system after heat pain.  

PubMed

Opioids modulate the affective component of pain and in vivo data indicate that opioids induce activation changes in the rostral ACC, insula and other brain areas. Hence, opioidergic release is to be expected in these brain regions following experimental pain stimulation. We examined healthy volunteers during heat pain and control subjects during rest using [18F]fluorodiprenorphine-PET. Pain stimulation led to significant reduction of diprenorphine binding in limbic and paralimbic brain areas including the rostral ACC and insula. The finding of altered opioidergic receptor availability in the rostral ACC after experimental nociceptive pain is novel and provides direct evidence for the involvement of this region in endogenous opioidergic inhibition of pain. PMID:16527398

Sprenger, Till; Valet, Michael; Boecker, Henning; Henriksen, Gjermund; Spilker, Mary E; Willoch, Frode; Wagner, Klaus J; Wester, Hans J; Tölle, Thomas R

2006-05-01

334

Utilization of the MPI Process for in-tank solidification of heel material in large-diameter cylindrical tanks  

SciTech Connect

A major problem faced by the US Department of Energy is remediation of sludge and supernatant waste in underground storage tanks. Exhumation of the waste is currently the preferred remediation method. However, exhumation cannot completely remove all of the contaminated materials from the tanks. For large-diameter tanks, amounts of highly contaminated ``heel'' material approaching 20,000 gal can remain. Often sludge containing zeolite particles leaves ``sand bars'' of locally contaminated material across the floor of the tank. The best management practices for in-tank treatment (stabilization and immobilization) of wastes require an integrated approach to develop appropriate treatment agents that can be safely delivered and mixed uniformly with sludge. Ground Environmental Services has developed and demonstrated a remotely controlled, high-velocity jet delivery system termed, Multi-Point-Injection (MPI). This robust jet delivery system has been field-deployed to create homogeneous monoliths containing shallow buried miscellaneous waste in trenches [fiscal year (FY) 1995] and surrogate sludge in cylindrical (FY 1998) and long, horizontal tanks (FY 1999). During the FY 1998 demonstration, the MPI process successfully formed a 32-ton uniform monolith of grout and waste surrogates in about 8 min. Analytical data indicated that 10 tons of zeolite-type physical surrogate were uniformly mixed within a 40-in.-thick monolith without lifting the MPI jetting tools off the tank floor. Over 1,000 lb of cohesive surrogates, with consistencies similar to Gunite and Associated Tank (GAAT) TH-4 and Hanford tank sludges, were easily intermixed into the monolith without exceeding a core temperature of 100 F during curing.

Kauschinger, J.L.; Lewis, B.E.

2000-01-01

335

Effect of a rocker non-heeled shoe on EMG and ground reaction forces during gait without previous training.  

PubMed

Unstable shoes have been designed to promote "natural instability" and during walking they should simulate barefoot gait, enhancing muscle activity and, thus, attributing an advantage over regular tennis shoes. Recent studies showed that, after special training on the appropriate walking pattern, the use of the Masai Barefoot Technology (MBT) shoe increases muscle activation during walking. Our study presents a comparison of muscle activity as well as horizontal and vertical forces during gait with the MBT, a standard tennis shoe and barefoot walking of healthy individuals without previous training. These variables were compared in 25 female subjects and gait conditions were compared using ANOVA repeated measures (effect size:0.25). Walking with the MBT shoe in this non-instructed condition produced higher vertical forces (first vertical peak and weight acceptance rate) than walking with a standard shoe or walking barefoot, which suggests an increase in the loads received by the musculoskeletal system, especially at heel strike. Walking with the MBT shoe did not increase muscle activity when compared to walking with the standard shoe. The barefoot condition was more effective than the MBT shoe at enhancing muscle activation. Therefore, in healthy individuals, no advantage was found in using the MBT over a standard tennis shoe without a special training period. Further studies using the MBT without any instruction over a longer period are needed to evaluate if the higher loads observed in the present study would return to their baseline values after a period of adaptation, and if the muscle activity would increase over time. PMID:22424760

Sacco, Isabel C N; Sartor, Cristina D; Cacciari, Licia P; Onodera, Andrea N; Dinato, Roberto C; Pantaleão, Elcio; Matias, Alessandra B; Cezário, Fernanda G; Tonicelli, Lucas M G; Martins, Maria Cecília S; Yokota, Mariane; Marques, Paulo Eduardo C; Costa, Paulo Henrique C

2012-06-01

336

Native American lithic procurement along the international border in the boot heel region of southwestern New Mexico  

NASA Astrophysics Data System (ADS)

Multidisciplinary field projects can be very useful to a more fundamental understanding of the world around us, though these projects are not as common as they should be. In particular, the combination of archeology and geology combines our understanding of human behavior and human use of the landscape with an intimate knowledge of geologic processes and the materials available for human use in order to gain a broader understanding of human-Earth interaction. Here we present data from a cross-disciplinary project that uses a common dataset, archeological artifacts, to explore the anthropological and geologic implications of useage patterns. Archeological excavations and surveys conducted by the Office of Contract Archeology in 2007 along the route of the proposed international border fence reveal patterns of use of geologic materials by Archaic, Formative and Protohistoric Native Americans in the Boot Heel of southwestern New Mexico. Thousands of artifacts were recorded in multiple sites from Guadalupe Pass in the southern Peloncillo Mountains to the Carrizalillo Hills west of Columbus. We identified the lithologies of artifacts, ranging from projectile points to groundstones, and then constructed material movement maps based on either known procurement sites ("quarries") or outcrops identified as the closest source to a given site for each lithology. Not unexpectedly, the majority of the rock types utilized by native peoples are local siliceous volcanic materials. However, several artifacts constructed from obsidian were transported into the region from northern Mexico and eastern Arizona, indicating long-distance travel and/or trade routes. We also examine useage pattern difference between Archaic, Formative and Protohistoric sites. Additionally, a dramatic change in distribution of sources for geologic materials occurs between one pre-Spanish site and one post-Spanish site that are adjacent to one another.

Zeigler, K. E.; Hogan, P.; Hughes, C.; Kurota, A.

2011-06-01

337

Native American lithic procurement along the international border in the boot heel region of southwestern New Mexico  

NASA Astrophysics Data System (ADS)

Multidisciplinary field projects can be very useful to a more fundamental understanding of the world around us, though these projects are not as common as they should be. In particular, the combination of archeology and geology combines our understanding of human behavior and human use of the landscape with an intimate knowledge of geologic processes and the materials available for human use in order to gain a broader understanding of human-Earth interaction. Here we present data from a cross-disciplinary project that uses a common dataset, archeological artifacts, to explore the anthropological and geologic implications of useage patterns. Archeological excavations and surveys conducted by the Office of Contract Archeology in 2007 along the route of the proposed international border fence reveal patterns of use of geologic materials by Archaic, Formative and Protohistoric Native Americans in the Boot Heel of southwestern New Mexico. Thousands of artifacts were recorded in multiple sites from Guadalupe Pass in the southern Peloncillo Mountains to the Carrizalillo Hills west of Columbus. We identified the lithologies of artifacts, ranging from projectile points to groundstones, and then constructed material movement maps based on either known procurement sites ("quarries") or outcrops identified as the closest source to a given site for each lithology. Not unexpectedly, the majority of the rock types utilized by native peoples are local siliceous volcanic materials. However, several artifacts constructed from obsidian were transported into the region from northern Mexico and eastern Arizona, indicating long-distance travel and/or trade routes. We also examine useage pattern difference between Archaic, Formative and Protohistoric sites. Additionally, a dramatic change in distribution of sources for geologic materials occurs between one pre-Spanish site and one post-Spanish site that are adjacent to one another.

Zeigler, K. E.; Hughes, C.; Kurota, A.; Hogan, P.

2010-12-01

338

Pain and Inflammatory Bowel Disease  

PubMed Central

Abdominal pain is a common symptom of inflammatory bowel disease (IBD: Crohn’s disease, ulcerative colitis). Pain may arise from different mechanisms, which can include partial blockage and gut distention as well as severe intestinal inflammation. A majority of patients suffering from acute flares of IBD will experience pain, which will typically improve as disease activity decreases. However, a significant percentage of IBD patients continue experiencing symptoms of pain despite resolving inflammation and achieving what appears to be clinical remission. Current evidence suggests that sensory pathways sensitize during inflammation, leading to persistent changes in afferent neurons and central nervous system pain processing. Such persistent pain is not only a simple result of sensory input. Pain processing and even the activation of sensory pathways is modulated by arousal, emotion, and cognitive factors. Considering the high prevalence of iatrogenic as well as essential neuropsychiatric comorbidities including anxiety and depression in IBD patients, these central modulating factors may significantly contribute to the clinical manifestation of chronic pain. The improved understanding of peripheral and central pain mechanisms is leading to new treatment strategies that view pain as a biopsychosocial problem. Thus, improving the underlying inflammation, decreasing the excitability of sensitized afferent pathways, and altering emotional and/or cognitive functions may be required to more effectively address the difficult and disabling disease manifestations. PMID:19130619

Bielefeldt, Klaus; Davis, Brian; Binion, David G.

2010-01-01

339

[Post-surgical neuropathic pain].  

PubMed

The traumatic lesions during surgical interventions often turn into a persistent pain. Pain persists in the location of surgical intervention for a long time, beyond the usual course of natural healing of an acute pain and it is different from that suffered preoperatively. It is usually a chronic pain and it is associated to lesions of the central or peripheral nervous system. Pain is usually described as burning or tingling, or electric shock-like; it can be continuous or parossistic, often associated to paraesthesia, iperalgesia and allodinya. If circumstances preclude the surgical revision, the treatment of post-surgical neuropathic pain is based on drugs, according to the guidelines. The drugs of choice are the tricyclic antidepressants, the serotonin and adrenaline re-uptake selective inhibitors (SSRI), local antiepileptics of new generation (gabapentin, pregabalin) and topical anaesthetics. Drugs of second line are: opioid analgesics, tramadol; drugs of third line are: mexiletine, antagonist of NMDA receptor and capsaicine. The post-surgical neuropathic pain is often resistant to the pharmacologic treatment; for this reason the spinal cord neuromodulation can be applied only after careful selection of the patients according to the international guidelines. The incidence of post-surgical neuropathic pain in the Pain Units is approximately 20% of the patients admitted to hospital. Therefore it is necessary a greater attention for the post-surgical analgesia, adopting appropriate surgical techniques in order to avoid the onset of the post-surgical neuropathic pain. PMID:19725479

Shaladi, Ali Muftah; Saltari, Maria Rita; Crestani, Francesco; Piva, Bruno

2009-01-01

340

Nurse's Knowledge of Neuropathic Pain.  

PubMed

The aim of our study was to determine the levels of information and awareness of the nurses who work on neuropathic pain in the departments of physical medicine and rehabilitation, neurology and neurosurgery. A total of 60 nurses (20 per each department) who work in the physical medicine and rehabilitation, neurology and neurosurgery departments of Beyhekim State Hospital of Konya in Turkey took part in the study. The level of information and awareness of the nurses on neuropathic pain were assessed via a questionnaire prepared by specialists in the light of recent literature. The questionnaire was composed of 30 questions including the definition, symptoms, treatment and management of neuropathic pain. None of 60 nurses participating in the study were given any previous in-service training on neuropathic pain. According to the assessments, 80% of nurses (48) were found not to have sufficient knowledge about definition of neuropathic pain; 83.3% (50) about diseases causing neuropathic pain; 83.3% (50) about symptoms of neuropathic pain; and 90% (54) about management of neuropathic pain. The findings obtained from the nurses of these three departments showed no statistically significant relation. Our findings indicated that the knowledge of participants' about neuropathic pain who work in these three departments seriously lack of information. Informing nurses about neuropathic pain during in-service training will be an important step towards improving the quality of services provided. PMID:25309714

Karahan, Ali Yavuz; Kucuksarac, Seher; Soran, Neslihan; Ordahan, Banu; Tekin, Levent; Basaran, Aynur

2014-08-01

341

Visceral Pain: The Neurophysiological Mechanism  

PubMed Central

The mechanism of visceral pain is still less understood compared with that of somatic pain. This is primarily due to the diverse nature of visceral pain compounded by multiple factors such as sexual dimorphism, psychological stress, genetic trait, and the nature of predisposed disease. Due to multiple contributing factors there is an enormous challenge to develop animal models that ideally mimic the exact disease condition. In spite of that, it is well recognized that visceral hypersensitivity can occur due to (1) sensitization of primary sensory afferents innervating the viscera, (2) hyperexcitability of spinal ascending neurons (central sensitization) receiving synaptic input from the viscera, and (3) dysregulation of descending pathways that modulate spinal nociceptive transmission. Depending on the type of stimulus condition, different neural pathways are involved in chronic pain. In early-life psychological stress such as maternal separation, chronic pain occurs later in life due to dysregulation of the hypothalamic–pituitary–adrenal axis and significant increase in corticotrophin releasing factor (CRF) secretion. In contrast, in early-life inflammatory conditions such as colitis and cystitis, there is dysregulation of the descending opioidergic system that results excessive pain perception (i.e., visceral hyperalgesia). Functional bowel disorders and chronic pelvic pain represent unexplained pain that is not associated with identifiable organic diseases. Often pain overlaps between two organs and approximately 35% of patients with chronic pelvic pain showed significant improvement when treated for functional bowel disorders. Animal studies have documented that two main components such as (1) dichotomy of primary afferent fibers innervating two pelvic organs and (2) common convergence of two afferent fibers onto a spinal dorsal horn are contributing factors for organ-to-organ pain overlap. With reports emerging about the varieties of peptide molecules involved in the pathological conditions of visceral pain, it is expected that better therapy will be achieved relatively soon to manage chronic visceral pain. PMID:19655104

Sengupta, Jyoti N.

2011-01-01

342

Cryoanalgesia in interventional pain management.  

PubMed

Cryoneuroablation, also known as cryoanalgesia or cryoneurolysis, is a specialized technique for providing long-term pain relief in interventional pain management settings. Modern cryoanalgesia traces its roots to Cooper et al who developed in 1961, a device that used liquid nitrogen in a hollow tube that was insulated at the tip and achieved a temperature of - 190 degrees C. Lloyd et al proposed that cryoanalgesia was superior to other methods of peripheral nerve destruction, including alcohol neurolysis, phenol neurolysis, or surgical lesions. The application of cold to tissues creates a conduction block, similar to the effect of local anesthetics. Long-term pain relief from nerve freezing occurs because ice crystals create vascular damage to the vasonervorum, which produces severe endoneural edema. Cryoanalgesia disrupts the nerve structure and creates wallerian degeneration, but leaves the myelin sheath and endoneurium intact. Clinical applications of cryoanalgesia extend from its use in craniofacial pain secondary to trigeminal neuralgia, posterior auricular neuralgia, and glossopharyngeal neuralgia; chest wall pain with multiple conditions including post-thoracotomy neuromas, persistent pain after rib fractures, and post herpetic neuralgia in thoracic distribution; abdominal and pelvic pain secondary to ilioinguinal, iliohypogastric, genitofemoral, subgastric neuralgia; pudendal neuralgia; low back pain and lower extremity pain secondary to lumbar facet joint pathology, pseudosciatica, pain involving intraspinous ligament or supragluteal nerve, sacroiliac joint pain, cluneal neuralgia, obturator neuritis, and various types of peripheral neuropathy; and upper extremity pain secondary to suprascapular neuritis and other conditions of peripheral neuritis. This review describes historical concepts, physics and equipment, various clinical aspects, along with technical features, indications and contraindications, with clinical description of multiple conditions amenable to cryoanalgesia in interventional pain management settings. PMID:16880882

Trescot, Andrea M

2003-07-01

343

TRANSLATIONAL PAIN RESEARCH: ACHIEVEMENTS AND CHALLENGES  

PubMed Central

The achievements in both preclinical and clinical pain research over the past four decades have led to significant progresses in clinical pain management. However, pain research still faces enormous challenges and there remain many obstacles in the treatment of clinical pain, particularly chronic pain. Translational pain research needs to involve a number of important areas including a) bridging the gap between pain research and clinical pain management, b) developing objective pain assessment tools, c) analyzing current theories of pain mechanisms and their relevance to clinical pain, d) exploring new tools for both preclinical and clinical pain research, and e) coordinating research efforts among basic scientists, clinical investigators, and pain medicine practitioners. These issues are discussed in this article in light of the achievements and challenges of translational pain research. PMID:19628433

Mao, Jianren

2009-01-01

344

Cancer pain and current theory for pain control.  

PubMed

This article discusses current trends in managing cancer pain, with specific regard to opioid transmission, descending pathway inhabitation, and ways to facilitate the endogenous antinociceptive chemicals in the human body. Various techniques for opioid and nonopioid control of potential pain situations of patients with cancer are discussed. The benefits of using pharmacogenetics to assess the appropriate medications are addressed. Finally, specific treatment of abdominal cancer pain using radiofrequency lesioning is discussed. PMID:24787342

Kahan, Brian

2014-05-01

345

Pain without Nociceptors? Nav1.7-Independent Pain Mechanisms  

PubMed Central

Summary Nav1.7, a peripheral neuron voltage-gated sodium channel, is essential for pain and olfaction in mice and humans. We examined the role of Nav1.7 as well as Nav1.3, Nav1.8, and Nav1.9 in different mouse models of chronic pain. Constriction-injury-dependent neuropathic pain is abolished when Nav1.7 is deleted in sensory neurons, unlike nerve-transection-related pain, which requires the deletion of Nav1.7 in sensory and sympathetic neurons for pain relief. Sympathetic sprouting that develops in parallel with nerve-transection pain depends on the presence of Nav1.7 in sympathetic neurons. Mechanical and cold allodynia required distinct sets of neurons and different repertoires of sodium channels depending on the nerve injury model. Surprisingly, pain induced by the chemotherapeutic agent oxaliplatin and cancer-induced bone pain do not require the presence of Nav1.7 sodium channels or Nav1.8-positive nociceptors. Thus, similar pain phenotypes arise through distinct cellular and molecular mechanisms. Therefore, rational analgesic drug therapy requires patient stratification in terms of mechanisms and not just phenotype. PMID:24440715

Minett, Michael S.; Falk, Sarah; Santana-Varela, Sonia; Bogdanov, Yury D.; Nassar, Mohammed A.; Heegaard, Anne-Marie; Wood, John N.

2014-01-01

346

Expressive dimensions of pain catastrophizing: An observational study in adolescents with chronic pain.  

PubMed

Investigated was the relationship between pain catastrophizing and pain intensity in adolescents suffering from chronic pain (n = 38) and the extent to which they expressed communicative pain and pain-related protective behaviours. Adolescents were observed on video performing a 2-Min Walk Test (2MWT). Behaviours were coded on videotape. The adolescents' verbalizations about the 2MWT were also rated by their parents. Analyses revealed that higher levels of catastrophic thinking about pain were associated with higher levels of facial pain expressions and verbalizations about their pain experience, beyond the effects of age, gender, pain duration and pain intensity. Pain-related protective behaviours did not vary with the adolescents' level of pain catastrophizing, but varied with pain intensity. The findings corroborate the functional distinctiveness of different types of pain behaviours. The results are discussed in terms of the processes linking (1) catastrophizing to communicative pain behaviours and (2) pain to pain-related protective behaviours. PMID:19683394

Vervoort, T; Goubert, L; Eccleston, C; Vandenhende, M; Claeys, O; Clarke, J; Crombez, G

2009-11-01

347

Pain intensity ratings were significantly reduced after the  

E-print Network

, such as in neuropathic chronic back pain and sympathetical4 Pain intensity ratings were significantly reduced after the administration of patch Session 1 MaxPainIntensity baseline pain rating stimulus pain rating (affected area) stimulus pain rating

Apkarian, A. Vania

348

Gynecological Management of Neuropathic Pain  

PubMed Central

Obstetrician/gynecologists often are the initial management clinicians for pelvic neuropathic pain. While treatment may require comprehensive team management and consultation with other specialists, there a few critical and basic steps that can be performed on an office visit that offer the opportunity to significantly improve quality of life in this patient population. A key first step is a thorough clinical examination to physically map the pain site and identify potentially involved nerves. Only limited evidence exists on how best to manage neuropathic pain, but generally a combination of surgical, manipulative or pharmacological methods should be considered. Experimental methods for more precisely characterizing the nature of the nerve dysfunction exist to diagnose and treat neuropathic pain, but additional scientific evidence is needed to unanimously recommend these options. In the meantime, an approach adopted from guidelines of the International Association for Study of Pain tailored for gynecological pain is suggested. PMID:21777899

TU, Frank F.; HELLMAN, Kevin; BACKONJA, Miroslav

2011-01-01

349

Genomics of pain in osteoarthritis  

PubMed Central

Summary Osteoarthritis (OA) accounts for the majority of the disease burden for musculoskeletal disorders and is one of the leading causes of disability worldwide. This disability is the result not of the cartilage loss that defines OA radiographically, but of the chronic pain whose presence defines symptomatic OA. It is becoming clear that many genes, each with a small effect size, contribute to the risk of developing OA. However, the genetics of OA pain are only just starting to be explored. This review will describe the first genes to have been identified in genomic studies of OA pain, as well as the possible dual roles of genes previously identified in genomic studies of OA in the context of pain. Difficulties associated with attempting to characterise the genetics of OA pain will be discussed and promising future avenues of research into genetic and epigenetic factors affecting OA pain described. PMID:23973152

Thakur, M.; Dawes, J.M.; McMahon, S.B.

2013-01-01

350

Pathogenesis of Painful Diabetic Neuropathy  

PubMed Central

The prevalence of diabetes is rising globally and, as a result, its associated complications are also rising. Painful diabetic neuropathy (PDN) is a well-known complication of diabetes and the most common cause of all neuropathic pain. About one-third of all diabetes patients suffer from PDN. It has a huge effect on a person's daily life, both physically and mentally. Despite huge advances in diabetes and neurology, the exact mechanism of pain causation in PDN is still not clear. The origin of pain could be in the peripheral nerves of the central nervous system. In this review, we discuss various possible mechanisms of the pathogenesis of pain in PDN. We discuss the role of hyperglycaemia in altering the physiology of peripheral nerves. We also describe central mechanisms of pain. PMID:24891949

Rajbhandari, Satyan

2014-01-01

351

Pain Catastrophizing: An Updated Review  

PubMed Central

Pain catastrophizing has been described for more than half a century which adversely affects the pain coping behavior and overall prognosis in susceptible individuals when challenged by painful conditions. It is a distinct phenomenon which is characterized by feelings of helplessness, active rumination and excessive magnification of cognitions and feelings toward the painful situation. Susceptible subjects may have certain demographic or psychological predisposition. Various models of pain catastrophizing have been proposed which include attention-bias, schema-activation, communal-coping and appraisal models. Nevertheless, consensus is still lacking as to the true nature and mechanisms for pain catastrophizing. Recent advances in population genomics and noninvasive neuroimaging have helped elucidate the known determinants and neurophysiological correlates behind this potentially disabling behavior. PMID:23441031

Leung, Lawrence

2012-01-01

352

[Testicular pain, a diagnostic challenge?].  

PubMed

Scrotal pain is frequently encountered in practice, as it affects 4 men in 1000, with a peak of incidence between the ages of 45 and 50. After excluding an urological or gastrointestinal cause, referred pain of musculoskeletal origin should be considered, even in the absence of back pain. Described by Dr. Robert Maigne, this referred pain originates from a minor intervertebral dysfunction of the thoracolumbar junction. Imaging of the spine is not helpful. Rather, the diagnosis is made by seeking pain triggered by the mobilization of the lumbar vertebrae; the pinch and roll skin manoeuvre will highlight this referred pain. Treatment is symptomatic, though manual therapies by spine specialists are also recommended. PMID:24383247

Monney, Christophe; Schnegg, Annatina; Favrat, Bernard; Amstutz, Vincent

2013-11-27

353

Effect of pain chronification and chronic pain on an endogenous pain modulation circuit in rats.  

PubMed

We tested the hypothesis that chronic pain development (pain chronification) and ongoing chronic pain (chronic pain) reduce the activity and induce plastic changes in an endogenous analgesia circuit, the ascending nociceptive control. An important mechanism mediating this form of endogenous analgesia, referred to as capsaicin-induced analgesia, is its dependence on nucleus accumbens ?-opioid receptor mechanisms. Therefore, we also investigated whether pain chronification and chronic pain alter the requirement for nucleus accumbens ?-opioid receptor mechanisms in capsaicin-induced analgesia. We used an animal model of pain chronification in which daily subcutaneous prostaglandin E2 (PGE2) injections into the rat's hind paw for 14days, referred to as the induction period of persistent hyperalgesia, induce a long-lasting state of nociceptor sensitization referred to as the maintenance period of persistent hyperalgesia, that lasts for at least 30days following the cessation of the PGE2 treatment. The nociceptor hypersensitivity was measured by the shortening of the time interval for the animal to respond to a mechanical stimulation of the hind paw. We found a significant reduction in the duration of capsaicin-induced analgesia during the induction and maintenance period of persistent mechanical hyperalgesia. Intra-accumbens injection of the ?-opioid receptor selective antagonist Cys(2),Tyr(3),Orn(5),Pen(7)amide (CTOP) 10min before the subcutaneous injection of capsaicin into the rat's fore paw blocked capsaicin-induced analgesia. Taken together, these findings indicate that pain chronification and chronic pain reduce the duration of capsaicin-induced analgesia, without affecting its dependence on nucleus accumbens ?-opioid receptor mechanisms. The attenuation of endogenous analgesia during pain chronification and chronic pain suggests that endogenous pain circuits play an important role in the development and maintenance of chronic pain. PMID:25451282

Miranda, J; Lamana, S M S; Dias, E V; Athie, M; Parada, C A; Tambeli, C H

2015-02-12

354

Abstract--Pain assessment is of high priority in the clinical setting. Facial Pain Scales (FPSs) are pain assessment tools  

E-print Network

Abstract-- Pain assessment is of high priority in the clinical setting. Facial Pain Scales (FPSs) are pain assessment tools generally used with school-aged children. The implicit theoretical bases not been addressed. We support the existence of a universal pain expression ­the Primal Face of Pain (PFP

Central Florida, University of

355

Psychosocial Issues in Cancer Pain  

Microsoft Academic Search

Cancer pain is a complex and multidimensional experience that affects and is affected by psychological and social factors.\\u000a This article reviews recent research that points to a number of key psychosocial factors associated with pain, including psychological\\u000a distress, coping, and social support, as well as the impact of socioeconomic factors on barriers to pain management. We also\\u000a review recent research

Laura S. Porter; Francis J. Keefe

356

Widespread Pain in Older Adults  

Microsoft Academic Search

\\u000a The differential diagnosis of widespread pain in older adults is broad, with fibromyaglia syndrome (FMS) leading the list.\\u000a While the exact pathogenesis of FMS is not clear, recent studies suggest that abnormal pain processing and central sensitization\\u000a contribute to the development of chronic muscle pain and tender points. Precise diagnosis of FMS requires a targeted history\\u000a and physical examination. A

Cheryl D. Bernstein; Jordan F. Karp; Debra K. Weiner

357

Cultural perspectives on pain management.  

PubMed

Bedouin women tend to remain quiet and expressionless while giving birth despite reporting high levels of pain and fear (Harrison 1991). Culture undoubtedly influences pain perception and expression but there are dangers in making assumptions about particular groups. This article explores the underlying research and the complex clinical picture highlighting the need for cultural awareness--but ultimately we must care for the individual person in pain. PMID:19051959

Briggs, Emma

2008-11-01

358

Individual differences in pain responses  

Microsoft Academic Search

The experience of pain is characterized by tremendous inter-individual variability. Indeed, an identical noxious stimulus\\u000a can produce vastly different pain responses across individuals. Historically, scientists have regarded this vari-ability as\\u000a a nuisance; however, substantial data suggest that these individual differences may provide valuable informa-tion that can\\u000a be used to enhance clinical management of pain. This paper discusses several factors that

Roger B. Fillingim

2005-01-01

359

Management of functional abdominal pain  

Microsoft Academic Search

Opinion statement  The diagnosis of functional abdominal pain should be made based on the Rome II symptom criteria with only limited testing\\u000a to exclude other disease. During physical examination the clinician may look for evidence of pain behavior which would be\\u000a supportive of the diagnosis. Reassurance and proper education regarding the clinical entity of functional abdominal pain is\\u000a critical for successful

Yuri A. Saito; Jean C. Fox

2004-01-01

360

Magnets and Pain Relief  

NSDL National Science Digital Library

Created by David M. Lane of Rice University, this case study assesses the question, "Can the application of magnetic fields be an effective treatment for pain?" It addresses concepts including: boxplots, stem and leaf displays, correlated t-test, two-sample t-test, repeated measures analysis of variance, and analysis of covariance. The author structures this study in this way: background, experimental design, materials, descriptive statistics, inferential statistics, interpretation and the raw data set. Overall, this is a great resource as it presents the statistical theories and then directly applies them to this case study.

Lane, David M.

2009-02-27

361

[Acute anal pain].  

PubMed

Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically. PMID:23798022

Pittet, Olivier; Demartines, Nicolas; Hahnloser, Dieter

2013-07-01

362

Otolaryngic myofascial pain syndromes.  

PubMed

It has been long recognized in the otolaryngic community that despite great effort dedicated to the physiology and pathology of the ear, nose, throat/head and neck, there are a number of symptoms, including pain in various locations about the head and neck, which cannot be explained by traditional otolaryngic principles. The tenets of myofascial dysfunction, however, as elucidated by Dr. Janet Travell, explain most of these previously unexplained symptoms; furthermore, treatment based on Dr. Travell's teachings is effective in relieving these symptoms. PMID:15509459

Teachey, William S

2004-12-01

363

Intelligent back pain advisor  

SciTech Connect

There is a great need for expert systems in the medical field for expert system applications in the field of medical diagnosis. There aren`t any expert systems available for diagnosing back pain, and this tool can be useful. In this paper, we present an expert system that was designed primarily for the diagnosis and treatment of herniated disks, which can occur in any part of the spine. This paper discusses the implementation of the system and some future improvements to the interface that would make this expert system more intelligent.

Bills, M.; Suh, Sang C. [Texas A& M Univ., Commerce, TX (United States)

1996-12-31

364

Recurrent pelvic pain in women.  

PubMed

We conducted a prospective survey from January to September 1999 on a random population from the city of Turin, Italy, to highlight pain pathologies at various ages and possible differences between sexes. By means of a questionnaire, women were asked about age, profession, marital status, menstrual pain, type of delivery, number of children, onset and presence of pain of any type. Pain-related questions included its characteristics, familial tendencies, treatment, type, duration, daily and monthly quantity of medication taken, habits, previous pathologies, or surgical operations. A control group of men was investigated. PMID:10998725

Margaria, E; Sortino, G; Gollo, E; Falletta, M

2000-01-01

365

Neurobiological Mechanisms of Pelvic Pain  

PubMed Central

Pelvic pain is a common condition which significantly deteriorates health-related quality of life. The most commonly identified causes of pain in the pelvic region are gynaecologic, urologic, gastrointestinal, neurological, and musculoskeletal. However, in up to 33% of patients the source of this symptom is not identified, frustrating both patients and health-care professionals. Pelvic pain may involve both the somatic and visceral systems, making the differential diagnosing challenging. This paper aimed to review the mechanisms involved in pelvic pain perception by analyzing the neural plasticity and molecules which are involved in these complex circuits. PMID:25110704

Leone Roberti Maggiore, Umberto; Candiani, Massimo

2014-01-01

366

Pain Associated With Hysteroscopic Sterilization  

PubMed Central

Background and Objectives: The safety and efficacy of female hysteroscopic sterilization using the Essure system has been well documented. Given the marked differences in the execution of hysteroscopic and laparoscopic sterilization, the objective of this study was to assess the experience of pain postprocedure between the 2. Secondary end-points included postoperative pain medication, time to return to normal activities, postprocedure bleeding, and patient satisfaction. Methods: Twenty cases each of laparoscopic sterilization (LS) and hysteroscopic sterilization (HS) were performed. Patients were surveyed regarding their experience of pain immediately postoperatively, 1 week, and 4 weeks post-procedure. Results: The average pain score immediately postprocedure was significantly lower among HS patients than among LS patients (t=?8.17, P<.0001). One-week post-procedure, none of the patients in the HS group reported any pain, while the average pain score among the LS patients was 2.65 (t =?9.67, P<.0001). Four weeks post-procedure, women in the HS group continued to report no pain, 35% of the LS group continued to report some pain (t=?3.04, P=.004). Conclusions: Hysteroscopic sterilization offers a minimally invasive, less painful, equally efficacious modality for sterilization than laparoscopic sterilization and should be available to all women seeking permanent birth control. PMID:17651558

Levy, Jenna; Childers, Meredith E.

2007-01-01

367

Laser stimulation for pain research  

NASA Astrophysics Data System (ADS)

Pain is a serious medical problem; it inflicts huge economic loss and personal suffering. Pain signals are conducted via small, non- and partially myelinated A-delta and C nerve fibers and lasers are particularly well suited to stimulating these fibers. Large myelinated fibers convey touch and vibration information and these fibers are also discharged when contact thermodes and other touch pain stimuli are used and this would give a more muddled signal for functional imaging experiments. The advantages of lasers over conventional methods of pain stimulation are good temporal resolution, no variable parameters are involved such as contact area and they give very reproducible results. Accurate inter-stimulus changes can be achieved by computer control of the laser pulse duration, pulse height and repetition rate and this flexibility enables complex stimulation paradigms to be realized. We present a flexible carbon dioxide laser system designed to generate these stimuli for the study of human cerebral pain responses. We discuss the advantages within research of this system over other methods of pain stimulation such as thermal, electrical and magnetic. The stimulator is used in conjunction with functional magnetic resonance imaging, positron emission tomography and electrophysiological methods of imaging the brain's activity. This combination is a powerful tool for the study of pain-induced activity in different areas of the brain. An accurate understanding of the brain's response to pain will help in research into the areas of rheumatoid arthritis and chronic back pain.

Clark, Stuart; Dickinson, Mark R.; King, Terence A.; Jones, Anthony; Chen, Andrew; Derbyshire, Stuart; Townsend, D. W.; Kinahan, Paul E.; Mintun, M. A.; Nichols, T.

1996-01-01

368

ANALYZING MUSCULAR PAIN AND THE EFFECTS OF EXERCISE ON CHRONIC PAIN  

E-print Network

Most people suffering from various chronic pain syndromes report deep tissue pain. However, our knowledge about chronic musculoskeletal pain is primarily based on rodent models of cutaneous pain. Little is known about muscle nociception and its...

Sharma, Neena

2008-08-22

369

Postdoctoral Fellowship and Research Associate Positions in Neuroimaging in Pain Stanford Systems Neuroscience and Pain Lab  

E-print Network

clinical trials of chronic low back pain, the candidate will be directly interacPostdoctoral Fellowship and Research Associate Positions in Neuroimaging in Pain Research Stanford Systems Neuroscience and Pain Lab Division of Pain Medicine, Department of Anesthesia Stanford University

Pillow, Jonathan

370

Spinal Cord Simulation for Chronic Pain Management  

E-print Network

Oak, Suite 275 Houston, TX 77090 2 Center for Computational Science and Advanced Distributed strong pain (chronic pain) that is not an indication of any physiological damage. Chronic pain the physiology of pain is still at its infancy, we need some indirect heuristic methods to get rid of the pain

Kreinovich, Vladik

371

Outside JEB I FEEL YOUR PAIN  

E-print Network

Outside JEB iv I FEEL YOUR PAIN Pain is not pleasant. We try to avoid it at all costs. Even witnessing another in pain can cause one to feel pain, particularly if it is someone we know. This ability in a recent Science publication that this ability may also exist in mice. Other studies had shown that pain

Husak, Jerry F.

372

Sensation and experience of pain in children.  

PubMed

The study explored children's self-assessment of the pain experience and to understood the relative factors that influence the words used to represent children's pain. Using an outline of a human figure and a section of the open questionnaire to study, 106 nine- to sixteen-year-old children marked their pain location using colors to represent pain. They rated the intensity and duration of their pain, and described their experience of pain (sensation, causes, and ways to manage pain). The results showed that children clearly described pain, that there were appreciable differences between feelings of headache, leg pain, backache, and shoulder pain with pain intensity and duration of pain; that explained the difference of occurrence of abdominal pain in cross effect between age and sex; that explained the difference of the occurrence of toothache in cross effect among triangle of hospitalized experience, age, and sex; that there was significant relationship between abdominal pain and family structure. For severe abdominal pain or toothache the children could ask doctors for pain relief. For the others, they could take medication or rest for their middle or mild abdominal pain. The ways to manage leg pain were injection and massage. Change of position was applied to relieve backache. From the children's self-reports, we understand that causes of children's pain were derived from bad sleep, food, decayed teeth, exercising, and hitting. Pain avoidance is best achieved by accident prevention, cultivation of good health habits, and integration of daily living skills. PMID:8320754

Chen, J Y

1993-04-01

373

Opioid-induced hyperalgesia: when pain killers make pain worse.  

PubMed

A 44-year-old woman had a temporal glioma and was admitted to the hospice with pain that was not controlled despite escalating opioids. Her pain levels rose after every dose increase resulting now in continuous pain, making her very low in mood. Her short-term memory had also declined in a stepwise fashion with each increase in opioids. Additionally, her poor health had had a detrimental effect on family life. Physical examination was difficult due to allodynia but no major abnormality was found. The team suspected opioid-induced hyperalgesia and decided to cut the patient's opioids by one-third initially. This immediately improved the overall pain. The opioids continued to be decreased incrementally every 1-2?days until the pain had disappeared completely. She was stabilised on a dose almost one-seventh of her original regime. Mood and memory also improved as opioids decreased and she was discharged home after 8?days. PMID:24899014

Kaneria, Anshuni

2014-01-01

374

Postoperative pain assessment after septorhinoplasty.  

PubMed

Postoperative pain after septorhinoplasty and its optimal management has not been described in detail. Fifty-two adult septorhinoplasty patients were included in a prospective cohort single center study. Patients' and surgical characteristics were evaluated. Outcome and process parameters were analyzed using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Management (QUIPS) on the first postoperative day. Pain during the first operative day after septorhinoplasty was moderate. Pain management predominately consisted of remifentanil intraoperatively, metamizole in the recovery room, in combination with piritramide in one-third of the patients, and metamizole on ward. Patients younger than 31 years were less satisfied with pain management (P = 0.018). Open rhinoplasty was associated with less satisfaction with pain management (P = 0.007). Use of rib grafts led to more mobility, breathing, sleeping and mood disturbances (P = 0.003, 0.047; 0.047; 0.022, respectively). Preoperative pain counseling was followed by higher satisfaction, less breathing and mood disturbances after surgery (P = 0.021; 0.004; 0.046, respectively). Opioids in the recovery room in addition to non-opioids and treatment with non-opioids on ward led to less maximal pain (P = 0.027 and 0.040, respectively). We conclude that QUIPS is an easy tool to evaluate the quality of postoperative pain management following rhinoplasty. Preoperative pain counseling, specific care for patients with rib grafts, consequent use of opioids in the recovery room in addition to non-opioids, and use of non-opioids on ward seem to be effective to improve pain management after septorhinoplasty. PMID:22130915

Wittekindt, D; Wittekindt, C; Schneider, G; Meissner, W; Guntinas-Lichius, O

2012-06-01

375

Conditioned pain modulation predicts duloxetine efficacy in painful diabetic neuropathy.  

PubMed

This study aims to individualize the selection of drugs for neuropathic pain by examining the potential coupling of a given drug's mechanism of action with the patient's pain modulation pattern. The latter is assessed by the conditioned pain modulation (CPM) and temporal summation (TS) protocols. We hypothesized that patients with a malfunctioning pain modulation pattern, such as less efficient CPM, would benefit more from drugs augmenting descending inhibitory pain control than would patients with a normal modulation pattern of efficient CPM. Thirty patients with painful diabetic neuropathy received 1 week of placebo, 1 week of 30 mg/d duloxetine, and 4 weeks of 60 mg/d duloxetine. Pain modulation was assessed psychophysically, both before and at the end of treatment. Patient assessment of drug efficacy, assessed weekly, was the study's primary outcome. Baseline CPM was found to be correlated with duloxetine efficacy (r=0.628, P<.001, efficient CPM is marked negative), such that less efficient CPM predicted efficacious use of duloxetine. Regression analysis (R(2)=0.673; P=.012) showed that drug efficacy was predicted only by CPM (P=.001) and not by pretreatment pain levels, neuropathy severity, depression level, or patient assessment of improvement by placebo. Furthermore, beyond its predictive value, the treatment-induced improvement in CPM was correlated with drug efficacy (r=-0.411, P=.033). However, this improvement occurred only in patients with less efficient CPM (16.8±16.0 to -1.1±15.5, P<.050). No predictive role was found for TS. In conclusion, the coupling of CPM and duloxetine efficacy highlights the importance of pain pathophysiology in the clinical decision-making process. This evaluative approach promotes personalized pain therapy. PMID:22480803

Yarnitsky, David; Granot, Michal; Nahman-Averbuch, Hadas; Khamaisi, Mogher; Granovsky, Yelena

2012-06-01

376

The validity and reliability of a portable slip meter for determining floor slipperiness during simulated heel strike.  

PubMed

A previously developed test rig was used as starting point for designing a portable slip meter with two new features. First, an inflatable pneumatic test wheel, consisting of six slider units, was introduced as the impacting contact element relative to floor surface. Second, an inductive trigger was built into the system to facilitate a precise timing of the slider-floor contact during the test. This new test rig was designed to measure transitional friction properties of contaminated floor surfaces during simulated heel strike, which is considered the most critical phase of gait from the slip and fall point of view. Another objective was to quantify the validity and reliability of this test method in the laboratory, but not yet in the field. The measurement process was evaluated on eight wet and oily floor surfaces (vinyl and ceramic tile floorings) using two slider materials (plain, profiled), two normal loads (100, 200 N), and two sliding velocities (0.15, 0.30 m/s) as independent variables. The outputs of the portable slip meter, in terms of transitional friction coefficients, were compared to force platform-based friction values and to slip resistance values obtained with a slip simulator apparatus for laboratory testing of shoes and floor surfaces. The outputs were also evaluated against slipperiness ratings made by three male subjects in paired comparison trials, in which the subjects walked over eight wet floor surfaces wearing shoes with the plain soling material. The results showed that test option 200 N and 0.15m/s led to optimum validity despite its tendency to promote frictional vibrations (stick-slip) in the contact surface. Compared to the lower sliding speed, the higher speed reduced both stick-slip and measurement bias. Test option 200 N and 0.30 m/s was the most reliable one in this experiment. It yielded lower friction coefficients than any other test option and reduced the likelihood of underestimating slip and fall hazards. The results implied that the minimum friction coefficient was 0.25 for preventing a fall on wet floor surfaces, whereas the limit for preventing a slip was in the range 0.30-0.35. Transitional friction measurement was found to be a valid and reliable indicator for slip resistance. A more accurate control of the normal force during testing is needed for actual field use of the test method. PMID:12504142

Grönqvist, Raoul; Hirvonen, Mikko; Rajamäki, Erkki; Matz, Simon

2003-03-01

377

Does Pain Catastrophizing Moderate the Relationship Between Spinal Nociceptive Processes and Pain Sensitivity?  

Microsoft Academic Search

Existing evidence indicates that pain catastrophizing is associated with enhanced pain reports and lower pain threshold\\/tolerance levels, but is not significantly related to nociceptive flexion reflex (NFR) threshold in healthy and clinical pain samples. This suggests pain catastrophizing may modulate pain threshold at a supraspinal level without influencing descending modulation of spinal nociceptive inputs. To examine this issue further, the

Jamie L. Rhudy; Christopher R. France; Emily J. Bartley; Amy E. Williams; Klanci M. McCabe; Jennifer L. Russell

2009-01-01

378

Parent perceptions of adolescent pain expression: The adolescent pain behavior questionnaire  

Microsoft Academic Search

Pain behaviors provide meaningful information about adolescents in chronic pain, enhancing their verbal report of pain intensity with information about the global pain experience. Caregivers likely consider these expressions when making judgments about their adolescents’ medical or emotional needs. Current validated measures of pain behavior target acute or procedural pain and young or non-verbal children, while observation systems may be

Anne M. Lynch-Jordan; Susmita Kashikar-Zuck; Kenneth R. Goldschneider

2010-01-01

379

Faces of Pain: Automated Measurement of Spontaneous Facial Expressions of Genuine and Posed Pain  

E-print Network

Faces of Pain: Automated Measurement of Spontaneous Facial Expressions of Genuine and Posed Pain to spontaneous facial expressions of pain. In this study, 26 participants were videotaped under three experimental conditions: baseline, posed pain, and real pain. In the real pain condition, subjects experienced

Bartlett, Marian Stewart

380

Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey  

Microsoft Academic Search

Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life. An international group of investigators assembled by a task force

Augusto Caraceni; Cinzia Martini; Ernesto Zecca; Russell K Portenoy; M. A. Ashby; G. Hawson; K. A. Jackson; N. Lickiss; N. Muirden; M. Pisasale; D. Moulin; V. N. Schulz; M. A. Rico Pazo; J. A. Serrano; H. S. Andersen; H. T. Henriksen; I. Mejholm; P. M. Sjogren; T. Heiskanen; E. Kalso; P. Pere; R. Poyhia; E. Vuorinen; I. Tigerstedt; P. Ruismaki; M. Bertolino; F. Larue; J. Y. Ranchere; G. Hege-Scheuing; I. Bowdler; F. Helbing; E. Kostner; L. Radbruch; K. Kastrinaki; S. Shah; S. Vijayaram; K. S. Sharma; P. S. Devi; P. N. Jain; P. V. Ramamani; A. Beny; C. Brunelli; M. Maltoni; S. Mercadante; R. Plancarte; S. Schug; P. Engstrand; A. F. Ovalle; X. Wang; M. F. Alves; M. R. Abrunhosa; W. Z. Sun; L. Zhang; A. Gazizov; M. Vaisman; S. Rudoy; M. G. Sancho; P. Vila; J. Trelis; P. Chaudakshetrin; M. L. Koh; R. T. M. van Dongen; A. Vielvoye-Kerkmeer; M. V. Boswell; T. Elliott; E. Hargus; L. Lutz

2004-01-01

381

Experimental muscle pain impairs descending inhibition  

PubMed Central

In chronic musculoskeletal pain conditions, the balance between supraspinal facilitation and inhibition of pain shifts towards an overall decrease in inhibition. Application of a tonic painful stimulus results in activation of diffuse noxious inhibitory controls (DNIC). The aims of the present experimental human study were (1) to compare DNIC, evoked separately, by hypertonic saline (6%)-induced muscle pain (tibialis anterior) or cold pressor pain; (2) to investigate DNIC evoked by concomitant experimental muscle pain and cold pressor pain, and (3) to analyze for gender differences. Ten males and 10 age matched females participated in two sessions. In the first session unilateral muscle pain or unilateral cold pressor pain were induced separately; in the second session unilateral muscle pain and unilateral cold pressor pain were induced concomitantly. Pressure pain thresholds (PPT) were measured around the knee joint before, during, and after DNIC induction. Cold pressor pain increased PPT in both males and females with greater increases in males. Hypertonic saline-evoked muscle pain significantly increased PPT in males but not in females. When cold pressor and muscle pain were applied concomitantly the PPT increases were smaller when compared to the individual sessions. This study showed for the first time that two concurrent conditioning tonic pain stimuli (muscle pain and cold pressor pain) cause less DNIC compared with either of the conditioning stimuli given alone; and males showed greater DNIC than females. This may explain why patients with chronic musculoskeletal pain have impaired DNIC. PMID:18977598

Arendt-Nielsen, Lars; Sluka, Kathleen A.; Nie, Hong Ling

2009-01-01

382

Imaging of Anterior Knee Pain  

Microsoft Academic Search

nterior knee pain (AKP) is a common complaint in primary care and orthopedic clinics. In fact, in the sports medicine clinic, up to 25% of patients with knee complaints have symptoms of anterior knee pain (1). Adolescent females and other young individuals are at particular risk for AKP. In these individuals, symptoms are usually related to increased use, fre- quently

Stephen R. Christian; M. Bret Anderson; Ronald Workman; William F. Conway; Thomas L. Pope

2006-01-01

383

Pain Management and the Amputee  

MedlinePLUS

... from Purdue Pharma L.P. A7158 6/03 Pain Management This Fact Sheet provides important—and practical—information ... you more information about your condition, treatment, and pain management. Remember: You have a right to ask questions ...

384

Studies with pain rating scales  

Microsoft Academic Search

Good correlation has been shown between pain scores derived from 4 different rating scales. The correlation was maintained when presentation of the scales was separated by a series of questions and by physical examination. There is good evidence that the 4 scales are measuring the same underlying pain variable as they calibrate well. There is also evidence that an 11-point

W W Downie; P A Leatham; V M Rhind; V Wright; J A Branco; J A Anderson

1978-01-01

385

Pain's Impact on Adaptive Functioning  

ERIC Educational Resources Information Center

Background: Pain interferes with the functioning of typical children, but no study has examined its effect on children with pre-existing intellectual disabilities (ID). Methods: Caregivers of 63 children observed their children for 2-h periods and recorded in 1-week diaries: pain presence, cause, intensity and duration. Caregivers also recorded…

Breau, L. M.; Camfield, C. S.; McGrath, P. J.; Finley, G. A.

2007-01-01

386

Patient education in pain control  

Microsoft Academic Search

Patients' concerns about reporting pain and using analgesics have been cited as major contributors to the problem of inadequate pain management. The purpose of this paper is to describe a program of research in which we have focused on these patient concerns, or as we refer to them, \\

S. Ward; S. Hughes; H. Donovan; R. Serlin

2001-01-01

387

Pain management in palliative care  

Microsoft Academic Search

A 58-year-old man who has cancer of the pancreas metastatic to lung and liver and who was initially diagnosed 8 months previously and treated with a Whipple procedure and chemotherapy presents to the emergency department with severe abdominal pain. His pain is located in the epigastrium and radiates bilaterally around to his back. He describes it as squeezing and rates

Loren L. Friedman; Phillip E. Rodgers

2004-01-01

388

Orofacial pain management: current perspectives  

PubMed Central

Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Temporomandibular disorders (TMD) are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities. PMID:24591846

Romero-Reyes, Marcela; Uyanik, James M

2014-01-01

389

Thomas Paine: Eighteenth Century Feminist  

ERIC Educational Resources Information Center

Unlike Franklin, Jefferson, and Adams, Thomas Paine was a feminist, a revolutionary in his time for the cause of women's rights and their liberation from servility. While others considered women second-class citizens whose only place was in the home. Paine argued for the political, legal, economic, and social rights of women. (Author/BC)

Harbison, John L.

1978-01-01

390

Chronic Pain and Exercise Therapy.  

ERIC Educational Resources Information Center

Aerobic and resistance exercise are currently prescribed by physicians to treat chronic pain. However, patient fitness level must improve before he/she feels better. Pain management programs help patients become more active so they can function at work and home. (SM)

Raithel, Kathryn Simmons

1989-01-01

391

Myofascial Pain, Fibromyalgia or Fibrositis?  

Microsoft Academic Search

The terms myofascial pain, fibromyalgia and fibrositis are critically examined. They constitute diagnostic labels for non-specific musculoskeletal aches and pains. Analysis of the evidence shows that none of these labels is substantiated by hard physical signs or by laboratory evidence of consistent pathological or biochemical abnormality. What is the objective evidence for disorder(s) of muscle, fascia or fibrous tissues, so

J. M. S. Pearce

2004-01-01

392

Hypnosis for Functional Abdominal Pain  

Microsoft Academic Search

Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other

David Gottsegen

2011-01-01

393

Pain: You Can Get Help  

MedlinePLUS

... Bingo games. But, at age 76, the constant pain she feels in her knees from osteoarthritis (joint disease) is starting to take a toll. It is also starting to keep her awake at night, leaving her feeling groggy and tired the next day. Sometimes, the pain stops her from doing the things she likes. ...

394

Improving Low Back Pain with Exercise  

MedlinePLUS

About seven out of every 10 adults develop back pain at least once in their lives. While most ... Medical School Commentary 2014-05-04 Acute Low Back Pain Persistent Low Back Pain An Exercise Prescription Keeping ...

395

Prevention: The Best Treatment for Back Pain  

MedlinePLUS

... Calculators AOA Partnerships Prevention: The Best Treatment for Back Pain Page Content A n estimated 50 million Americans ... prevent or eliminate back pain. Tips to Minimize Back Pain Here are some tips for preventing or minimizing ...

396

Disc Replacement for Low Back Pain  

MedlinePLUS

... for Low Back Pain Disc Replacement for Low Back Pain Page Content The evolution of disc replacement surgery may help select patients who have chronic low back pain. However, choosing which type of patient this procedure ...

397

[Pain management in radiation oncology].  

PubMed

The goal of this article is to propose some practical means of pain management in radiation departments. Pain management in radiation oncology is difficult because of the high proportion of painful patients, underestimation by medical teams, and limited therapeutic options. Pain can cause mobilization difficulties, set-up errors, treatment interruption. According to procedure steps, a preventive attitude (for pre-radiation consultation) or an active attitude (for treatment) to quickly relieve the patient can be planned. This work is a brain storming about pain management. It is not a review about analgesic radiotherapy. The practical situations apply to patients to whom radiotherapy is indicated. Teamwork and anticipation are keywords to relieve patients. All proposed means are not always available for different reasons (time, finance, staff, training). The idea is to establish simple procedures that are appropriate to each center to fluidify acts, to optimize time for a successful irradiation. PMID:23948427

Feuvret, L; Cuenca, X; Lavaud, P; Anane, S; Colin, E

2013-10-01

398

Pain—Mechanisms and Management  

PubMed Central

In the past two decades there has been remarkable progress in understanding the neural mechanisms of pain. However, chronic pain is poorly understood and, by definition, poorly managed. In addition to hyperactivity of the sympathetic nervous system and damage to normal inhibitory mechanisms, social and psychological factors play a major role in producing the disability of chronic pain. New approaches to manage chronic pain include nonopiate drugs, transcutaneous electral nerve stimulation and psychological and behavioral methods. A nervous system network has recently been described that suppresses pain. This analgesic action is mediated by endogenous opioid peptides (endorphins) and by biogenic amines. The analgesia network can be activated either by electral stimulation or by opiates such as morphine or methadone. Images PMID:6209862

Fields, Howard L.; Levine, Jon D.

1984-01-01

399

Back pain in athletes.  

PubMed Central

There were one hundred and ninety seven patients who presented with back pain to an Athletes Clinic over four years. Their mode of presentation, investigations, diagnoses and treatments are analysed. The majority of patients were male and below 30 years of age. The average duration of symptoms prior to presentation, despite an easy access policy, was 42 weeks. Injury was usually related to six popular sports. Radiological examination was a rewarding investigation in these patients and included an A-P view of the pelvis. The diagnostic label of prolapsed intervertebral disc appears to have been used too frequently. Physiotherapy was the most useful treatment modality regardless of age, mode of onset and duration of symptoms. Images p159-a p159-b Fig. 1 Fig. 2 Fig. 3 PMID:6237708

Cannon, S. R.; James, S. E.

1984-01-01

400

Pain and other symptoms in cancer survivors.  

PubMed

Pain is common in cancer survivors. Long-term pain, often of neuropathic origin, is common after operations, radiotherapy, and chemotherapy. Pain and other concomitant symptoms and side effects should be assessed with validated and reliable scales and questionnaires. Cancer survivors with severe pain should be seen by a pain specialist. Multidisciplinary rehabilitation and individualized pain management may improve quality of life in cancer survivors. Four case reports are presented to illustrate this. PMID:24801977

Westerling, Dagmar

2014-06-01

401

Clinical use of opioids for cancer pain  

Microsoft Academic Search

Successful management of pain in the cancer patient requires careful assessment of the components of the pain complaint and\\u000a accurate diagnosis of the cause of pain. Symptomatic management of pain involves pharmacotherapeutic strategies that focus\\u000a on opioid use. Factors influencing the choice of opioid in patients with cancer pain include the severity of pain, the presence\\u000a of coexisting disease, response

Dermot R. Fitzgibbon

2007-01-01

402

Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability  

Microsoft Academic Search

There is growing evidence for the idea that in back pain patients, pain-related fear (fear of pain\\/physical activity\\/(re)injury) may be more disabling than pain itself. A number of questionnaires have been developed to quantify pain-related fears, including the Fear-Avoidance Beliefs Questionnaire (FABQ), the Tampa Scale for Kinesiophobia (TSK), and the Pain Anxiety Symptoms Scale (PASS). A total of 104 patients,

Geert Crombez; Johan W. S Vlaeyen; Peter H. T. G Heuts; Roland Lysens

1999-01-01

403

Feynman's Achilles' Heel?  

NASA Astrophysics Data System (ADS)

Feynman1 argued that a ratchet of the type used in heavy machinery could be used, in a scaled-down version, to show that the second law of thermodynamics is not just a statistical law, but has absolute status. Hidden is the assumption that this model represented the completely general example of this device—and that it remained so, across the complete range of magnitudes from macro- to micro-domains. It will be argued here, that Feynman's example is only one construct of a ratchet and cannot represent the general case. A mechanism, with sufficient difference and confined to the micro-domain, is the subject of the present discussion. Its unique feature is the compressible nature of the pawl as it librates in pawl-space. The motions of the gear and the pawl are governed by the energy exchanges between them and with the ambient gas. The average linear pressure on the pawl which varies with the magnitude of pawl-space is associated with the compressibility of the pawl. Feynman's objective was to show that the prototypal ratchet is incapable of converting heat into work in a manner contrary to the second law. The dubious nature of his examination is not due to an incorrect analysis of his thought experiment, but lies within the assumption that his example represented the general case. In contrast, the ratchet analyzed here does not conform to the principle of detailed balance and thereby the absolute status of the law remains an open question.

Gordon, Lyndsay G. M.

2011-12-01

404

Calcaneus (Heel Bone) Fractures  

MedlinePLUS

... may persist a er recovery include: • Skin irritation. Footwear can irritate the skin or tendons in the ... 7 ) AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided ...

405

[Neurobiology of the chronicisation of pain in children: the memory of pain and its painful memory].  

PubMed

Reviewing the development of nociceptive circuits provides the rationale behind the need to modify and reduce premature painful experiences, especially during the "plastic" neonatal phase. Indeed, if physiological mechanisms of the functional nociceptive system follow a harmonious and predetermined development, it is the individual personal experience, intrinsically random, which will shape the final reactivity of this system and the later painful experience. If pain would not have been the organism's alarm system, we could have simply compared it by analogy to other sensorial systems, which its development depends exclusively on the presence of environmental stimuli. The eyes wait for light, the ears for sound, the skin to be touched, the tongue to taste and the olfactory bulbs to smell. However with pain it is not the quantitative exposure that determines its development, but rather the context-laden aspects of its affliction which in turn create the complex experience and "memory" of pain. Prolonged, but also "unnecessary" exposure to pain transforms it into a futile sensation, which impacts the individual immediately but also resonates into its future. This article reviews recent neurobiological mechanisms (such as neural circuitry, neurotrophins, peripheral and central sensitization, inhibitory pathways) now known to develop during the chronicisation and apprenticing of pain in the growing individual. Its cognizance is vital for a better comprehension of adult pain. PMID:17524600

Cahana, A; Jones, D

2007-06-01

406

Predictors of Genital Pain in Young Women  

PubMed Central

Despite the high prevalence of genital pain in healthy young adult women, limited research has addressed genital pain during intercourse using contemporary models of multidimensional sexual function. The objectives of this study were threefold: (1) to identify differences in sexual functioning in women who experience genital pain compared to pain free women; (2) to identify predictors of sexual functioning in women with and without genital pain; and (3) to identify predictors of sexual satisfaction in women with and without genital pain. Sexually active female undergraduates (n = 651) were administered the Female Sexual Function Index and the Derogatis Sexual Functioning Inventory. We evaluated the sexual factors that impact the sexual function of women with any pain (including high and low pain groups) versus women with no history of pain. Women with genital pain reported greater rates of sexual dysfunction as compared to pain-free women; however, sexual functioning in the high versus low pain groups was distinguished primarily by vaginal lubrication. Women in the high pain group showed negative correlations between domains of sexual satisfaction and genital pain frequency and intensity that were not found in the low pain group. For pain-free women, intercourse played a strong role in sexual satisfaction, whereas non-intercourse sexual behavior was central to sexual satisfaction in women who reported pain. The evaluation of levels of genital pain may provide insight into the mechanisms underlying the impairment of sexual function, sexual behavior, and sexual satisfaction. PMID:17674182

Farmer, Melissa A.; Meston, Cindy M.

2010-01-01

407

Therapeutic opportunities for targeting cold pain pathways.  

PubMed

Cold pain is a frequent symptom in neuropathic pain. Compared to other pain modalities, such as heat pain, the mechanisms behind physiological and pathological cold pain remain elusive. Moreover, it is becoming increasingly evident that cold pain pharmacology differs between various neuropathic pain conditions, making mechanism-directed treatment based on an understanding of the underlying pathophysiological mechanisms imperative to achieving clinical success. Here we review the processes of physiological and abnormal cold sensing, the pharmacology of cold nociception, cold hyperalgesia and cold allodynia, and provide an overview of cold pain syndromes and their current and potential treatments. PMID:25316567

Yin, Kathleen; Zimmermann, Katharina; Vetter, Irina; Lewis, Richard J

2015-01-15

408

The multilevel organization of vicarious pain responses: effects of pain cues and empathy traits on spinal nociception and acute pain.  

PubMed

The shared-representation model of empathy suggests that vicarious pain processes rely partly on the activation of brain systems underlying self-pain in the observer. Here, we tested the hypothesis that self-pain may be facilitated by the vicarious priming of neural systems underlying pain perception. Pictures illustrating painful agents applied to the hand or the foot (sensory information), or painful facial expressions (emotional information) were shown to 43 participants to test the effects of vicarious pain on the nociceptive flexion reflex (NFR) of the lower limb and pain intensity and unpleasantness produced by transcutaneous electrical stimulation applied over the sural nerve. Results confirmed the expected priming effects of vicarious pain on spinal and perceptual processes. However, for comparable pain intensity and arousal evoked by the pain pictures, the facilitation of the NFR and the self-pain unpleasantness measurements was more robust in response to pictures depicting pain sensory compared to emotional information. Furthermore, the facilitation of the NFR by pain pictures was positively correlated with the empathy trait of the observer. In contrast, the change in perceived shock-pain intensity was negatively correlated with empathic traits. This dissociation implies that low-level vicarious priming processes underlying pain facilitation may be downregulated at higher pain-processing stages in individuals reporting higher levels of empathy. We speculate that this process contributes to reducing self-other assimilation and is necessary to adopt higher-order empathic responses and altruistic behaviors. PMID:21439727

Vachon-Presseau, Etienne; Martel, Marc O; Roy, Mathieu; Caron, Etienne; Jackson, Philip L; Rainville, Pierre

2011-07-01

409

Neurovascular Unit in Chronic Pain  

PubMed Central

Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU) has been recently proposed. In particular, the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB), two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment. PMID:23840097

Radu, Beatrice Mihaela; Bramanti, Placido; Osculati, Francesco; Flonta, Maria-Luisa; Radu, Mihai; Bertini, Giuseppe; Fabene, Paolo Francesco

2013-01-01

410

Relief of Pain and Suffering  

NSDL National Science Digital Library

The symposium and exhibit titled Pain and Suffering in History - Narrative Science, Medicine and Culture marks the dedication of the John C. Liebeskind History of Pain Collection at the Louise M. Darling Biomedical Library, UCLA. The Relief of Pain and Suffering site, prepared in conjunction with the aforementioned symposium and exhibit, gives us plenty for which to be thankful in terms of advancements in the area of pain management. Tracing the modern roots of this field back to the nineteenth century and earlier, users can view historical pictures of botanicals, tools, and early writings all related to the alleviation of pain and suffering. Descriptions of syndromes like phantom limbs and causalgia abound as users travel towards the 21st century. Modern methods discussed include interdisciplinary team approaches to pain management and the Hospice movement's philosophies on pain treatment. Users can navigate the site in a variety of ways: through a series of topical links off of the main page, by moving through the site using arrow buttons, or through an index of illustrations and keywords. A final page of links to professional organizations related to the field nicely rounds out the site.

1998-01-01

411

Abnormal Pain Modulation in Patients with Spatially Distributed Chronic Pain: Fibromyalgia  

PubMed Central

Many chronic pain syndromes including fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, migraine headache, chronic back pain, and complex regional pain syndrome are associated with hypersensitivity to painful stimuli and with reduced endogenous pain inhibition. These findings suggest that modulation of pain-related information may be related to the onset and/or maintenance of chronic pain. Although pain sensitivity and pain inhibition are normally distributed in the general population, they are not useful as reliable predictors of future pain. The combination of heightened pain sensitivity and reduced pain-inhibition, however, appears to predispose individuals to greater risk for increased acute clinical pain (e.g., postoperative pain). It is unknown at this time whether such pain processing abnormalities may also place individuals at increased risk for chronic pain. Psychophysical methods, including heat sensory and pressure pain testing have become increasingly available and can be used for the evaluation of pain sensitivity and pain inhibition. However, long-term prospective studies in the general population are lacking which could yield insight into the role of heightened pain sensitivity and pain disinhibition for the development of chronic pain disorders like fibromyalgia. PMID:19647141

Staud, Roland

2009-01-01

412

Chronic abdominal pain in children.  

PubMed

Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists, and surgical specialists. Chronic abdominal pain in children is usually functional, that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion. The subcommittee examined the diagnostic and therapeutic value of a medical and psychological history, diagnostic tests, and pharmacologic and behavioral therapy. The presence of alarm symptoms or signs (such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea, and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache, and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems, or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive. PMID:15741363

2005-03-01

413

[Perception and attitude toward pain].  

PubMed

Traditionally, the pain sends back to the infringement of the flesh and the suffering on the infringement of the psyche. The relation of care and the accompanying are due to nature a social fact of relation. In the right line of a first study (Péoc'h et al., 2007) concerning professional representations of health care professionals with respect to the care of the pain, we studied in the context of the theoretical model of the "social thought" (Rouquette, 1973), attitudes, perceptions and the ideological positions of patients about their pain's living. 244 patients hospitalized within the Hospitals of Toulouse have completed a questionnaire included free associations tasks, attitude answers, and answers concerning the ideological dimension of pain (beliefs, religious or anthropological orientation), in fine, a fourth party entered into a phenomenological perspective. The object "pain" will be suspected under the angle of the consciousness and the lived of the patient by using the protocol of the "narrative story of life" (Le Grand, 1989), with a praxeological design. Results indicate that the conceptions of the pain proposed by the patient make references to two different areas: that of the body (evil, handicap) and that of the psyche (evil-being, suffering). The term suffering reveal the social face of the pain in a double constituent: existential (solitude, incomprehension) and ideological (" it is necessary to take its evil in patience ", P = 73,3 %; chi2 = 39,83, p. < .05). The representation universe of the pain comes along with a certain indecision between these two events of the disease : pain versus suffering. PMID:23091918

Péoc'h, Nadia

2012-09-01

414

Evidence Based Practice of Chronic Pain  

PubMed Central

The patients with chronic pain are increasingly reporting to the physicians for its management. Chronic pain are associated with head, neck and shoulder pain, spinal pain, pain in the joints and extremities, complex regional pain syndrome and phantom pain. The chronic pain is being managed worldwide. The different specialty of medicine is producing a lot of evidence through the published literature but the same is not being published in the field of chronic pain management. Though some evidence is being reported as to different aspects of pain management from different parts of the world but same is lacking from Indian subcontinent. This is in contrast to much done clinical work in this field as well. We present here the available evidence in relation to chronic pain management. PMID:23439674

Garg, Rakesh; Joshi, Saurabh; Mishra, Seema; Bhatnagar, Sushma

2012-01-01

415

Chronic abdominal pain in children.  

PubMed

Chronic abdominal pain in children is usually not caused by organic disease. Diagnostic triage focuses on the assessment of alarm symptoms by means of history and physical examination. Additional diagnostic evaluation is not required in children without alarm symptoms. Family characteristics have an important influence on the chronicity of abdominal pain. A specific intervention is not recommended owing to lack of evidence of a beneficial effect. The greatest challenge is to identify children at risk of a prolonged course of pain and its correlated functional disability. The evaluation of family for coping strategies, psychosocial factors and appropriate follow-up can prevent ineffective use of healthcare resources. PMID:22886462

Singh, Utpal Kant; Prasad, Rajniti; Verma, Nishant

2013-02-01

416

Painful feet in rheumatoid arthritis.  

PubMed

Pain in the feet is an important diagnostic feature and a major management problem of rheumatoid arthritis. Of 50 hospitalized patients, 28% recalled painful feet as the sole presenting symptom of their disease.RHEUMATOID DISEASE COMMONLY AFFECTS THE FEET: 90% of the patients studied complained of foot pain at some time during the course of their disease, 86% had clinical involvement and 92% had radiological changes in their feet.The forefoot is most frequently involved. Midfoot involvement was noted in 68% but was symptomatic in only 22%. Changes in the ankle were least common but always symptomatic. PMID:4746132

Minaker, K; Little, H

1973-10-20

417

Somatic Pain Sensitivity in Children With Recurrent Abdominal Pain  

Microsoft Academic Search

OBJECTIVE:Evidence is accumulating that recurrent abdominal pain (RAP) in children is associated with visceral hyperalgesia. However, it is not known whether somatic sensitivity is altered as well. Therefore, the aim of our study was to assess somatic pain sensitivity in children with RAP and healthy controls at the abdomen and a distal site (thenar).METHODS:We examined 20 children with RAP (age

Katrin Zohsel; Johanna Hohmeister; Herta Flor; Christiane Hermann

2008-01-01

418

Glia and pain: Is chronic pain a gliopathy?  

PubMed Central

Activation of glial cells and neuro-glial interactions are emerging as key mechanisms underlying chronic pain. Accumulating evidence has implicated 3 types of glial cells in the development and maintenance of chronic pain: microglia and astrocytes of the central nervous system (CNS), and satellite glial cells of the dorsal root and trigeminal ganglia. Painful syndromes are associated with different glial activation states: (1) glial reaction (ie, upregulation of glial markers such as IBA1 and glial fibrillary acidic protein (GFAP) and/or morphological changes, including hypertrophy, proliferation, and modifications of glial networks); (2) phosphorylation of mitogen-activated protein kinase signaling pathways; (3) upregulation of adenosine triphosphate and chemokine receptors and hemichannels and downregulation of glutamate transporters; and (4) synthesis and release of glial mediators (eg, cytokines, chemokines, growth factors, and proteases) to the extracellular space. Although widely detected in chronic pain resulting from nerve trauma, inflammation, cancer, and chemotherapy in rodents, and more recently, human immunodeficiency virus-associated neuropathy in human beings, glial reaction (activation state 1) is not thought to mediate pain sensitivity directly. Instead, activation states 2 to 4 have been demonstrated to enhance pain sensitivity via a number of synergistic neuro-glial interactions. Glial mediators have been shown to powerfully modulate excitatory and inhibitory synaptic transmission at presynaptic, postsynaptic, and extrasynaptic sites. Glial activation also occurs in acute pain conditions, and acute opioid treatment activates peripheral glia to mask opioid analgesia. Thus, chronic pain could be a result of “gliopathy,” that is, dysregulation of glial functions in the central and peripheral nervous system. In this review, we provide an update on recent advances and discuss remaining questions. PMID:23792284

Ji, Ru-Rong; Berta, Temugin; Nedergaard, Maiken

2013-01-01

419

Imaging the pain of low back pain: functional magnetic resonance imaging in combination with monitoring subjective pain perception  

E-print Network

Imaging the pain of low back pain: functional magnetic resonance imaging in combination to generate predictor waveforms with which related brain activity can be identi®ed. Chronic low back pain-leg raising procedure is performed to exacerbate the back pain. In the normal volunteer, fMRI scans were done

Apkarian, A. Vania

420

The pain interactome: Connecting pain-specific protein interactions.  

PubMed

Understanding the molecular mechanisms associated with disease is a central goal of modern medical research. As such, many thousands of experiments have been published that detail individual molecular events that contribute to a disease. Here we use a semi-automated text mining approach to accurately and exhaustively curate the primary literature for chronic pain states. In so doing, we create a comprehensive network of 1,002 contextualized protein-protein interactions (PPIs) specifically associated with pain. The PPIs form a highly interconnected and coherent structure, and the resulting network provides an alternative to those derived from connecting genes associated with pain using interactions that have not been shown to occur in a painful state. We exploit the contextual data associated with our interactions to analyse subnetworks specific to inflammatory and neuropathic pain, and to various anatomical regions. Here, we identify potential targets for further study and several drug-repurposing opportunities. Finally, the network provides a framework for the interpretation of new data within the field of pain. PMID:24978826

Jamieson, Daniel G; Moss, Andrew; Kennedy, Michael; Jones, Sherrie; Nenadic, Goran; Robertson, David L; Sidders, Ben

2014-11-01

421

Study of experimental pain measures and nociceptive reflex in chronic pain patients and normal subjects.  

PubMed

This study evaluates (i) the effect of heterotopic chronic pain on various experimental pain measures, (ii) the relationship between experimental pain measures and chronic pain symptomatology assessment, and (iii) the influence of the various pain aetiologies on experimental pain measures. Fifty-three chronic pain patients were compared to 17 pain-free subjects with the following psychophysical and physiological indices: pain threshold (PTh), pain tolerance (PTol), verbal estimation of intensity and unpleasantness (intensity scale, IS; unpleasantness scale, US), threshold for intensity and unpleasantness (ITh and UTh), lower limb RIII nociceptive reflex (RIIITh and RIII frequency of occurrence). Chronic pain syndromes included neuropathic pain (n = 12), iodopathic pain (n = 12), myofascial syndromes (n = 9), headache (n = 9), and miscellaneous pain (n = 11). Chronic pain symptomatology was assessed with a visual analogue scale (VAS), a French MPQ adaptation (QDSA), Beck Depression Inventory (BDI), Spielberger State Trait Inventory (STAI) and Eysenck Personality Inventory (EPI). No significant difference was observed between chronic pain patients and pain-free control groups and between patient subgroups for PTh, PTol and RIIITh. No significant correlation was found between experimental pain measures and clinical pain, anxiety or depression scores. However, the chronic pain patients had a higher threshold for unpleasantness and judged the suprathreshold stimuli significantly less intense and less unpleasant than the control group. These results are discussed in relation to diffuse noxious inhibitory controls and the adaptation level theory of chronic pain experience. PMID:2052379

Boureau, F; Luu, M; Doubrère, J F

1991-02-01

422

The painful accessory navicular.  

PubMed

The accessory navicular is usually considered a normal anatomic and roentgenographic variant. The term may refer to two distinct patterns. First, a sesamoid bone may be present within the posterior tibial tendon (Type 1); this is anatomically separate from the navicular. Second, an accessory ossification center may be medial to the navicular (Type 2). During postnatal development this is within a cartilaginous mass that is continuous with the cartilage of the navicular. At skeletal maturity the accessory center usually fuses with the navicular to form a curvilinear bone. The Type 2 pattern may be associated with a painful foot, particularly in the athletic adolescent, and should not be arbitrarily dismissed as a roentgenologic variant in the symptomatic patient. The clinical, radiologic, pathologic, and surgical findings in ten cases are reviewed. Roentgenographically the ossicle is triangular or heart-shaped. 99mTc MDP imaging may be of value when the significance of the ossicle is uncertain. Even when the roentgenographic variant is bilateral, increased radionuclide activity occurs only on the symptomatic side. Histologic examination of surgically excised specimens reveals inflammatory chondro-osseous changes in the navicular-accessory navicular synchondrosis compatible with chronic trauma and stress fracture. Nonsurgical treatment with orthotics or cast immobilization produces variable results and resection of the accessory navicular may be the treatment of choice. PMID:6239377

Lawson, J P; Ogden, J A; Sella, E; Barwick, K W

1984-01-01

423

Non-Cardiac Chest Pain  

MedlinePLUS

... been termed “Esophageal or visceral hypersensitivity” (enhanced esophageal perception or sensitivity to balloon distension). Although the cause ... can be used to improve this exaggerated pain perception. Non-esophageal Causes of NCCP NCCP is a ...

424

Functional Abdominal Pain in Children  

MedlinePLUS

... be intermittent (recurrent abdominal pain or RAP) or continuous. Although the exact cause is not known, nerve ... fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological ...

425

Why Does the Pain Remain?  

NSDL National Science Digital Library

First monthly installment of our "What A Year!" website project, introducing life science breakthroughs to middle and high school students and their teachers. This issue is on complex regional pain syndrome 1.

2006-09-01

426

Psychosexual aspects of vulvovaginal pain.  

PubMed

Vulvovaginal pain problems are major health concerns in women of childbearing age. Controlled studies have shown that vulvovaginal pain can adversely affect women and their partners' general psychological well-being, relationship adjustment, and overall quality of life. These women have significantly lower levels of sexual desire, arousal, and satisfaction, as well as a lower intercourse frequency than normal controls. They also report more anxiety and depression, in addition to more distress about their body image and genital self-image. Empirical studies indicate that specific psychological and relationship factors may increase vulvovaginal pain intensity and its psychosexual sequelae. Randomized clinical trials have shown that psychosexual interventions, namely cognitive-behavioral therapy (CBT), are efficacious in reducing vulvovaginal pain and improving associated psychosexual outcomes. Women reporting significant psychological, sexual, and/or relationship distress should be referred for psychosexual treatment. A multimodal approach to care integrating psychosexual and medical management is thought to be optimal. PMID:25104563

Bergeron, Sophie; Likes, Wendy M; Steben, Marc

2014-10-01

427

Management of chronic pelvic pain.  

PubMed

Chronic pelvic pain (CPP) is a common complaint of women presenting for gynecologic and primary care. Evaluation of CPP requires obtaining a careful history including not only obstetrical and gynecologic information but also screening for gastrointestinal, urologic, musculoskeletal, and neurological disorders. A detailed physical examination is also necessary. Management of CPP depends largely on the cause. Gynecologic causes include endometriosis, pelvic inflammatory disease, adhesive disease, pelvic congestion syndrome, ovarian retention syndrome, ovarian remnant syndrome, adenomyosis, and leiomyomas. Some non-gynecologic causes are interstitial cystitis/painful bladder syndrome, irritable bowel syndrome, pelvic floor tension myalgia, and abdominal myofascial pain syndrome. Treatments may be directed toward specific causes or may be targeted to general pain management. The most effective therapy may involve using both approaches. The diagnosis and treatment of each of the above disorders, and the management of CPP itself, is discussed. PMID:20938429

Benjamin-Pratt, A R; Howard, F M

2010-10-01

428

Pain Management for Psoriatic Arthritis  

MedlinePLUS

... exercise choices that are easier on the joints. Acupuncture —Some studies show acupuncture is a valuable option for pain relief. Kelly Olbekson, of Cheney, Wash., uses acupuncture, combined with an anti-inflammatory diet and NSAIDs ...

429

Splanchnicectomy for Pancreatic Cancer Pain  

PubMed Central

Persistent pain is a serious problem that often contributes to a poor quality of life in pancreatic cancer patients. Medical management by opioid analgesics is often accompanied by side effects and incomplete pain relief. A celiac plexus block is a simple treatment which relieves pain, but the procedure demands a certain degree of proficiency and the duration of the effects obtained can be rather limited. Transhiatal bilateral splanchnicectomy achieves a certain denervation of splanchnic nerves, but it requires a laparotomy. Unilateral thoracoscopic splanchnicectomy is a minimally invasive procedure to cause definite denervation. Bilateral thoracoscopic splanchnicectomy is recommended for unsatisfactory cases or recurrent pain occurring after the initial unilateral splanchnicectomy. It is important to select the most suitable treatment depending on patients' actual medical state and the predicted outcomes. PMID:24868557

Masuda, Toshiro; Kuramoto, Masafumi; Shimada, Shinya; Ikeshima, Satoshi; Yamamoto, Kenichiro; Nakamura, Kenichi; Baba, Hideo

2014-01-01

430

Anterior Knee Pain (Chondromalacia Patellae).  

ERIC Educational Resources Information Center

This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

Garrick, James G.

1989-01-01

431

Vertebral pain in helicopter pilots  

NASA Technical Reports Server (NTRS)

Pathological forms of spinal pain engendered by piloting helicopters were clinically studied. Lumbalgia and pathology of the dorsal and cervical spine are discussed along with their clinical and radiological signs and origins.

Auffret, R.; Delahaye, R. P.; Metges, P. J.; VICENS

1980-01-01

432

The Fear of Pain Questionnaire (FOPQ): Assessment of Pain-Related Fear Among Children and Adolescents With Chronic Pain  

Microsoft Academic Search

An important construct in understanding pain-related disability is pain-related fear. Heightened pain-related fear may result in behavioral avoidance leading to disuse, disability, and depression; whereas confrontation of avoided activities may result in a reduction of fear over time and reengagement with activities of daily living. Although there are several measures to assess pain-related fear among adults with chronic pain, none

Laura E. Simons; Christine B. Sieberg; Elizabeth Carpino; Deirdre Logan; Charles Berde

2011-01-01

433

Assessing Persistent Cancer Pain: A Comparison of Current Pain Ratings and Pain Recalled from the Past Week  

PubMed Central

Recent guidelines developed by the U.S. Food and Drug Administration for the use of patient-reported outcomes discuss the rating of pain and other symptoms at their current level of severity versus rating these symptoms using a recall period, such as the past 24 hours or past week. To explore whether the overall experience of cancer patients is better represented by ratings of current pain or by pain recalled from the past week, we conducted a secondary analysis of Eastern Cooperative Oncology Group data from 1,147 cancer patients who had reported having persistent pain during the past week. Patients used the Brief Pain Inventory (BPI) to rate their current pain along with their pain at its worst, least, and average during the past week. T-tests were used to compare ratings of current pain and pain recalled from the past week. Linear regressions described the extent to which the various pain ratings contributed to overall pain interference, also derived from the BPI. Overall, patients rated their current pain as less severe than their worst or average pain recalled from the past week. Worst pain recalled from the past week contributed most to ratings of pain interference. These findings indicate that ratings of recalled worst pain, rather than ratings of current pain, might better reflect the overall experience of pain and its impact on function in cancer patients with persistent pain. Our results provide information that might guide the choice of recall period for cancer clinical trials with pain as a self-reported outcome. PMID:18676116

Shi, Qiuling; Wang, Xin Shelley; Mendoza, Tito R.; Pandya, Kishan J.; Cleeland, Charles S.

2009-01-01

434

Pain Assessment in Pediatric Sickle Cell Disease  

Microsoft Academic Search

The unpredictability of pain occurrence and the subjectivity of sickle cell pain create unique challenges in the assessment of pediatric sickle cell disease. A description and critique of current pain assessment measures, including verbal, motoric, and physiological-medical indices, and their applications with this population are provided. Pain assessment measures and corresponding research with pediatric sickle cell disease patients were found

Julie Stollger Jones; Steven A. Hobbs; Tara L. Brennan; Jennifer Maxwell Schmidt

2005-01-01

435

A Biopsychosocial Formulation of Pain Communication  

Microsoft Academic Search

We present a detailed framework for understanding the numerous and complicated interactions among psychological and social determinants of pain through examination of the process of pain communication. The focus is on an improved understanding of immediate dyadic transactions during painful events in the context of broader social phenomena. Fine-grain consideration of social transactions during pain leads to an appreciation of

Thomas Hadjistavropoulos; Kenneth D. Craig; Steve Duck; Annmarie Cano; Liesbet Goubert; Philip L. Jackson; Jeffrey S. Mogil; Pierre Rainville; Michael J. L. Sullivan; Amanda C. de C. Williams; Tine Vervoort; Theresa Dever Fitzgerald

2011-01-01

436

Radiofrequency ablation for chronic pain control  

Microsoft Academic Search

With an increased knowledge of neural anatomy and technologic improvement, radiofrequency ablation (RFA) became an often-used\\u000a technique for the pain control over an extended time period. Today, RFA is used safely for spinal pains of facet or discogenic\\u000a origin, sympathetically maintained pain, and other pains of neural origin.

Leonardo Kapural; Nagy Mekhail

2001-01-01

437

downloadthisbrochure Persistent Post-surgical Pain  

E-print Network

downloadthisbrochure Persistent Post-surgical Pain a Model for the study of chronic Pain Target to persistent post-surgical pain and acquire the knowledge in this area · identify implications, indications and interpretation of persistent post-surgical pain · Discuss the concept of and difficulties surrounding the study

Hitchcock, Adam P.

438

Opioids for Chronic Non-Cancer Pain  

E-print Network

Opioids for Chronic Non-Cancer Pain: Using the Canadian Guideline inYour Practice Subject Matter Experts: Allison Blain, BSc, BEd, MD, FRCPC Anesthesiologist and Chronic Pain Specialist, Hamilton Health Sciences, Pain Management Centre, Hamilton, ON. General Hospital, Minerva Pain Management Centre, Hamilton

Haykin, Simon

439

Exploring the Relationship Between Pain and Perception  

Microsoft Academic Search

It is the goal of this paper to contribute to the conceptual understanding of pain. We specifically explore the relationship between pain and perception, surveying three philosophical works that define pain somehow or other in terms of perception. We critique this work and also explore some of its empirical implications. We briefly consider for each of these accounts how pain

Alice I. Kyburg

440

PAIN MEDICINE Volume 6 Number 4 2005  

E-print Network

PAIN MEDICINE Volume 6 · Number 4 · 2005 © American Academy of Pain Medicine 1526-2375/05/$15.00/327 327­328 Blackwell Science, LtdOxford, UKPMEPain Medicine1526-2375American Academy of Pain Medicine H. Guarino, MD, Washington University School of Medicine, Department of Anesthesi- ology, Pain

Steinbach, Joe Henry

441

Pediatric and Adolescent Gastrointestinal Motility & Pain Program  

E-print Network

or inflammation. There are several pediatric functional gastrointestinal disorders associated with abdominal pain cramp, functional abdominal pain is a symptom that falls within the expected range of behaviors old enough to give accurate pain histories may have the same functional abdominal pain disorders

442

Hypnotherapy for the Management of Chronic Pain  

Microsoft Academic Search

This article reviews controlled prospective trials of hypnosis for the treatment of chronic pain. Thirteen studies, excluding studies of headaches, were identified that compared outcomes from hypnosis for the treatment of chronic pain to either baseline data or a control condition. The findings indicate that hypnosis interventions consistently produce significant decreases in pain associated with a variety of chronic-pain problems.

Gary Elkins; Mark P. Jensen; David R. Patterson

2007-01-01

443

Recent advances in the treatment of pain  

PubMed Central

Cancer pain and chronic non-malignant pain can be difficult to manage and may not respond satisfactorily to standard analgesics. Sequential empiric analgesic trials are usually done to manage individual patients. Experimental human pain models have helped to clarify mechanisms of opioid and adjuvant analgesic actions. Combinations of opioids and adjuvant analgesics better relieve pain than either opioids or adjuvant analgesics alone, as demonstrated in randomized controlled trials. The analgesic activity of antidepressants is largely dependent upon norepinephrine reuptake and activation of alpha 2 adrenergic receptors. Corticosteroids reduce postoperative orthopedic incident pain, which may allow patients to ambulate earlier and with less pain. Spinal corticosteroids reduce lower hemibody pain. Gabapentinoids as single high doses reduce postoperative pain and certain acute pain syndromes. Individuals who experience flares of pain while on spinal opioids benefit from intrathecal boluses of levobupivicaine or sublingual ketamine. Interventional approaches to pain management are often necessary due to the limitations of systemic analgesics. Electronics stimulators (peripheral, spinal and motor cortex) improve difficult to manage chronic pain syndromes. Pulsed radiofrequency reduces pain without tissue damage, which could be an advantage over chemical or radiofrequency neurotomy. Botulinum toxin A reduces focal neuropathic pain that is durable. Interventional related successes in relieving pain are operator dependent. Most reported benefits of systemic and regional analgesics and interventional approaches to pain relief are not based on randomized trials and are subject to selection bias, sampling error, and placebo responses, which may over-inflate reported benefits. Randomized controlled trials are needed to confirm reported benefits. PMID:21173850

2010-01-01

444

How Do Pain Relievers Work? (For Kids)  

MedlinePLUS

... Main Page The Pink Locker Society How Do Pain Relievers Work? KidsHealth > Kids > Q&A > Q & A > How Do Pain Relievers Work? Print A A A Text Size Yow! ... dad may have given you medicine called a pain reliever. The two pain relievers kids take most often ...

445

Pain Coping Strategies in Osteoarthritis Patients.  

ERIC Educational Resources Information Center

Investigated the relation of pain coping strategies to pain, health status, and psychological distress in a group of osteoarthritis patients with chronic pain. Patients completed various questionnaires. Medical status variables were also used. The Pain Control and Rational Thinking factor derived from the Coping Strategies Questionnaire proved to…

Keefe, Francis J.; And Others

1987-01-01

446

Functional Magnetic Resonance Imaging of Pain Consciousness  

E-print Network

reflex sympathetic dystrophy (RSD) and chronic back pain. The review emphasizes that differentFunctional Magnetic Resonance Imaging of Pain Consciousness: Cortical Networks of Pain Critically Depend on What is Implied by "Pain" A. Vania Apkarian, PhD Address SUNY Health Science Center, Department

Apkarian, A. Vania

447

Chronic and Recurrent Pelvic Pain  

Microsoft Academic Search

\\u000a Chronic and recurrent pelvic pain (CPP) in ­children and adolescents has been recognized for decades. However, data on the\\u000a etiology, natural history, treatment, and long-term consequences of painful pelvic conditions in these patients are lacking.\\u000a The problem’s prevalence remains uncertain, and the majority of therapies are extrapolated from research on adults. The normal\\u000a developmental changes and coping strategies of children

Lynda Wells

448

Dental pain in the elderly  

Microsoft Academic Search

Dental pain is a primary precipitator of dental treatment in the elderly population. Yet the pain in an older person is likely\\u000a to represent a more severe pathosis than in a younger individual. Increased internal mineralization of the teeth with time\\u000a results in increased brittleness and susceptibility to fracture. Gingival recession exposes softer, more caries-prone areas\\u000a of teeth to the

Patrick M. Lloyd; Kenneth Shay

1987-01-01

449

Pancreatic Pain: A Mini Review  

Microsoft Academic Search

Pain management is one of the corner stones in the treatment of pancreatitis. There are a variety of pharmacological and non-pharmacological strategies to manage the symptoms. Recognizing the type of pain, nociceptive or neuropathic, is essential for appropriate treatment. The pharmacological armamentarium currently available is substantial and includes adjuvant analgesics, non-steroidal anti-inflammatories, and opioids that are customized to the etiology

Ricardo A. Cruciani; Subhash Jain

2008-01-01

450

Complementary therapies for cancer pain  

Microsoft Academic Search

Pharmacologic treatment of pain does not always meet patients’ needs and may produce difficult side effects. Complementary\\u000a therapies, which are safe, noninvasive, and generally considered to be relatively free of toxicity, may be used adjunctively\\u000a with standard pain management techniques to improve outcome and reduce the need for prescription medication. Approaches such\\u000a as acupuncture, massage therapy, mind-body interventions, and music

Barrie Cassileth; Carrie Trevisan; Jyothirmai Gubili

2007-01-01

451

Massage therapy for cancer pain  

Microsoft Academic Search

Therapeutic massage as a cancer pain intervention appears to be safe and effective. Patients who receive massage have less\\u000a procedural pain, nausea, and anxiety and report improved quality of life. The use of massage in cancer care centers and hospitals\\u000a is on the rise. Massage has a positive effect on biochemistry, increasing levels of dopamine, lymphocytes, and natural killer\\u000a cells.

Elaine Calenda

2006-01-01

452

Neuropathic pain in hereditary coproporphyria  

PubMed Central

Acute porphyrias are rare diseases with varying incidences worldwide. These diseases are disorders of heme biosynthesis characterized by acute attacks of neurological symptoms. Acute porphyria should be considered in patients with unexplained abdominal pain or neurological damage. Clinical manifestations of acute porphyria are nonspecific and are associated with multiple organ systems. This report examines a rare case of an uncommon type of acute porphyria in a patient with an initial presentation of abdominal pain and progressive polyneuropathy. PMID:24353603

Chen, Guan-Liang; Yang, Deng-Ho; Wu, Jeng-Yuau; Kuo, Chia-Wen; Hsu, Wen-Hsiu

2013-01-01

453

Neuropathic pain in hereditary coproporphyria.  

PubMed

Acute porphyrias are rare diseases with varying incidences worldwide. These diseases are disorders of heme biosynthesis characterized by acute attacks of neurological symptoms. Acute porphyria should be considered in patients with unexplained abdominal pain or neurological damage. Clinical manifestations of acute porphyria are nonspecific and are associated with multiple organ systems. This report examines a rare case of an uncommon type of acute porphyria in a patient with an initial presentation of abdominal pain and progressive polyneuropathy. PMID:24353603

Chen, Guan-Liang; Yang, Deng-Ho; Wu, Jeng-Yuau; Kuo, Chia-Wen; Hsu, Wen-Hsiu

2013-04-01

454

Treatment of Painful Diabetic Neuropathy  

Microsoft Academic Search

Up to 50% of patients with chronic sensorimotor diabetic neuropathy will experience painful or uncomfortable symptoms, and\\u000a of these a significant minority may require pharmacological therapy. As painful symptomatology may be worsened by a sudden\\u000a change in glycaemic control, the first step in management should be the quest for stable, near normal glycaemic control avoiding\\u000a glycaemic flux. Of all the

Andrew J. M. Boulton

455

Smartphone applications for pain management.  

PubMed

Smartphone applications (or apps) are becoming increasingly popular. The lack of regulation or guidance for health-related apps means that the validity and reliability of their content is unknown. We have conducted a review of available apps relating to the generic condition of pain. The official application stores for five major smartphone platforms were searched: iPhone, Android, Blackberry, Nokia/Symbian and Windows Mobile. Apps were included if they reported a focus on pain education, management or relief, and were not solely aimed at health-care professionals (HCPs). A total of 111 apps met the inclusion criteria. The majority of apps reviewed claimed some information provision or electronic manual component. Diary tracking of pain variables was also a common feature. There was a low level of stated HCP involvement in app development and content. Despite an increasing number of apps being released, the frequency of HCP involvement is not increasing. Pain apps appear to be able to promise pain relief without any concern for the effectiveness of the product, or for possible adverse effects of product use. In a population often desperate for a solution to distressing and debilitating pain conditions, there is considerable risk of individuals being misled. PMID:21844177

Rosser, Benjamin A; Eccleston, Christopher

2011-01-01

456

Pharmacologic management of neuropathic pain.  

PubMed

The mechanisms underlying the pathogenesis of neuropathic pain are complex but are gradually coming to light. Agents that have been found effective in a variety of neuropathic pain conditions include drugs that act to modulate (a) sodium or calcium channels, (b) N-methyl-D-aspartate receptors, (c) norepinephrine or serotonin reuptake, (d) opioid receptors, and (e) other cellular processes. Clinical trials have primarily evaluated these treatments for postherpetic neuralgia and painful diabetic neuropathy, the two most common types of neuropathic pain. Nonetheless, the identification of effective treatment regimens remains challenging, often because multiple mechanisms may be operating in a given patient giving rise to the same symptom. Alternatively, a single mechanism may be responsible for multiple symptoms. Currently available diagnostic tools are inadequate to determine the best treatment using a mechanism-based model. Clinically, drug treatment of neuropathic pain is often a matter of treatment trials. This article presents a summary of available clinical information on first-line and lesser-known treatments for neuropathic pain. PMID:15644856

Gordon, Debra B; Love, Georgette

2004-12-01

457

Does acute intraoral pain alter cutaneous sensibility?  

PubMed Central

Cutaneous sensibility was tested in eight patients suffering from acute postoperative intraoral pain. Tactile-, cold-, warm-, and heat-pain thresholds as well as reaction time to cold pulses were unaffected by the presence of pain. However, reaction time to warm pulses was increased in the painful area on the day of pain compared to a non-painful state. The findings are discussed in relation to (1) functional convergence of different sensory fibres on central neurons (2) the phenomenon of diffuse noxious inhibitory controls and (3) secondary hyperalgesia. The observed effect of clinical pain on the warm pathway could be explained as an intrasegmental noxious inhibitory effect. PMID:3216205

Hansson, P; Ekblom, A; Lindblom, U; Marchettini, P

1988-01-01

458

Pain: A Distributed Brain Information Network?  

PubMed Central

Understanding how pain is processed in the brain has been an enduring puzzle, because there doesn't appear to be a single “pain cortex” that directly codes the subjective perception of pain. An emerging concept is that, instead, pain might emerge from the coordinated activity of an integrated brain network. In support of this view, Woo and colleagues present evidence that distinct brain networks support the subjective changes in pain that result from nociceptive input and self-directed cognitive modulation. This evidence for the sensitivity of distinct neural subsystems to different aspects of pain opens up the way to more formal computational network theories of pain. PMID:25562782

Mano, Hiroaki; Seymour, Ben

2015-01-01

459

[Acute pain management after orthopaedic surgery].  

PubMed

Provision of sufficient post-operative pain therapy is an obligation in the clinical management of patients. A wide range of medical, technical and organizational options is used to improve post-operative pain management in orthopaedic surgery. Measurement of pain is as important as the correct use of analgesics and application techniques. Standardized pain therapy algorithms should facilitate autonomous treatment of patients. Additional procedures like patient-controlled analgesia or local catheter for pain are necessary for individualized or operation-specific pain therapy. The balanced combination in postoperative pain therapy could reduce side effects and complication rates, increase mobility and enhance patient satisfaction. PMID:19018653

Giesa, M; Decking, J; Roth, K E; Heid, F; Jage, J; Meurer, A

2007-02-01

460

Children’s catastrophic thinking about their pain predicts pain and disability 6 months later  

Microsoft Academic Search

Catastrophic thinking about pain has been identified as an important determinant of adjustment to pain, in both adults and children. No study has investigated the prospective and unique role of catastrophizing in explaining later pain and disability in children. The aim of the present study was to investigate the prospective roles of catastrophic thinking about pain, pain intensity, and trait

T. Vervoort; C. Eccleston; L. Goubert; A. Buysse; G. Crombez

2010-01-01

461

Nucleus accumbens responses to painful aversive and rewarding stimuli change in chronic pain  

E-print Network

Nucleus accumbens responses to painful aversive and rewarding stimuli change in chronic pain M. N of Neurol. and Physiol., UCSF, San Francisco, CA Brain activity maps for perception of thermal pain 1 back pain (CBP) patients to acute thermal painful stimuli within the context of reward

Apkarian, A. Vania

462

Pain. Author manuscript Prevalence of chronic pain with neuropathic characteristics in the general  

E-print Network

Pain. Author manuscript Page /1 10 Prevalence of chronic pain with neuropathic characteristics.bouhassira@apr.aphp.fr> Abstract We conducted a large nationwide postal survey to estimate the prevalence of chronic pain chronic pain (defined as daily pain for at least 3 months), evaluating its intensity, duration and body

Paris-Sud XI, Université de

463

When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function  

Microsoft Academic Search

As a way of delineating different levels of cancer pain severity, we explored the relationship between numerical ratings of pain severity and ratings of pain's interference with such functions as activity, mood, and sleep. Interference measures were used as critical variables to grade pain severity. We explored the possibility that pain severity could be classified into groupings roughly comparable to

Ronald C. Serlin; Tito R. Mendoza; Yoshio Nakamura; Katherine R. Edwards; Charles S. Cleeland

1995-01-01

464

Evoked Pain Analgesia in Chronic Pelvic Pain Patients Using Respiratory-Gated Auricular  

E-print Network

with respiratory events to better optimize bs_bs_banner Pain Medicine 2012; *: **­** Wiley Periodicals, Inc. 1 #12Evoked Pain Analgesia in Chronic Pelvic Pain Patients Using Respiratory-Gated Auricular Vagal pain (CPP) due to endometriosis in a specialty pain clinic. Interventions/Outcomes. We evaluated evoked

Napadow, Vitaly

465

Towards a Pain Treatment Based on the Identification of the Pain-Generating Mechanisms?  

Microsoft Academic Search

Despite continuous improvements in available pain treatments, many patients with chronic pain still remain insufficiently relieved. Although such therapeutic failures are often ascribed to pharmacological or psychological factors, difficulties in elucidating pain-generating mechanisms may be the main cause of insufficient pain management. These difficulties arise from several origins, including the unsuitability of the usual classification of pain, the exclusive use

Radhouane Dallel; Daniel Voisin

2001-01-01

466

Pain-related guilt in low back pain Danijela Serbic, MSc1  

E-print Network

1 Pain-related guilt in low back pain Danijela Serbic, MSc1 Tamar Pincus, PhD2 1&2 Department that mediate recovery is imperative to improve outcomes in low back pain (LBP). Qualitative studies suggest words Low back pain, pain-related guilt, reliability, questionnaire, factor analysis #12;4 Introduction

Royal Holloway, University of London

467

Abnormal endogenous pain modulation is a shared characteristic of many chronic pain conditions  

PubMed Central

The intensity of acute and chronic pain depends on interactions between peripheral impulse input and CNS pain mechanisms, including facilitation and inhibition. Whereas tonic pain inhibition is a characteristic of most pain-free individuals, pain facilitation can be detected in many chronic pain patients. The capability to inhibit pain is normally distributed along a wide continuum in the general population and can be used to predict chronic pain. Accumulating evidence suggests that endogenous pain inhibition depends on activation of the prefrontal cortex, periaqueductal gray and rostral ventral medulla. Quantitative sensory test paradigms have been designed to acquire detailed information regarding each individual’s endogenous pain inhibition and facilitation. Such tests include: temporal summation of pain, which is mostly used to assess facilitatory pain modulation by measuring the change in pain perception during a series of identical nociceptive stimuli; and conditioned pain modulation, which tests pain inhibition by utilizing two simultaneously applied painful stimuli (the ‘pain inhibits pain’ paradigm). Considerable indirect evidence seems to indicate that not only increased pain facilitation but also ineffective pain inhibition represents a predisposition for chronic pain. This view is supported by the fact that many chronic pain syndromes (e.g., fibromyalgia, temporomandibular joint disorder, irritable bowel syndrome, headache and chronic fatigue syndrome) are associated with hypersensitivity to painful stimuli and reduced endogenous pain inhibition. However, future prospective studies will be necessary to provide definitive evidence for this relationship. Such research would not only provide important information about mechanisms relevant to chronic pain but would also permit identification of individuals at high risk for future chronic pain. PMID:22550986

Staud, Roland

2012-01-01

468

Theories on Common Adolescent Pain Syndromes  

Microsoft Academic Search

\\u000a Pain is a prevalent condition among adolescents. In fact, 30–40% of children and adolescents report experiencing pain at least\\u000a once a week (Palermo 2000), and 5–25% of adolescents report some form of recurrent or chronic pain (Perquin et al. 2000; Goodman\\u000a and McGrath 1991). Of those reporting recurrent pain, 30–40% of children report pain episodes at least once a week

Jill MacLaren Chorney; Kathryn Crofton; Brenda C. McClain

469

Attention to postoperative pain control in children  

PubMed Central

Even with the rapid development of pediatric postoperative pain management, pediatric patients have remained undertreated for postoperative pain because of difficulty in pain assessment and concerns regarding side effects of opioid analgesics. Although there are no perfect pain assessment techniques and no absolutely safe analgesics, proper monitoring and an individualized analgesic plan after due consideration of age, operative procedures, and underlying illness, using multimodal analgesics may improve the quality of pain control in children. PMID:24729838

Lee, Ji Yeon

2014-01-01

470

Use of a pressure plate to analyse the toe-heel load redistribution underneath a normal shoe and a shoe with a wide toe in sound warmblood horses at the walk and trot.  

PubMed

The objective of this study was to use a pressure plate to quantify the toe-heel load redistribution in the forelimbs of sound warmblood horses with normal shoes and shoes with a wide toe and narrow branches, used empirically in the treatment of superficial digital flexor tendon or suspensory ligament injuries. In a crossover-design study, six horses, randomly shod with normal shoes and shoes with a wide toe, were led over a dynamically calibrated pressure plate to record data from both forelimbs. There were no significant differences between both shoes in the toe-heel index of stance time, peak vertical force and vertical impulse. For the adapted shoe, the peak vertical pressure was slightly lower and was exerted slightly earlier in the stance phase, albeit not significantly. However, the significantly larger toe contact area of the adapted shoe resulted in a significantly lower total vertical pressure in the toe region. Hence, the pressure plate adequately visualised the individual loading of the toe and heel region, and clearly demonstrated the altered pressure distribution underneath the shoe with a wide toe. Although further research on a deformable surface is needed to confirm this hypothesis, the pressure redistribution from the toe to the heels could promote sinking of the heels in arena footing, thereby mimicking the biomechanical effects of a toe wedge and providing a rationale for its application in the treatment of SDFT or SL injuries. The pressure measuring equipment used in this study can offer to the clinician a diagnostic tool for the evaluation of the load distribution underneath the equine hoof and for the fine-tuning of corrective shoeing. PMID:22342126

Oomen, A M; Oosterlinck, M; Pille, F; Sonneveld, D C; Gasthuys, F; Back, W

2012-10-01

471

Stress fractures and bone pain  

SciTech Connect

Stress fractures result from an unusual repetitive physical activity causing absorption of bone in excess of repair and bone formation. This leads to the weakening of the bone and subsequently to a fracture. It is a benign condition that if recognized in time does not need any treatment besides rest. However, if diagnosis is not made and physical activity continues it may result in severe injury to the bone and a frank fracture may result. Pain is the typical clinical feature and bone scintigraphy, being more sensitive than radiography, is done to establish early diagnosis. The presence of asymptomatic sites of abnormal bone uptake typical of stress fracture in which pain appeared only about 2 weeks after scintigraphy, drew the authors' attention to the question of how close is the relationship between stress fractures and bone pain. Sixty-four military recruits diagnosed as suffering from stress fracture were investigated in order to correlate sites with abnormal uptake of Tc-99m MDP on bone scintigraphy with sites of local pain. In 37 (58%) subjects multiple sites of abnormal uptake were recognised. Of 123 sites of abnormal uptake, 31 (25%) were asymptomatic. In three patients bone pain appeared at the site of the abnormal uptake two weeks after scintigraphy. Bone scintigraphy appears to be more sensitive than bone pain in the diagnosis of stress fractures. The osteoblastic activity which manifests itself by abnormal uptake appears in some cases earlier than the pain caused by the fracture. Present findings may suggest that under certain circumstances, in a population prone to stress fracture, bone scan should be considered as a screening method.

Groshar, D.; Even-Sapir, E.; Lam, M.; Israel, O.; Front, D.

1984-01-01

472

Expressive dimensions of pain catastrophizing: a comparative analysis of school children and children with clinical pain.  

PubMed

We investigated the role of the child's pain catastrophizing in explaining (1) children's self-reported tendency to verbally share their pain experience with others and (2) different dimensions of pain expression, as described by the mother and the father, including non-verbal and verbal communicative pain behaviour and protective pain behaviour. Participants were school children, children with chronic or recurrent pain, and their parents. The results showed that: (1) Pain catastrophizing was associated with children's greater self-acknowledged tendency to verbally share their pain experience with others. (2) Mothers and fathers perceived highly catastrophizing children to be more communicative about their pain. (3) The role of pain catastrophizing in the child's verbal sharing of pain experiences and in explaining expressive behaviour as rated by parents did not differ between the school children and children with recurrent and chronic pain. (4) Nevertheless, findings indicated marked differences between school children and the clinical sample. Children of the clinical sample experienced more severe pain, more pain catastrophizing, more protective pain behaviour, but less verbal communications about their pain. These results further corroborate the position that catastrophic thoughts about pain have interpersonal consequences. Findings are discussed in terms of the possible functions and effects upon others of pain catastrophizing and associated categories of pain behaviour. PMID:17493753

Vervoort, T; Craig, K D; Goubert, L; Dehoorne, J; Joos, R; Matthys, D; Buysse, A; Crombez, G

2008-01-01

473

Pain Catastrophizing and Salivary Cortisol Responses to Laboratory Pain Testing in Temporomandibular Disorder and Healthy Participants  

PubMed Central

Pain catastrophizing is an important variable in the context of acute and chronic pain. The neurophysiological correlates of pain catastrophizing, however, have not been rigorously evaluated. We examined the relationship between trait pain catastrophizing and morning salivary cortisol levels before and following a 45-minute laboratory pain testing session in healthy, pain-free (n=22) and temporomandibular disorder (TMD) participants (n=39). We also examined whether TMD patients evidenced generalized hyperalgesia and hypercortisolism. Pain catastrophizing was associated with a flattened morning salivary cortisol profile in the context of pain testing, irrespective of pain status. Cortisol profiles did not differ between healthy and TMD participants. TMD was associated with mechanical hyperalgesia only at the masseter. These data are the first to show an association between pain catastrophizing and elevated salivary cortisol profiles in the context of standardized experimental pain testing. These findings in both healthy individuals and those with chronic orofacial pain suggest that aberrant adrenocortical responses to pain may serve as a neurophysiologic pathway by which pain catastrophizing enhances vulnerability for development of chronic pain and maintains and/or exaggerates existing pain and associated morbidity. Perspective Neurophysiological mechanisms by which pain catastrophizing is related to acute and chronic pain recently have come under empirical study. Understanding of these mechanisms has the unique potential to shed light on key central nervous system factors that mediate catastrophizing-pain relations and therapeutic benefits associated with changes in catastrophizing and related cognitive processes. PMID:19853521

Quartana, Phillip J.; Buenaver, Luis F.; Edwards, Robert R.; Klick, Brendan; Haythornthwaite, Jennifer A.; Smith, Michael T.

2009-01-01

474

Pain Sensitivity and Modulation in Primary Insomnia  

PubMed Central

Sleep of good quantity and quality is considered a biologically important resource necessary to maintain homeostasis of pain-regulatory processes. To assess the role of chronic sleep disturbances in pain processing, we conducted laboratory pain testing in subjects with primary insomnia. Seventeen participants with primary insomnia (mean±SEM 22.6±0.9 years, 11 women) were individually matched with 17 healthy participants. All participants completed daily sleep and pain diaries over a 2-week period. Laboratory pain testing was conducted in a controlled environment and included (1) warmth detection threshold testing, (2) pain sensitivity testing (threshold detection for heat and pressure pain), and (3) tests to access pain-modulatory mechanisms (temporal summation and pain inhibition). Primary insomnia subjects reported experiencing spontaneous pain on twice as many days as healthy controls during the at-home recording phase (p<0.05). During laboratory testing, primary insomnia subjects had lower pain thresholds than healthy controls (p<0.05 for heat pain detection threshold, p<0.08 for pressure pain detection threshold). Unexpectedly, pain facilitation, as assessed with temporal summation of pain responses, was reduced in primary insomnia compared to healthy controls (p<0.05). Pain inhibition, as assessed with the diffuse noxious inhibitory control paradigm (DNIC), was attenuated in insomnia subjects when compared to controls (p<0.05). Based on these findings, we hypothesize that pain-inhibitory circuits in patients with insomnia are in a state of constant activation to compensate for ongoing subclinical pain. This constant activation ultimately results in a ceiling effect of pain-inhibitory efforts, as indicated by the inability of the system to adequately function during challenge. PMID:22396081

Haack, Monika; Scott-Sutherland, Jennifer; Santangelo, Gabrielle; Simpson, Norah; Sethna, Navil; Mullington, Janet M.

2013-01-01

475

Expressive dimensions of pain catastrophizing: A comparative analysis of school children and children with clinical pain  

Microsoft Academic Search

We investigated the role of the child’s pain catastrophizing in explaining (1) children’s self-reported tendency to verbally share their pain experience with others and (2) di