Abstract 326: Postural Orthostatic Tachycardia Syndrome and its Associated Chronic Pain Symptoms

2015 ◽  
Vol 117 (suppl_1) ◽  
Author(s):  
Chandralekha Ashangari ◽  
Amer Suleman
Keyword(s):  
Chronic Pain ◽  
Medical Records ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
The Body ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Chronic Regional Pain Syndrome ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Very High

Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. The symptoms of POTS are widespread because the autonomic nervous system plays an extensive role in regulating functions throughout the body. The aim of this study is to determine the chronic pain symptoms in Postural Orthostatic tachycardia syndrome (POTS) patients. Method: Two hundred fifty-five (255) POTS patients were randomly selected from our clinic (January 2014 to March 2015) , reviewed the medical records of 255 POTS patients for chronic pain symptoms and performed data analysis. Results: Two hundred thirty-three of the 255 (91%) patients are females (n=233, age 29.20 ± 10.32), Twenty-three of the 255 (9%) patients are males (n=23, age 29.70 ± 14.52).63% (161 of the 255) had Joint Pain/aches, 51% (131 of the 255) had Chronic headache, 40% (102 of the 255) had chest pain, 31% (80 of the 255) had Migraine, 30% (76 of the 255) had Chronic back pain,16% (42 of the 255) had Heartburn,8%(20 of the 255) had Chronic pleurisy, Rheumatoid arthritis, Muscle aches, Chronic regional pain syndrome and Hip aches. Conclusion: Our study is the first to characterize that Patients with postural orthostatic tachycardia syndrome (POTS) have a very high prevalence of chronic pain symptoms.

scholarly journals Painful Sleep: Insomnia in Patients with Chronic Pain Syndrome and its Consequences

Folia Medica ◽  
2020 ◽  
Vol 62 (4) ◽  
pp. 645-654
Author(s):  
Tiffany Ostovar-Kermani ◽  
Daniel Arnaud ◽  
Andrea Almaguer ◽  
Ismael Garcia ◽  
Stephanie Gonzalez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
General Population ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Clinical History ◽  
Spinal Pain ◽  
Chronic Pain Syndrome ◽  
Pain Symptoms

Insomnia is a chronic condition that occurs a minimum of three times per week over a period of three or more subsequent months. There are multiple causes of insomnia, and even though it is considered a symptom, it can be associated with chronic illnesses. Chronic pain syndrome, which is defined as pain that persists for a period longer than 3 months, is one of several etiologies of insomnia. The prevalence of insomnia among chronic pain patients is greater in comparison with the general population (percentage or ratio). Chronic pain is common in patients with rheumatoid arthritis, spinal pain (such as chronic back pain) and fibromyalgia. The prevalence of in-somnia is also higher in cancer patients when compared to the general population. When the clinical history indicates a straightforward diagnosis of chronic pain syndrome, patients will complain of insomnia as part of their symptomatology. It is imperative to manage their underlying illness to alleviate their sleep disorder. Various medications may be used to relieve and even improve pain symptoms. Other than pharmacological interventions, non-pharmacological alternatives such as yoga, meditation, acupuncture, and psychotherapy can help improve the quality of life of these patients. The purpose of this article is to review the diagnosis and management of insomnia in chronic pain syndrome and its impact on the quality of life.

scholarly journals Analgetic effect of ozone therapy: myths of reality?

2020 ◽  
Author(s):  
Iryna Vladimirovna Baranova ◽  
Yurii A. Bezsmertnyi ◽  
Halyna V. Bezsmertnaya ◽  
Kateryna P. Postovitenko ◽  
Iryna A. Iliuk ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal System ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Neurological Complications ◽  
Potential Effect ◽  
Intervertebral Disk ◽  
Ozone Therapy ◽  
Pain Syndromes ◽  
Innovative Techniques

Introduction: Administration of an oxygen-ozone mixture is one of the innovative techniques used in single-drug or complex therapeutic schemes for treatment of many degenerative-dystrophic pathologies of the musculoskeletal system and related neurological complications. Aim: The aim was to determine the mechanisms of physiological action of the oxygen-ozone mixture in order to substantiate its efficacy for treatment of chronic pain syndrome with underlying degenerative-dystrophic pathologies of the musculoskeletal system. Material and methods: The article covers biochemical and pathomorphological studies that explain the mechanism of the pain syndrome and the potential effect of the ozone therapy. Results and discussion: The treatment schemes and benefits of different routes of ozone administration (intramuscularly, intravenously, intradiscally and intraarticularly) were analyzed. Diverse research data demonstrated influence on the causes of chronic pain, pathophysiological phases, and possible complications. The prospects of further studies for development of the most effective techniques for treatment of various pain syndromes were assessed. Conclusions: Ozone therapy is one of the alternative rehabilitation methods with a substantial pain relieving effect. As of today, the possibility of using the oxygen-ozone mixture for treatment of chronic back pain related to intervertebral disk hernia and fibromyalgia has been substantially confirmed.

Central sensitization in chronic lumbar spine pain – pathophysiology and diagnostics

Ból ◽  
2020 ◽  
Vol 21 (1) ◽  
pp. 1-9
Author(s):  
Barabara Kosińska ◽  
Paweł Turczyn ◽  
Krzysztof Wesołowski ◽  
Beata Tarnacka ◽  
Małgorzata Malec-Milewska
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Central Sensitization ◽  
Clinical Problem ◽  
Low Back ◽  
Spine Pain ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Patients Experience

Chronic low back pain is a substantial clinical problem because of its high prevalence, incidence, complex and heterogeneous symptomatology. The majority of patients experience nociceptive pain only, but in almost 40% of patients neuropathic component may be present. In many patients with low back pain symptoms associated with central sensitization may be present as well and therefore their pain can be classified as nocyplastic. (functional) This paper describes how clinicians can differentiate these types of pain, taking into account that in a given patient several mechanisms may contribute to chronic pain development, and pain results from complex mechanisms. In the second part, therapeutic options are presented for people with symptoms of central sensitization, with emphasis on non-pharmacological methods.

scholarly journals Risk Factors For Prolonged Opioid Use After Spine Surgery

2021 ◽  
pp. 219256822110038
Author(s):  
Christopher Kowalski ◽  
Ryan Ridenour ◽  
Sarah McNutt ◽  
Djibril Ba ◽  
Guodong Liu ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Spine Surgery ◽  
Pain Syndrome ◽  
Lumbar Spine Surgery ◽  
Opioid Use ◽  
Chronic Regional Pain Syndrome ◽  
Increased Risk ◽  
Operative Complications ◽  
Post Operative Complications

Study Design: Retrospective review. Objective: Our purpose was to evaluate factors associated with increased risk of prolonged post-operative opioid pain medication usage following spine surgery, as well as identify the risk of various post-operative complications that may be associated with pre-operative opioid usage. Methods: The MarketScan commercial claims and encounters database includes approximately 39 million patients per year. Patients undergoing cervical and lumbar spine surgery between the years 2005-2014 were identified using CPT codes. Pre-operative comorbidities including DSM-V mental health disorders, chronic pain, chronic regional pain syndrome (CRPS), obesity, tobacco use, medications, and diabetes were queried and documented. Patients who utilized opioids from 1-3 months prior to surgery were identified. This timeframe was chosen to exclude patients who had been prescribed pre- and post-operative narcotic medications up to 1 month prior to surgery. We utilized odds ratios (OR), 95% Confidence Intervals (CI), and regression analysis to determine factors that are associated with prolonged post-operative opioid use at 3 time intervals. Results: 553,509 patients who underwent spine surgery during the 10-year period were identified. 34.9% of patients utilized opioids 1-3 months pre-operatively. 25% patients were still utilizing opioids at 6 weeks, 17.3% at 3 months, 12.7% at 6 months, and 9.0% at 1 year after surgery. Pre-operative opioid exposure was associated with increased likelihood of post-operative use at 6-12 weeks (OR 5.45, 95% CI 5.37-5.53), 3-6 months (OR 6.48, 95% CI 6.37-6.59), 6-12 months (OR 6.97, 95% CI 6.84-7.11), and >12 months (OR 7.12, 95% CI 6.96-7.29). Mental health diagnosis, tobacco usage, diagnosis of chronic pain or CRPS, and non-narcotic neuromodulatory medications yielded increased likelihood of prolonged post-op opioid usage. Conclusions: Pre-operative narcotic use and several patient comorbidities diagnoses are associated with prolonged post-operative opioid usage following spine surgery. Chronic opioid use, diagnosis of chronic pain, or use of non-narcotic neuromodulatory medications have the highest risk of prolonged post-operative opioid consumption. Patients using opiates pre-operatively did have an increased 30 and 90-day readmission risk, in addition to a number of serious post-operative complications. This data provides spine surgeons a number of variables to consider when determining post-operative analgesia strategies, and provides health systems, providers, and payers with information on complications associated with pre-operative opioid utilization.

Pain Syndromes Other Than Headache

2016 ◽  
Author(s):  
Edgar L. Ross
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Sensory Processing ◽  
Pain Syndrome ◽  
The Body ◽  
Spinal Cord Dorsal Horn ◽  
Opioid Use ◽  
Nerve Injuries ◽  
Pain Syndromes ◽  
Chronic Pain Syndromes

Pain is experienced within a complex biologic, emotional, psychological, and social context that may defy physical examination, diagnostic procedures, and laboratory tests. This chapter aims to empower internists to improve their medical practices in pain management. It provides a scientific background that covers nociception and how sensory processing occurs at multiple levels in the body. Clinical assessment is detailed, as well as diagnostic categories that include mixed or uncertain chronic pain syndromes (back pain, fibromyalgia, postamputation pain, pain from cancer and bone) and neuropathic pain syndromes (polyneuropathy, mononeuropathy multiplex, ganglionopathy, genetic disorders, focal and regional syndromes). Treatment of chronic pain can be surgical or interventional. Pharmacologic treatment for acute and chronic nociceptive pain includes special considerations for geriatric and terminal patients. For treatment of neuropathic pain, medications are the major component. One tables lists iatrogenic nerve injuries that can cause posttraumatic neuralgia and complex regional pain syndrome. Other tables detail stepwise pharmacologic management of neuropathic pain and cite recommendations on opioid use from the Centers for Disease Control and Prevention. One figure illustrates how pain transducers monitor and influence tissue conditions. Other figures show sensory processing in the spinal cord dorsal horn, physical findings in the feet of patients with bilateral foot pain from small-fiber polyneuropathy, illustrate how examination can identify specific nerve injuries causing chronic pain, and provide classification of chronic pain syndromes. This chapter contains 82 references.

scholarly journals Mirabegron to manage symptoms of interstitial cystitis / bladder pain syndrome: A stone for two birds?

2021 ◽  
pp. 020-023
Author(s):  
Pereira-Correia João Antonio ◽  
Nahoum Luiza Amaral ◽  
Aldred Pinto João Ernesto ◽  
Fernandes Muller Valter José
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Urinary Urgency ◽  
Urinary Frequency ◽  
Bladder Pain ◽  
Pain Symptoms

Background: Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) patients often experience lowered quality of life due to pain, urinary urgency, and increases in urinary frequency. Like many chronic pain disorders, IC/BPS is poorly understood and treatment unsatisfactory. Materials and methods: We prospectively monitored the effects on pain and urinary complaints, of mirabegron associated with amitriptyline, for randomly selected women with IC/BPS. Results: Twenty-five women were randomly selected to treat pain symptoms of IC/BPS and 12 followed up until the end of the study. All patients showed improvement on all questionnaires referring to pain IC/BPS symptoms and urinary storage symptoms. There was no statistically significant improvement in urinary frequency. Conclusions: We suggest that mirabegron can work controlling urinary urgency and pain of IC/BPS patients.

scholarly journals Optimization of the management of a patient with a backache (with clinical observation)

2019 ◽  
pp. 43-50
Author(s):  
D. O. Rozhkov ◽  
O. E. Zinov’yeva ◽  
I. M. Vikhlyantsev ◽  
G. Z. Mikhaylova ◽  
A. D. Ulanova ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Cognitive Behavioural Therapy ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Behavioural Therapy ◽  
Pathological Process ◽  
Economic Losses ◽  
Prolonged Stay ◽  
Cognitive Behavioural

Back pain in terms of socio-economic losses over the past 5 years has come to the first place among the causes of disability, and therefore the problem of rapid effective anesthesia and rehabilitation of this large group of patients is topical. In most cases, the main sources of back pain are the structures of the musculoskeletal system, and the reasons are their microtraumatization due to sudden unprepared movements, prolonged stay in a static position, heavy physical labor. The task of clinical and instrumental examination is to exclude specific causes of dorsalgia. It is also important to present the results of the survey in an accessible form, in particular to correctly interpret the data from neuroimaging research methods. Adequate anaesthesia for acute back pain, informing the patient about the favorable prognosis of the disease and early motor activation are essential to prevent the transition of the physiological feeling of pain into the pathological process - chronic pain syndrome. When dealing with chronic pain, the interaction of specialists of different profiles in the multidisciplinary team is required. Kinesiotherapy, ergotherapy, cognitive-behavioural therapy are the main methods of non-drug treatment of lower back painIt is recommended that the patient maintains the usual level of physical activity and then increases it. It is necessary to teach the patient to correctly perform movements in the social, professional and domestic spheres, to explain how to avoid unsafe movements that can provoke dorsalgia. The article presents the observation of a patient with chronic back pain. Success in treatment has been achieved through effective anesthesia through rational selection of non-steroidal anti-inflammatory drugs (Dexalgin), local administration of local anesthetics to overcome kinesiophobia, and a combination of cognitive-behavioural therapy, kinesiotherapy, and ergotherapy.

Complete relief of CRPS-associated pain during magnesium infusion in a patient with postpartum preeclampsia

2019 ◽  
Vol 44 (4) ◽  
pp. 521-523 ◽  
Author(s):  
Jonathan A Niconchuk ◽  
Michael G Richardson
Keyword(s):  
Preterm Labor ◽  
Case Reports ◽  
Pain Syndrome ◽  
Pregnant Patient ◽  
Complete Relief ◽  
Intravenous Magnesium ◽  
Chronic Regional Pain Syndrome ◽  
Patient Reported ◽  
Pain Symptoms ◽  
Magnesium Therapy

A pregnant patient with chronic regional pain syndrome (CRPS) and indwelling spinal cord stimulator presented with twin gestation for induction of preterm labor due to preeclampsia. Intravenous magnesium was initiated and a lumbar epidural catheter was placed uneventfully for labor analgesia. The patient reported complete relief of her CRPS-associated pain during and for 24 hours after delivery, while receiving intravenous magnesium, with her pain symptoms returning shortly after discontinuing magnesium. To our knowledge, there are no case reports that describe CRPS-associated pain relief while on peripartum magnesium therapy.

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