Pain Disorders (pain + disorders)

Distribution by Scientific Domains


Selected Abstracts


ORIGINAL RESEARCH,SEXUAL PAIN DISORDERS: The Association between Sexual Function, Pain, and Psychological Adaptation of Men Diagnosed with Chronic Pelvic Pain Syndrome Type III

THE JOURNAL OF SEXUAL MEDICINE, Issue 3 2008
Sylvie Aubin PhD
ABSTRACT Introduction., Prostatitis/chronic pelvic pain syndrome (CPPS) is known to have a negative impact on quality of life, especially on intimate relationships and sexual function. Information is, however, missing on the contribution of demographic and psychological variables to sexual variables. Aim., We compared the sexual function of men with CPPS to men without pain, and examined the relationship between the sexual, demographic, and psychological measures in men with CPPS. Main Outcome Measures., Self-report questionnaires assessing demographic, pain, sexual function, and psychological adaptation. Methods., The sample consisted of 72 men diagnosed with CPPS and 98 men without any pain condition. Self-report questionnaires measuring demographic, pain, and sexual function were completed once at the eligibility visit by all subjects. CPPS subjects completed additional questionnaires related to pain and psychological adaptation. Results., CPPS subjects differed from controls by reporting significantly less frequent sexual desire or thoughts, less frequent sexual activities, less arousal/erectile function, less orgasm function, and higher frequencies of genital pain during/after intercourse. When we adjusted for age and marital status, the difference between groups remained for thoughts/desire, frequency of sexual activity, and arousal/erectile function. Analysis of factors related to sexual function in CPPS subjects included pain status and psychological adaptation. Results showed that frequency of sexual activity decreased with increasing depression, whereas arousal/erectile function decreased with increasing pain symptoms and stress appraisal. Orgasm function decreased with increasing depression and pleasure/satisfaction decreased with increasing pain symptoms, stress appraisal, and decreasing belief of a relationship between emotions and pain. Conclusions., We found a differential sexual profile for men with CPPS when compared to men without pain. The results suggest that interventions addressing psychological factors affecting sexual responses should be further studied in prospective clinical trials as one possible way to improve sexual function and satisfaction in men with CPPS. Aubin S, Berger RE, Herman JR, and Ciol MA. The association between sexual function, pain, and psychological adaptation of men diagnosed with chronic pelvic pain syndrome type III. J Sex Med 2008;5:657,667. [source]


ORIGINAL RESEARCH,SEXUAL PAIN DISORDERS: Interstitial Cystitis/Painful Bladder Syndrome as a Cause of Sexual Pain in Women: A Diagnosis to Consider

THE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007
Kristene Whitmore MD
ABSTRACT Introduction., Sexual pain, or dyspareunia, is a common symptom among women. Dyspareunia presents in many ways, and arises from a range of causes. Interstitial cystitis/painful bladder syndrome (IC/PBS) is one potential cause that may frequently be overlooked by clinicians. Interstitial cystitis is increasingly recognized as more common than was once thought. However, it can be difficult to identify, as the symptoms of IC/PBS (urinary urgency and frequency, dyspareunia, nocturia, and pelvic pain) overlap with other urogynecologic conditions. Aim., This article will review the association between dyspareunia and IC/PBS, and will provide an approach to the diagnosis and treatment of IC/PBS in women with sexual pain. Methods and Main Outcome Measures., Review of the medical literature and expert medical opinion. Results., Many women with IC/PBS experience dyspareunia, often in conjunction with chronic pelvic pain. When IC/PBS is suspected, there are simple measures to aid in the diagnosis of this condition, and treatments are readily available. Conclusions., When a woman presents with the symptoms of urinary urgency and frequency, dyspareunia, nocturia, and/or pelvic pain, IC/PBS should be part of the diagnostic evaluation. Whitmore K, Siegel JF, and Kellogg-Spadt S. Interstitial cystitis/painful bladder syndrome as a cause of sexual pain in women: A diagnosis to consider. J Sex Med 2007;4:720,727. [source]


Pharmacological Approaches to Managing Migraine and Associated Comorbidities,Clinical Considerations for Monotherapy Versus Polytherapy

HEADACHE, Issue 4 2007
Stephen D. Silberstein MD
Comorbidity is defined as an illness that occurs more frequently in association with a specific disorder than would be found as a coincidental association in the general population. Conditions that are frequently comorbid with migraine include depression, anxiety, stroke, epilepsy, sleep disorders, and other pain disorders. In addition, many common illnesses occur concomitantly (at the same time) with migraine and influence the treatment choice. Migraine management, and especially migraine prevention, can be challenging when patients have comorbid or concomitant illnesses. The objectives of this initiative are to review the literature on managing patients who have migraine and common comorbidities, present additional clinical approaches for care of these difficult patients, and evaluate the areas in which research is needed to establish evidence-based guidelines for the management of migraine with associated comorbid conditions. [source]


Neurotoxins in the Neurobiology of Pain

HEADACHE, Issue 2003
Stephen D. Silberstein MD
Migraine is a common, chronic, incapacitating, neurovascular disorder that affects an estimated 12% of the population. Understanding the basic mechanisms of pain is important when treating patients with chronic pain disorders. Pain, an unpleasant sensory and emotional experience, is usually triggered by stimulation of peripheral nerves and often associated with actual or potential tissue damage. Peripheral nerve fibers transmit pain signals from the periphery toward the spinal cord or brain stem. The different diameter pain fibers (A and C) vary in the speed of conduction and the type of pain transmitted (eg, sharp versus dull). When stimulated, peripheral pain fibers carrying sensory input from the body enter at different layers of the dorsal horn, which is then propagated toward the thalamus via the spinothalamic tract within the spinal cord. Conversely, sensory input from the face does not enter the spinal cord but enters the brain stem via the trigeminal nerve. This review describes in detail the neurobiological mechanisms and pathways for pain sensation, with a focus on migraine pain. [source]


Congenital insensitivity to pain: novel SCN9A missense and in-frame deletion mutations,

HUMAN MUTATION, Issue 9 2010
James J. Cox
Abstract SCN9Aencodes the voltage-gated sodium channel Nav1.7, a protein highly expressed in pain-sensing neurons. Mutations in SCN9A cause three human pain disorders: bi-allelic loss of function mutations result in Channelopathy-associated Insensitivity to Pain (CIP), whereas activating mutations cause severe episodic pain in Paroxysmal Extreme Pain Disorder (PEPD) and Primary Erythermalgia (PE). To date, all mutations in SCN9A that cause a complete inability to experience pain are protein truncating and presumably lead to no protein being produced. Here, we describe the identification and functional characterization of two novel non-truncating mutations in families with CIP: a homozygously-inherited missense mutation found in a consanguineous Israeli Bedouin family (Nav1.7-R896Q) and a five amino acid in-frame deletion found in a sporadic compound heterozygote (Nav1.7-,R1370-L1374). Both of these mutations map to the pore region of the Nav1.7 sodium channel. Using transient transfection of PC12 cells we found a significant reduction in membrane localization of the mutant protein compared to the wild type. Furthermore, voltage clamp experiments of mutant-transfected HEK293 cells show a complete loss of function of the sodium channel, consistent with the absence of pain phenotype. In summary, this study has identified critical amino acids needed for the normal subcellular localization and function of Nav1.7. © 2010 Wiley-Liss, Inc. [source]


Patients presenting with somatic complaints: epidemiology, psychiatric co-morbidity and management

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2003
Kurt Kroenke MD
Abstract Somatic symptoms are the leading cause of outpatient medical visits and also the predominant reason why patients with common mental disorders such as depression and anxiety initially present in primary care. At least 33% of somatic symptoms are medically unexplained, and these symptoms are chronic or recurrent in 20% to 25% of patients. Unexplained or multiple somatic symptoms are strongly associated with coexisting depressive and anxiety disorders. Other predictors of psychiatric co-morbidity include recent stress, lower self-rated health and higher somatic symptom severity, as well as high healthcare utilization, difficult patient encounters as perceived by the physician, and chronic medical disorders. Antidepressants and cognitive-behavioural therapy are both effective for treatment of somatic symptoms, as well as for functional somatic syndromes such as irritable bowel syndrome, fibromyalgia, pain disorders, and chronic headache. A stepped care approach is described, which consists of three phases that may be useful in the care of patients with somatic symptoms. Copyright © 2003 Whurr Publishers Ltd. [source]


Temporomandibular disorder subtypes according to self-reported physical and psychosocial variables in female patients: a re-evaluation

JOURNAL OF ORAL REHABILITATION, Issue 3 2005
T. I. SUVINEN
summary, Several studies support the relevance of psychological and psychosocial factors in the assessment and management of chronic musculoskeletal pain disorders, including temporomandibular pain disorders (TMDs). The aim of this study was to re-evaluate subtyping approach used in an earlier study (TI Suvinen, KR Hanes, JA Gerschman, PC Reade. J Orofac Pain 1997;11:200) and to compare perceived physical symptoms, psychological, coping and psychosocial variables between subtypes of patients who seek treatment for their temporomandibular pain and dysfunction. A total of 41 consecutive female patients were assessed multiaxially for physical symptoms, coping style and effectiveness and illness behaviour by a previously validated Temporomandibular Pain Dysfunction Questionnaire (TI Suvinen, KR Hanes, JA Gerschman, PC Reade. J Orofac Pain 1997;11:200). Additional measures of psychosocial variables included the global scores of the Beck Depression and Anxiety Inventory and Part I of the Multidimensional Pain Inventory. Subtypes were generated using an iterative partitioning method, k-means cluster analysis. Three clusters were identified and termed as Simple (22%), Intermediate (41%) and Complex (37%) temporomandibular disorders subtypes. Significant differences (P < 0·05) were found between clusters in psychological (coping style and effectiveness, disease conviction and affective disturbance) and in psychosocial variables (daily interference and social, work and family satisfaction), but not between physical variables. The results support previous studies that have shown differences in psychosocial variables in the presentation and subtyping of TMDs and the biopsychosocial orientation in assessment. The findings need to be reverified in a larger sample along specific physical diagnoses, but it is tentatively proposed how the three subtypes could be used in the classification of temporomandibular pain patients to guide management, based on the constellation of predominant psychological and psychosocial illness impact variables. [source]


Enhanced expression of mast cell growth factor and mast cell activation in the bladder following the resolution of trinitrobenzenesulfonic acid (TNBS) colitis in female rats,

NEUROUROLOGY AND URODYNAMICS, Issue 6 2007
Ruomei Liang
Abstract Aims Chronic pelvic pain disorders often overlap. We have shown that acute colonic irritation can produce acute irritative micturition patterns and acutely sensitize bladder afferent responses to mechanical and chemical stimuli. We hypothesize that with time, colonic irritation can lead to neurogenic changes in the bladder and the development of chronic bladder sensitization. Methods Micturition patterns were measured in rats 60,90 days after the induction of trinitrobenzenesulfonic acid (TNBS) colitis in the resolution phase of this model. Total and activated mast cells (MCs) were quantified in the bladder, while mRNA levels of stem cell factor (SCF; a.k.a. MC growth factor) and nerve growth factor (NGF; a MC and nociceptive C-fiber stimulator) were quantified in the bladder and L6-S1 dorsal root ganglia (DRG). Results Following intra-rectal TNBS, voiding volume was reduced (P,<,0.005), while voiding frequency was increased (P,<,0.05), both by ,50%. Furthermore, both the percentage and density of activated bladder MCs were significantly elevated (P,<,0.05), although total MC counts were not statistically increased. At the molecular level, urinary bladder SCF expression increased twofold (P,<,0.005), as did NGF (P,<,0.01), while L6-S1 DRG levels were not significantly elevated. Conclusions Chronic cystitis in the rat as evidenced by changes in micturition patterns and the recruitment of activated MCs can occur during the resolution phase of TNBS colitis. These changes, of which MCs may play an important role, appear to be maintained over time and may occur via stimulation of convergent pelvic afferent input resulting in the upregulation of neurotrophic factors in the target organ. Neurourol. Urodynam. 26:887,893, 2007. © 2007 Wiley-Liss, Inc. [source]


The use of quality of life measures in oral medicine: a review of the literature

ORAL DISEASES, Issue 5 2010
R Ni Riordain
Oral Diseases (2010) 16, 419,430 Objectives:, To explore the use of patient reported quality of life measures in oral medicine, to highlight the importance of use of these measures in oral medicine practice and to provide guidance for the selection of such measures in the future. Methods:, A detailed literature review was undertaken to investigate the use of quality of life measures in oral medicine. The databases searched were MEDLINE (through PubMed), EMBASE, CINDHL, Web of Science Citation Index and the Cochrane Database of Systematic Reviews and randomised controlled trials. Results:, The initial literature search yielded a total of 5310 citations; however, only 63 of these fulfilled the inclusion criteria. Twenty-two articles were regarding oral mucosal conditions, 14 related to orofacial pain disorders and 27 were regarding salivary gland-related conditions. Conclusions:, The evaluation of quality of life in oral medicine has a broad applicability, providing information in treatment-based studies and population-based studies. A predominance of generic and oral health specific quality of life measures are being used to a limited extent in oral medicine practice. A scarcity of reports of the development, validation or use of disease specific measures is evident. [source]


Hypertension-associated hypalgesia: a clue to the comorbidity of headache and other pain disorders

ACTA NEUROLOGICA SCANDINAVICA, Issue 2009
L. J. Stovner
Background ,, Primary headaches and chronic musculoskeletal pain are prevalent disorders with incompletely known causes. Aims ,, To review the data from the HUNT studies on the comorbidity of these pain disorders, and their relation to blood pressure levels Materials & Methods ,, Cross-sectional and prospective data from more than 50 000 persons participating in the HUNT studies, a large Norwegian population-based health survey Results ,, Headache and chronic musculoskeletal complaints in all parts of the body were comorbid, and the prevalence of pain in all locations was inversely related to blood pressure levels. Discussion ,, A likely cause for this is hypertension-associated hypalgesia, described in both animal and human experimental models, involving interactions between cardiovascular and pain modulating centres at the brainstem level, and probably also peripheral baroreceptor mechanisms. Conclusion ,, Better understanding of these mechanisms may be crucial for enabling better prevention and treatment of these very prevalent, costly and disabling disorders. [source]