Cause Of Chronic Pain Syndrome Research Articles

Etiological factors of chronic pain syndrome in young adults with post-coronavirus disease 2019 condition.

The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions. This was a case-control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS. This study included 120 individuals. Prolonged days of isolation (p=0.005), fear (p<0.001), stress overload (p<0.001), and impaired rehabilitation (p=0.003) were significantly associated with CPS. A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS. The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy.

Are there any gender differences in pain perception? Clinical and experimental studies in oncology

The review considers and analyzes scientific literature on gender differences in the incidence of pain syndromes, perception of clinical pain, including that in cancer patients and in experimental oncology. The literature highlights theoretical basis, some biological mechanisms and practical results associated with gender differences. Chronic pain no longer performs a protective function and is not biologically appropriate. The review presents results of experimental studies demonstrating the important role of sex hormones and regulatory systems of a living organism in the mechanisms of development, distribution and perception of pain. Some aspects of sexual dimorphism in the processes of nociception and antinociception are covered. We present the data on the causes of chronic pain syndrome and its perception in cancer patients of both sexes indicating genetically determined sexual reactivity of the body which causes an imbalance in the function of peripheral nervous system and CNS under the influence of prolonged permanent pain in a living organism. Various pain effects have been shown to cause changes in the main types of metabolism, mobilization of adaptive metabolic mechanisms, and tissue damage. Conclusions. The high prevalence of chronic pain in both women and men with cancer, heavy humanitarian and social and economic burden explains a significant increase in fundamental and clinical research in this direction.&#x0D; &#x0D; &#x0D;

Фибромиалгия: принципы диагностики и терапии

Fibromyalgia (FM) is one of the causes of chronic pain syndrome. The prevalence of FM in the general population is 2%. Etiology and pathogenesis of FM are not well understood. It is believed that the disorder results from interaction of genetic and psychosocial factors, as well as from environmental exposure. Central sensitization associated with inhibition of pain inhibitory pathways and altered levels of a number of neurotransmitters underlies pathogenesis of the disorder. Clinical pattern of FM is characterized by generalized chronic widespread pain that lasts for over three months and persists in the absence of any apparent organic lesions, which is usually accompanied by joint stiffness, pathological fatigue, sleep disturbances, cognitive dysfunction, and depression. Failure to define the site of injury makes FM difficult to diagnose. The diagnosis is often ignored or incorrectly established. To avoid such mistakes, it is recommended to begin the examination of the patient with suspected FM with the detection of generalized chronic widespread pain (calculating the Widespread Pain Index and Symptom Severity values) lasting for over three months. Upon detection of generalized chronic widespread pain, the major FM symptoms (sleep disturbances, fatigue) should be checked in accordance with the criteria, established by American College of Rheumatology in 2016. Pharmacological (antidepressants – duloxetine, milnacipran, amitriptyline; analgesics – tramadol, paracetamol; antiepileptic drugs – pregabalin) and non-pharmacological (education and awareness-raising activities, physiotherapy and psychotherapy) FM treatment methods are recommended. Unfortunately, these methods show moderate efficiency in reversing persistent symptoms, functional limitation and reduced quality of life in patients with FM.

مقایسه تاثیر پتدین، کتورولاک و ترکیب کتورولاک – دیازپام در کاهش درد بیماران مبتلا به درد حاد کمری: یک مطالعه کارآزمایی بالینی

Introduction: Low back pain is one of the most common diseases in different societies of the world. About 65% to 80% of people experience low back pain during their lifetime. Low back pain is the most common cause of chronic pain syndrome, which leads to limited activity in people younger than 45 years. This study was carried out on the patients referred to the emergency department of Peymanieh hospital in 2019. The study aimed to evaluate and compare the effects of pethidine, Ketorolac, and a combination of ketorolac-diazepam on patients with acute low back pain. Methods: In this double-blind, randomized clinical trial, 90 patients referred to the emergency department of Peymanieh Hospital in Jahrom due to acute low back pain were included in the study. Patients were randomly divided into three groups. First group 50 mg of pethidine, Second group 30 mg ketorolac and 10 mg diazepam and Third group 30 mg of Ketorolac. Blood pressure, heart rate, arterial blood oxygen saturation, and pain of patients were measured and recorded before drug injection, immediately after drug injection, and then at 5, 10, 20, 60, and 90 minutes. Pain intensity was measured and analyzed by the visual analog scale (VAS). Data analysis was performed using SPSS software version 21 and using descriptive and inferential statistical tests. Results: The results of the present study showed that the mean pain reduction in the pethidine group in 10 minutes (P = 0.006), 20 (P = 0.001), 60 (P = 0.001) and 90 minutes after injection (P = 0.001), respectively. Significance was greater than the ketorolac groups and the combination of ketorolac and diazepam. Conclusion: The present study results indicated that pethidine is more effective in reducing acute low back pain than ketorolac-diazepam and Ketorolac. The use of pethidine in these patients seems to be a suitable alternative to other drugs used for pain control in patients with acute low back pain referred to the emergency department.

The use of chondroitin sulfate (Mucosat) for the treatment of chronic back pain and osteoarthritis

The representation of pain syndromes of various localization is very extensive: in the knee and hip joints, this figure reaches 57,8% of the general population, in the shoulder joint 48–84%, and pain in the lower back is experienced by up to 85%. The prevalence of osteoarthritis (OA) increases with age. OA occupies a leading position among all rheumatological diseases, accounting for more than 60–70 % of their total number, and is the leading cause of chronic pain syndrome in the older age group. Clinical symptoms of OA are observed in 30–50% of the population in people over 65 years. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs for the treatment of pain syndromes. NSAIDs are characterized by a good analgesic effect, but are often the cause of the development of adverse events (NSAIDS). Alternative for the treatment of degenerative-dystrophic lesions of the joints is chondroprotectors (CP). CPS belong to the group of drugs of delayed action of symptomatic therapy (SYSADOA). Among CP, chondroitin sulfate (CS) is considered to be the most acceptable means that can affect metabolic processes in cartilage, synovial and bone tissue, suppressing the synthesis of proinflammatory mediators. The main effects that CS has on the joint in OA are: anti-inflammatory, analgesic, and protective. CS improves the phosphorus-calcium metabolism in cartilage, inhibits enzymes that violate the structure and function of articular cartilage, inhibits the degeneration of cartilage; stimulates the synthesis of glycosaminoglycans (GAG), normalizes the metabolism of hyaline tissue, promotes the regeneration of cartilage surfaces and the articular bag. The main effects that show CS on the joint in OA: anti-inflammatory, analgesic, protective. Slowing bone resorption, reduces the loss of Ca2+ and accelerates the processes of bone repair, inhibits the progression of OA. It has analgesic effect, reduces joint pain, pain at rest and when walking, the severity of inflammation, reduces the need for non-steroidal anti-inflammatory drugs (NSAIDs). One of the representatives of medicinal products based on CS is Mucosate (ampoules 1 and 2 ml) containing 100mg of CS in 1ml. A number of studies have demonstrated the effectiveness of therapy with Mucosat in the treatment of patients with low back pain (LBP) using the 2 ml intramuscularly every other day, a course of 25 injections, as well as in the treatment of OA using the 1 ml intramuscularly every other day, starting with the 4th injection – 2 ml every other day, also a course of 25 injections. Recent developments – a new oral form of Mucosate (capsule) containing harpagophytum and the NEM® complex can serve as a supplement to the injectable course of therapy.

Psychometric assessment of chronic pain syndrome in juvenile idiopathic arthritis

Background. Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood. Chronic pain is one of the most frequent and difficult to objectively assess symptom of JIA. The influence of psychosocial factors on the severity of pain complicates the objective assessment of pain syndrome in JIA, necessary to assess the control of the disease and raises the question of the possible use of psychological questionnaires to objectify pain in patients with JIA.&#x0D; Aim: to assess the intensity of pain syndrome, the level of social disadaptations, description of sensory and affective components of pain in patients with JIA, depending on the activity of the disease and the presence or absence of chronic pain syndrome.&#x0D; Materials and methods. 147 school-age patients with verified diagnosis of JIA were examined. All patients included in the study underwent a traditional rheumatological examination with the assessment of disease activity according to the criteria of the American College of rheumatologists for pediatric patients. The severity of pain syndrome on a visual analog scale (VAS) from 0 to 10 was determined separately by patients and their parents, patients independently filled in the Von Korff Questionnaire and the McGill pain questionnaire.&#x0D; Results. There were no differences in the severity of pain syndrome between patients with signs of arthritis activity and without signs of arthritis activity according to VAS, Van Korff and McGill questionnaires.&#x0D; Conclusion. On the example of the studied patients, it is not possible to link chronic pain syndrome in JIA with the activity of arthritis. It is necessary to further study the possible causes of chronic pain syndrome in children with JIA, including anxiety and depressive disorders for a better understanding of the nature of chronic pain and search for additional methods of its treatment.

Effect of transforaminal epidural block for relief of chronic low back pain with radiculopathy of multiple etiologies

Introduction: Low back pain is one of the most common causes of chronic pain syndrome. Epidural steroids are being used for relieving mechanical causes of back pain, accompanied by signs of nerve root irritation with good results. Transforaminal epidural block at a particular level is a convenient route for steroid injection. Methods: The study was carried out on patients attending our pain clinic complaining of low back pain with radiculopathy where conservative therapy failed. Patients were divided into three groups (20 in each, allocated by random number table), 1 st one having collapsed vertebra, 2 nd one having disc protrusion following degenerative changes, 3 rd one having Grade I spondylolisthesis in lumbosacral region. Each of them received transforaminal epidural block at one level (L1/L2) with a dose of 40 mg of depot methyl prednisolone, diluted with 1 ml of 0.25% isobaric bupivacaine (to make a volume of 2 ml for each level on both sides). Initial pain response (at 1 h) was assessed by visual analogue scale (VAS). Long-term pain and disability were assessed (at 1 st , 3 rd and 6 th months) by using VAS score and oswestry disability index (ODI) score. Results: Significant improvement in VAS and ODI score were observed in cases of collapsed vertebra and disc protrusion due to degenerative changes but in the cases of Grade I spondylolisthesis no such improvement was observed. Conclusion: Transforaminal epidural block causes significant relief of symptoms where compression of nerve roots at a particular level causing radiculopathy as in collapsed vertebra or disc protrusion, but not in spondylolisthesis.