The Clinical journal of pain
-
Fifteen patients with brachial plexus avulsion and five patients with postherpetic pain underwent dorsal root entry zone surgery with intraoperative impedance monitoring. The usual range of initial impedance values recorded in the superficial layers of the normal cord is from 1,000 to 1,500 omega. ⋯ In postherpetic neuralgia, measurements of impedance are abnormally low in the involved area, in which the roots appear macroscopically abnormal. In this study, tissue impedance was correlated with gross pathologic changes in the spinal cord.
-
Previous findings in patients with nonmalignant pain indicate a relationship between pain coping strategies and psychological factors. Although coping strategies have been explored in patients with cancer pain, relationships with such factors have not been reported. We wished to examine relationships between selected pain and psychological variables and the use of pain coping strategies. ⋯ Pain intensity and state anxiety demonstrated similar relationships. Pain quality as measured with the MPQ demonstrated moderately strong correlation with diverting attention, praying and hoping, catastrophizing, and increased activity. Interventions aimed at reinforcing or expanding a patient's pain coping repertoire should be developed with consideration given to the patient's anxiety level, pain intensity, pain quality, and pain expression preference.
-
Relationships between locus of control beliefs (HLC), psychological distress (GHQ-12), and coping strategies were studied in 415 subjects with low back pain (LBP) (2 of 3 were men, with a mean age of 45 years). Those with more external beliefs and symptoms of psychological distress reported more severe LBP. ⋯ Irrespective of the degree of LBP, use of more active behavioral coping strategies were more frequent in subjects who had strong beliefs in internal control over back pain. In addition, catastrophizing thoughts were more frequent in subjects who had symptoms of psychological distress.
-
This study examined factors that help to identify low back pain patients who do not benefit from a lumbar epidural steroid injection (LESI). Two-hundred and forty-nine chronic low back pain patients assessed their pain intensity before, 1 day after, and 2 weeks after receiving a LESI. All patients completed a comprehensive pain questionnaire and a Brief Symptom Inventory (BSI) prior to treatment. ⋯ Nine patients (7%) felt that the treatment was harmful. Four factors were identified that best predicted poor outcome 2 weeks after LESI: (a) greater number of previous treatments for pain; (b) more medications taken; (c) pain not necessarily increased by activities, and (d) pain increased by coughing. Factors that predicted no benefit 1 year after treatment included (a) pain does not interfere with activities; (b) unemployment due to pain; (c) normal straight-leg raise test prior to treatment; and (d) pain not decreased by medication.