The Problem of Deafferentation Pain in the Management of the Patient with Cancer

1987 ◽  
Vol 2 (2) ◽  
pp. 8-12 ◽  
Author(s):  
Ronald R. Tasker
Keyword(s):  
Malignant Disease ◽  
Pain Treatment ◽  
Treatment Strategies ◽  
Central Pain ◽  
Deafferentation Pain ◽  
Nociceptive Pathways ◽  
Appropriate Treatment ◽  
Chronic Pain Treatment ◽  
Painful Area ◽  
Stimulation Of

The concept of deafferentation and central pain has been slow to penetrate thinking about the management of chronic pain. Treatment strategies for pain caused, not by continual stimulation of nociceptors and continual traffic in nociceptive pathways, but by central neuronal functional abnormalities produced by deafferentation, obviously must differ from the conventional opiate therapy and denervating surgery used in nociceptive pain. It is even less well recognized that cancer commonly causes pain, first, of a nociceptive type by, usually, plexus compression, but later of a deafferentation type resulting from nervous destruction. Cancerous deafferentation pain shares all the characteristics of deafferentation pain caused by non-malignant disease, including resistance to opiates and persistence despite surgical denervation of the painful area. Hence pain in cancer must be carefully scrutinized and attention given to providing appropriate treatment for not only the nociceptive but also the commonly associated deafferentation element.

Chronic Tinnitus as Phantom Auditory Pain

2001 ◽  
Vol 124 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Robert L. Folmer ◽  
Susan E. Griest ◽  
William Hal Martin
Keyword(s):  
Sleep Disturbance ◽  
Pain Treatment ◽  
Medical Center ◽  
Treatment Strategies ◽  
Chronic Tinnitus ◽  
Anxiety And Depression ◽  
State Trait Anxiety Inventory ◽  
Tinnitus Severity ◽  
Chronic Pain Treatment ◽  
Highly Correlated

OBJECTIVES: To investigate similarities between patients who experience chronic tinnitus or pain and to formulate treatment strategies that are likely to be effective for patients who experience phantom auditory pain. STUDY DESIGN: A total of 160 patients rated the severity and loudness of their tinnitus and completed the State-Trait Anxiety Inventory (STAI) and an abbreviated version of the Beck Depression Inventory (aBDI). Patients received counseling, audiometric testing, and matched the loudness of their tinnitus to sounds played through headphones. SETTING: A specialized tinnitus clinic within an urban medical center. RESULTS: Tinnitus severity was highly correlated with patients’ degree of sleep disturbance, STAI, and aBDI scores. The self-rated (on a 1-to-10 scale)–but not the matched–loudness of tinnitus was correlated with tinnitus severity, sleep disturbance, STAI, and aBDI scores. CONCLUSIONS: The severity of chronic tinnitus is correlated with the severity of insomnia, anxiety, and depression. These relationships are the same for many patients with chronic pain. Treatment recommendations are discussed in reference to these results.

Non-invasive ultrasound-based imaging of atherosclerosis

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 126-133 ◽  
Author(s):  
Mathias Kaspar ◽  
Iris Baumgartner ◽  
Daniel Staub ◽  
Heinz Drexel ◽  
Christoph Thalhammer
Keyword(s):  
Large Population ◽  
Treatment Strategies ◽  
Intima Media Thickness ◽  
Scientific Work ◽  
Flow Mediated Dilation ◽  
Non Invasive ◽  
Grey Scale ◽  
Current Review ◽  
Appropriate Treatment ◽  
Contrast Enhanced

Abstract. Early detection of vascular damage in atherosclerosis and accurate assessment of cardiovascular risk factors are the basis for appropriate treatment strategies in cardiovascular medicine. The current review focuses on non-invasive ultrasound-based methods for imaging of atherosclerosis. Endothelial dysfunction is an accepted early manifestation of atherosclerosis. The most widely used technique to study endothelial function is non-invasive, flow-mediated dilation of the brachial artery under high-resolution ultrasound imaging. Although an increased intima-media thickness value is associated with future cardiovascular events in several large population studies, systematic use is not recommended in clinical practice for risk assessment of individual persons. Carotid plaque analysis with grey-scale median, 3-D ultrasound or contrast-enhanced ultrasound are promising techniques for further scientific work in prevention and therapy of generalized atherosclerosis.

Yoga as an Effective Mind--Body Therapy in Chronic-Pain Treatment

2007 ◽  
Author(s):  
Malinda Breda ◽  
Richard Gevirtz ◽  
Melanie A. Greenberg ◽  
James L. Spira
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Body Therapy ◽  
Chronic Pain Treatment

scholarly journals A Closer Look at the Cellular and Molecular Components of the Deep/Muscular Fasciae

2021 ◽  
Vol 22 (3) ◽  
pp. 1411
Author(s):  
Caterina Fede ◽  
Carmelo Pirri ◽  
Chenglei Fan ◽  
Lucia Petrelli ◽  
Diego Guidolin ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Connective Tissue ◽  
Treatment Strategies ◽  
Clear Understanding ◽  
Pathological Characteristics ◽  
Appropriate Treatment ◽  
Different Types ◽  
Molecular Components ◽  
Entire Network ◽  
Shed Light

The fascia can be defined as a dynamic highly complex connective tissue network composed of different types of cells embedded in the extracellular matrix and nervous fibers: each component plays a specific role in the fascial system changing and responding to stimuli in different ways. This review intends to discuss the various components of the fascia and their specific roles; this will be carried out in the effort to shed light on the mechanisms by which they affect the entire network and all body systems. A clear understanding of fascial anatomy from a microscopic viewpoint can further elucidate its physiological and pathological characteristics and facilitate the identification of appropriate treatment strategies.

scholarly journals Improved Dexterity after Chronic Electrical Stimulation of the Motor Cortex for Central Pain: A Special Relevance for Thalamic Syndrome

2012 ◽  
Vol 90 (6) ◽  
pp. 370-378
Author(s):  
Christophe Nuti ◽  
François Vassal ◽  
Patrick Mertens ◽  
Jean-Jacques Lemaire ◽  
Michel Magnin ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Cortex ◽  
Central Pain ◽  
Chronic Electrical Stimulation ◽  
Special Relevance ◽  
Stimulation Of

scholarly journals Characterizing pinprick-evoked brain potentials before and after experimentally induced secondary hyperalgesia

2015 ◽  
Vol 114 (5) ◽  
pp. 2672-2681 ◽  
Author(s):  
Emanuel N. van den Broeke ◽  
André Mouraux ◽  
Antonia H. Groneberg ◽  
Doreen B. Pfau ◽  
Rolf-Detlef Treede ◽  
...  
Keyword(s):  
Event Related Potentials ◽  
Stimulus Onset ◽  
Secondary Hyperalgesia ◽  
Brain Potentials ◽  
Nociceptive Pathways ◽  
Before And After ◽  
Pain Ratings ◽  
Related Potentials ◽  
Positive Complex ◽  
Stimulation Of

Secondary hyperalgesia is believed to be a key feature of “central sensitization” and is characterized by enhanced pain to mechanical nociceptive stimuli. The aim of the present study was to characterize, using EEG, the effects of pinprick stimulation intensity on the magnitude of pinprick-elicited brain potentials [event-related potentials (ERPs)] before and after secondary hyperalgesia induced by intradermal capsaicin in humans. Pinprick-elicited ERPs and pinprick-evoked pain ratings were recorded in 19 healthy volunteers, with mechanical pinprick stimuli of varying intensities (0.25-mm probe applied with a force extending between 16 and 512 mN). The recordings were performed before (T0) and 30 min after (T1) intradermal capsaicin injection. The contralateral noninjected arm served as control. ERPs elicited by stimulation of untreated skin were characterized by 1) an early-latency negative-positive complex peaking between 120 and 250 ms after stimulus onset (N120-P240) and maximal at the vertex and 2) a long-lasting positive wave peaking 400–600 ms after stimulus onset and maximal more posterior (P500), which was correlated to perceived pinprick pain. After capsaicin injection, pinprick stimuli were perceived as more intense in the area of secondary hyperalgesia and this effect was stronger for lower compared with higher stimulus intensities. In addition, there was an enhancement of the P500 elicited by stimuli of intermediate intensity, which was significant for 64 mN. The other components of the ERPs were unaffected by capsaicin. Our results suggest that the increase in P500 magnitude after capsaicin is mediated by facilitated mechanical nociceptive pathways.

scholarly journals Telemedicine for chronic pain treatment during the COVID‐19 pandemic: Do pain intensity and anxiousness correlate with patient acceptance?

Pain Practice ◽  
2021 ◽  
Author(s):  
Michael Alexander Harnik ◽  
Larissa Blättler ◽  
Andreas Limacher ◽  
Florian Reisig ◽  
Martin Grosse Holtforth ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Treatment ◽  
Patient Acceptance ◽  
Chronic Pain Treatment
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