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Our understanding of the natural history of chronic pain in the community is limited. This is partly due to the lack of a validated measure of chronic pain severity known to be responsive to change over time. The Chronic Pain Grade questionnaire has been shown to be valid and reliable for use in a general population as a self-completion questionnaire. However, its reliability and validity for use...
Pain is a serious secondary problem for many persons with cerebral palsy (CP). Cognitive–behavioral models of pain hypothesize that how patients cope with painful episodes plays an important role in their adjustment to chronic pain. The utility of this model, however, has never been tested in persons with CP-related pain. Fifty adults with CP and chronic pain were interviewed to assess pain experience,...
There are reports that complex regional pain syndrome, type I (reflex sympathetic dystrophy; CRPS-I/RSD) can spread from the initial site of presentation, but there are no detailed descriptions of the pattern(s) of such spread. We describe a retrospective analysis of 27 CRPS-I/RSD patients who experienced a significant spread of pain. Three patterns of spread were identified. ‘Contiguous spread (CS)’...
The inability of opioids to control pain over time may be influenced by different factors such as drug tolerance, hyperalgesia due to repeated morphine administration or progression of the original disease. In addition, chronic pain may alter morphine tolerance development. This study examined whether chronic morphine exposure differently affects mechanical and thermal stimulus evoked pain-related...
Previous studies have shown that nitric oxide (NO) has a strong influence on the background (resting) activity of dorsal horn neurones. The background activity of dorsal horn neurones is generally assumed to be responsible for the presence of paraesthesia or spontaneous pain in patients depending on the functional type of neurones that are active. However, nothing is known about a possible selective...
Sensitization of sensory neurons is a critical component of hypersensitivity that occurs during chronic pain and inflammation. Questions remain, however, whether this sensitization depends on the continuous activation of signal transduction pathways in sensory neurons, whether the sensitization persists once the agent causing sensitization is removed, and whether downregulation occurs in the ability...
Peripheral hypersensitivity (hyperalgesia and allodynia) are common phenomena both in inflammatory and in neuropathic pain conditions. Several rat models of mononeuropathy (Bennett, Seltzer and Gazelius models) display such symptoms following partial injury to the sciatic nerve. Using immunohistochemistry and behavioral tests, we investigated inflammatory cell and cytokine responses in the sciatic...
The purpose of this study was to determine the levels of change on standard pain scales that represent clinically important differences to patients. Data from analgesic studies are often difficult to interpret because the clinical importance of the results is not obvious. Differences between groups, as summarized by a change in mean values over time, can be difficult to apply to clinical care. Baseline...
Thalidomide reduces thermal hyperalgesia and mechanical allodynia in chronic constrictive sciatic nerve injury (CCI). Since thalidomide mainly inhibits tumor necrosis factor alpha (TNF-α) synthesis with less well defined effects on other cytokines, we investigated the effect of the drug on the expression of the proinflammatory cytokines TNF-α, interleukin-1β (IL-1β) and interleukin 6 (IL-6), and of...
Hyperalgesia on intradermal capsaicin application can be attenuated by systemic application of local anesthetics. We tested whether low doses of local anesthetics applied pre- or post-traumatically can reduce heat trauma-induced primary and secondary hyperalgesia in humans. Six healthy volunteers consented to the randomized, double-blind, and cross-over designed study. In each subject, a first-degree...
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