Short Form Of The McGill Pain Questionnaire Research Articles

Qualitative and quantitative assessment of headaches in people with temporomandibular joint disorders: A pilot study.

Headaches (HAs) and temporomandibular joint dysfunction (TMD) are common comorbidities, and the presence of one of them in a patient increases the incidence of the other. The relationship between these 2 conditions may involve common pathophysiological processes. Considering the topicality of the problem, it is justified to conduct research in this field. In this study, we assessed HA type and severity in people with TMD. The aim of the study was to conduct qualitative and quantitative assessments of HAs in people with temporomandibular joint (TMJ) disorders. The study group consisted of 51 subjects of both sexes with a TMD diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) test. A self-report questionnaire was utilized to self-assess the presence of TMD symptoms, while the standardized Short-Form of the McGill Pain Questionnaire was used to qualitatively and quantitatively assess HAs. People with TMD were significantly more likely to report HA occurrences (p < 0.001). Pain intensity was statistically significantly higher among individuals with TMD compared to those without TMD symptoms (p < 0.001). Most often, the HA was associated with a pressing pain (r = 0.82) and least often, it was described as cutting (r = 0.30). Neck and shoulder girdle pain (p = 0.059; 82.9%) and clenching and/or grinding of teeth (p = 0.021; 92.7%) were significantly more common among patients who declared HAs than among those without HAs. The results obtained so far may indicate a significant relationship between HA and TMD. We have described the relationship between the occurrence of HAs and TMD. Headaches are more frequent and more severe in people with TMD.

A Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Therapeutic Effect of Magnesium-L-Threonate Supplementation for Persistent Pain After Breast Cancer Surgery.

Post-mastectomy pain syndrome is a common yet debilitating neuropathic complication after breast cancer procedures, resulting in significantly reduced quality of life. Recently, emerging evidence has supported the therapeutic effect of magnesium administration in chronic pain. However, the role of magnesium supplementation in development of chronic pain after breast cancer surgery remains less known. The aim of this study was to evaluate therapeutic effect of magnesium supplementation on persistent pain after breast cancer procedure. This was a randomized, double-blind, placebo-controlled clinical trial. A total of 109 patients who underwent breast cancer procedure received magnesium-L-threonate (n = 48) or placebo (n = 61) for 12 weeks. Chronic pain incidence, short form of the McGill Pain Questionnaire (SF-MPQ), Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Telephone Interview for Cognitive Status (TICS) were evaluated at 3- and 6-month follow-up. About 31% (15 out of 48) of patients reported chronic pain after magnesium supplementation, and 26% (16 out of 61) of the control group at 6-month follow-up respectively. Total scores of SF-MPQ were significantly increased in the control group 6 months after surgical intervention (mean difference, 1.475; 95% CI, -2.730 to -0.2211), but NOT in the magnesium treated group (mean difference, 1.250; 95% CI, -2.775 to 0.2748). No significant differences were found between two cohorts on SF-MPQ, GAD-7, PHQ-9, PSQI, or TICS at each timepoint. Oral supplementation of magnesium-L-threonate did not effectively prevent the development of persistent pain in breast cancer survivors, nor provide sufficient pain relief over placebo. We did not observe improvement of pain, mood, sleep disorder, or cognitive function after 12-week magnesium supplementation. Future study may focus on magnesium combined with other effective anti-neuropathic pain treatment.

Individualized Homeopathic Medicines for Low Back Pain in Lumbar Spondylosis: Double-Blind, Randomized, Placebo-Controlled Trial.

Lumbar spondylosis (LS) is a degenerative disorder of the lumbar spine. Despite substantial research efforts, no gold-standard treatment for LS has been identified. The efficacy of individualized homeopathic medicines (IHMs) in LS has remained under-researched. In this study, the efficacy of IHMs was compared with identical-looking placebos in the treatment of low back pain associated with LS. A double-blind, randomized (1:1), placebo-controlled trial was conducted at the National Institute of Homoeopathy, West Bengal, India. Patients were randomized to receive IHMs or placebos, along with standardized concomitant care for both the groups. The Oswestry low back pain and disability questionnaire (ODQ) was the primary outcome; the Roland-Morris questionnaire (RMQ) and the short form of the McGill pain questionnaire (SF-MPQ) were the secondary outcomes. Each was measured at baseline and every month for 3 months. The intention-to-treat (ITT) sample was analyzed to detect any inter-group differences using two-way repeated measures analysis of variance models overall and by unpaired t-tests at different time points. Enrolment was stopped prematurely because of time restrictions; 55 patients were randomized (verum: 28; control: 27); 49 were analyzed by ITT (verum: 26; control: 23). Inter-group differences in ODQ (F 1, 47 = 0.001, p = 0.977), RMQ (F 1, 47 = 0.190, p = 0.665) and SF-MPQ total score (F 1, 47 = 3.183, p = 0.081) at 3 months were not statistically significant. SF-MPQ total score after 2 months (p = 0.030) revealed inter-group statistical significance, favoring IHMs against placebos. Some of the SF-MPQ sub-scales at different time points were also statistically significant: e.g., the SF-MPQ average pain score after 2 months (p = 0.002) and 3 months (p = 0.007). Rhus toxicodendron, Sulphur and Pulsatilla nigricans were the most frequently indicated medicines. Owing to failure in detecting a statistically significant effect for the primary outcome and in recruiting a sufficient number of participants, our trial remained inconclusive. CTRI/2019/11/021918.

Burning Mouth Syndrome and Hypertension: Prevalence, Gender Differences and Association with Pain and Psycho-Social Characteristics-A Case Control Study.

To assess the prevalence of hypertension (HTN) in burning mouth syndrome (BMS) patients and to investigate its relationship with sociodemographic factors, pain and the psychological profile. A case-control study was conducted by enrolling 242 BMS patients and 242 controls matched for age and gender. Sociodemographic and clinical characteristics were recorded, and all participants completed numeric rating scale (NRS), the short-form of the McGill pain questionnaire (SF-MPQ), the Hamilton rating scale for anxiety and depression (HAM-A, HAM-D), the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS). The BMS patients presented with a statistically significant higher prevalence of HTN compared to that in the controls (55% versus 33.5%; p-value: <0.001) and higher median scores of the NRS, SF-MPQ, HAM-A, HAM-D, PSQI and ESS (p < 0.001). Multivariate regression analysis in the BMS patients indicated positive correlations between HTN and age, systemic diseases, drug consumption and anxiety (p-value: <0.001) and these predictors were responsible for 11.3% of the HTN variance in the BMS patients, when considered together. The prevalence of HTN was significantly higher in the BMS patients, since ageing, the presence of comorbidities, drug consumption and anxiety were potential predictors. Further studies are needed to better investigate the relationship between BMS and HTN.

Analgesic Effect of a Single Drop of Nepafenac 0.3% on Pain Associated with Intravitreal Injections: A Randomized Clinical Trial.

To evaluate the analgesic effect of nepafenac 0.3% in patients undergoing intravitreal injections (IVI) of antivascular endothelial growth factors. This is a single-center, prospective, randomized, blinded, triple-arm, placebo-controlled interventional study. Patients were randomized into 3 Groups. Group 1 (n = 33) received nepafenac 0.1%, Group 2 (n = 32) received nepafenac 0.3%, and Group 3 (n = 31) received placebo 40 min before IVI. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the visual analog scale (VAS), the Main Component of the SF-MPQ, and the present pain intensity (PPI) scores immediately and 6 h postinjection. Immediately after IVI, the VAS pain score was statistically significantly lower in patients treated with nepafenac 0.1% and 0.3%, compared with placebo (P < 0.001 and P = 0.001, respectively). The PPI scores were statistically significantly lower when nepafenac 0.1% or 0.3% was instilled compared with placebo (P = 0.01 and P < 0.0001, respectively). The Main Component of the SF-MPQ scores were statistically significantly lower after nepafenac 0.1% and 0.3% administration compared with placebo (P = 0.001 and P < 0.001, respectively). Six hours post-IVI the nepafenac 0.3% demonstrated statistically significantly higher analgesic effect compared with nepafenac 0.1% and placebo as this was indicated by the VAS pain score (P = 0.013 and P < 0.00001, respectively) and by the PPI score (P = 0.01 and P < 0.00001, respectively). A single instillation of nepafenac 0.1% or 0.3% before IVI could effectively alleviate the IVI-related pain. The 0.3% formula exerts its analgesic effect more intensively at 6 h after the IVI.

The impact of pain on functionality and health related quality of life in patients with knee osteoarthritis

Introduction/Objective. Pain, stiffness and limited mobility are the main factors that lead to difficulties in performing daily activities and are also responsible for the decline in the quality of life in people with knee osteoarthritis (OA). The aim of this study was to evaluate the functional capacity and health related quality of life (HRQoL) compared to pain in patients with knee OA, as well as to determine the correlation between these three clinical variables. Methods. The study involved 931 patients diagnosed with knee OA. In all patients, pain was evaluated by a short form of the McGill pain questionnaire (SF-MPQ), functional status was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), while life quality was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The average age of patients was 61.21 ? 4.62 years, while 71.3% of them were women. The quality of life in patients with knee OA and all pain parameters contained in the SF-MPQ were highly statistically positively associated (p ? 0.01). In addition, the physical functioning was mostly affected by emotional pain (rho = -0.585). A high statistical correlation (p ? 0.01) was noted between stiffness and physical functioning from the WOMAC questionnaire and all of the parameters from the SF-MPQ. The physical functioning from the WOMAC questionnaire had the strongest correlation with total pain incorporated into the McGill questionnaire (rho = 0.530). Conclusion. Knee pain has a significant impact on functional capacity and HRQoL in patients with knee OA. Therefore, one of the main therapy goals for OA of the knee should be to reduce the pain in the affected knee, which can help to improve the functionality and HRQoL of these patients.

Prevalence, predictive factors and clinical course of persistent pain associated with teeth displaying periapical healing following nonsurgical root canal treatment: a prospective study.

To investigate the prevalence, pain catastrophizing and other predictive factors and clinical course of persistent pain/discomfort associated with teeth displaying periapical healing following nonsurgical root canal treatment (NSRCT). One hundred and ninety-eight patients (264 teeth) who had NSRCT were reviewed at 5-14months, postoperatively. Teeth with persistent post-treatment pain or discomfort, plus evidence of periapical healing were further monitored 0.5, 4 and 10years later. Pain Catastrophizing Scale (PCS) and Short Form of the McGill Pain Questionnaire (SF-MPQ) were completed. Predictive factors were investigated using logistic regression models. Twenty-four per cent (60/249) of teeth displaying periapical healing at first review were associated with persistent pain or discomfort. Fifty-five teeth monitored 6-7months later were associated with reduction in pain (17/30) or discomfort (7/25). Cone beam computed tomography (CBCT) of eight teeth with persistent symptoms and complete periapical healing (by conventional radiographs) revealed distinct, small apical radiolucencies (n=3) or root apex fenestration through the buccal plate (n=2). History of chronic pain (headache, temporo-mandibular joint, masticatory muscle, neck, shoulder or back pain; P=0.005), preoperative pain (P=0.04), responsive pulp (P=0.009), tooth crack (P=0.05) and small periapical radiolucency (P=0.005) were significant predictive factors. The PCS revealed 16 patients (22 teeth) were catastrophizers (PCS≥30), but this had no influence on post-treatment symptoms (P=0.5). Persistent pain or discomfort associated with teeth showing periapical healing at the first review after NSRCT, decreased in intensity in most cases over the following 6months. Longer-term follow-up revealed spontaneous improvement or symptom resolution in the majority of those with confirmed radiographic the absence of periapical disease. Five predictive factors (history of chronic pain, teeth with responsive pulps, association with pain, diagnosis of tooth crack before treatment and diameter of preoperative radiolucency) were identified.

Analgesic Effect of Topical Nepafenac 0.1% on Pain Related to Intravitreal Injections: A Randomized Crossover Study

ABSTRACTPurpose: To evaluate the analgesic effect of nepafenac 0.1%, a topical non-steroidal anti-inflammatory agent, in patients undergoing treatment with intravitreal injections (IVIs).Material and methods: It is a single center, prospective, randomized, double-blinded, placebo-controlled, crossover interventional study. Fifty-two patients scheduled to undergo IVI of anti-vascular endothelial growth factors were included in the study. Patients were randomized in a 1:1 ratio to receive topical nepafenac 0.1% or placebo 1 h before subsequent IVIs. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the Visual Analogue Scale (VAS), the Main Component of the SF-MPQ (MC-SF-MPQ), and the Present Pain Intensity (PPI) scores immediately and 6-h post-injection.Results: The VAS pain score was statistically significant lower immediately and 6-h post-IVI in patients treated with nepafenac (p = 0.001 and < 0.001, respectively). The MC-SF-MPQ scores were also statistically significant lower after nepafenac administration at both time points (p < 0.001). Finally, the PPI score was statistically significant lower when nepafenac was instilled before IVI (p = 0.015 immediately and p < 0.001 at 6-h post-injection).Conclusions: A single drop of nepafenac 0.1% before IVI could effectively alleviate the IVI-related pain immediately and up to 6 h after the injection.

Topic anaesthesia with a eutectic mixture of lidocaine/prilocaine cream after elective caesarean section: a randomised, placebo-controlled trial.

Aim of the study was to investigate the topical application of a eutectic mixture of lidocaine/prilocaine (EMLA®) cream after caesarean section (CS) and its effect on postoperative pain, time to mobilisation, and time to discharge. A total of 189 pregnant women were enrolled; full data sets were available for 139 of them, who were prospectively randomised to receive either placebo (control group) or EMLA® cream (study group) on the CS lesion directly as well as 24h after surgery. Postoperative pain was assessed 24 and 48h after surgery using the short form of the McGill Pain Questionnaire (SF-MPQ). Additional analgesic pain medication on demand was assessed in both groups. A total of 62 women were allocated randomly to the study and 77 patients to the control group before primary CS. There were no statistically significant differences regarding demographic and surgical parameters comparing both collectives. In addition, the postoperative total pain scores after 24h [McGill total: 38.5 (0-102) vs. 50 (0-120) p=0.0889] as well as after 48h [24 (0-79) vs. 30.5 (0-92); p=0.1455] showed no significant differences. Furthermore, time to mobilisation (hours) [9.68 (2.18-51.38) vs. 9.47 (4.18-41.77); p=0.5919] and time to discharge (hours) [98.6 (54.08-170.15) vs. 98.2 (43.45-195.87); p=0.5331] were comparable. The postoperative application of EMLA® cream after CS did not reduce postoperative pain or time to mobilisation or discharge, so that its use in this context has to be seen critically.

Diclofenac for pain associated with intravitreal injections: a prospective, randomized, placebo-controlled study.

Intravitreal injections (IVI) are often painful. To evaluate the analgesic effect of diclofenac in patients undergoing IVI. Single-centre, prospective, randomized, triple-arm, placebo-controlled, interventional study in the University Hospital of Patras. Seventy-four patients. Group 1 (n = 25) received topical diclofenac 45 min before IVI, Group 2 (n = 25) received oral diclofenac 4 h before IVI and topical diclofenac while Group 3 (n = 24) received placebo before IVI. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the visual analogue scale (VAS), the main component of the SF-MPQ and the Present Pain Intensity (PPI) scores immediately and 6 h post-IVI. The VAS pain score immediately post-IVI. Immediately post-IVI, patients in Group 2 reported significantly lower VAS pain scores compared to placebo while no statistically significant difference was found between patients that received topical diclofenac and placebo. Six hours post-IVI, patients in both treatment groups reported significant lower VAS pain scores compared to placebo. The scores of the main component of the SF-MPQ were significantly lower in patients of treatment groups compared to placebo at both time-points. Finally, while no statistically significant difference was found between the 3 Groups in PPI scores immediately post-IVI, 6 h later, patients of both treatment groups reported significantly lower PPI scores compared to placebo. The combination of topical and oral diclofenac demonstrated better analgesic effect than topical diclofenac administration in patients undergoing IVI immediately and up to 6 h post-IVI.

A clinical study of electro-acupuncture combined with Leitoufeng granules for primary trigeminal neuralgia

Objective To detect the therapeutic effectiveness of electro-acupuncture combined with Leitoufenggranules for primary trigeminal neuralgia. Methods A total of 60 patients with PTN were randomly divided into the control group and the treatment group (30 in each group). Control group received Carbamazepine, and the treatment group received the electro-acupuncture combined with Leitoufeng granules. Both groups were treated for 15 days as a period of treatment with 3 treatments in total. The outcomes were S hort form of the McGill Pain Questionnaire (SF-MPQ), painratingindex (PRI), the number of word feature (NWC), the present painindex (PPI), the Visual Analogue Scale (VAS) the clinical effect rate and recurrence rate. Results After treatment, compared with the control group, the effect rate (96.67% vs. 70.00%, χ2=5.880,) in the treatment group showed significantly higher (P=0.015). Compared with the control group, PRI (0.20±0.47 vs. 3.33±4.65, t=3.592), NWC (0.20±0.48 vs. 1.40±1.87, t=3.345), VAS (0.20±0.48 vs. 1.27±1.66, t=3.321), PPI (0.17±0.38 vs.0.90±0.99, t=3.771) and the total score (0.79±1.83 vs. 6.90±9.05, t=3.602) in the treatment group were significantly lower (P<0.01). In the follow-up of 3 months, compared with control group, the recurrence rate (10.0% vs.56.6%, χ2=12.675) in the treatment group significantly lower (P<0.01). Conclusion As to the treatment of primary trigeminal neuralgia, the effect of acupuncture combined withLeitoufeng granules was superior to the Carbamazepine. Key words: Primary trigeminal neuralgia; Electro-acupuncture; Leitoufeng granules; Pain measurement

Exploration of the conditioning electrical stimulation frequencies for induction of long-term potentiation-like pain amplification in humans.

Spinal nociceptive long-term potentiation (LTP) can be induced by high- or low-frequency conditioning electrical stimulation (CES) in rodent preparations in vitro. However, there is still sparse information on the effect of different conditioning frequencies inducing LTP-like pain amplification in humans. In this study, we tested two other paradigms aiming to explore the CES frequency effect inducing pain amplification in healthy humans. Cutaneous LTP-like pain amplification induced by three different paradigms (10, 100, and 200Hz CES) was assessed in fifteen volunteers in a crossover design. Perceptual intensity ratings to single electrical stimulation at the conditioned site and to mechanical stimuli (pinprick and light stroking) in the immediate vicinity were recorded; superficial blood flow was also measured. The short form of the McGill Pain Questionnaire (SF-MPQ) was used for characterizing the perception induced by CES. Compared with the control session, pain perception to pinprick stimuli and area of allodynia significantly increased after all three CES paradigms. In the 10 and 200Hz sessions, the superficial blood flow 10min after CES was significantly higher than in the control session reaching a plateau after 20 and 10min, respectively; for the 100Hz paradigm, a stable level was found without significant differences compared with CES and control sessions. 10Hz CES caused a lower SF-MPQ score than 100Hz. High-frequency (200Hz) and low-frequency (10Hz) paradigms can induce heterotopic pain amplification similar to the traditional 100Hz paradigm. The 10Hz paradigm can be an appealing alternative paradigm in future studies due to its specific association with low-level discharging of C-fibers during inflammation.

Postmastectomy Pain: A Cross-sectional Study of Prevalence, Pain Characteristics, and Effects on Quality of Life.

Background:Postmastectomy pain syndrome (PMPS) is defined as a chronic (continuing for 3 or more months) neuropathic pain affecting the axilla, medial arm, breast, and chest wall after breast cancer surgery. The prevalence of PMPS has been reported to range from 20% to 68%. In this study, we aimed to determine the prevalence of PMPS among mastectomy patients, the severity of neuropathic pain in these patients, risk factors that contribute to pain becoming chronic, and the effect of PMPS on life quality.Methods:This cross-sectional study was approved by the Sakarya University, Medical Faculty Ethical Council and included 146 patients ranging in age from 18 to 85 years who visited the pain clinic, general surgery clinic, and oncology clinic and had breast surgery between 2012 and 2014. Patients were divided into two groups according to whether they met PMPS criteria: pain at axilla, arm, shoulder, chest wall, scar tissue, or breast at least 3 months after breast surgery. All patients gave informed consent prior to entry into the study. Patient medical records were collected, and pain and quality of life were evaluated by the visual analog scale (VAS) for pain, a short form of the McGill Pain Questionnaire (SF-MPQ), douleur neuropathique-4 (DN-4), and SF-36.Results:Patient mean age was 55.2 ± 11.8 years (33.0–83.0 years). PMPS prevalence was 36%. Mean scores on the VAS, SF-MPQ, and DN-4 in PMPS patients were 1.76 ± 2.38 (0–10), 1.73 ± 1.54 (0–5), and 1.64 ± 2.31 (0–8), respectively. Of these patients, 31 (23.7%) had neuropathic pain characteristics, and 12 (9.2%) had phantom pain according to the DN-4 survey. Patients who had modified radical mastectomy were significantly more likely to develop PMPS than patients who had breast-protective surgery (P = 0.028). Only 2 (2.4%) of PMPS patients had received proper treatment (anticonvulsants or opioids).Conclusions:PMPS seriously impacts patients’ emotional situation, daily activities, and social relationships and is a major economic burden for health systems. We conclude that the rate of PMPS among patients receiving breast cancer surgery in Turkey is 64.1% and that challenges to the proper treatment of these patients deserve further investigation.

Skausmo katastrofizavimo sąsajos su priešoperacinio ir ūmaus pooperacinio skausmo intensyvumu riešo kanalo sindromu sergančių pacientų imtyje

Background and purpose . Research shows that pain catastrophizing might be an important predictor of pain related outcomes in patients with various health conditions despite of objective severity of the illness. This study aimed to evaluate prognostic value of catastrophizing the pain in predicting pain intensity before and one day after the surgery for median nerve decompression in a sample of patients with carpal tunnel syndrome (CTS). Methods . 53 patients with electrodiagnostically proven CTS participated in this study. Patients were assessed before and one day after the surgery for median nerve decompression using the Pain Catastrophizing Scale (PCS), and the Short Form of the McGill Pain Questionnaire (SF-MPQ). Intensity of pre- and acute postoperative pain was evaluated using visual analogue scales. Results . Level of reported pain decreased significantly one day after the surgery. No significant correlations were observed between pain catastrophizing and average level of pain during a week before and one day after the surgery. Correlation was observed between highest experienced level of pain after the surgery and preoperative total PCS score. However, pain catastrophizing did not predict neither preoperative nor acute postoperative pain one day after the surgery in multivariate analyses when other study variables were taken into account. Sensory dimension of SF-MPQ was a better predictor of preoperative pain. None of pain and demographic variables predicted acute postoperative pain. Conclusions. Pain catastrophizing was not found to be a significant predictor of pre- or acute postoperative pain in CTS patients.

Acupuncture at Houxi (SI 3) acupoint for acute neck pain caused by stiff neck: study protocol for a pilot randomised controlled trial

IntroductionThe use of acupuncture has been suggested for the treatment of acute neck pain caused by stiff neck in China. However, current evidence is insufficient to draw any conclusions about...

P.2.h.005 Somatic pain modulation and its role in typifying the dimension of pain in depression

with respect to suicide risk factors in CRPS patients are available. The purpose of this study was to assess risk factors for suicidal ideation in patients with CRPS and also we evaluated psychiatric comorbidity in this population. Methods: Based on criteria established by the International Association for the Study of Pain, 39 patients diagnosed with CRPS Type 1 or Type 2 were enrolled in this study. Suicidal ideation was assessed using item 3 of the Hamilton Depression Rating Scale (HAMD). The low-suicidal ideation (SI) group included those with scores of 1 or below on HAMD item 3 (0 = suicide ideation absent, 1 = feels that life is worth living), and the high-SI group included those with HAMD item 3 scores above 1. Symptoms of pain were evaluated using the short form of the McGill Pain Questionnaire (SF-MPQ). Psychiatric symptoms were assessed in using the Structured Clinical Interview for DSM-IV Disorders (SCID-I; SCID-II), the HAMD, the Hamilton Anxiety Rating Scale (HAMA), the Global Assessment of Functioning Scale (GAF), and the Pittsburgh Sleep Quality Index (PSQI). Betweengroup comparisons involving categorical data were performed using the chi-square statistic corrected for continuity; between-group comparisons involving continuous data (age and socio-economic status) were calculated using Student’s t-test. Pearson’s correlation analysis was used to assess correlations between suicidal ideation and other variables. Results: 33 (84.6%) were diagnosed with CRPS Type 1, and six (15.4%) were diagnosed with CRPS Type II. Males accounted for 61.5% (n = 24) of the patients, and females 38.5% (n = 15). The mean age of the patients at their initial evaluation at the pain clinic was 37.87 (±11.94) years, and the mean number of years of education was 12.49 (±2.68) years. Patients reported having CRPS symptoms for a mean of 2.84 years (±2.49) at the time of evaluation and had been prescribed 4.28 (range, 0−7) different kinds of medications on average. Twenty-nine patients (74.4%) were at high risk and 10 (25.6%) were at low risk for suicidal ideation. Risk factors significantly associated with suicidal ideation included depression (p= 0.002), severity of pain (p= 0.024), and low scores on the GAF (p= 0.027). No significant correlations were found between suicidal ideation and anxiety or quality of sleep. Conclusions: CRPS is recognized as one of the most difficult conditions to treat among pain syndromes. This study found that the factors most strongly associated with suicide in patients with CRPS were depression, pain severity, and general functioning. These results suggest that psychiatric evaluation and intervention should be included in the treatment of CRPS.

Topical anaesthetic patches for postoperative wound pain in laparoscopic gynaecological surgery: a prospective, blinded and randomised trial.

Aim of this prospective study was to investigate the effectiveness of eutectic mixture of local anaesthetic (EMLA) patches on every abdominal incision for pain relief after gynaecologic laparoscopic surgery. A total of 121 women were prospectively randomised to receive either placebo (control group) or EMLA (study group) patches on all abdominal incisions. Postoperative pain was assessed 24 and 48 h after surgery using the short form of the McGill Pain Questionnaire (SF-MPQ). The amount of analgesic pain medication on demand was assessed in both groups. Sixty women were allocated to the study group and 61 patients to the control group before laparoscopic surgery. There were no statistically significant differences regarding age, body mass index (BMI), duration of surgery and blood loss comparing both groups. There were no statistically significant differences between both groups with regard to postoperative total pain scores 24 h (McGill total score: 31.77 ± 27.95 vs. 36.80 ± 31.39, p = 0.3535) and 48 h (McGill total score: 19.18 ± 20.09 vs. 26.61 ± 27.70, p = 0.0942) after surgery. Time to mobilisation after surgery (hours) was significantly shorter in the study group (5.01 ± 3.72 vs. 5.78 ± 3.04, p = 0.0423). Despite of a significant reduction of time for mobilisation transdermal anaesthetic patches after gynaecologic laparoscopic surgery did not lead to decreased postoperative pain scores.

Walking and cognition, but not symptoms, correlate with dual task cost of walking in multiple sclerosis

BackgroundPerforming a cognitive task while walking results in a reduction of walking performance among persons with MS. To date, very little is known about correlates of this dual task cost (DTC) of walking in MS. PurposeWe examined walking performance, cognitive processing speed, and symptoms of fatigue, depression, anxiety, and pain as correlates of DTC of walking in MS. Methods82 persons with MS undertook a 6-min walk test (6MWT) and completed the Symbol Digit Modalities Test (SDMT), Fatigue Severity Scale (FSS), Short-form of the McGill Pain Questionnaire (SF-MPQ), Hospital Anxiety and Depression Scale (HADS), and self-reported Expanded Disability Status Scale (SR-EDSS). The participants completed 4 trials of walking at a self-selected pace on an electronic walkway that recorded spatiotemporal parameters of gait. The first 2 trials were performed without a cognitive task, whereas the second 2 trials were completed while performing a modified Word List Generation task. ResultsThere were significant and large declines in gait performance with the addition of a cognitive task for velocity (p<.001, η2=.52), cadence (p<.001, η2=.49), and step length (p<.001, η2=.23). 6MWT and SDMT scores correlated with DTC for velocity (r=−.41, p<.001 and r=−.32, p<.001, respectively) and step length (r=−.45, p<.001 and r=−.37, p<.001, respectively); there were no significant associations between FSS, SF-MPQ, and HADS scores with the DTC of walking. Regression analyses indicated that 6MW, but not SDMT, explained variance in DTC for velocity (ΔR2=.11, p<.001) and step length (ΔR2=.13, p<.001), after controlling for SR-EDSS scores. ConclusionWalking performance might be a target of interventions for reducing the DTC of walking in MS.

Two‐Week Test–Retest Stability of the Cold Pressor Task Procedure at two different Temperatures as a Measure of Pain Threshold and Tolerance

The cold pressor task (CPT) was originally developed as a clinically indicative cardiovascular test, and quantifies vascular response and pulse excitability when a subject's hand is immersed into ice water. Since the test procedure results in a gradually increasing cold pain, the CPT has been widely used as a nociceptive stimulus in experimental studies on adults and children. To evaluate the test-retest stability of response patterns using the CPT as a measure of pain threshold and pain tolerance. In the present study, sixty-one undergraduate students received painful stimulation using the CPT either at 4°C or 6°C. Measurements of pain threshold, pain tolerance and pain intensity ratings using the short form of the McGill pain questionnaire (SF-MPQ), were derived. The assessment was repeated twice over an interval of 2 weeks. Test-Retest stability was assessed within a three-layered approach, using ANOVAs, interclass correlation coefficients and standard error of the mean. A Bland-Altman analysis was also performed. Possible predictors of pain threshold and pain tolerance were assessed using random effect panel regression models. No significant differences emerged as a function of temperature (4°C or 6°C) on pain threshold, pain tolerance, and pain ratings. Environmental variables (room temperature and humidity) show no impact on measures of pain threshold and pain tolerance. Consistent with previous findings, regression analysis reveals that age is significantly associated with pain tolerance. The CPT procedure shows excellent 2 week test-retest stability to assess pain threshold and pain tolerance within a student population.

Risk Factors for Suicidal Ideation among Patients with Complex Regional Pain Syndrome.

ObjectiveChronic pain frequently coexists with psychiatric symptoms in patients diagnosed with complex regional pain syndrome (CRPS). Previous studies have shown a relationship between CRPS and the risk of suicide. The purpose of this study was to assess risk factors for suicidal ideation in patients with CRPS.MethodsBased on criteria established by the International Association for the Study of Pain, 39 patients diagnosed with CRPS Type 1 or Type 2 were enrolled in this study. Suicidal ideation was assessed using item 3 of the Hamilton Depression Rating Scale (HAMD), and symptoms of pain were evaluated using the short form of the McGill Pain Questionnaire (SF-MPQ). Psychiatric symptoms were assessed in using the Structured Clinical Interview for DSM-IV Disorders (SCID-I, SCID-II), the HAMD, the Hamilton Anxiety Rating Scale (HAMA), the Global Assessment of Functioning Scale (GAF), and the Pittsburgh Sleep Quality Index (PSQI).ResultsTwenty-nine patients (74.4%) were at high risk and 10 (25.6%) were at low risk for suicidal ideation. Risk factors significantly associated with suicidal ideation included depression (p=0.002), severity of pain (p=0.024), and low scores on the GAF (p=0.027). No significant correlations were found between suicidal ideation and anxiety or quality of sleep.ConclusionSignificant risk factors for suicidal ideation in patients with CRPS include severity of pain, depressive symptoms, and decreased functioning. These results suggest that psychiatric evaluation and intervention should be included in the treatment of CRPS.