Couple-Oriented Education and Support Intervention for Osteoarthritis: Effects on Spouses' Support and Responses to Patient Pain.

The purpose of this study was to determine whether a couple-oriented education and support intervention for osteoarthritis was more efficacious than a similar patient-oriented intervention in terms of enhancing spouses' support of patients and their positive and negative responses to patient pain. Repeated-measures analyses of covariance with the completers sample (N = 103 dyads) showed that at the postintervention assessment, patients in the couple-oriented intervention reported a greater decrease in their spouses' punishing responses (e.g.

The impact of chronic low back pain on older adults: a comparative study of patients and controls.

Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. Many older adults remain quite functional despite CLBP, and because age-related comorbidities often exist independently of pain (e.g.

Headache in pregnancy.

Conventional wisdom teaches that chronic headaches typically improve and often abate during pregnancy, leading many clinicians to take a wait-and-see approach of delaying treatment in hopes of seeing spontaneous improvement. Although headaches do improve in later pregnancy for up to 50% of chronic headache sufferers, headaches persist and may even worsen for the remainder. Clinicians must recognize that treating headache during pregnancy is important in order to limit excessive use of over-the-counter pain remedies, dehydration, and pain- related disability.

Prevention of motion sickness with rizatriptan: a double-blind, placebo-controlled pilot study.

Background: Serotonergic triptan medications effectively reverse pain and associated symptoms of migraine. Vestibular symptoms, including dizziness and vertigo, occur in about one-third of migraineurs. The most frequent and consistent balance symptom in migraineurs is motion sickness, which is experienced by about half of migraineurs and may be related to serotonergic influences.

The use of splines to calculate jerk for a lifting task involving chronic lower back pain patients.

Motion differences in a repetitive lifting task have been described previously using differences in the timing of body angle changes during the lift. These timing changes relied on small differences of motion and are difficult to measure. The purpose of this study was to evaluate shoulder jerk (rate of change of acceleration) in a repetitive lifting task as an alternative parameter to detect differences of motion between controls and chronic lower back pain (CLBP) patients and to measure the impact of a rehabilitation program on jerk.

Effects of disease activity, pain, and distress on activity limitations in patients with systemic lupus erythematosus.

Objective: To evaluate the extent to which disease activity, pain, and psychological distress predict activity limitations in persons with systemic lupus erythematosus (SLE).

Methods: A sample of 93 persons with SLE completed medical and psychosocial evaluations at one study visit. Sets of measures were chosen to represent constructs of Disease Activity, Pain, Distress, and Activity Limitations.

Headache in pregnancy.

Headache is a frequent symptom in women of childbearing age and during pregnancy. Benign and pathologic headaches may change in response to changes in estrogen after conception. Expected patterns of change are described for headaches that occur commonly during pregnancy.

Disability and chronic posttraumatic headache.

Objective: To test the hypothesis that chronic posttraumatic headache is associated with greater severity and psychological distress than headache of nontraumatic origin.

Methods: Two hundred eighty-nine consecutive patients with chronic headache attending a university headache clinic were evaluated. Questionnaires about headache symptoms, quality of life (Medical Outcome Survey SF-36 Health Survey), and psychological distress were completed.

The influence of weight and starting height on lifting mechanics in lower extremity amputees.

This study compares the lifting mechanics of lower extremity amputees to controls and describes the influence of weight lifted and starting height on lifting style. Subjects included three individuals with transtibial amputation (TTA), two individuals with transfemoral amputation (TFA), and three able-bodied controls (CO). Amputee subjects performed six repetitions of six weights, randomly ordered, from two starting heights.

Estrogen and tension-type headache.

The vast majority of people experience tension-type headache during their lifetimes. Boys experience tension-type headache slightly more than girls during preadolescent years. During adolescence and adult years, tension-type headache occurs more commonly in females.

Management of headache in women.

Chronic headache is more prevalent in women than in men. In addition, women often experience increases in headache activity in relation to different life stages. Changes in headache pattern coincide with changes in estradiol levels, with elevated levels of estradiol (e.

A double-blind provocative study of chocolate as a trigger of headache.

A provocative double-blind study of headache was performed using chocolate as the active agent and carob as the placebo. The chocolate and carob samples were formulated to duplicate products used in an earlier study (1) in which strong differential effects between the ability of chocolate and carob to trigger headache in migraine were shown. Sixty-three women with chronic headache (50% migraine, 37.

Headache during pregnancy and in the postpartum: a prospective study.

The association between sex hormones and chronic headache has been the subject of a good deal of speculation. Headache is predicted to improve during pregnancy, when estrogen levels rise steadily until delivery. Retrospective studies have suggested that women with a history of migraines do tend to report decreases in headache activity with pregnancy.

Plasma and saliva substance P levels: the effects of acute pain in pregnant and non-pregnant women.

Substance P like immunoreactivity (SPLI) and total protein (TP) concentrations in plasma and saliva were measured in 80 healthy female patients divided into the following four groups: women in group 1 were not pregnant and they were awaiting tubal ligation; women in group 2 were not pregnant but they experienced acute postoperative pain following hysterectomy; women in group 3 were pregnant and were awaiting elective cesarean section; and women in group 4 were in active labor and experienced acute labor pain. Pain intensity was assessed using verbal Likert pain scores. The absolute measured concentration of SPLI (SPLIabs) was divided by the TP concentration to obtain corrected SPLI (SPLIcorr) concentration.

Perception of traumatic onset, compensation status, and physical findings: impact on pain severity, emotional distress, and disability in chronic pain patients.

The primary purposes of the present study were to investigate the roles of physical findings, financial compensation, and types of pain onset (i.e., trauma vs.

Pain, disability, and physical functioning in subgroups of patients with fibromyalgia.

Objective: To investigate (1) whether patients with fibromyalgia (FM) could be subgrouped on the basis of psychosocial and behavioral responses to pain, and (2) the relationships among pain severity, perceived disability, and observed physical functioning, as measured by cervical spinal mobility.

Methods: 117 patients with FM received a comprehensive examination, underwent physical performance tasks during the evaluation, and completed self-report inventories.

Results: About 87% of the patients could be classified into the Multidimensional Pain Inventory clustering groups identified and validated in patients with a range of chronic pain problems (Dysfunctional, Interpersonally Distressed, and Adaptive Copers).

Maintenance of effects in the nonmedical treatment of headaches during pregnancy.

In a previous study, 30 pregnant women suffering from headaches were treated with physical therapy, relaxation training, and biofeedback. Eighty percent of these women experienced significant relief of headaches following treatment. Although this study demonstrated the effectiveness of nonmedical treatment during pregnancy, little is known about the influence of changing hormones during pregnancy on fluctuations in headache.

Functional capacity assessment: Influence of behavioral and environmental factors.

The environment surrounding the functional capacity evaluation (FCA) is complex and determined by both external factors as well as those specific to the testing situation. In this paper we (1) briefly review existing models of pain, (2) highlight how current FCAs of pain patients adhere in general to behavioral conceptualizations of chronic pain, (3) review some inadequacies of current conceptualizations of FCA when it applies to chronic pain, (4) review the many internal and external environmental factors that can significantly influence FCAs, and (5) consider some psychosocial factors that play an important role in patients' performances. We conclude that not only should evaluators more carefully consider the central influences of psychosocial factors when interpreting the results of FCAs, but that an alternate conceptual model that emphasizes both environmental and psychological factors is also needed to more adequately describe the physical performances obtained during FCAs.

The relationship of locus of control and psychosocial-behavioral response in chronic headache.

It has been suggested that patients' perceptions of the impact chronic headache has on their lives as well as perceived control of their headaches may be associated with the intensity, duration, and exacerbation of pain they experience. The present study examined associations among International Headache Society (IHS) diagnostic category, pain characteristics such as severity and duration, perceived impact and control of headaches, and adaptive response. Two hundred twenty-five patients with migraine, tension-type, or combined migraine and tension-type headache served as subjects.

Triggers of headache episodes and coping responses of headache diagnostic groups.

The frequency of common headache instigators or "triggers" and the use of specific behavioral responses to headache episodes were determined using the self-reports of patients with migraine, tension-type, and combined migraine and tension-type headache. Headache diagnostic groups were compared on the nature of headache triggers identified. The diagnostic groups were also compared on the frequency with which they engaged in a set of behavioral responses during headache episodes.

Psychosocial and behavioral characteristics in chronic headache patients: support for a continuum and dual-diagnostic approach.

The present study attempted to identify psychological differences among different headache diagnoses defined by IHS criteria as well as psychological differences by headache intensity and frequency. Differences between diagnostic categories reflected characteristics used to assign diagnoses, namely the constancy of pain and distracting behaviors of significant others due to isolating behavior from photophobia and phonophobia. A rating of headache intensity and frequency was a more powerful predictor of psychological ratings than diagnosis.

The scope and significance of anger in the experience of chronic pain.

This paper is divided into 3 sections. The first provides the conceptual framework by introducing definitions of anger and related constructs and highlighting pertinent aspects of the concept of pain. The second section examines the evidence for anger as a feature of chronic pain.

Chronic pain and depression: role of perceived impact and perceived control in different age cohorts.

Chronic pain adversely affects individuals' physical as well as emotional well-being. A cognitive-behavioral model has been proposed to explain the role of cognitive appraisal variables in mediating the development of emotional distress following pain of long duration. There is little evidence linking the prevalence of depression in chronic pain patients to life stage, but there are suggestions in the literature that the link between medical illness and depression may be stronger in elderly patients.

Differential treatment responses of TMD patients as a function of psychological characteristics.

A number of studies have reported that psychological factors play a significant role in TMD. Several studies have identified subgroups of patients based on their responses to psychological assessments; however, none of these studies have reported on the clinical utility of classifications of TMD patients on these various measures. In this study, the differential response of 133 TMD patients classified within 3 psychosocial-behaviorally based subgroups to a conservative, standardized treatment was examined.

A dual-diagnostic approach assesses TMD patients.

The understanding and treatment of patients with temporomandibular disorders, or TMDs, have been impeded by the lack of a consensually agreed-on classification system on which to make a differential diagnosis. A number of classification systems for these patients have been proposed. Some are based primarily on whether symptoms are myogenic or arthralgic--somatically based; some investigators have suggested that patients be differentiated on the basis of psychological characteristics.