Validation of the short-form McGill pain questionnaire-2 in younger and older people with cancer pain.

Unlabelled: Pain is among the most common symptoms of cancer. Because cancer can occur at any age, it is imperative that pain assessment tools are valid for use across the adult lifespan. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) is a valid and reliable tool for the assessment of the multidimensional qualities of pain in people with chronic nonmalignant pain, but its psychometric properties in people with cancer pain and in older versus younger people require investigation.

Pain.

Pain has many valuable functions. It often signals injury or disease, generates a wide range of adaptive behaviors, and promotes healing through rest. Despite these beneficial aspects of pain, there are negative features that challenge our understanding of the puzzle of pain, including persistent phantom limb pain after amputation or total spinal cord transection.

Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2).

The objective of the present research was to develop a single measure of the major symptoms of both neuropathic and non-neuropathic pain that can be used in studies of epidemiology, natural history, pathophysiologic mechanisms, and treatment response. We expanded and revised the Short-form McGill Pain Questionnaire (SF-MPQ) pain descriptors by adding symptoms relevant to neuropathic pain and by modifying the response format to a 0-10 numerical rating scale to provide increased responsiveness in longitudinal studies and clinical trials. The reliability, validity, and subscale structure of the revised SF-MPQ (SF-MPQ-2) were examined in responses from 882 individuals with diverse chronic pain syndromes and in 226 patients with painful diabetic peripheral neuropathy who participated in a randomized clinical trial.

Evolution of the neuromatrix theory of pain. The Prithvi Raj Lecture: presented at the third World Congress of World Institute of Pain, Barcelona 2004.

The neuromatrix theory of pain proposes that pain is a multidimensional experience produced by characteristic "neurosignature" patterns of nerve impulses generated by a widely distributed neural network-the "body-self neuromatrix"-in the brain. These neurosignature patterns may be triggered by sensory inputs, but they may also be generated independently of them. Acute pains evoked by brief noxious inputs have been meticulously investigated by neuroscientists, and their sensory transmission mechanisms are generally well understood.

The psychological assessment of candidates for spinal cord stimulation for chronic pain management.

It is known that, in spite of meeting appropriate clinical criteria for spinal cord stimulation (SCS) and having undergone flawless procedures, a significant number of patients who fail the therapy continues to exist. It is the purpose of this article to focus on the development of psychosocial indicators of success for SCS, if any. Referring to specialist literature authors present a review of what is known, what is not known, and what remains controversial on this topic.

Inflammation-susceptible Lewis rats show less sensitivity than resistant Fischer rats in the formalin inflammatory pain test and with repeated thermal testing.

Comparisons between Lewis and Fischer inbred strains of rats are used frequently to study the effect of inherent differences in function of the hypothalamic-pituitary-adrenal axis on pain-relevant traits, including differential susceptibility to chronic inflammatory disease and differential responsiveness to analgesic drugs. Increasing use of genetic models including transgenic knockout mice and inbred strains of rodents has raised our awareness of, and the importance of, thorough characterization (or phenotyping) of the strains of rodents being compared. Furthermore, genetic variability in analgesic sensitivity is correlated with, and may be caused by, genetically determined baseline sensitivity.

The McGill pain questionnaire: from description to measurement.

On the language of pain. By Ronald Melzack, Warren S. Torgerson.

Age-related differences in the qualities but not the intensity of chronic pain.

Age differences in the experience of chronic pain remain unclear. A serious barrier to progress in the field of pain and aging arises from the lack of data regarding the psychometric properties of pain scales for use with the elderly. The present study was designed to assess age differences in pain intensity and quality and to compare the psychometric properties of the McGill Pain Questionnaire (MPQ) in young and elderly chronic pain patients.

The role of corticotropin-releasing factor in pain and analgesia.

Corticotropin-releasing factor (CRF) is a peptide that is released from the hypothalamus and in widespread areas of the brain following exposure to stressors. It is considered to be a mediator of many of the effects of stress, and its analgesic properties have been demonstrated in many studies. However, for primarily methodological reasons, the effects of CRF in the central nervous system have been neglected whereas the peripheral effects of CRF have been overemphasized.

From the gate to the neuromatrix.

The gate control theory's most important contribution to understanding pain was its emphasis on central neural mechanisms. The theory forced the medical and biological sciences to accept the brain as an active system that filters, selects and modulates inputs. The dorsal horns, too, were not merely passive transmission stations but sites at which dynamic activities (inhibition, excitation and modulation) occurred.

The formalin test: a validation of the weighted-scores method of behavioural pain rating.

The formalin test was developed using an ordinal scale of weighted scores to rate the intensity of pain-related behaviours in animals. However, no studies have been carried out to establish the ordinal relationship of the behavioural categories used to generate the weighted pain intensity scores. The purpose of the present study was to evaluate the validity of the weighted-scores technique by assessing the ordinality of the behavioural categories associated with the specific category weights.

Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence.

Peripheral tissue damage or nerve injury often leads to pathological pain processes, such as spontaneous pain, hyperalgesia and allodynia, that persist for years or decades after all possible tissue healing has occurred. Although peripheral neural mechanisms, such as nociceptor sensitization and neuroma formation, contribute to these pathological pain processes, recent evidence indicates that changes in central neural function may also play a significant role. In this review, we examine the clinical and experimental evidence which points to a contribution of central neural plasticity to the development of pathological pain.

Temporal processes of formalin pain: differential role of the cingulum bundle, fornix pathway and medial bulboreticular formation.

Subcutaneous injection of formalin produces a characteristic biphasic pain response. An early phase develops in the first 5 min after injection; the pain then decreases for 10-15 min, followed by a gradual rise to a stable plateau that lasts about 1 h. Rats were injected with 1 microliter of 2% lidocaine or saline into the anterior cingulum bundle at 0 (immediately), 10 or 30 min prior to formalin injection, or 10, 20 or 30 min after formalin injection, and tested for analgesia in the late phase of the formalin test, 30-70 min after formalin injection.

Analgesia produced by lidocaine microinjection into the dentate gyrus.

The local anesthetic lidocaine was injected into the dentate gyrus (DG) of alert, unrestrained rats 10 min prior to investigation within the formalin test. Regional anesthesia of the DG resulted in a reduction of pain scores when administered contralateral to the site of subcutaneous formalin injection. The analgesic effect was evident 30-50 min after central infusion.

Pain 'memories' in phantom limbs: review and clinical observations.

This paper reviews reports of phantom limb sensations which resemble somatosensory events experienced in the limb before amputation. It also presents descriptions of this phenomenon in 68 amputees who took part in a series of clinical studies. These somatosensory memories are predominantly replicas of distressing pre-amputation lesions and pains which were experienced at or near the time of amputation, and are described as having the same qualities of sensation as the pre-amputation pain.

Comparisons between patients' and nurses' assessment of pain and medication efficacy in severe burn injuries.

In order to provide burn patients with adequate pain relief, the nurses must be able to accurately evaluate the patients' pain levels and to assess whether sufficient analgesia is achieved or not. The present study examined this issue by comparing the pain ratings in 42 patients hospitalized for burn injuries and 42 nurses. The patient and the attending nurse were asked to rate, independently of each other, the intensity of the pain felt by the patient during a therapeutic procedure and at rest.

Analgesia produced by injection of lidocaine into the anterior cingulum bundle of the rat.

The role of cingulum in the perception of tonic and phasic pain was examined by injecting lidocaine, a local anesthetic, into the anterior cingulum bundle of the rat. A cannula was stereotaxically implanted into the anterior cingulum on one side in anesthetized rats. Seven to 10 days after surgery, the rats were infused with 1 microliter of 2% lidocaine in saline or saline alone into the anterior cingulum bundle immediately prior to testing for analgesia in the formalin or foot-flick test.

An association between phantom limb sensations and stump skin conductance during transcutaneous electrical nerve stimulation (TENS) applied to the contralateral leg: a case study.

This report describes a placebo-controlled study of transcutaneous electrical nerve stimulation (TENS) applied to the contralateral lower leg and outer ears of an amputee with non-painful phantom sensations. The subject received TENS or placebo stimulation on separate sessions in which baseline periods of no stimulation alternated with periods of TENS (or placebo). Throughout the two sessions, continuous measures of stump skin conductance, surface skin temperature and phantom intensity were obtained.

Pain of first-trimester abortion: a study of psychosocial and medical predictors.

Pain during first-trimester abortion by suction-curettage under local anesthesia alone was measured with the McGill Pain Questionnaire (MPQ), and verbal and visual analogue scales in 109 women. The average intensity of abortion pain ranked among moderately intense pain recorded with the MPQ. However, the pain scores had a wide range and appeared influenced by several demographic, psychosocial and medical variables.

Labour pain: correlations with menstrual pain and acute low-back pain before and during pregnancy.

Low-back pain is a major component of labour pain in a substantial number of women. The purpose of this study was to determine whether episodes of acute low-back pain prior to pregnancy is a predictor of low-back pain during labour. 114 women received the Short-Form McGill Pain Questionnaire (SF-MPQ) during labour and were asked to describe the pain separately for front and back contraction pain or continuous pain.

Analgesia produced by normal doses of opioid antagonists alone and in combination with morphine.

In a recent study [30] it was reported that naloxone, at doses normally employed for opioid antagonism, produced a dose-dependent analgesia in BALB/c mice in the formalin test. We report here that another opioid antagonists, naltrexone, also produces analgesia under these conditions. Female BALB/c mice were injected subcutaneously with naltrexone (0.