ABSTRACT
BACKGROUND: A neuropathic component to chronic ischemic pain in peripheral arterial disease (PAD) has recently been shown using quantitative sensory testing (QST) and pain questionnaires. The aim of this study was to examine correlations between QST and pain questionnaires in patients with chronic ischemic pain. METHODS: A total of 10 patients with severe PAD (Fontaine stages III and IV) without diabetes mellitus answered a questionnaire and were examined with QST. The questionnaire consisted of several validated instruments which were used to examine the intensity of pain, quality of pain and neuropathic pain (VAS, SF-MPQ, S-LANSS, NPSI). RESULTS: The results of the QST confirmed previously published data. Several terms of the SF-MPQ showed a correlation with parameters of the QST, such as Allodynia (QST) which correlated with the term tender (SF-MPQ) (Spearman's correlation coefficient 0.911; p< or =0.001) and the NPSI subscore evoked pain correlated with the QST parameter wind-up ratio (0.683; p=0.042). CONCLUSION: The results suggest that there might be correlations between psychophysical tests (QST) and pain questionnaires. Subjective perceptions of pain might be represented by a certain pattern in the QST. These connections could contribute to further clarify the pathophysiologic mechanisms leading to the perception of pain.
Subject(s)
Arterial Occlusive Diseases/physiopathology , Ischemia/physiopathology , Leg/blood supply , Neuralgia/classification , Neuralgia/diagnosis , Neurologic Examination/statistics & numerical data , Nociceptors/physiology , Pain Measurement/statistics & numerical data , Pain/classification , Pain/diagnosis , Surveys and Questionnaires , Afferent Pathways/physiopathology , Aged , Arterial Occlusive Diseases/diagnosis , Female , Humans , Intermittent Claudication/classification , Intermittent Claudication/diagnosis , Intermittent Claudication/physiopathology , Ischemia/diagnosis , Male , Neuralgia/physiopathology , Pain/physiopathology , Pain Threshold/physiology , Psychometrics/statistics & numerical data , Psychophysics , Reproducibility of Results , Sensory Thresholds/physiology , Statistics as Topic , Thermosensing/physiologyABSTRACT
BACKGROUND: The intention of this study was to determine the status quo of commonly used pain therapies amongst treating physicians of different specialties and to examine their view on the problem of chronic ischemic pain. METHODS: A total of 281 physicians treating patients with chronic ischemic pain were surveyed. The surveyed physicians were mainly specialists in the fields of surgery, pain therapy, and internal medicine. RESULTS: Mainly a pharmacological therapy (metamizol/paracetamol, weak and strong opioids) was used in the treatment of chronic ischemic pain. We found differences between the specialties, for instance pain specialists used antidepressants and anticonvulsants more often than others. Therapeutic options were also evaluated differently by surgeons, pain therapists, and internal specialists: 57% of the surgeons considered the available symptomatic treatment options as sufficient whereas only 21% of the pain specialists agreed with that opinion. CONCLUSION: The differences among the specialties and the fact that the majority of physicians characterized the available symptomatic treatment options as insufficient point towards a need to review the treatment of ischemic pain in an interdisciplinary approach.
