ABSTRACT
Investigations of the evoked potentials (EPs) to noxious laser stimulation have indicated consistent strong linear relationships between subjective response (R), stimulus intensity (S), and EP amplitude (A). Thirty patients with chronic intractable benign pain syndromes (CIBPS) were tested to determine whether their patterns differed from previous studies with normal volunteers. Nearly half of the CIBPS patients were found to be relatively insensitive to acute pain stimuli. A large number were also found to show negative relationships between S and A. These differences from control subjects were considered of potential importance in their implications concerning the nature of chronic pain and its differences from the acute pain process.
Subject(s)
Nociceptors/physiopathology , Pain, Intractable/physiopathology , Somatosensory Cortex/physiopathology , Adult , Aged , Evoked Potentials , Female , Humans , Male , Middle Aged , Pain, Intractable/psychology , Reaction Time/physiology , Sensory ThresholdsSubject(s)
Brain/physiopathology , Hot Temperature/adverse effects , Pain/physiopathology , Adult , Electroencephalography , Female , Humans , Lasers , Male , Middle Aged , Pain/etiology , Sex Factors , Time FactorsSubject(s)
Neoplasms/complications , Pain, Intractable/therapy , Patient Care Team/methods , Death , Goals , Humans , Nurse Clinicians/statistics & numerical data , Pain, Intractable/etiology , Pain, Intractable/psychology , Pharmacy Service, Hospital/statistics & numerical data , Psychology, Clinical/methodsSubject(s)
Outcome and Process Assessment, Health Care , Pain, Intractable/therapy , Adolescent , Adult , Aged , Analgesics , Antidepressive Agents, Tricyclic , Attitude , Barbiturates , Female , Follow-Up Studies , Humans , Male , Middle Aged , Morphine Derivatives , Pain, Intractable/psychology , Substance-Related Disorders/epidemiology , Tranquilizing AgentsABSTRACT
There is sufficient reason to classify some ongoing pain problems as syndromes. Patients who suffer with chronic, intractable, benign pain syndromes (CIBPS) have truly functional biopsychosocial disorders. There is no longer any current pathophysiology operative, and the pain syndrome persists with its psychosocially perpetuating and disrupting features. An intense group psychotherapy approach in the therapeutic milieu of a medical-surgical setting fosters and evokes affect expression and understanding. This encourages the formation of cognitive patterns that are therapeutically useful in that they extend coping abilities and, hence, diminish the pain and suffering experience and life problems attendant to it.
Subject(s)
Pain, Intractable/therapy , Psychophysiologic Disorders/therapy , Psychotherapy, Brief , Psychotherapy, Group , Chronic Disease , Humans , Psychophysiologic Disorders/diagnosis , SyndromeABSTRACT
The authors present the concept that a multi-disciplinary interdepartmental pain center should include: 1) an initial out-patient pain clinic, 2) an inpatient pain service for diagnosis of pain problems and treatment of patients with intractable pain, including pain from cancer, 3) a psychotherapeutically-oriented chronic benign Pain Unit, 4) facilities for clinical and basic pain research, and 5) affiliations for an adequate teaching program.
