European journal of pain : EJP
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Low back pain patients (n=142) on sick leave for at least 8 weeks were given a multi-modal cognitive behavioural treatment program (MMCBT) that lasted for 4 weeks. Before treatment, all patients were tested with a comprehensive test battery. The outcome at 12-month follow-up was predictable from the pretest, but only when combining medical and psychological data. ⋯ Non-returners in the control group lacked energy, trained less regularly, worked in occupations that gave an almost constant load on the back, and did not expect to be back to work in the course of a couple of weeks. It seems to be important to develop further diagnostic tools to identify those who might benefit from extensive or specific treatments. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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To elucidate neurophysiological mechanisms of persistent pain induced by tissue injury, the present study was designed to investigate the effects of s.c. bee venom injection on responses of the dorsal horn nociceptive neurons and those of behavior in anesthetized and awake cats, respectively. A parallel comparative study was also performed to compare the effects of s.c. bee venom and formalin injections on neuronal responses by using an extracellular single-unit recording technique. The present results showed that s.c. bee venom injection into the peripheral cutaneous receptive field resulted in a protracted, tonic monophase of increase in spike responses of wide-dynamic-range (WDR) neurons for more than 1 h, while injection of the same volume of vehicle did not have such an effect. ⋯ Comparative studies showed that the duration and frequency of the bee venom-induced neuronal responses were comparable to those induced by s.c. formalin; however, responses of WDR neurons to mechanical stimuli applied to the injection site of the two chemical agents were quite different. Bee venom produced a significant enhancement of mechanical responses of WDR neurons, while, on the contrary, formalin produced a desensitization of sensory receptors in the injection site, suggesting that the two tonic pain models may have different underlying mechanisms. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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Surveys show consistently that pain is not treated well. Improvement depends on knowing which treatments are the most effective. We used systematic review to compare the relative efficacy of two common analgesics, ibuprofen and diclofenac, in post-operative pain. ⋯ Both drugs worked well. Choosing between them is an issue of dose, safety and cost. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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Temporal summation of pain is suggested to be an important factor during various clinical conditions. Controversies exist as to whether temporal summation exists for Adeltafibre-mediated first pain. The aim of the present human experimental study was to investigate the importance of stimulus configuration (intensity, inter-pulse interval, location) for temporal summation of radiant (laser)- and contact-heat-induced pain. ⋯ Taking the latency from stimulation to perception into consideration, we were able to differentiate and find summation of first (Adeltafibre-mediated) and second pain (C fibre-mediated). Summation of first pain was more pronounced for high (38 degrees C) than for low (30-32 degrees C) baseline temperature. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.