Articles: pain-threshold.
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Present-day hypotheses about the origin of pain in deep tissues are based on the idea that pain is anindependent sensation with its own specialized apparatus of sensors, conduction pathways and centers. The sensors are callednociceptors ornocisensors, and the neuronal structures they activate are thenociceptive system. Accordingly, the reception, conduction and central nervous processing of noxious signals together are termednociception. ⋯ Finally an account is presented of pain produced by excitation of the nociceptive system proximal to the nociceptors. These pain states include pain resulting from pathophysiological impulse generation in nociceptive fibers (neuralgia orneuralgic pain) which usually projects into the region containing the sensory endings of these fibers (projected pain). Furthermore, brief descriptions of pain due to spinal root compression and ofcentral pain arising from various sites of the central nervous system are given.
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The problem of nociception and pain development in radicular pain syndromes is not clarified. In the pathophysiology of pain of radicular compression caused by stenosis or disc prolapse, morphological complex nerve root/ganglion is the key structure. Chronic compression forces on the nerve structure cause structural changes. ⋯ The membrane threshold shift in nociceptive fibers is an important prerequisite for pain perception in nerve root compression. New biochemical aspects in the pathophysiology of radicular syndromes are presented, which could explain the discrepancy between pain and objective clinical findings. The article concludes that a better understanding of the nerve root pathophysiology will bring a more differentiated pain-management strategy.
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Many types of headache that occur in the form of attacks show a notably high incidence at certain times of the day. Attacks are often accompanied by emotional instability, irritability, exhaustion and other impairments of well-being. The cause for the frequent daytime occurrence of attacks is not clear. ⋯ These findings show that headache sensitivity follows circadian patterns. Daytime variations, however, are only significant for sensitivity to high intensities. Thus these results may explain, in part, why violent attacks of pain occur predominantly at night and in the early morning.
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A randomized, double-blind study was performed to test the analgesic effect of salmon calcitonin (sCT). The pain threshold of ten healthy subjects was measured during electrical stimulation of the dental pulp. Each subject underwent four different tests, whereby sCT at doses of 50 IU, 100 IU and 200 IU or placebo was administered subcutaneously. ⋯ The maximal threshold change was also significantly dependent on the dosage: with placebo the maximal change was 4 mA, while with sCT 50, sCT 100, and sCT 200 it was 14, 17 and 18 mA, respectively. The plasma levels of sCT and its analgesic activity were significantly correlated, as was demonstrated by means of linear regression based upon the bilogarithmic transformation of the plasma concentration. Altogether, the results prove conclusively that calcitonin given systemically possesses primary analgesic efficacy, a property that fits well into its spectrum of activity in the treatment of (painful) bone diseases.
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Tursky's pain perception profile [16] has been revised and adapted for use in German-speaking conditions, and this new modification is presented. It integrates six different methods of clinical and experimental methods of clinical and experimental pain measurement, which are intended to meet the enhanced demands put forward in pain research for multivariate measurement of pain by a variety of methods. ⋯ The results document the many aspects of chronic pain and the necessity for multimodal measurement. In addition, they supply a means of achieving a better pain-related classification of pain patients on an experimental basis.