Dissertations / Theses on the topic 'Chronic pain'
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1
Hanson-Parkes, Jannae. "Chronic pain." Online version, 2002. http://www.uwstout.edu/lib/thesis/2002/2002hansonparkesj.pdf.
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Peters, Madelon Louise. "Chronic pain and pain perception." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1992. http://arno.unimaas.nl/show.cgi?fid=8259.
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Häuser, Winfried, Frederik Wolfe, Peter Henningsen, Gabriele Schmutzer, Elmar Brähler, and Andreas Hinz. "Untying chronic pain." Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-144172.
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Background: Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods: A cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load,
were tested by Poisson and logistic regression analyses. Results: 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and
6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion: Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load.
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Blackwelder, Reid B. "Chronic Pain Syndrome." Digital Commons @ East Tennessee State University, 2002. https://www.amzn.com/1560534400.
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Book Summary: This new reference ― part of The Secrets Series® provides balanced coverage of all current complementary and alternative therapies by leading experts in the field. Discusses each CAM modality and the disorders for which it has been proven beneficial; what to look for in a practitioner of each field; whether there is a "best" CAM approach; supporting evidence; and the effectiveness of CAM compated to allopathic approaches. Includes chapters on the various alternative therapies as well as chapters on medical disorders and the CAM treatments for those diseases Focuses on the evidence for the effectiveness of CAM therapies Kohatsu one of the leaders in the field (member of first group of fellows of Andrew Weil at University fo Arizona Department of Integrative Medicine Book uses an "integrative" approach---not just CAM therapies, but therapies used in conjunction with total program for treating patient's condition (including standard medical therapies, nutrition, etc). Concise answers that include the author's pearls, tips, memory aids, and "secrets".
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Blackwelder, Reid B. "Chronic Pain Management." Digital Commons @ East Tennessee State University, 2003. https://dc.etsu.edu/etsu-works/6991.
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Blackwelder, Reid B. "Chronic Pain Management." Digital Commons @ East Tennessee State University, 2002. https://dc.etsu.edu/etsu-works/6996.
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Guy, Lynette M. "The Meanings of Chronic Pain: Chronic Pain as a 'Biographical Disruption'." Thesis, Griffith University, 2006. http://hdl.handle.net/10072/368083.
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Understanding the meaning that the patient makes of their pain is critical to the effective management of chronic pain. Not only do individual patients with chronic pain have difficulty coping with changes to their bodies and to their way of living, in many cases they also face a future of uncertainty and increasing disability. Over time, having chronic unrelenting pain can bring about a loss of self-identity and self-esteem, with threats to future vocational or career prospects. This has the potential to disrupt previous biographical plans and aspirations, to create a 'biographical disruption', in sociological terms. Full appreciation of the biological, the psychological and social influences on the patient, the biopsychosocial perspective, is important, therefore, to the successful management of those with chronic pain. In current times, when an aging workforce and increasing numbers of disabled adults are placing increased burden on social structures and insurance schemes, successful management of chronic pain is becoming even more important. This study set out to investigate these factors amongst patients and professionals dealing with this condition. Analysis of data from in-depth interviews with treating practitioners and patients in relation to their perceptions of 'success' in pain management, and 'barriers to success' supported the emergence of three distinct patient groups. Patient outcomes were defined in the form of a patient typology, described as: 'Disempowered': those who were disempowered, depressed and remaining dependent upon social benefits and ongoing health care, with a 'disappearing
biography'; 'Empowered': patients who were socially mobile, able to become empowered and 'reclaiming a biography'; and 'Seeking revenge': those seeking validation of their injury, remaining angry and intent on revenge, seeking to regain their 'stolen biography'. These interpretations were a product of interactions with others, which included treating practitioners, insurance company and rehabilitation personnel. The findings of this qualitative study provide original and significant application and elaboration of the concept of 'biographical disruption' to chronic pain management. Findings from this research suggest that social factors have previously been underestimated as determinants of successful outcomes in relation to pain management. Rather than biological and psychological factors, social factors were identified as playing a major role in the development and maintenance of disability, pain and dysfunction in this population.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Public Health
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Dominick, Clare. "Patterns of chronic pain in New Zealand: Factors associated with chronic pain." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/10109.
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Internationally chronic pain is recognised as a major health problem that has considerable impact individually, socially and economically. This thesis sought to: address gaps in knowledge about the prevalence and impact of chronic pain in the New Zealand general population; further elucidate understanding of the relative roles and interrelationships of prominent biological, psychological, social and material influences on chronic pain; and explore the association of chronic pain with functional outcomes within the general population. An underpinning assumption, also tested within the research, was that chronic pain is a condition in its own right. The thesis drew on concepts from social and life course epidemiology, psychology and physiology and the research questions were investigated within a mixed methods approach. The majority of the thesis was a quantitative epidemiological analysis of a nationally representative general population cross-sectional survey. A smaller qualitative study sought to generate greater understanding of the influence of social interactions on the self-management of chronic pain by individuals living in the community. Novel findings include support, from a population perspective, that chronic pain is a condition in its own right; that co-morbid load (allostatic load) is associated with chronic pain; the association of low levels of physical activity with chronic pain are likely to be confounded by chronic physical conditions and mental health conditions; levels of material resources are independently and significantly associated with chronic pain and with functional outcomes; gender although associated with use of medical treatment was not associated with reporting chronic pain; and age is not associated with chronic pain per se, rather the relationship of age with chronic pain is confounded by other factors, in particular chronic physical conditions. Reciprocal influences among factors over time could usefully be investigated in future.
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Nippert, Amy Ruth. "The Expression of Chronic Pain: A Multimodal Analysis of Chronic Pain Patients." Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/579321.
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There is currently no viable objective methods to validate a patient is suffering from chronic pain. In order to investigate the face and voice of chronic pain, a pilot analysis was run using publicly available videos from a dental clinic and neurology clinic. The stimuli include patients discussing their pain in addition to segments where the patients discuss how they feel after an efficacious pain-relieving procedure. The patients in the videos suffer from sciatic pain or pain from temporomandibular joint disorder (TMD) and are real patients who have undergone a physical examination. The relevant sections from the clips were coded using a manual FACs, and a pilot stimulus was run using layered vocal analysis (LVA) software provided by Nemesysco. The results of this experiment provide valuable and applicable insight into the expression of chronic pain. This may be helpful in determining true pain patients from drug and attention-seeking individuals. In addition, these methodologies could provide a way to examine pain in individuals that may not be able to express themselves, including patients with mental disorders. The insights from this experiment suggest that these analytic methods may be applicable for additional study and possible implementation in a medical setting.
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Pamich, A. "Chronic pain and identity." Thesis, University College London (University of London), 2006. http://discovery.ucl.ac.uk/1445769/.
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This review explores how the experience of chronic pain impacts upon a person's identity. Firstly, drawing on an established body of literature, an outline of chronic pain research is provided. This includes an introduction to theories on cause and treatment, followed by an overview of the physical, psychological and social impact of chronic pain. Secondly, a detailed literature review is conducted on the impact of chronic illness on identity, followed by the impact of chronic pain on identity. Thirdly, factors relating to adjustment in chronic pain are reviewed along with their usefulness in helping us understand what may lead to identity change. Finally, the limitations of studies are discussed along with gaps and directions for future research.
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Taylor, Michelle Andrea. "Flourishing With Chronic Pain." Antioch University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1615920359395019.
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Abooj, Mruvil Vikas. "Mechanisms Underlying Chronic Pain." OpenSIUC, 2014. https://opensiuc.lib.siu.edu/dissertations/790.
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Based on duration, pain is categorized as acute and chronic pain. Acute pain is a short-term phenomenon that resolves after the noxious stimulus is removed or the injury is healed. On the other hand, chronic pain is a long-lasting debilitating condition. In a substantial number of cases, acute pain converts to chronic pain after months or years of the initial injury or damage. The current pain models are designed to study either acute or chronic pain, but not the transition from acute to chronic pain. Also, currently available pain models do not permit a direct comparison of molecular changes occurring in each condition or during the transitory process. Despite decades of research, current treatments seek to alleviate but not resolve chronic pain. Previous studies have shown that prolonged inflammation is a critical factor for initiation and maintenance of chronic pain. On a different platform of research, regenerative medicine strategies have employed Extracellular Matrix (ECM) for wound healing. This goal is achieved over a complex myriad of processes, which mainly involve inhibition of long-term inflammation. Based on these, I hypothesize that neurochemical changes become persistent in chronic pain conditions and components in ECM prevent these changes. The current study addresses two main issues: 1) establishing a pain model that allows the study of transition of acute to chronic pain and 2) using ECM as a possible therapy against chronic pain conditions. In the first aim of the study, low-dose of CFA induced acute pain (a short-term thermal hyperalgesia) and a high-dose of CFA induced chronic pain (a long-term thermal hyperalgesia and mechanical allodynia). In low-dose CFA-treated group, RT-PCR analyses revealed a significant increase in mRNA levels of anti-inflammatory mediators (IL-10, IL-13 and TGF-beta) and a significant decrease in mRNA levels of pro-inflammatory mediators (IL-1beta, IL-6, MCP-1, MMP-9, MMP-12 and TNF-alpha) and these neurochemical changes corresponded with behavior. In high-dose CFA-treated group, chronic pain states corresponded with a significant elevation of mRNA levels of pro-inflammatory mediators, while there was a significant decrease in mRNA levels of anti-inflammatory mediators. These findings were validated with well-established models of acute pain (intraplantar capsaicin or carrageenan) and chronic pain (Chronic Constriction Injury; CCI and Streptozotocin-induced neuropathy). The changes observed in low-dose CFA-treated group were similar to those of capsaicin or carrageenan treatment, whereas changes in the high-dose CFA-treated group resembled to those of CCI and STZ-treatment. TRPV1, a nociceptive ion channel expression and function were significantly increased in both acute and chronic pain models. TRPV1 function in the DRG is more pronounced in acute pain, while there was a greater change in the spinal cord in chronic pain, suggesting a differential role of DRG and spinal cord in acute and chronic pain conditions. The role of TRPV1 was further explored by intrathecal administration of RTX, which attenuated only inflammatory thermal hyperalgesia. These results demonstrate that graded doses of CFA as a possible model to study the transition from acute to chronic pain. Monocyte Chemoattractant Protein (MCP-1) and Matrix Metalloproteinases (MMP-9 and MMP-12) are key molecules; the levels of which increase in acute pain conditions and facilitate the transition to chronic pain conditions. In fact, RTX is in clinical trials as a viable treatment option in treating terminal debilitating cancer pain conditions. In the second aim of the study, high-dose of CFA treatment and CCI were used to mimic chronic pain conditions. Significantly, unlike RTX treatment, intrathecal administration of ECM alleviated both inflammatory thermal hyperalgesia and mechanical allodynia. ECM treatment also reduced the intensity of TRPV1 staining in spinal dorsal horn which, was substantiated by a significant decrease in basal and TRPV1-mediated CGRP release in spinal cord samples. RT-PCR analysis of spinal cord and DRG samples revealed that ECM treatment significantly decreased mRNA levels of several pro-inflammatory cytokines. On the other hand, mRNA levels of anti-inflammatory mediators were significantly increased after ECM treatment in both DRG and spinal cord samples. ECM treatment also decreased intensity of OX-42 (a marker for activated microglia) staining in the spinal dorsal horn. Taken together, these data suggest that ECM treatment restores homeostasis by balancing the levels of pro-inflammatory and anti-inflammatory mediators, which leads to alleviation of chronic pain. Therefore, ECM or components in ECM may provide a novel treatment option for chronic pain.
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Khusnullina, Aygul A. "Neuroimaging of chronic pain." Thesis, Bangor University, 2016. https://research.bangor.ac.uk/portal/en/theses/neuroimaging-of-chronic-pain(39542293-ad7d-4163-beab-203ac359e2a2).html.
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Chronic pain is a debilitating symptom of a wide range of conditions. These conditions are both highly prevalent and create adverse consequences for individuals and society. Whilst understanding of chronic pain conditions has improved, in a number of cases the mechanisms of chronic pain are not fully understood and no cure is available. It is appreciated that chronic pain is not only unpleasant in itself, but can also lead to a reorganisation of the nervous system resulting in further suffering. These factors present a justification for further investigation into the mechanisms and effects of chronic pain to enable progress towards more effective treatments. Neuroimaging techniques have helped our understanding the mechanisms and effects of chronic pain. Techniques have been developed to examine the structure, chemistry and activity of the brain. This thesis describes investigations that used neuroimaging to examine the effects of chronic pain on the human brain. A distinction has been drawn between chronic widespread pain (CWP) and chronic localised pain (CLP). Historically, the latter was seen as a condition of the peripheral components of the pain system. More recently, however, an understanding has been gained that central mechanisms may also be a factor in these conditions. The purpose of my investigations was to examine differences and similarities in the effects of two CWP and CLP conditions on the human brain. Fibromyalgia (FM) and Knee Osteoarthritis (OA) were chosen as representatives of these classes of condition. The effects on neurochemistry, brain structure and coordinated brain activity in these conditions were compared using magnetic resonance spectroscopy (MRS), voxel-based morphometry (VBM) and resting state functional connectivity (rs-FC). Using MRS I observed a reduction in N-Acetylaspartic acid (NAA) in the thalamus of OA patients when compared to FM. Using VBM I observed that grey matter volume (GMV) was reduced in the left brainstem and posterior cingulate cortex in FM patients when compared to OA. GMV was reduced in the left precentral, middle frontal and supramarginal gyri in OA when compared to FM. Using rs-FC I observed an increase in functional connectivity in the default mode network of FM patients when compared to OA. I observed increased functional connectivity within the default mode network (DMN) in both pain conditions compared to healthy controls. I also observed increased functional connectivity between the precuneus and regions in both the DMN and executive attention networks. Consideration is given to these findings in the context of previous relevant research. The implications of the results are related the patients’ own experience of their condition and links to clinical measures are also discussed. The findings provide further evidence for the neural basis of elements of patients’ experience of their condition and further understanding of the differences between the wider presentations of these conditions. The findings are drawn together to demonstrate where the effects of CWP and CLP overlap and where their effects contrast. Consideration is given to the mechanisms at work in these conditions that suggest differing effects on the components of the pain system and also to demonstrate where prolonged abnormal peripheral input may be a factor driving adaptation in CLP.
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Markham, Jennifer Rose. "Coping styles of chronic pain patients for both acute and chronic pain experiences." Case Western Reserve University School of Graduate Studies / OhioLINK, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=case1057682099.
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McKillop, Hannah N. "Psychosocial Factors in Pediatric Chronic Pain: An Examination of Chronic Pain Patient Profiles." Case Western Reserve University School of Graduate Studies / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=case1536267497341521.
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Mills, Emily. "Pain-modulation neural circuits underlying chronic orofacial pain." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21813.
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We have all experienced short-term pain that results from a brief noxious (harmful) stimulus. When we encounter noxious stimuli, the intensity of our pain response is modulated through the activation of pain-modulation neural circuits in the brain. Specifically, systems within the brainstem can both inhibit and facilitate nociceptive (i.e. pain-related) information when it first enters the central nervous system, either in the spinal cord dorsal horn or in the spinal trigeminal nucleus (SpV) in the brainstem for information relating to orofacial (face and mouth) regions. Pain-modulation systems serve a clear biological purpose – in some situations, pain inhibition is highly beneficial as it allows us to focus on escape or defensive behaviours; in other circumstances, pain facilitation can be helpful as it encourages us to rest and recover from potential tissue damage. Despite many of us experiencing short-term pain that is associated with an injury, for reasons that are unclear, some individuals experience long-lasting chronic pain that persists for months or years after the initial injury has healed. There is growing evidence from experimental animal investigations to suggest that the functioning of the pain-modulation circuits, particularly those centred around the rostral ventromedial medulla (RVM) and locus coeruleus in the brainstem, is compromised in chronic pain conditions. These preclinical studies suggest that both neuropathic pain (i.e. pain related to somatosensory nervous system damage) and non-neuropathic pain (i.e. pain related to non-nervous tissue injury) are associated with a functional shift in the pain-modulation system such that it favours an overall facilitation of pain processing. This may contribute to the maintenance of long-term pain in some individuals even after the initial injury has resolved. In humans, there is emerging evidence from psychophysical studies to suggest that some chronic pain conditions, including orofacial conditions, are associated with altered pain-modulation capacities. However, to date, pain-modulation circuit functioning has not been directly explored in individuals with chronic pain. The overall aim of this thesis was to use resting-state functional magnetic resonance imaging (fMRI) to explore the ongoing function of brainstem pain-modulation neural circuits in humans with chronic neuropathic and non-neuropathic orofacial pain. The first investigation (Chapter 2) aimed to determine whether a neuropathic pain condition, painful trigeminal neuropathy (PTN), is associated with altered ongoing functioning in RVM and locus coeruleus pain-modulation pathways. We performed functional connectivity analyses to investigate whether there is an altered coupling of fMRI signals between the RVM, locus coeruleus and other pain-modulation regions in PTN patients compared with pain-free controls. We identified that individuals with PTN display enhanced functional connectivity (signal coupling) between the RVM and other pain-modulation sites, including the midbrain periaqueductal gray (PAG), locus coeruleus and subnucleus reticularis dorsalis (SRD). Additionally, we found that PTN patients display enhanced RVM functional connectivity with the SpV, the region that first receives nociceptive information from orofacial regions. Together, these results show that PTN is associated with functional alterations within the brainstem pain-modulation network and the SpV. Considering the existing experimental animal literature, it is likely that this represents an ongoing and enhanced engagement of brainstem pain-facilitating processes that may contribute to persistent pain in individuals with neuropathic pain conditions. The second investigation (Chapter 3) aimed to explore whether painful temporomandibular disorder (TMD), a non-neuropathic pain condition characterised by pain around the temporomandibular joint, is also associated with alterations in signal coupling between the RVM and other brainstem pain-modulation regions. In this investigation, we employed two functional connectivity techniques to explore the coupling of fMRI signals averaged over the entire scan (“static” functional connectivity) in addition to changes in signal coupling over the course of the scan (“dynamic” functional connectivity) to explore pain-modulation circuit function in TMD patients compared with pain-free controls. We identified that, compared to controls, TMD patients display enhanced RVM static and dynamic connectivity with the SpV and SRD, and no change in RVM connections with the PAG and locus coeruleus. These findings show that TMD is associated with functional alterations within specific brainstem pain-modulation circuits that regulate nociceptive processing at the SpV. Consistent with the findings from preclinical studies, and similar to neuropathic conditions, these ongoing functional changes in TMD likely reflect an enhanced descending facilitation of nociceptive processing at the SpV that contributes to the maintenance of pain in these individuals. The first two investigations (Chapters 2 and 3) revealed that individuals with both neuropathic and non-neuropathic pain display functional alterations within pain-modulation circuits that likely contribute to the presence of ongoing pain. In addition to persistent pain, many patients with neuropathic pain report spontaneous fluctuations in their pain intensity. It is possible that moment-to-moment variations in pain-modulation system functioning can contribute to these spontaneous fluctuations in chronic pain intensity. As such, the third investigation (Chapter 4) aimed to determine whether, within PTN individuals, there are differences in RVM functional connectivity strengths with other brainstem regions during scan periods in which patients experience high versus low pain. We found that PTN patients displayed stronger RVM connectivity strengths with both the PAG and SpV during the period of highest compared with lowest reported pain. These findings show that moment-to-moment fluctuations in spontaneous neuropathic pain intensity are associated with functional changes in the pain-modulation system. Given that this system can both facilitate and inhibit nociception, these findings may reflect short-term variations in descending pain-modulation output at the SpV that contribute to short-term changes in spontaneous pain intensity. Overall, this series of investigations reveals that both neuropathic and non-neuropathic orofacial pain conditions are associated with ongoing functional changes in the brainstem pain-modulation circuits. Additionally, in neuropathic pain, short-term variations in brainstem system functioning are associated with spontaneous fluctuations in ongoing pain intensity. Together, these findings suggest that functional alterations within the pain-modulation neural circuits are associated with the presence and intensity of ongoing chronic orofacial pain in humans. Considering these data alongside the existing experimental animal research, it is likely that, following injury, some individuals experience a change in pain-modulation circuit functioning such that it favours the facilitation of nociceptive processing. This may contribute to the maintenance and intensity of persistent orofacial pain in some individuals following injury.
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Bricker, Bryce, and Lisa Munson. "Survey of Chronic Pain Specialists and Their Experiences with Pharmacies in Managing Chronic Pain." The University of Arizona, 2011. http://hdl.handle.net/10150/623566.
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Class of 2011 AbstractOBJECTIVES: The purpose of this study was to survey prescribers who manage patients with chronic pain to evaluate how pharmacy services are perceived to affect patients’ quality of life. METHODS: Surveys were sent to prescribers who manage patients with chronic pain. Prescribers rated pharmacy services on a scale of 0 – 5 (0 being not important at all, and 5 being extremely important) to the quality of life of patients with chronic pain. RESULTS: Surveys were completed by 23 subjects. Prescribers ranked pharmacy services as follows: the pharmacy fills opioid prescriptions for all pain conditions (mean = 4.2; SD = 1.0), the patient is able to obtain the entire quantity of pain medication (mean = 4.1; SD = 1.5), the pharmacy treats the patient as dependent on, not addicted to opioids (mean = 3.9; SD = 1.6), the pharmacy collaborates with the prescriber to manage opiate therapy (mean = 3.9; SD = 1.5), the pharmacy stocks new and recently approved pain medications (mean = 3.8; SD = 1.1), the pharmacy provides the patient with information on adverse effects of pain medications (mean = 3.8; SD = 1.5), the pharmacy is able to use manufacturer co-pay cards to minimize out-of-pocket costs (mean = 3.5; SD = 1.7), the patient can have prescriptions delivered to their home (mean = 2.1; SD = 1.8) and the patient can obtain a prescription without having to wait a specified time period determined by their pharmacy (mean = 1.8; SD = 1.5). CONCLUSION: Prescribers in this study felt that certain pharmacy services are very important in the treatment of patients with chronic pain. Pharmacies may improve patients’ quality of life in the management of their chronic pain by providing these services.
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Kellen, Rebecca Margaret. "Sleep Patterns and Chronic Pain." Thesis, University of North Texas, 1991. https://digital.library.unt.edu/ark:/67531/metadc500658/.
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Sleep, emotions and pain are intimately connected,
physiologically, by their location and utilization of the
same brain centers and neurotransmitters. Sleep disturbances
have been clinically observed in chronic pain populations;
yet, no treatment program has formally addressed this aspect
of patient care. It is hypothesized that a pain population
(PN) will differ significantly from a non-injured workforce
(WF) when reviewing quantitative and qualitative sleep data.
This study strongly supports that sleep disturbances and
socioeconomic decrements exist in chronic pain patients.
Forty-seven variables were surveyed and 13 were found to show
significant differences between the groups and seven were
found to discriminate between the PN and WF groups at less than the .0001 level. A discriminant analysis was performed to determine the smallest model which could efficiently classify cases, according to successive root variables. The major discriminators are pain levels, medication, amount of sleep obtained and number of awakenings.
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Kung, Francis Tat-yan. "Chronic pain in older people." Connect to thesis Connect to thesis, 2001. http://adt1.lib.unimelb.edu.au/adt-root/public/adt-VU2001.0028/index.html.
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Hakenberg, Oliver W., and Manfred P. Wirth. "Chronic Pelvic Pain in Men." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133847.
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Chronic pelvic pain is a condition which receives less attention in men than in women. It is often difficult to diagnose and more difficult to treat. The new classification of prostatitis and its variants has introduced the term ‘chronic pelvic pain syndrome’ which underlines the difficulties in dealing with this disorder which may represent a variety of chronically painful conditions with a large functional componentDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Thorne, Kirsty Margaret. "Emotional control and chronic pain." Thesis, University of Southampton, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264672.
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Hakenberg, Oliver W., and Manfred P. Wirth. "Chronic Pelvic Pain in Men." Karger, 2002. https://tud.qucosa.de/id/qucosa%3A27541.
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Chronic pelvic pain is a condition which receives less attention in men than in women. It is often difficult to diagnose and more difficult to treat. The new classification of prostatitis and its variants has introduced the term ‘chronic pelvic pain syndrome’ which underlines the difficulties in dealing with this disorder which may represent a variety of chronically painful conditions with a large functional component.Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Blackwelder, Reid B. "Strategies in Chronic Pain Management." Digital Commons @ East Tennessee State University, 2001. https://dc.etsu.edu/etsu-works/7000.
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Rapacz, Katherine Emily. "Human patterning and chronic pain." Case Western Reserve University School of Graduate Studies / OhioLINK, 1991. http://rave.ohiolink.edu/etdc/view?acc_num=case1055787688.
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Thrush, Elizabeth Neely. "Explanatory models of chronic pain." Morgantown, W. Va. : [West Virginia University Libraries], 1999. http://etd.wvu.edu/templates/showETD.cfm?recnum=1030.
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Armstrong, Mary P. "Chronic low back pain : effectiveness of pain management programmes." Thesis, University of Ulster, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273038.
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Muir, R. "Living with chronic pain following a pain management programme." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2008410/.
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Chronic pain is pain that has lasted for longer than six months (B.H. Smith, Elliott, & Hannaford, 2004) and has a wide ranging impact on individuals’ lives, affecting physical, social and psychological functioning (B. H. Smith et al., 2001). Despite the impact of chronic pain and the significantly increased use of healthcare (Von Korff, Wagner, Dworkin, & Saunders, 1991), the effectiveness of treatments for chronic pain are limited to a minority of individuals, whether of a medical or psychological orientation (Turk, 2005). One approach to chronic pain is through pain management programmes, which aim to increase individuals’ quality of life, psychological functioning and levels of activity (British Pain Society, 2007). Although previous reviews of the effectiveness of pain management programmes have concluded that such programmes are effective (Eccleston, Williams, & Morley, 2012; Flor, Fydrich, & Turk, 1992; Scascighini, Toma, Dober-Spielmann, & Sprott, 2008), these reviews have focussed on the short-term (less than 12 months) outcomes. Considering that such programmes do not ameliorate pain and that individuals will often experience pain for the rest of their lives there is a need for review of the long-term outcomes of these programmes. Paper one of this thesis is a review of the quantitative literature concerning long-term (greater than 12 months) psychological and quality of life outcomes of pain management programmes. Whilst quantitative research concerning chronic pain has focussed upon the shortterm effectiveness of psychological treatments, qualitative research has focused upon the experience of chronic pain prior to interventions (Hellström, 2001; J. A. Smith & Osborn, 2007; Toye et al., 2013). In particular, this research has highlighted themes relating to a changing understanding of individuals’ bodies and a threat to their identity (Hellström, 2001; Osborn & Smith, 2006; J. A. Smith & Osborn, 2007; Toye et al., 2013). As there is now greater certainty of the effectiveness of psychological approaches to chronic pain (Eccleston, Williams, & Morley, 2012) there is currently a shift away from studies of the effectiveness of interventions to a greater focus upon the mechanisms of change (McCracken & Marin, 2014; Morley, Williams, & Eccleston, 2013). Qualitative research of living with chronic pain following pain management programmes would inform both clinicians’ and researchers’ understanding of the experience of living with chronic pain after an intervention and therefore contribute to the development of this area of research. It would also help to contextualise psychological models of chronic pain (Hayes, Strosahl, & Wilson, 2004; Vlaeyen & Linton, 2000) within a phenomenological understanding (J. A. Smith, Flowers, & Larkin, 2009). The second paper of this thesis aims to provide a phenomenological account of the experiences of participants who have completed a pain management programme 12-36 months prior to participating in the research.
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Galli, Ursula. "Stress and pain (dys)regulation in chronic orofacial pain." Göttingen Cuvillier, 2008. http://d-nb.info/99103158X/04.
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Wartolowska, Karolina. "Understanding patn processing in chronic pain patients using neuroimaging tools." Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.526128.
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Mahon, Mary L. "Pain perception in chronic pain patients : a signal detection analysis." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/31127.
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The purpose of this investigation was to examine the supposition that chronic pain patients (CPPs) have altered pain perception. Two models were examined that led to opposing predictions as to how CPPs would respond to painful stimuli (i.e., the hypervigilance and adaptation-level models). Both predictions have been supported by past research but because of methodological variation and the type of pain disorder studied, it has remained unclear under what circumstances the predictions of these two models may be met.
The responses of pain patients to painful stimuli have been found to vary for patients-with different clinical presentations (i.e. those with and without medically incongruent signs and symptoms). Therefore, the present investigation sought to compare the responses to radiant heat stimuli of sixty CPPs (thirty with and thirty without a medically incongruent pain presentation) to thirty age and sex matched normal control subjects (i.e., pain-tree individuals). Signal detection theory methodology was used in order to separately evaluate sensory sensitivity and the response bias to report sensations as painful. In addition, cognitive and affective factors were assessed in order to identity potential psychological correlates of altered pain perception.
The results of this study indicated that the presence of a medically incongruent pain presentation distinguished patients on their subjective report of disability and to a lesser extent cognitive appraisal and affective distress regarding their pain condition. They did not differ in their responses to painful stimuli. In a post hoc analysis where CPPs were classified into 'organic' and 'functional’ diagnostic groups, significant differences in pain threshold and the response bias to report pain were found. Patients classified as 'organic' had significantly higher pain thresholds compared to normal control subjects and patients classified as 'functional'. Differences in pain threshold were primarily represented by the response' bias to report sensations as painful rather than sensory sensitivity to the stimuli. The 'functional' group had a slightly lower pain threshold than the normal control group but this difference was not significant. The results are discussed in light of the two models of pain perception. The two methods used to classify pain patients are discussed according to their orthogonal characteristics on sensory, cognitive, and affective components.Arts, Faculty of
Psychology, Department of
Graduate
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Rawle, Heather Margaret. "Circumstances of pain onset, blame, and adjustment in chronic pain." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326857.
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Perry, Mark Paul. "Does age moderate self-pain enmeshment in chronic pain patients?" Thesis, University of Leeds, 2013. http://etheses.whiterose.ac.uk/5505/.
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Research has demonstrated that chronic pain can compromise identity by becoming enmeshed and centralised with pain. Pain-identity enmeshment and pain-identity centrality are associated with greater affective distress and poorer chronic pain adjustment. However, the literature infers differences between older and younger individuals in terms of pain adjustment, whereby older adults perceive pain as concomitant of aging and experience this as less biographically disruptive and perceive themselves to be younger than their chronological age, which is associated with greater psychological wellbeing. Research has yet to explore the relationship between perceived age and pain-identity enmeshment and adjustment in chronic pain. The purpose of this research was to investigate age in relation to pain-identity enmeshment and centrality and to examine the predictive value of age in pain adjustment. 90 patients with osteoarthritis (OA) and chronic pain were recruited from a musculoskeletal service. Participants completed standardised measures of pain intensity and perceived control (VAS), pain severity and interference (BPI), acceptance (CPAQ), identity (CES, Possible Selves Interviews), affective distress (HADS), and catastrophising (PCS) and provided information regarding their perceived age. Statistical analysis included; correlation, chi square, analysis of variance and linear regression to investigate potential age differences. Chronological age evidenced few significant relationships with variables of pain adjustment and identity. Perceived age evidenced significant relationships with all variables of adjustment and identity, however, did not statistically predict chronic pain adjustment. However, hoped-for proximity and centrality significantly predicted chronic pain adjustment. The CES demonstrated significant relatedness to enmeshment, although effect sizes were small. Therefore, it appears possible that an individual may experience pain becoming central to their identity yet remain un-enmeshed with pain. These findings indicate the necessity to assess hoped-for proximity and centrality in chronic pain populations across all age groups. This research indicates the potential for incorrectly perceiving expectedness and adjustment ease in old age. The implications of these findings are explored, in conjunction with the limitations of this research and potential areas for further research.
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Negrete, Buela Roger. "Neurobiological mechanisms involved in chronic pain." Doctoral thesis, Universitat Pompeu Fabra, 2016. http://hdl.handle.net/10803/481991.
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Chronic pain is currently a major clinical issue that represents huge economic and social burdens. Chronic pain treatment currently available presents limited efficacy and significant side effects. One of the reasons for this lack of effective therapeutic approaches is the insufficient knowledge of the mechanisms involved in the development and maintenance of chronic pain and pain-related comorbidities, such as emotional and cognitive manifestations. These associated symptoms negatively affect the life quality of the patients. In our study, we have first validated the different outcomes to measure the nociceptive, emotional and cognitive components of chronic neuropathic pain in mice, and the effects of repeated treatment with pregabalin on these manifestations. We have then identified the influence of different personality traits in the individual variability to chronic neuropathic pain perception in mice, and the emotional and cognitive manifestations associated to this chronic pain using different behavioural, electrophysiological and genetic techniques. The opioid system is a crucial therapeutic target for the treatment of chronic pain, despite the multiple side effects associated to opioid compounds. Thus, we have evaluated the involvement of specific components of the endogenous opioid system in the behavioural, emotional, cognitive, neurochemical and epigenetic manifestations of chronic osteoarthritis pain in mice. We have identified the endogenous dynorphin / opioid receptor system as an interesting pharmacological target for the treatment of the different manifestations of chronic pain.El dolor crònic és actualment una barrera clínica greu que representa una enorme càrrega econòmica i social. Els tractaments disponibles actualmente per al dolor crònic presenten una eficàcia limitada amb considerables efectes adversos. Un dels motius d’aquesta manca d’eficàcia terapèutica recau en l’insuficient coneixement dels mecanismes involucrats en el desenvolupament i el manteniment del dolor crònic i el seus components emocionals i cognitius. Aquests símptomes associats tenen un impacte negatiu en la qualitat de vida dels pacients. En el nostre estudi, primer hem validat les diferents manifestacions nociceptives, emocionals i cognitives de dolor neuropàtic crònic en ratolins, i els efectes del tractament crònic amb pregabalina en aquestes manifestacions. A continuació, hem identificat la influència dels diferents trets de personalitat en les diferències sobre la percepció del dolor en ratolins, així com les manifestacions emocionals i cognitives del dolor crònic en ratolins mitjançant diferents tècniques comportamentals, electrofisiològiques i genètiques. El sistema opioid representa una diana terapèutica crucial per al tractament del dolor crònic, tot i els seus múltiples efectes adversos associats als compostos opioids. Per això hem avaluat la implicació de components específics del sistema opioid endogen en les manifestacions conductuals, emocionals, cognitives, neuroquímiques i epigenètiques en el dolor osteoartrític crònic en ratolins. Hem identificat el sistema endogen dinorfina/receptor opioid com a una interessant diana farmacològica per al tractament de les diferents manifestacions clíniques del dolor crònic.
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Boulton, Holly. "Chronic Pain after Spinal Cord Injury." Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.484857.
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Chronic pain is a common and problematic issue for many individuals with spinal cord injury (SCI; Kennedy, Lude, & Taylor, 2006). Whilst understanding of chronic pain in the general population is increasing, understanding of such pain after SCI remains limited. The literature review explores the issue ofchronic pain after SCI and considers how two dominant models of pain may be applied to chronic pain after SCI. Three pertinent psychological issues are discussed that may play an important role in the maintenance and exacerbation of chronic pain in individuals with SCI; attention, depression, and PTSD. The review stresses that further research into these factors is vital in order to further understanding ofchronic pain in individuals with SCI. The empirical paper focuses of one of the main psychological factors highlighted in the literature review: attentional bias. The study explores whether individuals with SCI and chronic pain possess an attentional bias for pain-related words. Three groups were recruited: chronic pain and SCI (n =14), SCI (n = 15), and healthy controls (n = 15). All participants completed a dot probe computer task that presented pain-related words, pertaining to sensory and affective characteristics ofchronic pain, and neutral words. Words were presented at two exposure durations, 500ms and 1250 ms. Results showed that individuals with chronic pain and SCI possessed an overall attentional bias towards pain related information, in comparison with the other two groups. This difference in attentional bias between the groups was not significantly affected by exposure duration (500ms vs. 1250 ms) or type ofpain words (affective vs. sensory pain words). The general theoretical and clinical implications are discussed, and some suggestions are made for future research
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Dhanasobhon, Dhanasak. "Spinal cholinergic system and chronic pain." Thesis, Strasbourg, 2017. http://www.theses.fr/2017STRAJ090/document.
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Chez les rongeurs et humains, un « tonus » cholinergique spinal endogène modulant les comportements nociceptifs (douloureux) a été décrit. Une source potentielle de cette acétylcholine sont les interneurones cholinergiques de la corne dorsale (CD) de la moelle épinière. Nos objectifs étaient les suivants : (1) caractériser le « tonus » cholinergique spinal responsable de l’établissement des seuils mécaniques nociceptifs et (2) élucider le rôle des neurones cholinergiques CD dans la modulation de l'information sensorielle chez des animaux naïfs et neuropathiques. Nous avons confirmé la présence d'un « tonus » cholinergique qui module les seuils mécaniques et démontré qu'il est encore présent, bien qu'il soit modifié, après une neuropathie. Les interneurones cholinergiques reçoivent des entrées excitatrices localisées sur des segments plus distants et reçoivent généralement une faible fréquence d’entrées inhibitrices. De plus, ils sont indirectement reliés par des afférences primaires nociceptives qui expriment TRPV1, ce qui démontre leur implication dans le circuit nociceptif. Dans les conditions neuropathiques, les entrées des neurones LIII / IV ne sont pas affectées après une lésion du nerf périphérique. Une meilleure compréhension du système cholinergique spinal peut ouvrir la voie à une thérapie alternative contre la douleurAn endogenous spinal cholinergic tone modulating nociceptive (painlike) behaviors has been demonstrated in rodents and humans. One potential source of this acetylcholine is the spinal Dorsal Horn (DH) cholinergic interneurons. Our objectives were to: (1) characterize the spinal cholinergic tone establishing mechanical nociceptive thresholds and (2) to elucidate the role of DH cholinergic neurons in the modulation of sensory information of naïve and neuropathic animals. We have confirmed the presence of a cholinergic tone modulating mechanical thresholds and demonstrated that it is still present, although altered, after neuropathy. The DH cholinergic interneurons receive excitatory inputs from distant spinal segments and generally receive lower inhibitory inputs. In addition, they are indirectly connected by a subset of nociceptive primary afferents expressing TRPV1, demonstrating their involvement in nociceptive processing. In neuropathic spinal circuits, the inputs to LIII/IV neurons appears to be unaffected after injury. Better understanding the spinal cholinergic system can pave way to alternative pain therapy
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Harman, Katherine. "Sleep and chronic low back pain." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ26854.pdf.
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McDermid, Ann J. "Generalized hypervigilance in chronic pain patients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ58407.pdf.
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Lau, Choi Chun. "Intramuscular stimulation for chronic myofascial pain." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/23915.
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Background: Myofascial pain is a common musculoskeletal disorder characterized by muscles in a contracted state with increased tone and stiffness. It is one of the most common chronic pain syndromes that lead to disability and lower quality of life, creating a significant public health and economic burden. Intramuscular stimulation (IMS) is a dry needling technique that targets specifically chronic myofascial pain and is utilized in multidisciplinary pain centers around the world. Despite its wide use, the effect of IMS has been poorly studied.
Methods: We conducted two chart reviews to generate information regarding IMS effectiveness and the feasibility of conducting a randomized clinical trial (RCT). Success rate of pain improvement (at least 1 unit reduction on pain score) was documented in percentage. In addition, an inter-rater reliability test was conducted to assess the consistency among IMS practitioners in examining patients. Intra-class correlation coefficient (ICC) and multiple-raters kappa were used to assess the agreement between practitioners in identifying number of taut bands and identifying taut bands in each muscle respectively.
Results: From the two chart reviews, we found that a majority of patients (nearly 30%) had their pain for 10 or more years. Most of them had chronic low back pain. The percentage of success was at least 34% (95% CI: 25%, 43%) and 30% (95% CI: 22%, 38%) for worst and average pain (last week) respectively. For inter-rater reliability test, ICC values ranged from 0.64 to 0.77 (substantial agreement) but kappa values of identifying tender taut band in each muscle were ranged from -0.05 (poor agreement) to 0.46 (moderate agreement).
Conclusion: Chart review showed positive results regarding short-term effect of IMS in relieving chronic pain and improving pain consequences. Given the difficulty in treating chronic pain, it is worth conducting a sham controlled RCT to further evaluate the effect of IMS. Population characteristics and success rate of pain improvement will be used in justifying the type and size of sample in the design of a RCT. Good consistency among practitioners in treating patients has to be achieved before conducting the RCT.
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McGowan, Linda. "Psychological dimensions of chronic pelvic pain." Thesis, Staffordshire University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267384.
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Page, Blaithin. "Chronic pain following inguinal hernia repair." Thesis, University of Glasgow, 2009. http://theses.gla.ac.uk/2579/.
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Introduction: In the past five years chronic post herniorrhaphy pain has become the predominant post operative complication following the common procedure of inguinal hernia repair. However information regarding the precise aetiological factors of this chronic post surgical pain is lacking. To date no previous studies have assessed the long term outcome of patients who report chronic severe pain following inguinal hernia surgery. There are no studies assessing the presence of preoperative pain and the effect of surgical intervention on these pain scores. One factor thought to contribute to post herniorrhaphy chronic pain is the mesh type used by the surgeon. The characteristics of two different mesh types are evaluated with respect to postoperative chronic pain. Aims: The aim of the first study was to assess the outcome of patients who report severe or very severe pain three months after groin hernia repair. The aim of the second study was to quantify patients’ pain from their inguinal hernia prior to surgery and to examine the effect of surgery on this pain. The aim of the third study was to compare the composite partially absorbable and ultimately lighter weight (Vypro 11) mesh with an example of a conventional polyprolene mesh (Atrium) in a tension free repair of an inguinal hernia. Methods: One hundred and twenty five patients were identified as experiencing severe chronic pain at 3 months post herniorrhaphy, from the prospective National Hernia database1 of 5506 patients (97% of total) between 1 April 1998 and 31 march 1999. These 125 patients were assessed at 30 months post-surgery, with the use of the modified SF36 quality of life questionnaire. For the second study, consecutive patients referred for elective inguinal hernia repair between January 1998 and October 2000 completed visual analogue pain scores (VAS) pre- and 1 year post-repair. These patients were Western Infirmary patients who were part of a larger multicentre clinical trial comparing local versus general anaesthesia 2 for inguinal hernia repair. The third study examined patients who were involved in a multicentre trial comparing the incidence and severity of chronic pain following elective inguinal hernia repair, comparing the light weight or partially absorbable (PA) to the standard heavy weight or non-absorbable (NA) mesh. Results: In the first study, of the 125 patients who experienced severe chronic pain at three months post repair, at 30 months post-surgery 25% had persistent, unchanged chronic pain 45% had a reduction in pain to mild or very mild, and 29% were pain-free. In the 25% of patients that had persistence of severe chronic pain, the symptoms had a significant effect on all daily activities and quality of life, for example in measurement of general enjoyment of life, those with mild pain scored 2.32 (1.5-3.13) compared to 7.14 (5.97 - 8.30) in those with persistent severe pain (P<0.05) . In the second study 63% of patients completed VAS scores at follow-up. Prior to surgery the majority of patients had no pain or only mild pain at rest (80.5%) or on movement (58.8%). At 1 year follow-up the mean (SD) VAS score reduced by 2.9 (1.2) at rest, and reduced by 9.2 (1.8) on movement. However the majority of the beneficial effect was seen in those with moderate to high pre=operative pain scores. Those with preoperatively VAS score >10 had a reduction of 22.8 (3.7) at rest, compared to a slight increase in pain (+1.8) in those with no pain pre-operatively (P<0.05). Similar effects were seen on movement (improvement of 32.2 (4.8) in those with preoperative pain score >10, and little change in pain, -0.3 (1.6), in those with no, or only mild, preoperative pain (P<0.05). In the third study 162 patients received the PA mesh and 159 received the NA mesh. The PA mesh was not associated with less pain at 1 year postoperatively, compared to the NA mesh, with the proportion experiencing any pain being 39.5% in the PA group compared to 51.6% in the NA group (P=0.033). The proportion experiencing severe pain was similar, being 3% for the PA group and 4% for the NA group, and the recurrence rate was greater with the PA mesh compared to the NA mesh (4.9% versus 0.6%, P=0.037). Conclusion: Of those with chronic severe pain at 3 months post inguinal hernia repair, the majority will have still have some pain at 30 months post operatively. The greatest benefit in terms of pain reduction in patients undergoing inguinal hernia repair is experienced by those with the more severe preoperative pain. From our data there is no clear overall benefit in using the PA mesh over the standard mesh, as whilst pain scores were slightly lower in the PA group, this was countered by a higher recurrence rate. Further attention to the multiple factors that contribute to pain post-inguinal hernia repair is required, including the development of superior mesh technology.
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Aggarwal, Vishal R. K. "Epidemiology of chronic oro-facial pain." Thesis, University of Manchester, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.496345.
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The principal aims of the present study were to determine, in an unselected general population: (a) whether chronic oro-facial pain co-occurs with other frequently unexplained symptoms (b) whether factors associated with chronic oro-facial pain are common across symptoms. A population-based cross-sectional study was conducted using 4200 randomly selected adults who were recruited from the age-sex register of a General Medical Practice in North West, England. The study examined the prevalence and co-occurrence of chronic oro-facial pain with three other chronic symptoms that are frequently unexplained: chronic widespread pain, Irritable bowel syndrome and chronic fatigue. Validated instruments were used to measure the occurrence of symptoms and to collect information on a variety of associated factors: demographic (age and gender), psychosocial (anxiety, depression, illness behaviour, life stressors and reporting of somatic symptoms), mechanical (teeth grinding, facial trauma, missing teeth and reporting that the teeth did not fit together properly). 2505 subjects returned completed questionnaires (adjusted response rate 72%). The prevalence of Chronic Widespread Pain was 15%. Chronic Oro-facial Pain 7%. Irritable Bowel Syndrome 9% and Chronic Fatigue 8%. The study found that 587 subjects (27%) reported one or more symptoms: 404 (18%) reported one symptom, 134 (6%) reported two, 34 (2%) reported three, whilst 15 (1%) reported all four symptoms. This study has shown that chronic symptoms (including Chronic Oro-facial pain) that are frequently unexplained co-occur in the general population and share common associated factors. These findings are consistent with the hypothesis that chronic oro-facial pain may share a common aetiology with other frequently unexplained symptoms although this needs to be confirmed in a prospective study.
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Lonsdale, Jennifer Helen. "Imagery and emotion in chronic pain." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/5517.
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Psychological factors have important implications for adjustment to chronic pain, which itself has a variety of emotional consequences. Mental imagery has historically been assumed to be closely connected to emotional responses, and some experimental and clinical evidence has supported this claim. Around two in five people with chronic pain spontaneously report having mind‟s-eye mental images of their pain, although this phenomenon has received only limited research attention. This study aimed to see whether, for people with chronic pain who report these images, evoking their pain images is different from describing their pain using only single descriptive words. It was hypothesised that evoking the images would result in a stronger negative emotional response, weaker positive emotional response and an increase in the perceived pain intensity. It was also hypothesised that, compared to baseline scores, emotional and pain intensity ratings would be higher under both experimental conditions. Thirty-six participants completed an experiment interview, which employed a repeated measures design. The dependent variables were visual analogue scale ratings of pain intensity and strength of emotional experience (fear, sadness, anger, disgust and happiness). Other measures completed assessed the nature of the imagery and level of overall psychological distress. The study found that evoking pain-related mental images resulted in a temporary increase in pain intensity, sadness, anger and disgust and a decrease in happiness. However, these emotional responses were no different from those experienced when participants described their pain in single words, although this verbal task did not result in the increase in pain intensity seen when images were evoked. These results suggest that for this group of people, pain imagery is no more closely connected to emotional responses than equivalent verbal representations. However, the fact that imagery evocation resulted in a temporary increase in pain intensity where the verbal condition did not perhaps suggests that this represents a qualitatively different kind of paying attention to pain. The next steps for this small but growing field of research are considered.
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Messing, Liza. "Coping with chronic pain and hypnotizability." Thesis, University of East Anglia, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302188.
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Davies, Caitlin. "Self-discrepancy theory and chronic pain." Thesis, University of Leeds, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270673.
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Sudwell, Mark Ian. "Chronic back pain : a narrative analysis." Thesis, University of Exeter, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367457.
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De, Lemos Adail Ivan. "Family atmosphere and chronic pain maintainence." Thesis, King's College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430178.
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Holmes, Steve Anna Louise. "Information processing bias in chronic pain." Thesis, University of Southampton, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369878.
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Delaney, Ada. "Intracellular mechanisms in chronic pain states." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/24517.
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Neuropathic pain is a pervasive chronic condition that lacks adequate therapeutic treatment, making the identification of new candidate targets for drug development a priority. Underlying the development of this pathological pain state is a process of neuronal plasticity, termed central sensitisation that results in hyperexcitability of sensory neurons in the spinal cord. Stimulation of peripheral nociceptive inputs can cause downstream activation of kinases in the spinal dorsal horn that may contribute to the generation of this hyperexcitable state in the spinal cord. Here, using the chronic constriction injury (CCI) model of neuropathic pain, the role played by p42/44 and p38 mitogen-activated protein (MAP) kinases was addressed. Inhibition of both the p42/44 and p38 MAP kinase pathways attenuated the behavioural reflex sensitisation seen following nerve injury. The study explored the part played by spinal VPAC2 and NK2 receptors, (which respond to the afferent excitatory neuropeptides VIP and NKA respectively), in addition to glially mediated events in the activation of these kinases. Following nerve injury, both spinal activation of p42/44 and p38 MAP kinases and behavioural sensitisation (which was sensitive to p42/44 and p38 pathway inhibitors) was prevented by VPAC2, NK2 and NMDA receptor antagonists and glial or TNF-a inhibitors. The NMDA receptor, which is thought to be crucially involved in central sensitisation in the spinal cord, binds to the multivalent adapter protein PSD-95; an interaction which is necessary for the development of neuropathic behavioural reflex sensitisation. Here we show that mutant mice expressing a single point mutation in the Src homology 3 (SH3) domain of PSD-95 (PSD-95SH3W470L mutants), have intact neuropathic behavioural reflexes but blunted inflammatory responses. These findings indicate that different domains of the same protein may contribute selectively to different pain states. Examining further the role played by PSD-95, we found that the expression of both PSD- 95 and one of its signalling partner kinases, Pyk 2, was increased in the same superficial dorsal horn neurons following nerve injury. These studies suggest the importance of specific receptors and signalling pathways, non-neuronal cells and of protein:protein complexes associated with the NMDA receptor in chronic pain states and point to their future potential in the design of novel therapeutic targets.
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Blackwelder, Reid B. "Practical Approach to Chronic Pain Management." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6980.
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Dimitriadis, Zacharias. "Respiratory dysfunction in chronic neck pain." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/respiratory-dysfunction-in-chronic-neck-pain(0b9355db-dab1-41b7-8f2f-e06f7ebd3855).html.
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Background: Patients with chronic neck pain have a number of factors that could constitute a predisposition for respiratory dysfunction. However, the existing evidence is limited and not well established, and many questions such as the association of neck pain deficits with respiratory function remain unanswered. Thus, the aim of this study was to investigate whether patients with chronic neck have accompanying respiratory dysfunction and which are the neck pain deficits which principally predispose to these respiratory disturbances.Methods: In this case-control observational study, 45 patients with chronic idiopathic neck pain (>6 months, at least once per week) and 45 healthy age-, gender-, height- and weight-matched controls were voluntarily recruited. A third group of 10 patients with chronic non-spinal musculoskeletal pain was also used, but only for future reference. Participants' neck muscle strength and endurance were measured by an isometric neck dynamometer and craniocervical flexion test respectively. Range of movement was assessed by using an ultrasound-based motion analysis system. Forward head posture was assessed by obtaining lateral photographs and calculating the craniovertebral angle. Disability and neck pain intensity were assessed through the Neck Disability Index and Visual Analogue Scale. Psychological assessment was performed by using the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale and the Tampa Scale for Kinesiophobia. Spirometry was used for assessing pulmonary volumes, flows and maximal voluntary ventilation. Respiratory muscle strength was assessed by using a mouth pressure meter. Finally, PaCO2 was assessed by using transcutaneous blood gas monitoring.Results: Patients with chronic neck pain were found to have weaker respiratory muscles than healthy controls (p<0.05). Their pulmonary volumes and maximal voluntary ventilation were also found to be reduced (p<0.05). Their mean respiratory flows were found to be unaffected (p>0.05), whereas their peak flows were reduced (p<0.05). Their partial pressure of carbon dioxide was also found to be affected (p<0.05), revealing existence of hypocapnia (PaCO2<35mmHg). The neck pain deficits that were found to be mostly correlated with these respiratory parameters were the neck muscle strength, neck muscle endurance, kinesiophobia, catastrophizing and pain intensity (r>0.3, p<0.05). Finally, the regression models revealed that neck pain deficits and especially neck muscle strength can provide a quite generalizable accurate estimation of this respiratory dysfunction (R2=0.28-0.52).Conclusions: Patients with chronic neck pain present dysfunction of their respiratory system which can be mainly manifested as respiratory weakness and/or hypocapnia. Pain intensity, neck muscle weakness, fatigue and kinesiophobia seem to be the most important deficits predisposing to this respiratory dysfunction. The understanding of this dysfunction could have a great impact on various clinical aspects notably patient assessment, rehabilitation and drug prescription. However, further research is suggested mainly directed towards optimizing treatment protocols and developing classification systems improving clinical reasoning.