Nociplastic pain: controversy of the concept.

Classically, pain can be of a nociceptive or neuropathic nature, which refers to non-neural or neural tissue lesions, respectively. Chronic pain in conditions such as migraine, fibromyalgia, and complex regional pain syndrome (CRPS), is thought to perpetuate without a noxious input. Pain in such patients can be assigned neither to the nociceptive nor neuropathic category.

The roles of extracranial intravascular lesion, vasodilation-induced neural entrapment, and arteriolysis in migraine treatment.

The few available studies of biopsies performed during migraine surgery have revealed intravascular changes of the occipital and superficial temporal arteries. It is not clear whether these abnormalities are purely of local origin or of systemic nature. This letter discusses possible associations between extracranial vascular alterations and vasodilatory neural entrapment.

Neurovascular Compression-Induced Intracranial Allodynia May Be the True Nature of Migraine Headache: an Interpretative Review.

Purpose Of Review: Surgical deactivation of migraine trigger sites by extracranial neurovascular decompression has produced encouraging results and challenged previous understanding of primary headaches. However, there is a lack of in-depth discussions on the pathophysiological basis of migraine surgery. This narrative review provides interpretation of relevant literature from the perspective of compressive neuropathic etiology, pathogenesis, and pathophysiology of migraine.

Fetal head-down posture may explain the rapid brain evolution in humans and other primates: An interpretative review.

Evolutionary cerebrovascular consequences of upside-down postural verticality of the anthropoid fetus have been largely overlooked in the literature. This working hypothesis-based report provides a literature interpretation from an aspect that the rapid evolution of the human brain has been promoted by fetal head-down position due to maternal upright and semi-upright posture. Habitual vertical torso posture is a feature not only of humans, but also of monkeys and non-human apes that spend considerable time in a sitting position.

Chronic pain and local pain in usually painless conditions including neuroma may be due to compressive proximal neural lesion.

It has been unexplained why chronic pain does not invariably accompany chronic pain-prone disorders. This question-driven, hypothesis-based article suggests that the reason may be varying occurrence of concomitant peripheral compressive proximal neural lesion (cPNL), e.g.

Negative Pressure Wound Therapy: Supra-Physiological or Just Physical Effects of Positive Pressure?

This communication provides a new insight into the unexplained physiology of beneficial effects of negative pressure wound therapy (NPWT). Possible mechanisms of beneficial effects of NPWT in failing replantation and free tissue transfer are discussed. Positive pressure generated by NPWT as well as its draining action creates exudate-free tight tissue-to-tissue interface, which may enhance neovascularization.

Mechanism of Origin of Positive Tissue Pressure During Negative-Pressure Wound Therapy.

This report provides a simplified insight into the previously unexplained physical mechanism of the origin of local positive tissue pressure during negative-pressure wound therapy (NPWT). A chain of 2 spring model could be used to show the biomechanical interaction between the NPWT dressing and the adjacent body tissues. It is important to assume that the application of NPWT dressing to the body surface creates a new closed compartmentalized volume.

Relativity of the Conventional Hand Tendon Zones and the Actual Glide Zones of Tendon Injury and Repair: A Need for Concept Reappraisal.

The conventional hand tendon zones and subzones do not reflect the actual lengths covered by the involved locus of the tendon during full digital and wrist motion, which warrant reappraisal of the tendon zone concept. Because of the tendon excursions many lacerations should be regarded as multiple zone injuries. Furthermore, the length-spans of glide of the distal tendon stump and of the tendon junction (i.

History of plastic surgery: Art, philosophy, and rhinoplasty.

The 200th anniversary of K. F. Graefe's "Rhinoplasty," E.

Self-regulated frequent power pinch exercises: A non-orthotic technique for the treatment of old mallet deformity.

The utilization of an orthotic device to treat a mallet finger injury is common practice. This author describes a different approach to treating patients with an old mallet finger injury. The incorporation of frequent, self-regulated exercises without the use of an orthosis is described.

Reliability of the standard goniometry and diagrammatic recording of finger joint angles: a comparative study with healthy subjects and non-professional raters.

Background: Diagrammatic recording of finger joint angles by using two criss-crossed paper strips can be a quick substitute to the standard goniometry. As a preliminary step toward clinical validation of the diagrammatic technique, the current study employed healthy subjects and non-professional raters to explore whether reliability estimates of the diagrammatic goniometry are comparable with those of the standard procedure.

Methods: The study included two procedurally different parts, which were replicated by assigning 24 medical students to act interchangeably as 12 subjects and 12 raters.

Is diagrammatic goniometry feasible for finger ROM evaluation and self-evaluation?

Background: While "diagrammatic" evaluation of finger joint angles using two folded paper strips as goniometric arms has been proposed and could be an alternative to standard goniometry and a means for self-evaluation, the measurement differences and reliability are unknown.

Questions/purposes: This study assessed the standard and diagrammatic finger goniometry performed by an experienced examiner on patients in terms of (1) intragoniometer and intergoniometer (ie, intrarater) differences and reliability; (2) interrater differences and reliability relative to patients' diagrammatic self-evaluation; and (3) the interrater differences related to patient's hand dominance.

Methods: Sixty-one patients without previous training self-evaluated active extension of all joints of the fifth finger of one hand once using two rectangular strips of paper.

A technique of direct tracing for recording digital range of motion.

This report describes a technique for recording range of motion of digital joints. The technique involves tracing digital outlines with an angled marker on a sheet of paper attached to a special interray pad. A complete dorsal silhouette of the entire ray can be obtained by mounting the pad and the paper astride the palm parallel to the ray of the digit being evaluated.