ABSTRACT
Two experiments examined the use of pain descriptors by chronic pain patients with different medical and/or psychiatric diagnoses. Experiment I subjected patients' responses to the 20 descriptor categories on the McGill Pain Questionnaire to 3 separate multiple discriminant analyses to examine the differential diagnostic properties of pain language. None of the analyses generated a discriminant function, indicating that chronic pain patients do not use pain descriptors in a precise and systematic manner. Experiment II demonstrated that as affective disturbance increased within a chronic benign pain population pain language became more diffuse. These results suggest that pain language is not accurate for medical diagnosis in patients who suffer affective disturbance.
Subject(s)
Affective Symptoms , Language , Pain , Communication Barriers , Diagnosis, Differential , Female , Humans , Male , Pain/psychology , Physician-Patient Relations , Surveys and QuestionnairesABSTRACT
Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective pain descriptors. Possible explanations for this difference are discussed.
Subject(s)
Affect , Neoplasms/psychology , Pain, Intractable/psychology , Adult , Aged , Female , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
A statistical analysis of 61 consecutive patients who underwent facet denervation for chronic low back pain and sciatica showed that the average patient improved with lower pain estimates and use of narcotics, while activity levels increased. At 1-2 year follow-up there was a trend for patients to report an increase in their pain estimate although they maintained consistently high acativity levels and low analgesic intake.
Subject(s)
Back Pain/therapy , Denervation , Chronic Disease , Fluoroscopy , Humans , Sciatica/therapy , Statistics as TopicABSTRACT
In a series of 13 cats the effect of electrical stimulation of peripheral nerve on the mechanism of fast axoplasmic transport was studied. Electrical stimulation was used for varying time periods at parameters reported in the range of those used to produce electroanalgesia in man. Our results indicate that at these parameters, electrical stimulation produced no effect on this important aspect of nerve function, and, therefore, our work lends support to the safety of these devices in pain states.
Subject(s)
Axonal Transport , Electric Stimulation , Peripheral Nerves/physiology , Animals , Cats , Electronarcosis , Ganglia, Spinal/physiology , Sciatic Nerve/physiologyABSTRACT
Two-year and 3-year follow-up analyses show that those who did not receive surgery for pain relief did as well as those who did receive such surgery during their stay, both groups showing consistently lower pain levels and analgesic intake than on admission, while activity levels progressively increased. The surgical patients were more likely to be readmitted for their pain problem than were the others, whereas the others were more likely to be readmitted for other medical problems.
Subject(s)
Pain/surgery , Activities of Daily Living , Analgesics/therapeutic use , HumansABSTRACT
One year follow-up data are analyzed for the effects of using transcutaneous neurostimulators on patients with chronic benign pain. Those who have successful surgery for pain relief have lower pain and analgesic intake levels than those who supplement their surgery with neurostimulation. Those who do not receive surgery for pain but use neurostimulators have greatly increased activity levels than those who do not use these devices. The neurostimulators lower the clinical pain level component of the tourniquet test score for non-surgery patients to a degree comparable to that of patients with successful surgical outcomes, but maximum pain tolerance is not significantly altered. This supports the hypothesis that the analgesic effect is primarily a peripheral one.
