scholarly journals A patient with chronic pain syndrome

Author(s):  
V. I. Moroz ◽  
M.. B. Balaeva ◽  
A. V Naumov ◽  
N. O. Khovasova

This article describes a clinical case of a patient with chronic pain syndrome on the background of osteoarthritis, with a history of joint replacement. The reason for hospitalization was a fall, after which a constant pain syndrome persisted and a neuropathic component joined, which the patient could not stop with anything.As a result of a comprehensive geriatric assessment, the patient was diagnosed with frailty and the following geriatric syndromes: mild dependence on outside help, chronic pain syndrome, balance disorders, falls, stress urinary incontinence. Non-drug methods of treatment and complex therapy (gabapentin + B vitamins + uridine) and antiosteoporetic therapy were recommended, against which the intensity of the pain syndrome decreased to a mild degree (according to the VAS scale of 2 points at the time of discharge) and a decrease in neuropathy copatterns was noted.

2020 ◽  
Vol 10 (4) ◽  
pp. 83-85
Author(s):  
Olga Bobrova ◽  
Sergey Zyryanov ◽  
Natalia Shnayder ◽  
Marina Petrova

PERSONALIZED CHOICE OF OPIOID THERAPY IN A PATIENT WITH CHRONIC PAIN SYNDROME ON THE BACKGROUND OF PANCREAS CANCER: CLINICAL CASE REPORT


2019 ◽  
Vol 98 (1) ◽  
pp. 115-121
Author(s):  
A.V. Pshonkin ◽  
◽  
I.V. Serkova ◽  
N.V. Myakova ◽  
N.N. Kotskaya ◽  
...  

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S333 ◽  
Author(s):  
F.R. James ◽  
R.G. Large

Author(s):  
Maksim Vladimirovich Shpagin ◽  
Mikhail Valerievich Kolesnikov ◽  
Olga Yurievna Khutorskaya ◽  
Dmitriy Evgenievich Timoshkin ◽  
Artem Andreevich Belikin ◽  
...  

From the informational and structural point of view, the chronicity of pain is associated with the migration of nociogenic zones. The phenomenon of migration is based on the mechanisms of neuroplasticity, compensatory-restorative processes in the nervous system. On the basis of the phenomenon of migration of the nociogenic zone, a system of regional integrative therapy of chronic pain syndrome has been developed. Recommendations on the advisability of invasive shutdown of the nociogenic zone using invasive pharmacotherapy or surgical denervation have been proposed. In the course of studying the characteristics of chronic pain, depending on the duration of the disease, a direct proportional correlation was revealed between the increase in the components of pain and the duration of the pain syndrome, which can be explained by the increase in the number of nociogenic structures that form the complexity and stability of the pain syndrome. Thus, the necessity of neurodestructive interventions increases for attaining positive results. An important area of therapy is the inclusion of psychotherapy, pharmacotherapy and neuromodulation into the system of regional-integrative influence.


2021 ◽  
Vol 27 (1-2) ◽  
pp. 36-45
Author(s):  
M.I. Bozhenko ◽  

Aim of the research is to analyze the patterns of pain syndromes and their characteristics in multiple sclerosis patients. Materials and Methods. A total of 104 multiple sclerosis patients complaining of pain during the last month were examined in Lviv Regional Multiple Sclerosis Center. We analyzed medical records, performed general medical and neurological examinations and compiled history of lifestyle, illness and pain. The VAS and PainDetect questionnaires were used to assess the characteristics of pain syndromes. The patients were asked to choose one of the 4 typical patterns of pain, which best described their feelings. Then the analysis of pain syndrome patterns and their characteristics was carried out. Results and Discussions. All 4 typical patterns of pain syndromes were registered in multiple sclerosis patients. However, only 26.92% of the participants experienced an intermittent pain pattern. The rest of patients suffered from patterns characterized by persistent pain. The evaluation of the patterns and their characteristics revealed typical features. The highest intensity of the severest and average pain during the last month was present in the patients suffering from constant pain with distinct attacks: 8.0 [7.0; 9.0] points (p<0.05) and 7.0 [5.0; 8.0] points (p<0.05), respectively. Persistent paroxysmal pain was more common in the multiple sclerosis patients with neuropathic pain (43.8±8.8% vs 20.4±5.8%, p<0.05). Irradiating pain is also characteristic to this pattern in 52.9±8.6% of patients (p<0.05). The head is the most common pain localization in the patients experiencing persistent pain with severe attacks - 82.4±9.2% of cases (p<0.05). Conclusions. Pain is a permanent symptom in a significant number of multiple sclerosis patients. It can have different patterns of progression. However, it has typical characteristics and their understanding will aid in the diagnosis, prognosis and treatment of pain syndromes in multiple sclerosis patients


2020 ◽  
Vol 14 (2) ◽  
pp. 72-85
Author(s):  
Arina P. Spasova ◽  
I. V. Kurbatova ◽  
O. Y. Barysheva ◽  
G. P. Tikhova

The goal of the study was to explore the influence of single-nucleotide polymorphisms of the COMT gene on the formation and features of pain syndrome, the level of anxiety, and the need for narcotic analgesics in patients with breast cancer. Materials and methods. The intensity of pain and opioid consumption in the postoperative period were evaluated in 58 patients who met the inclusion criteria of the study and were operated for breast cancer. The frequency of chronic pain syndrome after mastectomy was studied in the same group of patients after a year by using short pain questionnaires, McGill Pain Questionnaire and PainDetect. The anxiety level was assessed by using the HADS questionnaire. Genotyping was performed for single-nucleotide polymorphisms, rs4680, rs740603, rs2097603 = rs2070577, rs4633, of the COMT gene localized in the 22q11.21 region in the studied group of patients. The relationship between the carrier of different genotypes and the intensity of acute and chronic pain, the severity of the pain rating index for sensory and affective characteristics, the presence of a neuropathic component of pain, and the severity of anxiety were studied in the entire sample. The use of narcotic analgesics was evaluated in the postoperative period (IU/day and IU/course) and for the relief of chronic pain. Results. It is shown that the intensity of postoperative pain and the severity of anxiety do not depend on the presence of a mutant allele for the studied polymorphisms of the COMT gene, while the postoperative consumption of opioids in patients with the rs4680 missense mutation in the exon of this gene is significantly less. The dependence of the intensity of chronic pain syndrome and the severity of anxiety on the presence of a mutant allele for the polymorphic locus rs4680 localized in the exon of the COMT gene was established. No significant relationship was observed between the mutant alleles and the use of opioids for chronic pain relief after mastectomy. Conclusion. Genotyping for the COMT gene polymorphisms can be useful for choosing the optimal tactics of pain management in patients with breast cancer.


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