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Sample records for chronic pelvic pain

  1. Chronic Pelvic Pain

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  2. Interstitial Cystitis: Chronic Pelvic Pain Syndrome

    OpenAIRE

    Fatih Atuğ; Naime Canoruç

    2005-01-01

    Interstitial cystitis, is a chronic inflammatory disease of the bladder of unknown etiology characterized by urinary frequency, urgency, nocturia and suprapubic pain. The syndrome presents differently in many patients, with the unifying factor being chronic pelvic pain and disruption of daily life activities.Although there are abundance of theories, the etiology of the condition remains unclear. This review focuses on recently published literature on the epidemiology, etiology, diagnosis and ...

  3. EAU Guidelines on Chronic Pelvic Pain

    NARCIS (Netherlands)

    Fall, Magnus; Baranowski, Andrew P.; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J.; Oberpenning, Frank; Williams, Amanda C. de C.

    2010-01-01

    Context: These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. Objective: To revise guidelines for the diagnosis,

  4. Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh.

    Science.gov (United States)

    Gyang, Anthony N; Feranec, Jessica B; Patel, Rakesh C; Lamvu, Georgine M

    2014-03-01

    In 2001, the US Food and Drug Administration (FDA) approved the first transvaginal mesh kit to treat pelvic organ prolapse (POP). Since the introduction of vaginal mesh kits, some vaginal meshes have been associated with chronic pelvic pain after reconstructive pelvic floor surgery. Pelvic pain results in between 0 % and 30 % of patients following transvaginal mesh placement. Common causes of chronic pelvic pain include pelvic floor muscle spasm, pudendal neuralgia, and infection. Paucity of data exists on the effective management of chronic pelvic pain after pelvic reconstructive surgery with mesh. We outline the management of chronic pelvic pain after transvaginal mesh placement for reconstructive pelvic floor repair based on our clinical experience and adaptation of data used in other aspects of managing chronic pelvic pain conditions.

  5. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

    Science.gov (United States)

    Pastore, Elizabeth A; Katzman, Wendy B

    2012-01-01

    Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP.

  6. Chronic pelvic pain: comorbidity between chronic musculoskeletal pain and vulvodynia

    Directory of Open Access Journals (Sweden)

    G. Biasi

    2014-06-01

    Full Text Available Chronic pelvic pain (CPP is a common condition that has a major impact on the quality of life of both men and women. Male CPP is usually attributable to well-defined urogenital conditions (most frequently infectious/non infectious prostatic diseases or musculoskeletal or bowel diseases, whereas the features of female CPP are much more complex and are of particular clinical and epidemiological importance. It is a multifactorial syndrome that can be due to diseases of the urogenital, gastrointestinal, or musculoskeletal systems, or to neurological or neuropsychiatric disorders. It is not always easy to identify its predominant pathogenesis, although it often occurs as a central sensitization syndrome triggered by an initial stimulus which is no longer detectable and only manifests itself clinically through pain. In this respect, there are some very interesting relationships between vulvodynia and fibromyalgic syndrome, as identified in a preliminary study of women with chronic musculoskeletal pain in which it was demonstrated that vulvar pain plays an important role, although it is often overlooked and undiagnosed.

  7. Biofeedback therapy for chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhang-QunYE; DanCAI; Ru-ZhuLAN; Guang-HuiDU; Xiao-YiYUAN; ZhongCHEN; Yang-ZhiMA; You-MingHU; Gui-YunZENG

    2003-01-01

    Aim: To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome(CPPS). Methods: From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI)and classified by the NIH classification standard. Sixty-two patients of CPPS category Ⅲ were involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid +-+++ and bacterial culture negative. Their NIH-CPSI were 12-40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA-23 mA and duration of 20 minutes. Results: Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2-3treatment courses and other symptoms disappeared after 4-5 courses. Conclusion: Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action. ( Asian J Androl 2003 Jun; 5:155-158 )

  8. A standard for terminology in chronic pelvic pain syndromes

    DEFF Research Database (Denmark)

    Doggweiler, Regula; Whitmore, Kristene E; Meijlink, Jane M

    2016-01-01

    AIMS: Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected...... by chronic pelvic pain syndromes. The standard aims to facilitate research, enhance therapy development and support healthcare delivery, for healthcare providers, and patients. This document looks at the whole person and all the domains (organ systems) in a systematic way. METHODS: A dedicated working group...... for symptoms, signs, and evaluation (diagnostic work-up) of female and male patients with chronic pelvic pain syndromes, serving as a platform for ongoing development in this field. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc....

  9. Chronic Prostatitis/Chronic Pelvic Pain Syndrome Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Cem Nedim Yuceturk

    2014-08-01

    Full Text Available Chronic prostatitis is a chronic syndrome that effects men with a wide range of age. The etiology, natural history and appropriate therapy models are still unclear. According to the classification of National Institutes of Health; 4 types of prostatitis were defined; acute bacterial prostatitis (category I, chronic bacterial prostatitis (category II, chronic nonbacterial prostatitis/chronic pelvic pain syndrome (category III and asymptomatic prostatitis (category IV.Since microorganisms can only be isolated from a small percent of patients, empiric treatment is given to the most of the men. Multidisciplinary approach to the patients with suspected chronic prostatitis will help clinicians to play an active role in the treatment and prevent unnecessary medical therapies. [Archives Medical Review Journal 2014; 23(4.000: 691-702

  10. High incidence of chronic pain following surgery for pelvic fracture

    DEFF Research Database (Denmark)

    Meyhoff, Christian Sylvest; Thomsen, Camilla Højland; Rasmussen, Lars Simon

    2006-01-01

    OBJECTIVES: To determine the incidence of chronic pain after surgery for pelvic fracture using a strict definition and measures of intensity and health-related quality of life. METHODS: In April 2004, a questionnaire was sent to 221 patients who underwent surgery for pelvic fracture in the period...... 1996 to 2000. Chronic pain was defined as pain at present that related back to the pelvic fracture and was not a consequence of other disease. Health-related quality of life was measured using the 15D questionnaire. RESULTS: The response rate was 72.9% after a median follow-up of 5.6 years. Chronic...... pain was seen in 48.4% (95% confidence interval, 40.7%-56.2%). These patients had a combination of somatic nociceptive, visceral nociceptive, and neuropathic pain and had significantly lower health-related quality of life. Also, the use of opioids (14.1% vs. 4.8%) and nonsteroidal anti...

  11. Women in pain : the course and diagnostics of chronic pelvic pain

    NARCIS (Netherlands)

    Weijenborg, Philomena Theodora Maria

    2009-01-01

    The main subject of this thesis is pelvic pain in women in secondary and/or tertiary medical care. Studies aim to examine: 1. The clinical course of acute abdominal pain and risks of pain persistence. 2. The clinical course of chronic pelvic pain (CPP) and predictors of recovery. 3. The moderat

  12. Risk factors for chronic postsurgical abdominal and pelvic pain

    NARCIS (Netherlands)

    Rijckevorsel, D.C.M. van; Vries, M. de; Schreuder, L.T.W.; Wilder-Smith, O.H.G.; Goor, H. van

    2015-01-01

    SUMMARY Chronic postsurgical pain (CPSP) may develop after any surgical procedure, and is a common feature after abdominal and pelvic surgery with a prevalence varying between 10 and 40%. The pathological mechanisms leading to chronic CPSP are probably inflammation, tissue and nerve damage and alter

  13. Pelvic floor muscle dysfunctions are prevalent in female chronic pelvic pain

    DEFF Research Database (Denmark)

    Loving, S; Thomsen, Thordis; Jaszczak, Poul P.

    2014-01-01

    BACKGROUND: No current standardized set of pelvic floor muscle (PFM) outcome measures have been specifically tested for their applicability in a general female chronic pelvic pain (CPP) population. We aimed to compare PFM function between a randomly selected population-based sample of women...

  14. Bedside Testing for Chronic Pelvic Pain: Discriminating Visceral from Somatic Pain

    OpenAIRE

    John Jarrell; Maria Adele Giamberardino; Magali Robert; Maryam Nasr-Esfahani

    2011-01-01

    Objectives. This study was done to evaluate three bedside tests in discriminating visceral pain from somatic pain among women with chronic pelvic pain. Study Design. The study was an exploratory cross-sectional evaluation of 81 women with chronic pelvic pain of 6 or more months' duration. Tests included abdominal cutaneous allodynia (aCA), perineal cutaneous allodynia (pCA), abdominal and perineal myofascial trigger points (aMFTP) and (pMFTP), and reduced pain thresholds (RPTs). Results. Eigh...

  15. From interstitial cystitis to chronic pelvic pain.

    Science.gov (United States)

    Persu, C; Cauni, V; Gutue, S; Blaj, Irina; Jinga, V; Geavlete, P

    2010-01-01

    There are still many things to be found out about interstitial cystitis/painful bladder syndrome (IC/PBS) because the pathological processes underlying the condition are not yet elucidated, biological markers of the condition are not yet available, and the type and severity of symptoms can vary, so, clearly defining the condition is not yet possible. For example, it is not clearly understood whether IC/PBS represents a systemic disease, if it is localized in the bladder, or if it was initially localized in the bladder and it later evolved into a systemic disease. This condition is best managed by using a multidisciplinary approach. Management requires a good integration and knowledge of all pelvic organ systems and other systems including musculoskeletal, neurologic, and psychiatric systems.

  16. Role of laparoscopy in evaluation of chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Hebbar Shripad

    2005-01-01

    Full Text Available Introduction: Chronic pelvic pain (CPP is a common medical problem affecting women. Too often the physical signs are not specific. This study aims at determining the accuracy of diagnostic laparoscopy over clinical pelvic examination. Settings and Design: A retrospective study of patients who underwent diagnostic laparoscopy for CPP. Materials and Methods: The medical records of 86 women who underwent laparoscopic evaluation for CPP of at least 6-month duration were reviewed for presentation of symptoms, pelvic examination findings at the admission, operative findings and follow up when available. Statistical analysis used: McNemar Chi-square test for frequencies in a 2 x 2 table. Results: The most common presentation was acyclic lower abdominal pain (79.1%, followed by congestive dysmenorrhoea (26.7%. 61.6% of women did not reveal any significant signs on pelvic examination. Pelvic tenderness was elicited in 27.9%. Diagnostic laparoscopy revealed significant pelvic pathology in 58% of those who essentially had normal pervaginal findings. The most common pelvic pathology by laparoscopy was pelvic adhesions (20.9%, followed by pelvic congestion (18.6%. Laparoscopic adhesiolyis achieved pain relief only in one-third of the women. Conclusion: The study revealed very low incidence of endometriosis (4.7%. Overall clinical examination could detect abnormality in only 38% of women, where as laparoscopy could detect significant pathology in 66% of women with CPP. This shows superiority of diagnostic laparoscopy over clinical examination in detection of aetiology in women with CPP (P < 0.001. Adhesiolysis helps only small proportion of women in achieving pain control.

  17. Providing holistic care for women with chronic pelvic pain.

    Science.gov (United States)

    Abercrombie, Priscilla D; Learman, Lee A

    2012-01-01

    Chronic pelvic pain (CPP) is one of the most common pain conditions affecting women and can have a significant impact on quality of life. Assessment of women with CPP is best approached in a comprehensive, systematic manner that includes exploration of physiological and psychological causes. A range of treatment options that draw from conventional medicine and complementary and alternative modalities should be offered. The women's health nurse plays a pivotal role in all aspects of care.

  18. Physical Activity and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Zhang, Ran; Chomistek, Andrea K.; Dimitrakoff, Jordan D.; Giovannucci, Edward L.; Willett, Walter C.; Rosner, Bernard A.; Wu, Kana

    2014-01-01

    Purpose Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urologic disorder among men, but its etiology is still poorly understood. Our objective was to examine the relationship between physical activity and incidence of CP/CPPS in a large cohort of male health professionals. Methods We conducted a prospective cohort study among men in the Health Professionals Follow-up Study followed from 1986 to 2008. The study population included 20,918 men who completed all CP/CPPS questions on the 2008 questionnaire. Leisure-time physical activity, including type and intensity of activity, was measured by questionnaire in 1986. A National Institute of Health Chronic Prostatitis Symptom Index pain score was calculated based on the responses on the 2008 questionnaire. Participants with pain scores ≥ 8 were considered CP/CPPS cases (n=689). Results Higher leisure-time physical activity was associated with lower risk of CP/CPPS. The multivariable-adjusted odds ratio (OR) comparing >35.0 to ≤3.5 MET-h/wk of physical activity was 0.72 (95% confidence interval (CI): 0.56, 0.92, p for trend <0.001). Observed inverse associations between physical activity and CP/CPPS were similar for both moderate- and vigorous-intensity activities. Sedentary behavior, measured as time spent watching television, was not associated with risk of CP/CPPS (p for trend 0.64). Conclusions Findings from this study, the first large scale and most comprehensive study to date on this association, suggest that higher levels of leisure-time physical activity may lower risk of CP/CPPS in middle-aged and older men. PMID:25116086

  19. Musculoskeletal Dysfunctions in Patients With Chronic Pelvic Pain

    DEFF Research Database (Denmark)

    Mieritz, Rune Mygind; Thorhauge, Kirsten; Forman, Axel;

    2016-01-01

    OBJECTIVE: The purpose of this study was to determine the prevalence of musculoskeletal dysfunctions based on a standardized clinical examination of patients with chronic pelvic pain (CPP) who were referred to a specialized tertiary care center for laparoscopic examination. In addition, we...... stratified levels of self-reported pelvic pain, self-rated health, education, and work status based on musculoskeletal dysfunction status. METHODS: This study used a cross-sectional design to determine the prevalence of musculoskeletal dysfunctions in women with CPP who were referred to a tertiary care......: Ninety-four patients returned the questionnaire, completed the clinical examination, and fulfilled the inclusion criteria. More than half of the referred patients with CPP (48 out of 94) had musculoskeletal dysfunctions in the lumbar/pelvic region. No statistically significant differences were found...

  20. Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

    Science.gov (United States)

    Randolph, Mary E.; Reddy, Diane M.

    2006-01-01

    Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index…

  1. Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study.

    Directory of Open Access Journals (Sweden)

    Thomas Torstensson

    Full Text Available To describe referred pain patterns provoked from intra-pelvic structures in women with chronic pelvic pain (CPP persisting after childbirth with the purpose to improve diagnostics and give implications for treatment.In this descriptive and comparative study 36 parous women with CPP were recruited from a physiotherapy department waiting list and by advertisements in newspapers. A control group of 29 parous women without CPP was consecutively assessed for eligibility from a midwifery surgery. Inclusion criterion for CPP was: moderate pain in the sacral region persisting at least six months after childbirth confirmed by pelvic pain provocation tests. Exclusion criteria in groups with and without CPP were: persistent back or pelvic pain with onset prior to pregnancy, previous back surgery and positive neurological signs. Pain was provoked by palpation of 13 predetermined intra-pelvic anatomical landmarks. The referred pain distribution was expressed in pain drawings and described in pain maps and calculated referred pain areas.Pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions, with or without pain referred down the ipsilateral leg. The average pain distribution area provoked by palpation of all 13 anatomical landmarks was 30.3 mm² (19.2 to 53.7 in women with CPP as compared to 3.2 mm² (1.0 to 5.1 in women without CPP, p< 0.0001.Referred pain patterns provoked from intra-pelvic landmarks in women with CPP are consistent with sclerotomal sensory innervation. Magnification of referred pain patterns indicates allodynia and central sensitization. The results suggest that pain mapping can be used to evaluate and confirm the pain experience among women with CPP and contribute to diagnosis.

  2. IL-17 is not essential for inflammation and chronic pelvic pain development in an experimental model of chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Motrich, Ruben D; Breser, María L; Sánchez, Leonardo R; Godoy, Gloria J; Prinz, Immo; Rivero, Virginia E

    2016-03-01

    Pain and inflammation in the absence of infection are hallmarks in chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) patients. The etiology of CP/CPPS is unclear, and autoimmunity has been proposed as a cause. Experimental autoimmune prostatitis (EAP) models have long been used for studying CP/CPPS. Herein, we studied prostate inflammation induction and chronic pelvic pain development in EAP using IL-12p40-KO, IL-4-KO, IL-17-KO, and wild-type (C57BL/6) mice. Prostate antigen (PAg) immunization in C57BL/6 mice induced specific Th1 and Th17 immune responses and severe prostate inflammation and cell infiltration, mainly composed of CD4 T cells and macrophages. Moreover, chronic pelvic pain was evidenced by increased allodynia responses. In immunized IL-17-KO mice, the presence of a prominent PAg-specific Th1 immune response caused similar prostate inflammation and chronic pelvic pain. Furthermore, markedly high PAg-specific Th1 immune responses, exacerbated prostate inflammation, and chronic pelvic pain were detected in immunized IL-4-KO mice. Conversely, immunized IL-12p40-KO mice developed PAg-specific Th2 immune responses, characterized by high IL-4 secretion and neither infiltration nor damage in the prostate. As observed in wild-type control animals, IL12p40-KO mice did not evidence tactile allodynia responses. Our results suggest that, as in patients, chronic pelvic pain is a consequence of prostate inflammation. After PAg immunization, a Th1-associated immune response develops and induces prostate inflammation and chronic pelvic pain. The absence of Th1 or Th2 cytokines, respectively, diminishes or enhances EAP susceptibility. In addition, IL-17 showed not to be essential for pathology induction and chronic pelvic pain development.

  3. Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Arora, Hans C; Eng, Charis; Shoskes, Daniel A

    2017-01-01

    Analysis of the human microbiome continues to reveal new and previously unrealized associations between microbial dysbiosis and disease. Novel approaches to bacterial identification using culture-independent methods allow practitioners to discern the presence of alterations in the taxa and diversity of the microbiome and identify correlations with disease processes. While some of these diseases that have been extensively studied are well-defined in their etiology and treatment methods (colorectal cancer), others have provided much more significant challenges in both diagnosis and treatment. One such condition, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), has several etiological and potentiating contributions from infection, inflammation, central nervous system (CNS) changes, stress, and central sensitization-all factors that play important roles in the crosstalk between the human body and its microbiome. No singular cause of CP/CPPS has been identified and it is most likely a syndrome with multifactorial causes. This heterogeneity and ambiguity are sources of significant frustration for patients and providers alike. Despite multiple attempts, treatment of chronic prostatitis with monotherapy has seen limited success, which is thought to be due to its heterogeneous nature. Phenotypic approaches to both classify the disease and direct treatment for CP/CPPS have proven beneficial in these patients, but questions still remain regarding etiology. Newer microbiome research has found correlations between symptom scores and disease severity and the degree of dysbiosis in urine and gut (stool) microbiomes in these patients as compared to un-afflicted controls. These findings present potential new diagnostic and therapeutic targets in CP/CPPS patients.

  4. Psychosomatic group treatment helps women with chronic pelvic pain.

    Science.gov (United States)

    Albert, H

    1999-12-01

    This study evaluates group treatment for women suffering from chronic pelvic pain. The concept of group treatment was based on psychosomatic and physio-therapeutical principles and on cognitive and operant behavioral therapy. Each group was composed of up to six women suffering from chronic pelvic pain, and two physiotherapists. Each group treatment session lasted 2.5 h per week for a period of 10 weeks. The women completed questionnaires and pain drawings four times during the treatment period from the beginning of the period till 15 months later. During 13 group treatment periods 53 women accomplished the treatment. Before the treatment the women had experienced pain for an average period of 5 years and 9 months (ranging from 6 months to 22 years). The women's descriptions of the changes derived from group treatment were analyzed according to the Grounded Theory Method. A methodical triangulation of quantitative and qualitative data as well as analyzes of the drawings were applied. One year after the end of the treatment, 39% of the women were pain-free. The average level of pain measured according to the Visual Analog Scale was reduced from 2.8 to 0.9 (p Theory Analysis a model of the development process was elaborated. The process begins with the development of self-knowledge, followed by the woman assuming self responsibility for her own life and performing self-activeness. During the process the woman increases her feeling of self-control and personal mastery of her emotions. The women's pain drawings improved, resulting in more detailed drawings, the color intensity abating, the extent of pains declining, and the outlines blurring. In conclusion this kind of group treatment brings the women relief from their pain thus reducing the use of the National Health Service by women suffering from chronic pelvic pain. The women also experience a positive psychological development. This method of treatment, in which a synergetic combination of physical and

  5. Complementary and alternative medications for chronic pelvic pain.

    Science.gov (United States)

    Leong, Fah Che

    2014-09-01

    Chronic pelvic pain is common, but rarely cured, thus patients seek both second opinions and alternative means of controlling their pain. Complementary and alternative medicine accounts for 11.2% of out-of-pocket medical expenditures for adults for all conditions in the United States. Although there are many treatments, rigorous testing and well-done randomized studies are lacking. Dietary changes and physical modalities such as physical therapy have often been included in the category of alternative medicine, but their use is now considered mainstream. This article concentrates on other sources of alternative and complementary medicine, such as dietary supplementation and acupuncture.

  6. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

    OpenAIRE

    2016-01-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report...

  7. Centering as a model for group visits among women with chronic pelvic pain.

    Science.gov (United States)

    Chao, Maria T; Abercrombie, Priscilla D; Duncan, Larissa G

    2012-01-01

    Providing comprehensive care for chronic pelvic pain is impeded by time and resource constraints of the standard health care visit. To provide patient education, psychosocial support, and health care assessment, we developed group visits for women with chronic pelvic pain using an evidence-based, holistic nursing approach. In this article, we describe the structure of group visits, the process of conducting Centering group visits focused on empowerment, and the content of a holistic curriculum for women with chronic pelvic pain.

  8. Associations between chronic pelvic pain and psychiatric disorders and symptoms

    Directory of Open Access Journals (Sweden)

    ANA CAROLINA FRANCO CARVALHO

    2015-02-01

    Full Text Available Background Chronic pelvic pain (CPP is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using the terms (chronic pelvic pain AND (psychiatry OR psychiatric OR depression OR anxiety OR posttraumatic stress OR somatoform. The searches returned a total of 529 matches that were filtered according to predefined inclusion and exclusion criteria. A total of 18 articles were selected. Results The investigations focused mainly on the assessment of depression and anxiety disorders/symptoms, with rather high rates (17-38.6%. Depression and anxiety symptoms were more prevalent among women with CPP compared to healthy groups. Comparisons between groups with CPP and with specific pathologies that also have pain as a symptom showed that depression indicators are more frequent in CPP. Depressive symptoms tend to be more common in CPP and have no particular association with pain itself, the core feature of CPP. Discussion Other aspects of CPP seem to play a specific role in this association. Anxiety and other psychiatric disorders require further investigation so that their impact on CPP can be better understood.

  9. Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Chiarioni; Corrado Asteria; William E Whitehead

    2011-01-01

    This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: A recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

  10. Pelvic Pain

    Science.gov (United States)

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  11. Physical therapy management of female chronic pelvic pain: Anatomic considerations.

    Science.gov (United States)

    George, Susan E; Clinton, Susan C; Borello-France, Diane F

    2013-01-01

    The multisystem nature of female chronic pelvic pain (CPP) makes this condition a challenge for physical therapists and other health care providers to manage. This article uses a case scenario to illustrate commonly reported somatic, visceral, and neurologic symptoms and their associated health and participation impact in a female with CPP. Differential diagnosis of pain generators requires an in-depth understanding of possible anatomic and physiologic contributors to this disorder. This article provides a detailed discussion of the relevant clinical anatomy with specific attention to complex interrelationships between anatomic structures potentially leading to the patient's pain. In addition, it describes the physical therapy management specific to this case, including examination, differential diagnosis, and progression of interventions.

  12. Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion.

    Science.gov (United States)

    Fry, R P; Beard, R W; Crisp, A H; McGuigan, S

    1997-01-01

    Social and psychological factors have long been proposed as being of importance in a sizeable subgroup of women complaining of unexplained chronic pelvic pain (CPP). The aim of this study was to examine this in two subgroups of CPP patients, thereby eliminating pain alone as the determining variable. Consecutive attenders at a clinic for CPP were assessed on a range of somatic, historical, social, and psychological variables using detailed interviews and questionnaires. They were subsequently allocated to one of two groups, based on the presence or absence of pelvic venous congestion (PVC). Significant associations emerged between some social arrangements, paternal parenting, and patterns of hostility in the group with pelvic venous congestion. The groups also differed in patterns of family illness, and the congested group tended to report more childhood sexual abuse (CSA). Clear case definition in CPP is important. In the subgroup with pelvic venous congestion early social experience may play an important role. Father-daughter relationships may be particularly relevant. Hostility patterns may influence the development of the condition. CSA does not appear to play a specific role in all unexplained CPP cases, but may have relevance for the subgroup with pelvic venous congestion.

  13. [Endovascular treatment of persistent dysuria and chronic pelvic pain in women with pelvic varicose veins].

    Science.gov (United States)

    Neĭmark, A I; Shelkovnikova, N V

    2012-01-01

    The results of the examination and treatment of 16 patients aged from 26 to 46 years with persistent urinary disorders and chronic pelvic pain due to severe pelvic varicose veins are presented. Using ultrasound with color Doppler mapping and venography of renal and ovarian vein for evaluation of condition of the venous system of the pelvis, the significant dilation of the internal iliac, ovarian and uterine veins with a pronounced decrease in blood flow in veins up to the stasis of blood, accompanied by flow turbulence and powerful backflow of renal blood through ovarian veins were found in all patients. According to uroflowmetry, there was a decrease in detrusor tone and a violation of evacuation capacity of the bladder. Evaluation of microcirculation using LDF allowed to diagnose congestive hemodynamic type of microcirculation. Scleroembolization for varicose ovarian vein with Gianturco coil and ethoxysclerol was performed in all patients. Positive therapeutic effect in the form of eliminating varicose pelvic veins, pain relieve, disappearance of persistent dysuria, and the remission of chronic cystitis was achieved in 86% of women. This intervention provided the normal outflow of blood from the pelvic veins, contributed to the normalization of uroflowmetry data and restoration of normal microcirculation in the urinary bladder.

  14. Tryptase - PAR2 axis in Experimental Autoimmune Prostatitis, a model for Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Roman, Kenny; Done, Joseph D.; Schaeffer, Anthony J.; Murphy, Stephen F.; Thumbikat, Praveen

    2014-01-01

    Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) affects up to 15% of the male population and is characterized by pelvic pain. Mast cells are implicated in the murine experimental autoimmune prostatitis (EAP) model as key to chronic pelvic pain development. The mast cell mediator tryptase-β and its cognate receptor protease-activated receptor 2 (PAR2) are involved in mediating pain in other visceral disease models. Prostatic secretions and urines from CP/CPPS patients were examined for the presence of mast cell degranulation products. Tryptase-β and PAR2 expression were examined in murine experimental autoimmune prostatitis (EAP). Pelvic pain and inflammation were assessed in the presence or absence of PAR2 expression and upon PAR2 neutralization. Tryptase-β and carboxypeptidase A3 were elevated in CP/CPPS compared to healthy volunteers. Tryptase-β was capable of inducing pelvic pain and was increased in EAP along with its receptor PAR2. PAR2 was required for the development of chronic pelvic pain in EAP. PAR2 signaling in dorsal root ganglia lead to ERK1/2 phosphorylation and calcium influx. PAR2 neutralization using antibodies attenuated chronic pelvic pain in EAP. The tryptase-PAR2 axis is an important mediator of pelvic pain in EAP and may play a role in the pathogenesis of CP/CPPS. PMID:24726923

  15. Tryptase-PAR2 axis in experimental autoimmune prostatitis, a model for chronic pelvic pain syndrome.

    Science.gov (United States)

    Roman, Kenny; Done, Joseph D; Schaeffer, Anthony J; Murphy, Stephen F; Thumbikat, Praveen

    2014-07-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects up to 15% of the male population and is characterized by pelvic pain. Mast cells are implicated in the murine experimental autoimmune prostatitis (EAP) model as key to chronic pelvic pain development. The mast cell mediator tryptase-β and its cognate receptor protease-activated receptor 2 (PAR2) are involved in mediating pain in other visceral disease models. Prostatic secretions and urines from CP/CPPS patients were examined for the presence of mast cell degranulation products. Tryptase-β and PAR2 expression were examined in murine EAP. Pelvic pain and inflammation were assessed in the presence or absence of PAR2 expression and upon PAR2 neutralization. Tryptase-β and carboxypeptidase A3 were elevated in CP/CPPS compared to healthy volunteers. Tryptase-β was capable of inducing pelvic pain and was increased in EAP along with its receptor PAR2. PAR2 was required for the development of chronic pelvic pain in EAP. PAR2 signaling in dorsal root ganglia led to extracellular signal-regulated kinase (ERK)1/2 phosphorylation and calcium influx. PAR2 neutralization using antibodies attenuated chronic pelvic pain in EAP. The tryptase-PAR2 axis is an important mediator of pelvic pain in EAP and may play a role in the pathogenesis of CP/CPPS.

  16. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis.

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    Lee, Dae Wook; Lim, Chang Hun; Han, Jae Young; Kim, Woong Mo

    2016-10-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

  17. Turn-Amplitude Analysis as a Diagnostic Test for Myofascial Syndrome in Patients with Chronic Pelvic Pain

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    Fernando Itza

    2015-01-01

    Full Text Available BACKGROUND: Myofascial pain syndrome of the pelvic floor (MPSPF is a common disease in the context of chronic pelvic pain (CPP; however, there is currently no gold-standard test to diagnose it.

  18. Bedside Testing for Chronic Pelvic Pain: Discriminating Visceral from Somatic Pain

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    John Jarrell

    2011-01-01

    Full Text Available Objectives. This study was done to evaluate three bedside tests in discriminating visceral pain from somatic pain among women with chronic pelvic pain. Study Design. The study was an exploratory cross-sectional evaluation of 81 women with chronic pelvic pain of 6 or more months' duration. Tests included abdominal cutaneous allodynia (aCA, perineal cutaneous allodynia (pCA, abdominal and perineal myofascial trigger points (aMFTP and (pMFTP, and reduced pain thresholds (RPTs. Results. Eighty-one women were recruited, and all women provided informed consent. There were 62 women with apparent visceral pain and 19 with apparent somatic sources of pain. The positive predictive values for pelvic visceral disease were aCA-93%, pCA-91%, aMFTP-93%, pMFTP-81%, and RPT-79%. The likelihood ratio (+ and 95% C.I. for the detection of visceral sources of pain were aCA-4.19 (1.46, 12.0, pCA-2.91 (1.19, 7.11, aMTRP-4.19 (1.46, 12.0, pMFTP-1.35 (0.86, 2.13, and RPT-1.14 (0.85, 1.52, respectively. Conclusions. Tests of cutaneous allodynia, myofascial trigger points, and reduced pain thresholds are easily applied and well tolerated. The tests for cutaneous allodynia appear to have the greatest likelihood of identifying a visceral source of pain compared to somatic sources of pain.

  19. Lifestyle and Risk of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health Professionals

    Science.gov (United States)

    Zhang, Ran; Sutcliffe, Siobhan; Giovannucci, Edward; Willett, Walter C.; Platz, Elizabeth A.; Rosner, Bernard A.; Dimitrakoff, Jordan D.; Wu, Kana

    2015-01-01

    Purpose Although chronic prostatitis/chronic pelvic pain syndrome is a prevalent urological disorder among men of all ages, its etiology remains unknown. Only a few previous studies have examined associations between lifestyle factors and chronic prostatitis/chronic pelvic pain syndrome, of which most were limited by the cross-sectional study design and lack of control for possible confounders. To address these limitations we performed a cohort study of major lifestyle factors (obesity, smoking and hypertension) and chronic prostatitis/chronic pelvic pain syndrome risk in the HPFS (Health Professionals Follow-up Study), a large ongoing cohort of United States based male health professionals. Materials and Methods The HPFS includes 51,529 men who were 40 to 75 years old at baseline in 1986. At enrollment and every 2 years thereafter participants have completed questionnaires on lifestyle and health conditions. In 2008 participants completed an additional set of questions on recent chronic prostatitis/chronic pelvic pain syndrome pain symptoms modified from the NIH (National Institutes of Health)-CPSI (Chronic Prostatitis Symptom Index) as well as questions on approximate date of symptom onset. The 653 participants with NIH-CPSI pain scores 8 or greater who first experienced symptoms after 1986 were considered incident chronic prostatitis/chronic pelvic pain syndrome cases and the 19,138 who completed chronic prostatitis/chronic pelvic pain syndrome questions but did not report chronic prostatitis/chronic pelvic pain syndrome related pain were considered noncases. Results No associations were observed for baseline body mass index, waist circumference, waist-to-hip ratio, cigarette smoking and hypertension with chronic prostatitis/chronic pelvic pain syndrome risk (each OR ≤1.34). Conclusions In this large cohort study none of the lifestyle factors examined was associated with chronic prostatitis/chronic pelvic pain syndrome risk. As the etiology of chronic

  20. Optimal management of chronic cyclical pelvic pain: an evidence-based and pragmatic approach

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    Ha Ryun Won

    2010-08-01

    Full Text Available Ha Ryun Won, Jason AbbottDepartment of Endo-Gynecology, Royal Hospital for Women, Sydney, New South Wales, AustraliaAbstract: This article reviews the literature on management of chronic cyclical pelvic pain (CCPP. Electronic resources including Medline, PubMed, CINAHL, The Cochrane Library, Current Contents, and EMBASE were searched using MeSH terms including all ­subheadings and keywords: “cyclical pelvic pain”, “chronic pain”, “dysmenorrheal”, “nonmenstrual ­pelvic pain”, and “endometriosis”. There is a dearth of high-quality evidence for this common ­problem. Chronic pelvic pain affects 4%–25% of women of reproductive age. Dysmenorrhea of varying degree affects 60% of women. Endometriosis is the commonest pathologic cause of CCPP. Other gynecological causes are adenomyosis, uterine fibroids, and pelvic floor myalgia, although other systems disease such as irritable bowel syndrome or interstitial cystitis may be responsible. ­Management options range from simple to invasive, where simple medical ­treatment such as the combined oral contraceptive pill may be used as a first-line treatment prior to invasive ­management. This review outlines an approach to patients with CCPP through history, physical examination, and investigation to identify the cause(s of the pain and its optimal management.Keywords: cyclical pelvic pain, chronic pain, dysmenorrhea, nonmenstrual pelvic pain, endometriosis

  1. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction.

    Science.gov (United States)

    Aredo, Jacqueline V; Heyrana, Katrina J; Karp, Barbara I; Shah, Jay P; Stratton, Pamela

    2017-01-01

    Chronic pelvic pain is a frustrating symptom for patients with endometriosis and is frequently refractory to hormonal and surgical management. While these therapies target ectopic endometrial lesions, they do not directly address pain due to central sensitization of the nervous system and myofascial dysfunction, which can continue to generate pain from myofascial trigger points even after traditional treatments are optimized. This article provides a background for understanding how endometriosis facilitates remodeling of neural networks, contributing to sensitization and generation of myofascial trigger points. A framework for evaluating such sensitization and myofascial trigger points in a clinical setting is presented. Treatments that specifically address myofascial pain secondary to spontaneously painful myofascial trigger points and their putative mechanisms of action are also reviewed, including physical therapy, dry needling, anesthetic injections, and botulinum toxin injections.

  2. Presence of Mental Imagery Associated with Chronic Pelvic Pain: A Pilot Study

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    Berna, Chantal; Vincent, Katy; Moore, Jane; Tracey, Irene; Goodwin, Guy M; Holmes, Emily A

    2011-01-01

    Objective To ascertain whether a small sample of patients with chronic pelvic pain experienced any pain-related cognitions in the form of mental images. Patients Ten women with chronic pelvic pain consecutively referred from a tertiary referral center by the physicians in charge of their treatment. Outcome measures An interview was used to determine the presence, emotional valence, content, and impact of cognitions about pain in the form of mental images and verbal thoughts. The Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Spontaneous Use of Imagery Scale (SUIS), and Hospital Anxiety and Depression Scale (HADS) were completed. Results In a population of patients with a prolonged duration of pain and high distress, all patients reported experiencing cognitions about pain in the form of mental images. For each patient, the most significant image was both negative in valence and intrusive. The associated emotional-behavioral pattern could be described within a cognitive behavioral therapy framework. Eight patients also reported coping imagery. Conclusion Negative pain-related cognitions in the form of intrusive mental imagery were reported by women with chronic pelvic pain. Targeting such imagery has led to interesting treatment innovation in the emotional disorders. Thus, imagery, hitherto neglected in pain phenomenology, could provide a novel target for cognitive behavioral therapy in chronic pain. These exciting yet preliminary results require replication and extension in a broader population of patients with chronic pain. PMID:21668746

  3. New concepts on functional chronic pelvic and perineal pain: pathophysiology and multidisciplinary management.

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    Ploteau, Stéphane; Labat, Jean Jacques; Riant, Thibault; Levesque, Amélie; Robert, Roger; Nizard, Julien

    2015-03-01

    The management of chronic pelvic and perineal pain has been improved by a better understanding of the mechanisms of this pain and an optimized integrated multidisciplinary approach to the patient. The concept of organic lesions responsible for a persistent nociceptive factor has gradually been replaced by that of dysregulation of nociceptive messages derived from the pelvis and perineum. In this setting, painful diseases identified by organ specialists are usually also involved and share several common denominators (triggering factors, predisposing clinical context). These diseases include painful bladder syndrome, irritable bowel syndrome, vulvodynia, and chronic pelvic pain syndrome. The painful symptoms vary from one individual to another and according to his or her capacity to activate pain inhibition/control processes. Although the patient often attributes chronic pain to a particular organ (with the corollary that pain will persist until the organ has been treated), this pain is generally no longer derived from the organ but is expressed via this organ. Several types of clinical presentation of complex pelvic pain have therefore been pragmatically identified to facilitate the management of treatment failures resulting from a purely organ-based approach, which can also reinforce the patient's impression of incurability. These subtypes correspond to neuropathic pain, central sensitization (fibromyalgia), complex regional pain syndrome, and emotional components similar to those observed in post-traumatic stress disorder. These various components are also often associated and self-perpetuating. Consequently, when pelvic pain cannot be explained by an organ disease, this model, using each of these four components associated with their specific mechanisms, can be used to propose personalized treatment options and also to identify patients at high risk of postoperative pelvic pain (multi-operated patients, central sensitization, post-traumatic stress disorder, etc

  4. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  5. Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection

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    Jia-Fong Jhang

    2015-06-01

    Full Text Available Chronic pelvic pain (CPP is defined as pain in the pelvic organs and related structures of at least 6 months’ duration. The pathophysiology of CPP is uncertain, and its treatment presents challenges. Botulinum toxin A (BoNT-A, known for its antinociceptive, anti-inflammatory, and muscle relaxant activity, has been used recently to treat refractory CPP with promising results. In patients with interstitial cystitis/bladder pain syndrome, most studies suggest intravesical BoNT-A injection reduces bladder pain and increases bladder capacity. Repeated BoNT-A injection is also effective and reduces inflammation in the bladder. Intraprostatic BoNT-A injection could significantly improve prostate pain and urinary frequency in the patients with chronic prostatitis/chronic pelvic pain syndrome. Animal studies also suggest BoNT-A injection in the prostate decreases inflammation in the prostate. Patients with CPP due to pelvic muscle pain and spasm also benefit from localized BoNT-A injections. BoNT-A injection in the pelvic floor muscle improves dyspareunia and decreases pelvic floor pressure. Preliminary studies show intravesical BoNT-A injection is useful in inflammatory bladder diseases such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria is the most common adverse effect after BoNT-A injection. Very few patients develop acute urinary retention after treatment.

  6. [Combination of intersticial cystitis and adenomyosis in females suffering from chronic pelvic pain syndrome].

    Science.gov (United States)

    Neĭmark, A I; Shelkovnikova, N V

    2011-01-01

    General and endoscopic examinations of 25 patients aged 40-48 years with chronic pelvic pain syndrome (CPPS) revealed combination of two urogenital diseases: interstitial cystitis and adenomyosis of the second-third degree. The complex treatment including a course of lavomax immunocorrection relieved CPPS in 72% (18) patients, reduced the number of recurrences of chronic pelvic diseases in 16% (4) patients. The therapeutic complex proposed may serve an alternative to surgical treatment of adenomyosis of the second-third degree which is uncomplicated with posthemorrhagic iron-deficiency anemia, manifests with pain only and associated with interstitial cystitis.

  7. [A modern view on the problem of the chronic pelvic pain at the women].

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    Udovika, N A; Manishchenkov, S N

    2011-01-01

    The article contains the basic causes and consequences of chronic pelvic pain (HPP) at the women. Shown that HPP - serious medical and social problem, which changes the psyche and behavior of women, violates her social adaptation. Pathogenesis HPP associated with persistent violations intraorganic and regional hemodynamics and hypoxia and acidosis that occur at the same time, cause degeneration of receptors and conduction system of pelvic organs, malnutrition solar cells and aortic nerve plexuses. Briefly described stages of HPP and this characteristic psychogenic pain as a diagnosis of exclusion. These basic ways to eliminate pain and pharmacological methods, physio and psychological action at HPP.

  8. Pelvic Pain: Other FAQs

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Pelvic Pain: Other FAQs Skip sharing on social media links ... more than one reason for my pain? Can pelvic pain affect my ability to become pregnant? Can alternative ...

  9. Correlation between altered central pain processing and concentration of peritoneal fluid inflammatory cytokines in endometriosis patients with chronic pelvic pain.

    Science.gov (United States)

    Neziri, Alban Y; Bersinger, Nick A; Andersen, Ole K; Arendt-Nielsen, Lars; Mueller, Michael D; Curatolo, Michele

    2014-01-01

    Translational research has not yet elucidated whether alterations in central pain processes are related to peripheral inflammatory processes in chronic pain patients. We tested the hypothesis that the concentration of cytokines in the peritoneal fluid of endometriosis patients with chronic pain correlate with parameters of hyperexcitability of the nociceptive system. The concentrations of 15 peritoneal fluid cytokines were measured in 11 patients with chronic pelvic pain and a diagnosis of endometriosis. Six parameters assessing central pain processes were recorded. Positive correlations between concentration of some cytokines in the peritoneal fluid and amplification of central pain processing were found. The results suggest that inflammatory mechanisms may be important in the pathophysiology of altered central pain processes and that cytokines produced in the environment of endometriosis could act as mediators between the peripheral lesion and changes in central nociceptive processes.

  10. Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP

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    Jason J. Kutch

    2015-01-01

    Full Text Available Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28, as well as group of age-matched healthy male controls (N = 27, had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing.

  11. Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP

    Science.gov (United States)

    Kutch, Jason J.; Yani, Moheb S.; Asavasopon, Skulpan; Kirages, Daniel J.; Rana, Manku; Cosand, Louise; Labus, Jennifer S.; Kilpatrick, Lisa A.; Ashe-McNalley, Cody; Farmer, Melissa A.; Johnson, Kevin A.; Ness, Timothy J.; Deutsch, Georg; Harris, Richard E.; Apkarian, A. Vania; Clauw, Daniel J.; Mackey, Sean C.; Mullins, Chris; Mayer, Emeran A.

    2015-01-01

    Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28), as well as group of age-matched healthy male controls (N = 27), had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing. PMID:26106574

  12. Mast cells in chronic inflammation, pelvic pain and depression in women.

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    Graziottin, Alessandra; Skaper, Stephen D; Fusco, Mariella

    2014-07-01

    Inflammatory and neuroinflammatory processes are increasingly recognized as critical pathophysiologic steps in the development of multiple chronic diseases and in the etiology of persistent pain and depression. Mast cells are immune cells now viewed as cellular sensors in inflammation and immunity. When stimulated, mast cells release an array of mediators to orchestrate an inflammatory response. These mediators can directly initiate tissue responses on resident cells, and may also regulate the activity of other immune cells, including central microglia. New evidence supports the involvement of peripheral and central mast cells in the development of pain processes as well as in the transition from acute, to chronic and neuropathic pain. That behavioral and endocrine states can increase the number and activation of peripheral and brain mast cells suggests that mast cells represent the immune cells that peripherally and centrally coordinate inflammatory processes in neuropsychiatric diseases such as depression and anxiety which are associated with chronic pelvic pain. Given that increasing evidence supports the activated mast cell as a director of common inflammatory pathways/mechanisms contributing to chronic and neuropathic pelvic pain and comorbid neuropsychiatric diseases, mast cells may be considered a viable target for the multifactorial management of both pain and depression.

  13. Phenotyping chronic pelvic pain based on latent class modeling of physical examination.

    Science.gov (United States)

    Fenton, B W; Grey, S F; Reichenbach, M; McCarroll, M; Von Gruenigen, V

    2013-01-01

    Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam criteria for the classes discovered. Methods. A total of 476 patients meeting the criteria for CPP were examined using pain pressure threshold (PPT) algometry and standardized numeric scale (NRS) pain ratings at 30 distinct sites over 4 pelvic regions. Exploratory factor analysis, latent profile analysis, and ROC curves were then used to identify classes, optimal examination points, and threshold scores. Results. Latent profile analysis produced two classes for each region: high and low pain groups. The optimal examination sites (and high pain minimum thresholds) were for the abdominal wall region: the pair at the midabdomen (PPT threshold depression of > 2); vulvar vestibule region: 10:00 position (NRS > 2); pelvic floor region: puborectalis (combined NRS > 6); vaginal apex region: uterosacral ligaments (combined NRS > 8). Conclusion. Physical examination scores of patients with CPP are best categorized into two classes: high pain and low pain. Standardization of the physical examination in CPP provides both researchers and general gynecologists with a validated technique.

  14. Category IIIB chronic prostatitis/chronic pelvic pain syndrome and sexual dysfunction

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    A. V. Sivkov

    2015-01-01

    Full Text Available The paper reviews the literature on the topical urological problem category IIIB chronic nonbacterial prostatitis (CNBP/chronic pelvic pain syndrome (CPPS and sexual dysfunction in this abnormality. As of now, there is no precise information on the etiology and pathogenesis of CNBP/CPPS and sexual dysfunction in this disease. Despite a considerable body of published work, the disease remains inadequately studied and untreatable.The diagnosis of CNBP/CPPS is most likely to mask a high range of different conditions, including those when the prostate is only indirectly or by no means involved in the pathological process. Some factors, such as pudendal neuropathy with the development of chronic prostatitis, CPPB, vesical obstruction, and neuroautonomic disorders, may be etiological and pathogenetic simultaneously.The problem of CNBP therapy remains unsolved so far in spite of a diversity of used treatments. Therapeutic approaches are generally aimed only at improving quality of life in a patient. All existing treatments for chronic prostatitis imply for reducing the level of sexual dysfunction too as a desirable result. Hopes for improving the results of treatment are associated with progress in the diagnosis and differential diagnosis of these conditions, with the improvement and detailed elaboration of clinical classification of the disease, and with the accumulation of the valid clinical results characterizing the efficacy and safety of drugs in well-defined patient groups.

  15. Evaluation of hysteroscopy as a complementary exam in the investigation of chronic pelvic pain.

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    Bruno Hállan Meneses Dias

    2013-09-01

    Full Text Available Introduction: Chronic pelvic pain (CPP is a difficult condition to identify and many disorders are correlated. This study investigates the role of hysteroscopy as a complementary exam in the diagnosis of CPP. Methods: One hundred ninety-one medical records of women with indication to perform a hysteroscopy and presented CPP were reviewed. Results: The analysis showed abnormalities in 99 patients. Of these, more than 70% presented conditions that could cause CPP. Cervical stenosis and findings suggestive of adenomyosis were the most frequent ocurrences. Conclusions: Hysteroscopy is useful to detect pathological conditions of the cervix and uterine cavity that may coexist with chronic pelvic pain.

  16. Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

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    Christos Papandreou

    2009-01-01

    Full Text Available The use of antidepressant drugs for the management of chronic pelvic pain has been supported in the past. This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs were identified (two for amitriptyline and two for sertraline with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not adequately supported by methodologically sound RCTs. From the existing studies amitriptyline may be effective in interstitial cystitis but publication bias should be considered as an alternative explanation. All drugs were generally well tolerated with no serious events reported.

  17. Novel PI3Kγ Mutation in a 44-Year-Old Man with Chronic Infections and Chronic Pelvic Pain

    Science.gov (United States)

    Hoischen, Alexander; Veltman, Joris; Allsop, Stephen A.; Granadillo, Victor J. Anciano; William, Arsani; Netea, Mihai G.; Dimitrakoff, Jordan

    2013-01-01

    A 44-year-old man is presented here with 14 years of chronic purulent sinusitis, a chronic fungal rash of the scrotum, and chronic pelvic pain. Treatment with antifungal therapy resulted in symptom improvement, however he was unable to establish an effective long-term treatment regimen, resulting in debilitating symptoms. He had undergone extensive work-up without identifying a clear underlying etiology, although Candida species were cultured from the prostatic fluid. 100 genes involved in the cellular immune response were sequenced and a missense mutation was identified in the Ras-binding domain of PI3Kγ. PI3Kγ is a crucial signaling element in leukotaxis and other leukocyte functions. We hypothesize that his mutation led to his chronic infections and pelvic pain. PMID:23861857

  18. Acupuncture and Immune Function in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Controlled Study

    Science.gov (United States)

    Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay; Krieger, John N

    2014-01-01

    Objective The immune system has been implicated as one mechanism underlying the benefits of acupuncture therapy. Evidence suggests that acupuncture can ameliorate symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the association between clinical response and the immune system has not been investigated. Design/Setting We investigated 12 CP/CPPS patients participating in a prospective randomized clinical trial comparing acupuncture versus sham acupuncture for effects on cellular immunity. Blood samples were taken before the first needling and after the last of 20 treatment sessions (week 10). Patients also completed questionnaires examining their CP/CPPS symptoms and mood status at the baseline and end of study visits. Results At the end of study 8 of 12 participants (67%) were classified as treatment responders, 4 participants each from the acupuncture and sham groups. The acupuncture group averaged a 5% increase in natural killer cell levels compared to corresponding sham (-13%; p=0.03). Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined, supporting the possibility that immunity might be important in the pathophysiology of CP/CPPS. Conclusions The specific effect of acupuncture on CP/CPPS remains unclear. Further research is warranted to examine the mechanisms by which acupuncture therapy may improve clinical symptoms in patients with CP/CPPS. PMID:25453515

  19. Complementary and Alternative Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome

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    Jillian L. Capodice

    2005-01-01

    Full Text Available To discuss challenges concerning treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and review complementary and alternative medical (CAM therapies being evaluated for this condition, we performed a comprehensive search of articles published from 1990–2005 using the PubMed, Medline databases. Data from the articles were abstracted and pooled by subject. Keywords cross-searched with CP/CPPS included: complementary, alternative, integrative, therapies, interventions, nutrition, antioxidants, herbs, supplements, biofeedback and acupuncture. Listed articles with no abstracts were not included. Various CAM therapies for CP/CPPS exist including biofeedback, acupuncture, hyperthermia and electrostimulation. Additionally, a variety of in vitro and in vivo studies testing herbal and nutritional supplements were found. Saw palmetto, cernilton and quercetin were the most frequently tested supplements for CP/CPP Although many CAM therapies demonstrate positive preliminary observations as prospective treatments for CP/CPPS, further exploratory studies including more randomized, controlled trials are necessary for significant validation as treatment options for this complex disorder.

  20. Complex mullerian duct anomaly in a young female with primary amenorrhoea, infertility, and chronic pelvic pain

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    Sanyal Kumar

    2012-01-01

    Full Text Available Mullerian duct anomalies, though rare, can be a treatable cause of pelvic pain and infertility. Various complex Mullerian duct anomalies may exist with combination of features of more than one class. Since there are no precise clinical or imaging criteria to enable specific categorisation, there is ambiguous classification of these anomalies by various radiologists and clinicians. A young female presented with complaints of chronic pelvic pain, primary amenorrhoea and infertility. The patient was evaluated by sonography and Magnetic Resonance Imaging and diagnosed as case of complex mullerian duct anomaly, a unicornuate uterus with cervical dysgenesis and cavitated, noncommunicating, rudimentary right horn. The findings were confirmed on laprohysteroscopy and the patient underwent hystertectomy. There should be an integrated clinico-radiological classification scheme and familiarity with rare and complex anomalies for appropriate diagnosis and management of complex Mullerian duct anomalies.

  1. Effects of yogic intervention on pain scores and quality of life in females with chronic pelvic pain

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    Saxena, Rahul; Gupta, Manish; Shankar, Nilima; Jain, Sandhya; Saxena, Arushi

    2017-01-01

    Context: Chronic pelvic pain (CPP) is a common condition of women of the reproductive age group. It has a negative impact on a woman's personal health and quality of life (QOL). Practicing yoga has shown numerous benefits in various chronic painful conditions. Aim: To study the effects of yogic intervention on pain scores and quality of life in females of reproductive age group with CPP, on conventional therapy. Settings and Design: It is a follow-up, randomized case-control study done in a tertiary care hospital. Subjects and Methods: Sixty female patients of CPP in the age group of 18–45 years were randomly divided into Group I (n = 30) and Group II (n = 30). Group I received only conventional therapy in the form of NSAIDS and Group II received yoga therapy in the form of asanas, pranayama, and relaxation along with the conventional therapy for 8 weeks. They were assessed twice (pre- and post-treatment) for pain scores through visual analog scale (VAS) score and QOL by the World Health Organization quality of life-BREF (WHOQOL-BREF) questionnaire. Statistical Analysis Used: Repeated measure ANOVA followed by Tukey's test. P yoga causes a reduction in the pain intensity and improves the quality of life in patients with chronic pelvic pain. PMID:28149062

  2. Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for Treatment of Urologic Chronic Pelvic Pain Syndrome

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    FitzGerald, Mary P; Anderson, Rodney U; Potts, Jeannette; Payne, Christopher K; Peters, Kenneth M; Clemens, J Quentin; Kotarinos, Rhonda; Fraser, Laura; Cosby, Annamarie; Fortman, Carole; Neville, Cynthia; Badillo, Suzanne; Odabachian, Lisa; Sanfield, Anna; O’Dougherty, Betsy; Halle-Podell, Rick; Cen, Liyi; Chuai, Shannon; Landis, J Richard; Kusek, John W; Nyberg, Leroy M

    2010-01-01

    Objectives To determine the feasibility of conducting a randomized clinical trial designed to compare two methods of manual therapy (myofascial physical therapy (MPT) and global therapeutic massage (GTM)) among patients with urologic chronic pelvic pain syndromes. Materials and Methods Our goal was to recruit 48 subjects with chronic prostatitis/chronic pelvic pain syndrome or interstitial cystitis/painful bladder syndrome at six clinical centers. Eligible patients were randomized to either MPT or GTM and were scheduled to receive up to 10 weekly treatments, each 1 hour in duration. Criteria to assess feasibility included adherence of therapists to prescribed therapeutic protocol as determined by records of treatment, adverse events which occurred during study treatment, and rate of response to therapy as assessed by the Patient Global Response Assessment (GRA). Primary outcome analysis compared response rates between treatment arms using Mantel-Haenszel methods. Results Twenty-three (49%) men and 24 (51%) women were randomized over a six month period. Twenty-four (51%) patients were randomized to GTM, 23 (49%) to MPT; 44 (94%) patients completed the study. Therapist adherence to the treatment protocols was excellent. The GRA response rate of 57% in the MPT group was significantly higher than the rate of 21% in the GTM treatment group (p=0.03). Conclusions The goals to judge feasibility of conducting a full-scale trial of physical therapy methods were met. The preliminary findings of a beneficial effect of MPT warrants further study. PMID:19535099

  3. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

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    Qin, Zongshi; Wu, Jiani; Zhou, Jing; Liu, Zhishun

    2016-03-01

    Acupuncture is a promising therapy for relieving symptoms in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which affects >15% of adult men worldwide. The aim of the study was to assess the effects and safety of the use of acupuncture for CP/CPPS. MEDLINE, EMBASE, CENTRAL, Web of Science, CBM, CNKI, Wang-Fang Database, JCRM, and CiNii were searched from their inception through 30 November 2015. Grey literature databases and websites were also searched. No language limits were applied. Only randomized controlled trials (RCTs) with CP/CPPS treated by acupuncture were included. Two reviewers extracted data and assessed the risk of bias of RCTs using the Cochrane Risk of Bias Tools, respectively. Seven trials were included, involving 471 participants. The result of meta-analysis indicated that compared with sham acupuncture (MD: -6.09 [95%CI: -8.12 to -5.68]) and medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) (MD: -4.57 [95%CI: -7.58 to -1.56]), acupuncture was more effective at decreasing the total NIH-CPSI score. Real acupuncture was superior to sham acupuncture in improving symptoms (pain, voiding) and quality of life (Qof) domain subscores. Compared to sham acupuncture and medicine, acupuncture appears to be more effective at improving the global assessment. Two trials found that there is no significant difference between acupuncture and sham acupuncture in decreasing the IPSS score. Acupuncture failed to show more favorable effects in improving both symptoms and the Qof domain compared with medicine. Overall, current evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Based on the meta-analysis, acupuncture is superior to sham acupuncture in improving symptoms and Qof. Acupuncture might be similar to medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) in its long-term effects, but evidence was limited due to high ROB among included trials as well as potential heterogeneity

  4. Redundant prepuce increases the odds of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

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    Zhao, Yu-Yang; Xu, Dong-Liang; Zhao, Fu-Jun; Han, Bang-Min; Shao, Yi; Zhao, Wei; Xia, Shu-Jie

    2014-01-01

    Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients (case group) and 341 nonCP/CPPS patients (control group). Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin (odds ratio (OR): 1.66, 95% confidence interval (CI): 1.04–2.66). In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 (95% CI, 1.2–2.88). The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS. PMID:24875824

  5. Redundant prepuce increases the odds of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS

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    Yu-Yang Zhao

    2014-10-01

    Full Text Available Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients (case group and 341 nonCP/CPPS patients (control group. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin (odds ratio (OR: 1.66, 95% confidence interval (CI: 1.04-2.66. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 (95% CI, 1.2-2.88. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.

  6. Fluoxetine ameliorates symptoms of refractory chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; WANG Ping; CHEN Jun; WANG Shuo; JIANG Hai

    2011-01-01

    Background Category Ⅲ chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common syndrome of unclear etiology with significant impact on quality of life. Because the outcomes of multiple therapies for CP/CPPS have been far from approving, the possible psychological factors have been considered to play an important role in CP/CPPS.Based on this, we investigated the role of antidepressant drug (fluoxetine) in men with refractory CP/CPPS.Methods In this study, 42 men diagnosed with refractory CP/CPPS without response to standard therapy (include multiple antibiotic courses and a-blockers) were referred for fluoxetine therapy. All patients received fluoxetine (20 mg/d) for three months and were clinically evaluated before (baseline), and after 4, 8 and 12 weeks of therapy. The evaluation included a National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) and a Beck depression inventory (BDI) questionnaire. Moreover, the subjective global assessment (SGA) was assessed at the 4th, 8th and 12th week of therapy.Results Significant decreases were observed for total NIH-CPSI (28.55 to 9.29), NIH-CPSI pain (14.69 to 5.19),NIH-CPSI urinary (4.95 to 1.88 ), NIH-CPSI quality of life (8.83 to 2.20), and BDI (34.67 to 13.95) scores compared with baseline, all P values <0.05. Twenty-nine (69.05%) reported marked improvement on the subjective global assessment and 33 (78.57%) had a greater than 50% decrease in NIH-CPSI at the end of therapy (12th week). At the same time, the Pearson correlation coefficient analysis demonstrated a positive correlation between BDI score and each CPSI score. No adverse events were reported in this study.Conclusions Fluoxetine appears to be a safe and effective treatment in improving symptoms in, and the quality of life of, men with difficult CP/CPPS. Moreover, amelioration of difficult CP/CPPS-related symptoms could be related to a decrease in depressive symptoms.

  7. Multimodal therapy for category III chronic prostatitis/chronic pelvic pain syndrome in UPOINTS phenotyped patients

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    MAGRI, VITTORIO; MARRAS, EMANUELA; RESTELLI, ANTONELLA; WAGENLEHNER, FLORIAN M.E.; PERLETTI, GIANPAOLO

    2015-01-01

    The complex network of etiological factors, signals and tissue responses involved in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) cannot be successfully targeted by a single therapeutic agent. Multimodal approaches to the therapy of CP/CPPS have been and are currently being tested, as in the frame of complex diagnostic-therapeutic phenotypic approaches such as the urinary, psychosocial, organ-specific, infection, neurological and muscle tenderness (UPOINTS) system. In this study, the effect of combination therapy on 914 patients diagnosed, phenotyped and treated in a single specialized prostatitis clinic was analyzed. Patients received α-blockers, Serenoa repens (S. repens) extracts combined or not with supplements (lycopene and selenium) and, in the presence of documented or highly suspected infection, antibacterial agents. Combination treatment induced marked and significant improvements of National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) prostatitis symptom scores, International Index of Erectile Function (IIEF) sexual dysfunction scores, urinary peak flow rates and bladder voiding efficiency. These improvements, assessed after a 6-month course of therapy, were sustained throughout a follow-up period of 18 months. A clinically appreciable reduction of ≥6 points of the total NIH-CPSI score was achieved in 77.5% of patients subjected to combination therapy for a period of 6 months. When the patients were divided in two cohorts, depending on the diagnosis of CP/CPPS [inflammatory (IIIa) vs. non-inflammatory (IIIb) subtypes], significant improvements of all signs and symptoms of the syndrome were observed in both cohorts at the end of therapy. Intergroup comparison showed that patients affected by the IIIa sub-category of CP/CPPS showed more severe signs and symptoms (NIH-CPSI total, pain and quality of life impact scores, and Qmax) at baseline when compared with IIIb patients. However, the improvement of symptoms after

  8. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

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    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

  9. Myofascial pelvic pain.

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    Kotarinos, Rhonda

    2012-10-01

    Myofascial pelvic pain is fraught with many unknowns. Is it the organs of the pelvis, is it the muscles of the pelvis, or is the origin of the pelvic pain from an extrapelvic muscle? Is there a single source or multiple? In this state of confusion what is the best way to manage the many symptoms that can be associated with myofascial pelvic pain. This article reviews current studies that attempt to answer some of these questions. More questions seem to develop as each study presents its findings.

  10. Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network.

    Science.gov (United States)

    Alger, Jeffry R; Ellingson, Benjamin M; Ashe-McNalley, Cody; Woodworth, Davis C; Labus, Jennifer S; Farmer, Melissa; Huang, Lejian; Apkarian, A Vania; Johnson, Kevin A; Mackey, Sean C; Ness, Timothy J; Deutsch, Georg; Harris, Richard E; Clauw, Daniel J; Glover, Gary H; Parrish, Todd B; Hollander, Jan den; Kusek, John W; Mullins, Chris; Mayer, Emeran A

    2016-01-01

    The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network is an ongoing multi-center collaborative research group established to conduct integrated studies in participants with urologic chronic pelvic pain syndrome (UCPPS). The goal of these investigations is to provide new insights into the etiology, natural history, clinical, demographic and behavioral characteristics, search for new and evaluate candidate biomarkers, systematically test for contributions of infectious agents to symptoms, and conduct animal studies to understand underlying mechanisms for UCPPS. Study participants were enrolled in a one-year observational study and evaluated through a multisite, collaborative neuroimaging study to evaluate the association between UCPPS and brain structure and function. 3D T1-weighted structural images, resting-state fMRI, and high angular resolution diffusion MRI were acquired in five participating MAPP Network sites using 8 separate MRI hardware and software configurations. We describe the neuroimaging methods and procedures used to scan participants, the challenges encountered in obtaining data from multiple sites with different equipment/software, and our efforts to minimize site-to-site variation.

  11. MR aspect of the prostate in CPPS patients (chronic pelvic pain syndrome); MR-Befundmuster der Prostata bei Patienten mit CPP Syndrom (chronic pelvic pain syndrome)

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    Wiesinger, B.; Lichy, M.P.; Claussen, C.D.; Schlemmer, H.P. [Abt. fuer Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Naegele, U.; Anastasiadis, A. [Abt. fuer Urologie, Universitaetsklinikum Tuebingen (Germany)

    2008-07-15

    Purpose: to describe typical morphological patterns of abacterial prostatitis using magnetic resonance imagine (MRI) in chronic pelvic pain syndrome patients including spectroscopy. Materials and methods: 18 patients (age range between 25 and 67 years, average 46.2 years) with recurrent chronic pelvic pain syndrome for at least 3 months were evaluated clinically in the urological department and included if there were no suspicious findings from endorectal digital palpation and if their PSA values were < 5 ng/ml. A retrospective analysis of these 18 patients with 30 contrast-enhanced MRI investigations with endorectal coils in 28 of 30 cases was performed with a 1.5T MRI. T2w signal intensity (SI) and spectroscopy data (9/18 patients) were acquired for the normal peripheral zone, the central zone, for the peripheral zone suspected of inflammation and for the muscle including SI ratios for the unaltered and the suspicious inflammatory peripheral zone. Results: typical MR patterns of signal alterations suspected of inflammation of CPPS patients were able to be detected as T2w hypointense triangular, stringy (n = 12, 66.6%) contrast-enhancing signal alterations without a nodular shape with well circumscribed margins of the capsula and without pericapsular signal alterations. In 6 patients changes also had a triangular but more homogeneous aspect (33.3%). Three patients had an additional periurethral uptake (16.6%). T2w SI measurements and T2w SI ratios showed much lower values for the peripheral zone suspected of inflammation as compared to the normal peripheral zone of the prostate (277.29 STD 77.5 to 432.9 STD 112.02 and 4.94 STD 1.47 to 7.58 STD 2.01 respectively). The spectroscopic analysis of the signal alterations suspected of inflammation showed normal Cholin+ Creatin/Citrate SI ratio values in 3 patients (SI < 0.5), ratios suspected of low grade cancer in 3 patients (SI 0.5 and < 0.7) and ratios suspected of intermediate grade prostate cancer in 3 patients (SI

  12. Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review

    DEFF Research Database (Denmark)

    Loving, Sys; Nordling, Jørgen; Jaszczak, Poul

    2012-01-01

    dysfunction is frequently cited as a possible aetiology. Physiotherapy is therefore recommended as one treatment modality. The aim of this systematic review was to source and critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment...... of female CPP. Methods Electronic databases, conference proceedings, text books and clinical guidelines were searched for quantitative, observational, and prospective clinical intervention studies of female chronic pelvic pain where physiotherapy was a sole or significant component of the intervention...... in the other study types. Physiotherapy treatments varied between studies and were provided in combination with psychotherapeutic modalities and medical management. This did not allow for the ‘stand-alone’ value of physiotherapy to be determined. Heterogeneity across the studies, with respect to participants...

  13. Irritable bowel syndrome and chronic pelvic pain: A singular or two different clinical syndrome?

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    Anna Matheis; Ute Martens; Johannes Kruse; Paul Enck

    2007-01-01

    Irritable bowel syndrome (IBS) and chronic pelvic pain (CPP) are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differences and the similarities related to epidemiology and psychosocial aspects like stressful life events, physical and sexual abuse, illness behaviour and comorbidity. The technical literature was reviewed systematically from 1971 to 2006 and compared. According to literature, IBS and CPP seem to be one rather than two different entities with the same localisation of pain. Both syndromes also are similar concerning prevalence, the coexistence of mental and somatoform disorders, the common history of sexual and physical abuse in the past and their health care utilization. It could be shown that there were many similarities between IBS and CPR Nevertheless both are traded as different clinical pictures as far. Therefore it seems to be reasonable and necessary to generate a common diagnosis algorithm and to bring gynaecologists and gastroenterologists into dialogue.

  14. Pharmacological treatment and regional anesthesia techniques for pain management after completion of both conservative and surgical treatment of endometriosis and pelvic adhesions in women with chronic pelvic pain as a mandated treatment strategy

    Directory of Open Access Journals (Sweden)

    Małgorzata Malec-Milewska

    2015-05-01

    Full Text Available Introduction. Chronic pelvic pain syndrome occurs in 4–14% of women. Pain pathomechanism in this syndrome is complex, as it is common to observe the features of nociceptive, inflammatory, neuropathic and psychogenic pain. The common findings in women with pelvic pain are endometriosis and pelvic adhesions. Objective. Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally used in the management of endometriosis and pelvic adhesions. Materials and method. 18 women were treated between January 2010 – October 2013 in the Pain Clinic of the Department of Anaesthesiology and Intensive Care at the Centre for Postgraduate Education in Warsaw due to chronic pelvic pain syndrome related to either endometriosis or pelvic adhesions. During the previous step of management, both conservative and surgical treatments were completed without achieving satisfactory results. Initial constant pain severity was 3–9 points on the Numeric Rating Scale, while the reported paroxysmal pain level was 7–10. The pharmacological treatment implemented was based on oral gabapentinoids and antidepressants, aided by neurolytic block of ganglion of Walther, pudendal nerve blocks and topical treatment (5% lidocaine, 10% amitriptyline, 10% gabapentin. Results. In 17 women, a significant reduction of both constant and paroxysmal pain was achieved, of which complete and permanent cessation of pain occurred in 6 cases. One patient experienced no improvement in the severity of her symptoms. Conclusions. The combination of pain management with pharmacological treatment, pudendal nerve blocks, neurolysis of ganglion impar (Walther and topical preparations in cases of chronic pelvic pain syndrome seems to be adequate medical conduct after failed or otherwise ineffective causative therapy.

  15. How Is Pelvic Pain Treated?

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    ... Information Clinical Trials Resources and Publications How is pelvic pain treated? Skip sharing on social media links Share ... Page Content Treatment depends on the cause of pelvic pain, how intense the pain is, and how often ...

  16. An Exploratory Study into Objective and Reported Characteristics of Neuropathic Pain in Women with Chronic Pelvic Pain.

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    Lucy H R Whitaker

    Full Text Available Chronic pelvic pain (CPP affects 5.7-26.6% women worldwide. 55% have no obvious pathology and 40% have associated endometriosis. Neuropathic pain (NeP is pain arising as a consequence of a lesion/disease affecting the somatosensory system. The prevalence of NeP in women with CPP is not known. The diagnosis of NeP is challenging because there is no gold-standard assessment. Questionnaires have been used in the clinical setting to diagnose NeP in other chronic pain conditions and quantitative sensory testing (QST has been used in a research setting to identify abnormal sensory function. We aimed to determine if women with chronic pelvic pain (CPP have a neuropathic pain (NeP component to their painful symptoms and how this is best assessed. We performed an exploratory prospective cohort study of 72 pre-menopausal women with a diagnosis of CPP. They underwent a clinician completed questionnaire (DN4 and completed the S-LANSS and PainDETECT™ questionnaires. Additionally QST testing was performed by a clinician. They also completed a patient acceptability questionnaire. Clinical features of NeP were identified by both questionnaires and QST. Of the women who were NeP positive, 56%, 35% and 26% were identified by the S-LANSS, DN4 and PainDETECT™ respectively. When NeP was identified by questionnaire, the associated laparoscopy findings were similar irrespective of which questionnaire was used. No subject had entirely unchanged QST parameters. There were distinct loss and gain subgroups, as well as mixed alteration in function, but this was not necessarily clinically significant in all patients. 80% of patients were confident that questionnaires could diagnose NeP, and 90% found them easy to complete. Early identification of NeP in women with CPP with a simple questionnaire could facilitate targeted therapy with neuromodulators, which are cheap, readily available, and have good safety profiles. This approach could prevent unnecessary or fertility

  17. Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome.

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    Lin, Guiting; Reed-Maldonado, Amanda B; Lin, Maofan; Xin, Zhongcheng; Lue, Tom F

    2016-07-01

    Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is one of the most common urologic diseases, and no curative treatments have been identified. Low-intensity pulsed ultrasound (LIPUS) has been successfully used in promoting tissue healing, inhibiting inflammation and pain, differentiating stem cells, and stimulating nerve regeneration/muscle regeneration, as well as enhancing angiogenesis. Very recently, LIPUS has been proven an effective approach for CP/CPPS. This review summarizes the possible mechanisms responsible for the therapeutic effect of LIPUS for CP/CPPS. To search publications relevant to the topics of this review, the search engine for life sciences of Entrez was used. We reviewed the available evidence from 1954 through 2015 concerning LIPUS for CP/CPPS. According to the literature, both transrectal and transperineal approaches of LIPUS are effective for CP/CPPS.

  18. Effects and Mechanisms of Low-Intensity Pulsed Ultrasound for Chronic Prostatitis and Chronic Pelvic Pain Syndrome

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    Guiting Lin

    2016-07-01

    Full Text Available Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS is one of the most common urologic diseases, and no curative treatments have been identified. Low-intensity pulsed ultrasound (LIPUS has been successfully used in promoting tissue healing, inhibiting inflammation and pain, differentiating stem cells, and stimulating nerve regeneration/muscle regeneration, as well as enhancing angiogenesis. Very recently, LIPUS has been proven an effective approach for CP/CPPS. This review summarizes the possible mechanisms responsible for the therapeutic effect of LIPUS for CP/CPPS. To search publications relevant to the topics of this review, the search engine for life sciences of Entrez was used. We reviewed the available evidence from 1954 through 2015 concerning LIPUS for CP/CPPS. According to the literature, both transrectal and transperineal approaches of LIPUS are effective for CP/CPPS.

  19. Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

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    Krsmanovic, Adrijana; Tripp, Dean A.; Nickel, J. Curtis; Shoskes, Daniel A.; Pontari, Michel; Litwin, Mark S.; McNaughton-Collins, Mary F.

    2014-01-01

    Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL. Methods: Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements. Results: Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness-focused coping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model. Conclusion: Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management. PMID:25553153

  20. Chronic Pelvic Pain frequency among a group of Iranian employed women

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    Dehghan FM

    2009-01-01

    Full Text Available "nBackground: Chronic Pelvic Pain (CPP, a common health problem in women, characterized by lower abdominal pain that has lasted at least for six months. Although, it's annual prevalence estimated 3.8 to 49%, there is no data in Iranian society. This study was aimed at gathering comprehensive and reliable data regarding the prevalence of CPP in female employees at two university hospitals in Tehran in 2006-2007. "nMethods: A cross-Sectional study was conducted to determine the CPP prevalence on 303 volunteer females aged 19-63(34.7±9.2 years, working in two university hospitals, Tehran. A designed questionnaire with four parts containing questions regarding demographic information, gynecological, urinary and gastrointestinal symptoms was used. The ethical committee of the Shaheed Beheshti Medical University approved the study. "nResults: The prevalence of present pelvic pain unrelated to menstrual cycle was 22.3% and totally 10.2% subjects suffered from CPP during the last 6-12 months. Our data showed a significant difference in prevalence of CPP between women with and without vaginal delivery (37% VS. 24 P=0.036%. There was a significant relationship between incomplete and hard defecation and occurrence of CPP (p<0.001. The prevalence of LBP & PPD in women with CPP was higher than women with no CPP (p<0.001. "nConclusions: Regarding to the prevalence of CPP and its relationship with gynecological, urinary, musculoskeletal and gastrointestinal factors, we emphasize on a multidisciplinary approach for management of CPP, also recommend performing further community-based epidemiological studies.

  1. Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study.

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    Papeš, Dino; Pasini, Miram; Jerončić, Ana; Vargović, Martina; Kotarski, Viktor; Markotić, Alemka; Škerk, Višnja

    2017-01-01

    In <10% of patients with prostatitis syndrome, a causative uropathogenic organism can be detected. It has been shown that certain organisms that cause sexually transmitted infections can also cause chronic bacterial prostatitis, which can be hard to diagnose and treat appropriately because prostatic samples obtained by prostatic massage are not routinely tested to detect them. We conducted a clinical study to determine the prevalence of Chlamydia, mycoplasma, and trichomonas infection in 254 patients that were previously diagnosed and treated for chronic prostatitis/chronic pelvic pain syndrome due to negative urethral swab, urine, and prostate samples. Urethral swabs and standard Meares-Stamey four-glass tests were done. Detailed microbiological analysis was conducted to detect the above organisms. Thirty-five (13.8%) patients had positive expressed prostatic secretions/VB3 samples, of which 22 (10.1%) were sexually transmitted organisms that were not detected on previous tests.

  2. Classifying Patients with Chronic Pelvic Pain into Levels of Biopsychosocial Dysfunction Using Latent Class Modeling of Patient Reported Outcome Measures

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    Bradford W. Fenton

    2015-01-01

    Full Text Available Chronic pelvic pain affects multiple aspects of a patient’s physical, social, and emotional functioning. Latent class analysis (LCA of Patient Reported Outcome Measures Information System (PROMIS domains has the potential to improve clinical insight into these patients’ pain. Based on the 11 PROMIS domains applied to n=613 patients referred for evaluation in a chronic pelvic pain specialty center, exploratory factor analysis (EFA was used to identify unidimensional superdomains. Latent profile analysis (LPA was performed to identify the number of homogeneous classes present and to further define the pain classification system. The EFA combined the 11 PROMIS domains into four unidimensional superdomains of biopsychosocial dysfunction: Pain, Negative Affect, Fatigue, and Social Function. Based on multiple fit criteria, a latent class model revealed four distinct classes of CPP: No dysfunction (3.2%; Low Dysfunction (17.8%; Moderate Dysfunction (53.2%; and High Dysfunction (25.8%. This study is the first description of a novel approach to the complex disease process such as chronic pelvic pain and was validated by demographic, medical, and psychosocial variables. In addition to an essentially normal class, three classes of increasing biopsychosocial dysfunction were identified. The LCA approach has the potential for application to other complex multifactorial disease processes.

  3. Qualitative research as the basis for a biopsychosocial approach to women with chronic pelvic pain.

    Science.gov (United States)

    Souza, Paula Patricia; Romão, Adriana Salata; Rosa-e-Silva, Julio Cesar; Reis, Francisco Candido dos; Nogueira, Antonio Alberto; Poli-Neto, Omero Benedicto

    2011-12-01

    Chronic pelvic pain (CPP) is a highly prevalent clinical condition and is recognized as a public health problem. Although the number of qualitative studies related to the topic is increasing, it is essential that this knowledge be presented in a synthesized manner, grounded in the context of the care provided to patients with CPP, in order to increase the clinical and research applicability of the findings. Little attention is given to CPP in undergraduate courses and in meetings for the continuing education of health professionals, the approach to CPP typically being based on the biomedical model. We believe that qualitative research can provide insights into CPP and form the basis for a biopsychosocial approach to the condition, which can in turn lead to better results, including resolution of the pain and greater patient/health professional satisfaction. Therefore, we conducted a metasynthesis of seven qualitative studies of CPP, the principal themes of which were as follows: (a) coping with CPP versus secondary gain; (b) the great importance of determining the cause of the pain; (c) expectations regarding the doctor-patient relationship; and (d) gender issues. We hope that the present study can aid in restoring the humanistic aspects of CPP treatment.

  4. How Is Pelvic Pain Diagnosed?

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    ... Information Clinical Trials Resources and Publications How is pelvic pain diagnosed? Skip sharing on social media links Share ... needed to help diagnose the cause of the pelvic pain. These tests or procedures may include 1 , 2 : ...

  5. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity

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    Gülmezoglu Metin

    2006-07-01

    Full Text Available Abstract Background Health care planning for chronic pelvic pain (CPP, an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. Methods We identified data available from Medline (1966 to 2004, Embase (1980 to 2004, PsycINFO (1887 to 2003, LILACS (1982 to 2004, Science Citation index, CINAHL (January 1980 to 2004 and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. Results There were 178 studies (459975 participants in 148 articles. Of these, 106 studies were (124259 participants on dysmenorrhoea, 54 (35973 participants on dyspareunia and 18 (301756 participants on noncyclical pain. There were only 19/95 (20% less developed and 1/45 (2.2% least developed countries with relevant data in contrast to 22/43 (51.2% developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5% high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. Conclusion There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where

  6. Feasibility of robotic radical prostatectomy for medication refractory chronic prostatitis/chronic pelvic pain syndrome: Initial results

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    Sameer Chopra

    2016-01-01

    Full Text Available Four patients diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, met criteria for National Institute of Health (NIH Category III prostatitis, failed multiple medicinal treatments and underwent robotic radical prostatectomy (RRP. Median operative time (range: 157 (127–259 min. Validated functional questionnaires responses and NIH CP symptom index (NIH-CPSI score were collected for each patient's status at different time points pre- and post-operatively. Median decreases (range were: International Prostate Symptom Score - 14 (1–19; Sexual Health Inventory for Men - 6 (−14–22; and NIH-CPSI total - 23.5 (13–33. Median length of follow-up (range was 34 (24–43 months. RRP appears to be an option for carefully selected patients with medication-refractory CP/CPPS who understand that baseline sexual function may not be restored postoperatively.

  7. Feasibility of robotic radical prostatectomy for medication refractory chronic prostatitis/chronic pelvic pain syndrome: Initial results.

    Science.gov (United States)

    Chopra, Sameer; Satkunasivam, Raj; Aron, Monish

    2016-01-01

    Four patients diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), met criteria for National Institute of Health (NIH) Category III prostatitis, failed multiple medicinal treatments and underwent robotic radical prostatectomy (RRP). Median operative time (range): 157 (127-259) min. Validated functional questionnaires responses and NIH CP symptom index (NIH-CPSI) score were collected for each patient's status at different time points pre- and post-operatively. Median decreases (range) were: International Prostate Symptom Score - 14 (1-19); Sexual Health Inventory for Men - 6 (-14-22); and NIH-CPSI total - 23.5 (13-33). Median length of follow-up (range) was 34 (24-43) months. RRP appears to be an option for carefully selected patients with medication-refractory CP/CPPS who understand that baseline sexual function may not be restored postoperatively.

  8. Reduction of blood nitric oxide levels is associated with clinical improvement of the chronic pelvic pain related to endometriosis

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    M.G. Rocha

    2015-04-01

    Full Text Available The objective of this prospective study was to determine the plasma levels of nitric oxide (NO in women with chronic pelvic pain secondary to endometriosis (n=24 and abdominal myofascial pain syndrome (n=16. NO levels were measured in plasma collected before and 1 month after treatment. Pretreatment NO levels (μM were lower in healthy volunteers (47.0±12.7 than in women with myofascial pain (64.2±5.0, P=0.01 or endometriosis (99.5±12.9, P<0.0001. After treatment, plasma NO levels were reduced only in the endometriosis group (99.5±12.9 vs 61.6±5.9, P=0.002. A correlation between reduction of pain intensity and reduction of NO level was observed in the endometriosis group [correlation = 0.67 (95%CI = 0.35 to 0.85, P<0.0001]. Reduction of NO levels was associated with an increase of pain threshold in this group [correlation = -0.53 (-0.78 to -0.14, P<0.0001]. NO levels appeared elevated in women with chronic pelvic pain diagnosed as secondary to endometriosis, and were directly associated with reduction in pain intensity and increase in pain threshold after treatment. Further studies are needed to investigate the role of NO in the pathophysiology of pain in women with endometriosis and its eventual association with central sensitization.

  9. Postural changes in women with chronic pelvic pain: a case control study

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    Nogueira Antonio A

    2009-07-01

    Full Text Available Abstract Background Chronic pelvic pain (CPP is a lower abdominal pain lasting at least 6 months, occurring continuously or intermittently and not associated exclusively with menstruation or intercourse. Although the musculoskeletal system has been found to be involved in CPP, few studies have assessed the contribution of posture in women with CPP. We aimed to determine if the frequency of postural changes was higher in women with CPP than healthy subjects. Methods A case-control study included 108 women with CPP of more than 6 months' duration (CPP group who consecutively attended at the Hospital of the University of São Paulo and 48 healthy female volunteers (control group. Postural assessment was noninvasive and performed in the standing position, with the reference points of Kendall used as normal parameters. Factors associated with CPP were assessed by logistic regression analysis. Results Logistic regression showed that the independent factors associated with CPP were postural changes in the cervical spine (OR 4.1; 95% CI 1.6–10.7; p Conclusion Musculoskeletal changes were associated with CPP in 34% of women. These findings suggest that a more detailed assessment of women with CPP is necessary for better diagnosis and for more effective treatment.

  10. Characteristics of pathological findings in women with chronic pelvic pain using conscious mini-laparoscopic pain mapping

    Institute of Scientific and Technical Information of China (English)

    XU Hong-mei; ZHANG Na-wei; ZHANG Zhen-yu; LI Shu-hong; SHI Xiu-ting; LIU Chong-dong

    2010-01-01

    @@ Chronic pelvic pain (CPP) is a common and disabling disorder of women that may have a significant impact on a woman's personal health and quality of life.Data have shown an annual prevalence of 3.8% in women 15 to 73 years of age, making its prevalence comparable to that of asthma (3.7%), back pain (4.1%), and migraines (2.1%). CPP in women is described as "intermittent or constant pain in the lower abdomen or pelvis of at least six months duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy". In addition, the condition is considered as a symptom, not a diagnosis. CPP is estimated to account for 10% of all referrals to gynecologists, 12% of all hysterectomies, and more than 40% of gynecologic diagnostic laparoscopies. The etiology is complex and may involve disorders of the reproductive tract,gastrointestinal tract, urinary tract, musculoskeletal system, and psychoneurological system. The diagnosis is often difficult, especially when nothing positive is found on physical examimation and imaging studies. The optimal management is usually difficult due to the unknown etiology.

  11. Effects of “Danzhi Decoction” on Chronic Pelvic Pain, Hemodynamics, and Proinflammatory Factors in the Murine Model of Sequelae of Pelvic Inflammatory Disease

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    Xiaoling Bu

    2015-01-01

    Full Text Available Objective. To evaluate the effect of Danzhi decoction (DZD on chronic pelvic pain (CPP, hemodynamics, and proinflammatory factors of sequelae of pelvic inflammatory diseases (SPID in murine model. Methods. SPID mice were randomly treated with high-dose DZD, mid-dose DZD, low-dose DZD, aspirin, and vehicle for 3 estrous circles. The Mouse Grimace Scale (MGS was performed to evaluate CPP; blood flows of the upper genital tract, pelvic wall, and mesentery were used to assess hemodynamics in SPID mice; expressions of vascular endothelial growth factor (VEGF, angiopoietin-2 (Ang-2, and osteopontin (OPN were measured by Western blot and immunochemistry. Results. Treatment with dose-dependent DZD significantly decreased the MGS scores, accelerated blood flows of the pelvis, and reduced expressions of VEGF, Ang-2, and OPN in the upper genital tract. Conclusions and Discussions. DZD was effective in relieving CPP and improving hemodynamics of the pelvic blood-stasis microenvironment in SPID mice. There was a relationship between CPP and the pelvic blood-stasis microenvironment. Furthermore, DZD might play a positive role in the anti-inflammatory process.

  12. Pelvic congestion syndrome and chronic pelvic pain%盆腔淤血综合征与慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    肖喜荣; 李斌

    2013-01-01

    Pelvic congestion syndrome (PCS), caused by mechanical and/or hormonal factors, plays an important role in the disease of chronic pelvic pain. Patients commonly present with pelvic pain without positive physical examination finding. The imaging examination such as doppler ultrasound, contrast-enhanced magnetic resonance venography and pelvic venogra-phy is vital in the assessment of PCS and is often used to confirm the clinical suspicion of this condition. Besides traditional therapy, transcatheter embo-lotherapy gradually turns to be the optimal treatment option.%盆腔淤血综合征是慢性盆腔痛的重要原因,其发生与盆腔静脉解剖、体循环、内分泌等因素有关.盆腔淤血综合征患者的临床症状与体征不符,超声、增强磁共振静脉造影及盆腔静脉造影有助于诊断.在沿袭传统治疗的同时,经导管栓塞技术已逐步成为治疗盆腔淤血综合征的首选方案.

  13. A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain

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    Stone Brian A

    2007-02-01

    Full Text Available Abstract Background The etiology and treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS remain poorly understood. Pain, lower urinary tract voiding symptoms and negative impact on quality of life (QOL are the most common complaints. Acupuncture, which has been widely used to treat painful and chronic conditions, may be a potential treatment to alleviate the constellation of symptoms experienced by men with CP/CPPS. The purpose of our study was to assess the impact of standardized full body and auricular acupuncture in men refractory to conventional therapies and collect pilot data to warrant further randomized trials. Methods Ten men diagnosed with category IIIA or IIIB CP/CPPS >6 months, refractory to at least 1 conventional therapy (antibiotics, anti-inflammatory agents, 5-α reductase inhibitors, α-1 blockers and scoring >4 on the pain subset of the NIH-CPSI were prospectively analyzed in an Institutional Review Board (IRB approved, single-center clinical trial (Columbia University Medical Center IRB#AAAA-7460. Standardized full body and auricular acupuncture treatment was given twice weekly for 6 weeks. The primary endpoints were total score of the NIH-CPSI and assessment of serious adverse events. The secondary endpoints were individual scores of the NIH-CPSI and QOL questionnaire scores of the short-form 36 (SF-36. Results The median age of the subjects was 36 years (range 29–63. Decreases in total NIH-CPSI scores (mean ± SD after 3 and 6 weeks from baseline (25.1 ± 6.6 were 17.6 ± 5.7 (P Conclusion The preliminary findings, although limited, suggest the potential therapeutic role of acupuncture in the treatment of CP/CPPS. Data from this and previous studies warrant randomized trials of acupuncture for CP/CPPS and particular attention towards acupuncture point selection, treatment intervention, and durability of acupuncture.

  14. Prevalence and conditions associated with chronic pelvic pain in women from São Luís, Brazil

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    L.S.C. Coelho

    2014-09-01

    Full Text Available The objective of the present study was to estimate the prevalence of chronic pelvic pain in the community of São Luís, capital of the State of Maranhão, Northeastern Brazil, and to identify independent conditions associated with it. A cross-sectional study was conducted, including a sample of 1470 women older than 14 years predominantly served by the public health system. The interviews were held in the subject's home by trained interviewers not affiliated with the public health services of the municipality. The homes were visited at random according to the city map and the prevalence of the condition was estimated. To identify the associated conditions, the significant variables (P=0.10 were selected and entered in a multivariate analysis model. Data are reported as odds ratio and 95% confidence interval, with the level of significance set at 0.05. The prevalence of chronic pelvic pain was 19.0%. The independent conditions associated with this diagnosis were: dyspareunia (OR=3.94, premenopausal status (OR=2.95, depressive symptoms (OR=2.33, dysmenorrhea (OR=1.77, smoking (OR=1.72, irregular menstrual flow (OR=1.62, and irritative bladder symptoms (OR=1.90. The prevalence of chronic pelvic pain in Sao Luís is high and is associated with the conditions cited above. Guidelines based on prevention and/or early identification of risk factors may reduce the prevalence of chronic pelvic pain in São Luís, Brazil.

  15. Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome

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    Ming-Huei Lee

    2015-09-01

    Conclusion: IC/BPS women with dyspareunia have significantly more severe urological pain and a higher PUF scale score than women without dyspareunia. Physicians should consider sexual pain disorder in the management of patients with IC/BPS and use the PUF scale to evaluate not only IC-specific lower urinary tract symptoms, but also sexual pain disorder.

  16. Chronic pain in the pelvic area or lower extremities after rectal cancer treatment and its impact on quality of life: a population-based cross-sectional study.

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    Feddern, Marie-Louise; Jensen, Troels Staehelin; Laurberg, Søren

    2015-09-01

    The aim of this investigation was to examine the prevalence of and factors associated with chronic pain in the pelvic area or lower extremities after rectal cancer treatment and its impact on quality of life (QoL). This is a population-based cross-sectional study of chronic pain and QoL in patients treated for rectal cancer from 2001 to 2007. A modified version of the Brief Descriptive Danish Pain Questionnaire and the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire were mailed to 1713 Danish patients. Informative answers were obtained from 1369 patients (80%). A total of 426 patients (31%) reported chronic pain in the pelvic area or lower extremities, 173 (41%) of whom had daily pain. Pain in other parts of the body was associated with the presence of pain in the pelvic region (odds ratio [OR] 4.81 [3.63-6.38], P pain in female patients (OR 1.91 [1.51-2.43], P pelvic pain. Chronic pain in the pelvic region or lower extremities after rectal cancer treatment is a common but largely neglected problem that is associated with female gender, type of surgery, radio(chemo)therapy, and young age, all of which impact the patient's QoL.

  17. Clinical Significance of National Institutes of Health Classification in Patients With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

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    Sung, Yun Hsien; Jung, Jae Hung; Ryang, Seung Hoon; Kim, Sung Jin

    2014-01-01

    Purpose We determined the effects of alpha-blockers and quinolone in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) classified by National Institute of Health (NIH) consensus group. Materials and Methods Data from a total of 111 patients who were diagnosed with CP/CPPS between June 2010 and June 2012 were analyzed retrospectively. The patients were classified into group 1 (category IIIA, n=40) and group 2 (category IIIB, n=71). Treatment using alfuzosin and levofloxacin was given to both groups for 6 weeks. International Prostate Symptom Score (IPSS) and NIH Chronic Prostatitis Symptom Index were measured before and after therapy. Results Group 1 had a significant decrease in total IPSS score, CPSI pain score, CPSI quality of life (QoL) score, and total CPSI score (p=0.043, p=0.006, p=0.015, and p=0.006, respectively). Group 2 had a significant decrease in IPSS voiding symptom score, IPSS storage symptom score, total IPSS, CPSI pain score, CPSI voiding score, CPSI QoL score, and total CPSI score (p=0.002, p=0.004, p=0.001, p=0.001, p=0.006, p=0.001, and p=0.001, respectively). The CPSI score was reduced by 6 points or more in 50.0% of patients (n=18) in group 1 and in 51.6% of patients (n=32) in group 2. However, there was no statistically significant difference between the changes in IPSS and CPSI scores across the 2 groups. Conclusions Although combination treatment reduced the CPSI score in both groups, there was no significant difference between the groups after combination treatment. We suggest that factors other than inflammation also contribute to symptoms associated with CP/CPPS. PMID:24741418

  18. Osteopathy for Endometriosis and Chronic Pelvic Pain – a Pilot Study

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    Sillem, M.; Juhasz-Böss, I.; Klausmeier, I.; Mechsner, S.; Siedentopf, F.; Solomayer, E.

    2016-01-01

    Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20–65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option. PMID:27681520

  19. Depression and Somatic Symptoms May Influence on Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Preliminary Study

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    Koh, Jun Sung; Ko, Hyo Jung; Wang, Sheng-Min; Cho, Kang Joon; Kim, Joon Chul; Lee, Soo-Jung

    2014-01-01

    The present study is the first one to investigate the impacts of depression and somatization on the disease severity and quality of life (QoL) in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The Korean version of National Institutes of Health (NIH)- Chronic Prostatitis Symptom Index (CPSI) for severity of CP/CPPS. Korean version of Patient Health Questionnaire-9 (PHQ-9) for depression, Korean version of Patient Health Questionnaire-15 (PHQ-15) for somatization, and Korean version of EuroQol Questionnaire-5 Dimensions (EQ-5D)- [(EQ-5D utility index and visual analog scale (EQ-5D VAS)] for QoL, were administered. Eighty patients were enrolled. The NIH-CPSI total scores were significantly higher in those with depression (25.3%, p=0.01) or somatization (23.2%, p=0.03) than in those without. These trends toward significantly negative influence of depression and somatic symptoms on QoL were also observed. Our preliminary results indicate that depression and somatization may have negative influence on the symptom severity and QoL in patients with CP/CPPS. However, adequately-powered and more well-designed studies are mandatory to prove our results. PMID:25395984

  20. Management of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): an evidence-based approach

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods: The randomized controlled trials (RCTs) about the treatment for CP/CPPS all over the world were searched. MEDLINE (January 1966 to June 2007), EMBASE (January 1988 to June 2007), and 4 Chinese databases were electronically searched. The studies included in the references of eligible studies were additionally searched. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by crosschecking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results: Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obviously with WMD of NIH-CPSI, total score and pain score were -4.10 (95%CI: -6.92 to -1.28) and -1.68 (95%CI: -2.54 to -0.82). Antibiotics could not improve the symptoms obviously with WMD of NIH-CPSI; total score and pain score were -2.71 (95%CI: -4.78 to -0.64) and -0.86 (95%CI: -2.07 to 0.36). Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 (95%CI: -5.17 to -0.74) and -2.31 (95% CI: -4.05 to 0.03). Prostat could improve the NIH CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being -7.60 (95%CI: -9.97 to -5.23) and -2.02 (95%CI: -4.07 to 0.04). Conclusion: Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and follow-up of participants. It is important to improve the quality

  1. What Are the Symptoms of Pelvic Pain?

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    ... Resources and Publications What are the symptoms of pelvic pain? Skip sharing on social media links Share this: Page Content The symptoms of pelvic pain vary from woman to woman. Pelvic pain can ...

  2. Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Wang, X-J; Xia, L-L; Xu, T-Y; Zhang, X-H; Zhu, Z-W; Zhang, M-G; Liu, Y; Xu, C; Zhong, S; Shen, Z-J

    2016-04-01

    There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats.

  3. Association between chronic prostatitis/chronic pelvic pain syndrome and anxiety disorder: a population-based study.

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    Shiu-Dong Chung

    Full Text Available BACKGROUND: This case-control study utilized a population-based dataset to examine the association of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS with prior anxiety disorder (AD by comparing the risk of prior AD between subjects with CP/CPPS and matched controls in Taiwan. METHODS: We study used data sourced from the Taiwan Longitudinal Health Insurance Database. The cases comprised 8,088 subjects with CP/CPPS and 24,264 randomly matched subjects as controls. We used a conditional logistic regression to calculate the odds ratio (OR for having been previously diagnosed with AD between subjects with and without CP/CPPS. RESULTS: Of the 24,264 sampled subjects, 2309 (7.1% had received an AD diagnosis before the index date; AD was found in 930 (11.5% cases and 1379 (5.7% controls (p59 years. In particular, subjects aged 40∼59 years had the highest adjusted OR (of 2.53 for prior AD among cases compared to controls. CONCLUSIONS: We concluded that CP/CPPS is associated with previously diagnosed AD. Urologists should be alert for the association between CP/CPPS and AD in subjects suffering from AD.

  4. Chronic Prostatitis/Chronic Pelvic Pain Syndrome is associated with Irritable Bowel Syndrome: A Population-based Study.

    Science.gov (United States)

    Liao, Chun-Hou; Lin, Herng-Ching; Huang, Chao-Yuan

    2016-05-26

    This study aimed to examine this association by comparing the risk of prior irritable bowel syndrome (IBS) between patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and matched controls in Taiwan. Data were retrieved from the Longitudinal Health Insurance Database 2005. This study included 4870 cases with CP/CPPS and 4870 age-matched controls. Conditional logistic regressions were conducted to examine associations of CP/CPPS with previously diagnosed IBS. We found that a total of 753 (7.7%) of the 9740 sampled patients had IBS prior to the index date; IBS was found in 497 (10.2%) cases and in 256 (5.3%) controls. Conditional logistic regression revealed a higher odds ratio (OR) of prior IBS (OR 2.05, 95% CI = 1.75-2.40) for cases than controls. Furthermore, after adjusting for the patients' monthly income, geographical location, urbanization level, and hypertension and coronary heart disease, the conditional logistic regression analysis indicated that cases were more likely than controls to have prior IBS (OR = 1.96, 95% CI = 1.67-2.29). Furthermore, we found that CP/CPPS was consistently and significantly associated with prior IBS regardless of age group. We concluded that the diagnosis of CP/CPPS was associated with previously diagnosed IBS. Urologists should be aware of the association between CP/CPPS and IBS when treating patients.

  5. Musculoskeletal etiologies of pelvic pain.

    Science.gov (United States)

    Prather, Heidi; Camacho-Soto, Alejandra

    2014-09-01

    Several musculoskeletal diagnoses are frequently concomitant with pelvic floor pathology and pain. The definition of pelvic pain itself often depends on the medical specialist evaluating the patient. Because there is variability among disorders associated with pelvic pain, patients may seek treatment for extended periods as various treatment options are attempted. Further, health care providers should recognize that there may not be a single source of dysfunction. This article discusses the musculoskeletal disorders of the pelvic girdle (structures within the bony pelvis) and their association with lumbar spine and hip disorders.

  6. Transcutaneous electrical nerve stimulation (TENS in the symptomatic management of chronic prostatitis/chronic pelvic pain syndrome: a placebo-control randomized trial

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    Sikiru Lamina

    2008-12-01

    Full Text Available OBJECTIVE: The aim of the study was to investigate the therapeutic efficacy of transcutaneous electrical nerve stimulation (TENS in the symptomatic management of chronic prostatitis pain/chronic pelvic pain syndrome. DESIGN: A pretest, posttest randomized double blind design was used in data collection. PARTICIPANT: Twenty-four patients diagnosed with chronic prostatitis- category IIIA and IIIB of the National Institute of Health Chronic Pain (NIH-CP were referred for physiotherapy from the Urology department. Intervention: Pre treatment pain level was assessed using the NIH-CP (pain domain index. The TENS group received TENS treatment, 5 times per week for a period of 4 weeks (mean treatment frequency, intensity, pulse width and duration of 60Hz, 100µS, 25mA and 20 minutes respectively. The Analgesic group received no TENS treatment but continued analgesics; the Control group received no TENS and Analgesic but placebo. All subjects were placed on antibiotics throughout the treatment period. Outcome measures: Post-treatment pain level was also assessed using NIH-CP pain index. RESULT: Findings of the study revealed significant effect of TENS on chronic prostatitis pain at p < 0.05. CONCLUSION: TENS is an effective means of non-invasive symptomatic management of chronic prostatitis pain.

  7. Nongynecological factors leading to chronic pelvic pain%非妇科因素致慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    杨欣

    2013-01-01

    慢性盆腔痛是影响女性健康的常见问题,疼痛的症状和病因常涉及妇科学、胃肠病学、泌尿和疼痛医学.非妇科因素导致的慢性盆腔痛的常见原因有肠易激综合征、膀胱疼痛综合征、腹部肌筋膜疼痛综合征等等.所以需要多学科共同参与诊治.%Chronic pelvic pain is a major public health problem for women. The symptoms and reasons of CPP include gynaecology, gastroenterology, urology and pain medicine. The common diseases of non-gynecological CPP are irritable bowel syndrome, painful bladder syndrome, intersitial cystitis, abdominal myo-fascial pain syndrome, ets. Pelvic pain should be approached by a multidisciplinary team in order to reach the best results in diagnosis and treatments.

  8. Medical Treatments for Endometriosis-Associated Pelvic Pain

    OpenAIRE

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endome...

  9. Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jeffrey M Cohen

    Full Text Available BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS has been treated with several different interventions with limited success. This meta-analysis aims to review all trials reporting on therapeutic intervention for CP/CPPS using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI. METHODS: We searched Medline, PubMed, the Cochrane Pain, Palliative & Supportive Care Trials, the Cochrane Register of Controlled Trials, CINAHL, ClinicalTrials.gov, and the NIDDK website between 1947 and December 31, 2011 without language or study type restrictions. All RCTs for CP/CPPS lasting at least 6 weeks, with a minimum of 10 participants per arm, and using the NIH-CPSI score, the criterion standard for CP/CPPS, as an outcome measure were included. Data was extracted from each study by two independent reviewers. Gillbraith and I-squared plots were used for heterogeneity testing and Eggers and Peters methods for publication bias. Quality was assessed using a component approach and meta-regression was used to analyze sources of heterogeneity. RESULTS: Mepartricin, percutaneous tibial nerve stimulation (PTNS, and triple therapy comprised of doxazosin + ibuprofen + thiocolchicoside (DIT resulted in clinically and statistically significant reduction in NIH-CPSI total score. The same agents and aerobic exercise resulted in clinically and statistically significant NIH-CPSI pain domain score reduction. Acupuncture, DIT, and PTNS were found to produce statistically and clinically significant reductions in the NIH-CPSI voiding domain. A statistically significant placebo effect was found for all outcomes and time analysis showed that efficacy of all treatments increased over time. Alpha-blockers, antibiotics, and combinations of the two failed to show statistically or clinically significant NIH-CPSI reductions. CONCLUSION: Results from this meta-analysis reflect our current inability to effectively manage CP/CPPS. Clinicians and

  10. The Efficacy of Mirodenafil for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Middle-Aged Males

    Science.gov (United States)

    Kong, Do Hoon; Yun, Chang Jin; Park, Nam Cheol

    2014-01-01

    Purpose The aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Materials and Methods Eighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment. Results The mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05). Conclusions Mirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS. PMID:25606563

  11. 慢性盆腔痛的研究进展%Progress in research on chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    李晓宏; 高崇荣; 杨承祥; 李光仪

    2008-01-01

    慢性盆腔痛(chronic pelvic pain,CPP)是疼痛科和妇科门诊的常见疾病,因其病因复杂,其中有妇科方面的因素,也有非妇科方面的原因,所以诊断异常棘手,目前诊断的金标准是腹腔镜检查;CPP的保守治疗效果欠佳,临床治疗主要是以手术为主,如腹腔镜下骶前神经的切除,但现提倡多学科的治疗,如介入治疗的上腹下丛神经毁损,也能取得很好的效果.%Chronic pelvic pain (CCP) is a common pain syndrome which has complex causes including gynecologic and nongynecologic factors. A exact diagnosis is difficult to be delivered. The current gold standard of diagnostic examination is abdominoscopy. Lacking ideal effect with conventional therapy, the main therapeutic method adopted is surgical intervention, such as laparoscopic presacral neureetomy. Muhidisciplinary managements, for example, superior hypogastric plexus neurolysis using interventional therapy,are expected to be effective.

  12. Endometriosis and chronic pelvic pain%子宫内膜异位症与慢性盆腔痛

    Institute of Scientific and Technical Information of China (English)

    陈正云; 林俊

    2013-01-01

    Chronic pelvic pain is the manifestation of endometriosis The pathophysiology and causes of endometriosis-associated pain are complex. Management can be medical (first-line treatment is oral contraceptive pills combined with along with NSAIDs), surgical, or and the two combined (surgery combined with suppression of ovarian function). It is recommended that long-term treatment combined with multiple modes of therapies for the pain associated with endometriosis individually.%慢性盆腔痛是子宫内膜异位症(内异症)的常见症状.内异症相关疼痛的机制复杂,可采取药物(首选口服避孕药联合非甾体类抗炎药)、手术以及手术联合药物抑制卵巢功能的治疗,现多主张采取长期综合个体化治疗.

  13. The 2013 EAU Guidelines on Chronic Pelvic Pain : Is Management of Chronic Pelvic Pain a Habit, a Philosophy, or a Science? 10 Years of Development

    NARCIS (Netherlands)

    Engeler, Daniel S.; Baranowski, Andrew P.; Dinis-Oliveira, Paulo; Elneil, Suzy; Hughes, John; Messelink, Embert J.; van Ophoven, Arndt; Williams, Amanda C.

    2013-01-01

    Context: Progress in the science of pain has led pain specialists to move away from an organ-centred understanding of pain located in the pelvis to an understanding based on the mechanism of pain and integrating, as far as possible, psychological, social, and sexual dimensions of the problem. This c

  14. Development and validation of an animal model of prostate inflammation-induced chronic pelvic pain: evaluating from inflammation of the prostate to pain behavioral modifications.

    Directory of Open Access Journals (Sweden)

    Feng Zeng

    Full Text Available BACKGROUND: Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS is the most common type of prostatitis. Due to the lack of a suitable animal model partly, the pathogenesis for this condition is obscure. In the current study we developed and validated an animal model for nonbacterial prostatitis and prostate inflammation-induced chronic pelvic pain in rats with the use of intraprostatic injection of λ-carrageenan. METHODS: Male Sprague-Dawley rats weighing 250-350 g were used for the experiments. After intraprostatic injection of 3% λ-carrageenan, at different time points(after 24 h, 7 d, 14 d and 30 d of injection, radiant heat and von Frey filaments were applied to the scrotum of rats to measure the heat and mechanical thresholds respectively. Then the prostate was removed for histology, and cyclooxygenase (COX 2 protein expression was determined by Western-blot. Evans blue(50 mg/kg was also injected intravenously to assess for plasma protein extravasation at different time points after injection of λ-carrageenan. RESULTS: Compared to control group, inflamed animals showed a significant reduction in mechanical threshold (mechanical allodynia at 24 h and 7d(p = 0.022,0.046, respectively, and a significant reduction in heat threshold (thermal hyperalgesia at 24 h, 7d and 14 d(p = 0.014, 0.018, 0.002, respectively in the scrotal skin. Significant increase of inflammatory cell accumulation, COX2 expression and Evans blue extravasation were observed at 24 h, 7d and 14 d after injection. CONCLUSIONS: Intraprostatic λ-carrageenan injection induced neurogenic prostatitis and prostate inflammation pain, which lasted at least 2 weeks. The current model is expected to be a valuable preclinical tool to study the neurobiological mechanisms of male chronic pelvic pain.

  15. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  16. 慢性盆腔痛的非手术治疗%Non-surgical management of chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    武昕; 钟艳芬

    2013-01-01

    The etiology of chronic pelvic pain (CPP) is complicated. The aim of treatment is improved function and alleviated pain. We summarized the methods of non-surgical treatments for CPP. First, Chinese and Western medical therapies, Second, ladder analgesics. Third, ultrasound and interventional as well as Physiotherapy. Fourth, psychotherapy including medicine and psychological persuasion.%慢性盆腔痛的病因复杂,治疗的目标在于改善功能,并尽可能缓解疼痛.文章就非手术治疗的中西药物治疗,阶梯性镇痛,超声、介入、理疗等物理治疗,药物及心理疏导的心理治疗进行归纳与概括.

  17. A preliminary evaluation of the psychometric profiles in Chinese men with chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    ZHANG Guo-xi; BAI Wen-jun; XU Tao; WANG Xiao-feng

    2011-01-01

    Background As one of the most commonly diagnosed diseases, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by a variety of complex symptoms. Anxiety and depression are two of the most prevalent clinical manifestations of patients with CP/CPPS, and have adverse effects on the health of the subjects and prognosis of comorbidities. Such psychological disorders, however, have not been deeply and thoroughly studied in China. The aim of this study was to investigate the prevalence and severity of psychological disorders in Chinese adults with CP/CPPS.Methods From April 2008 to June 2009, 80 patients and 40 age-matched healthy men participating in a voluntary health examination were recruited. The majority of the subjects completed the questionnaires on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) as well as the hospital anxiety and depression scale (HADS).Results Of all the participants, 77 (96.3%) patients and 37 (92.5%) healthy controls completed the questionnaires. The average NIH-CPSI total score was 21.0±9.5 for the patients and 2.2±1.5 for the controls (P=0.03). Of the 77 patients with CP/CPPS, 48 (62.3%), 5 (6.5%), and 1 (1.2%) had anxiety symptoms, depression symptoms, or both anxiety and depression symptoms, respectively. For the controls, the average HADS anxiety and depression scores in patients were 14.5±6.8 and 5.2±4.5, which were both significantly higher than in controls. Moreover, the prevalence and the symptom scores of both the HADS anxiety and depression were higher for the younger age group (<35 years) than for the older age group (<35 years).Conclusions This preliminary study revealed that male patients with CP/CPPS had a higher prevalence of psychological disorders than in the control subjects. Moreover, the differences of the prevalence and severity of the psychological symptoms between the two different age groups may imply that psychological disorders related to CP/CPPS may be

  18. The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain.

    Science.gov (United States)

    Mohseni-Bandpei, Mohammad A; Rahmani, Nahid; Behtash, Hamid; Karimloo, Masoud

    2011-01-01

    Dysfunction of spinal stability seems to be one of the causes of low back pain (LBP). It is thought that a large number of muscles have a role in spinal stability including the pelvic floor muscle (PFM). The purpose of this study was to investigate the effect of PFM exercise in the treatment of chronic LBP. After ethical approval, a randomized controlled clinical trial was carried out on 20 women with chronic LBP. Patients were randomly allocated into two groups: an experimental and a control group. The control group was given routine treatment including electrotherapy and general exercises; and the experimental group received routine treatment and additional PFM exercise. Pain intensity, functional disability and PFM strength and endurance were measured before, immediately after intervention and at 3 months follow-up. In both groups pain and functional disability were significantly reduced following treatment (p0.05). All measurements were improved in both groups (p<0.01) although patients in the experimental group showed greater improvement in PFM strength and endurance (p<0.01). It seems that the PFM exercise combined with routine treatment was not superior to routine treatment alone in patients with chronic LBP.

  19. Abordagem da dor pélvica crônica em mulheres Management of chronic pelvic pain in women

    Directory of Open Access Journals (Sweden)

    Antonio Alberto Nogueira

    2006-12-01

    Full Text Available Dor pélvica crônica é uma doença debilitante e de alta prevalência, com grande impacto na qualidade de vida e produtividade, além de custos significantes para os serviços de saúde. O dilema no manejo da dor pélvica crônica continua a frustrar médicos confrontados com o problema, em parte porque sua fisiopatologia é pobremente compreendida. Conseqüentemente, seu tratamento é muitas vezes insatisfatório e limitado ao alívio temporário dos sintomas. Nesta revisão, nós discutimos uma abordagem ampliada da dor pélvica crônica. Salientamos que uma história clínica e exame físico adequados deveriam incluir atenção especial aos sistemas gastrintestinal, urinário, ginecológico, músculo-esquelético, neurológico, psicológico e endócrino. Dessa forma, uma abordagem multidisciplinar é recomendada. Adicionalmente, enfatizamos que, embora úteis, procedimentos cirúrgicos específicos, tais como a laparoscopia, deveriam ser indicados somente para pacientes selecionadas, após excluir principalmente síndrome do intestino irritável e dor de origem miofascial.Chronic pelvic pain is a debilitating and highly prevalent disease with a major impact on quality of life and work productivity, beyond significant costs to health services. The dilemma of managing patients with chronic pelvic pain continues to frustrate physicians confronted with these complaints, in part because its pathophysiology is poorly understood. Consequently, its treatment is often unsatisfactory and limited to temporary symptom relief. In the present revision, we discuss the adequate management of chronic pelvic pain. We point out that a comprehensive medical history and physical examination should include special attention to gastrointestinal, urological, gynecological, muscle-skeletal, neurological, psychiatric, and endocrine systems. Thus, a multidisciplinary approach is recommended. Additionally, we emphasize that, although useful, specific surgical

  20. Chronic Pain

    Science.gov (United States)

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis ...

  1. Urinary Metabolomics Identifies a Molecular Correlate of Interstitial Cystitis/Bladder Pain Syndrome in a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network Cohort

    Directory of Open Access Journals (Sweden)

    Kaveri S. Parker

    2016-05-01

    Full Text Available Interstitial cystitis/bladder pain syndrome (IC/BPS is a poorly understood syndrome affecting up to 6.5% of adult women in the U.S. The lack of broadly accepted objective laboratory markers for this condition hampers efforts to diagnose and treat this condition. To identify biochemical markers for IC/BPS, we applied mass spectrometry-based global metabolite profiling to urine specimens from a cohort of female IC/BPS subjects from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network. These analyses identified multiple metabolites capable of discriminating IC/BPS and control subjects. Of these candidate markers, etiocholan-3α-ol-17-one sulfate (Etio-S, a sulfoconjugated 5-β reduced isomer of testosterone, distinguished female IC/BPS and control subjects with a sensitivity and specificity >90%. Among IC/BPS subjects, urinary Etio-S levels are correlated with elevated symptom scores (symptoms, pelvic pain, and number of painful body sites and could resolve high- from low-symptom IC/BPS subgroups. Etio-S-associated biochemical changes persisted through 3–6 months of longitudinal follow up. These results raise the possibility that an underlying biochemical abnormality contributes to symptoms in patients with severe IC/BPS.

  2. Pollen extract in association with vitamins provides early pain relief in patients affected by chronic prostatitis/chronic pelvic pain syndrome

    Science.gov (United States)

    CAI, TOMMASO; WAGENLEHNER, FLORIAN M.E.; LUCIANI, LORENZO GIUSEPPE; TISCIONE, DANIELE; MALOSSINI, GIANNI; VERZE, PAOLO; MIRONE, VINCENZO; BARTOLETTI, RICCARDO

    2014-01-01

    The therapeutic efficacy for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is currently unsatisfactory. The aim of the present study was to assess the safety and efficacy of pollen extract in association with vitamins (DEPROX 500®) in males with CP/CPPS. All patients with a diagnosis of CP/CPPS attending the same urologic centre between March and October 2012 were enrolled in this randomised controlled phase III study. Participants were randomised to receive oral capsules of DEPROX 500® (two capsules every 24 h) or ibuprofen (600 mg, one tablet three times a day) for four weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score and Quality of Well-Being (QoL) questionnaires were used. In the intention-to-treat analysis, 87 males (25 class IIIa and 62 class IIIb) with a mean age of 33.6±5.9 years were randomly allocated to the DEPROX 500® (n=41) or ibuprofen (n=46) treatment groups. At the follow-up examination (following one month of treatment), in the DEPROX 500® group, 31/41 patients (75.6%) reported an improvement in quality of life, defined as a reduction of the NIH-CPSI total score by ≥25%, compared with 19/46 (41.3%) in the control group (P=0.002). The greater improvement in the DEPROX 500® group compared with the ibuprofen group was statistically significant (treatment difference in the NIH-CPSI pain domain, −2.14±0.51, P<0.001; QoL scores, P=0.002). All patients were negative at the Meares-Stamey test evaluation. Adverse events were less frequent in the DEPROX 500® group than in the ibuprofen group. The DEPROX 500® treatment significantly improved total symptoms, pain and quality of life compared with ibuprofen in patients with CP/CPPS, without severe side-effects. PMID:25187793

  3. Gabapentin for the Management of Chronic Pelvic Pain in Women (GaPP1: A Pilot Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Steff C Lewis

    Full Text Available Chronic pelvic pain (CPP affects 2.1-24% of women. Frequently, no underlying pathology is identified, and the pain is difficult to manage. Gabapentin is prescribed for CPP despite no robust evidence of efficacy. We performed a pilot trial in two UK centres to inform the planning of a future multicentre RCT to evaluate gabapentin in CPP management. Our primary objective was to determine levels of participant recruitment and retention. Secondary objectives included estimating potential effectiveness, acceptability to participants of trial methodology, and cost-effectiveness of gabapentin. Women with CPP and no obvious pelvic pathology were assigned to an increasing regimen of gabapentin (300-2700mg daily or placebo. We calculated the proportion of eligible women randomised, and of randomised participants who were followed up to six months. The analyses by treatment group were by intention-to-treat. Interviews were conducted to evaluate women's experiences of the trial. A probabilistic decision analytical model was used to estimate cost-effectiveness. Between September 2012-2013, 47 women (34% of those eligible were randomised (22 to gabapentin, 25 to placebo, and 25 (53% completed six-month follow-up. Participants on gabapentin had less pain (BPI difference 1.72 points, 95% CI:0.07-3.36, and an improvement in mood (HADS difference 4.35 points, 95% CI:1.97-6.73 at six months than those allocated placebo. The majority of participants described their trial experience favorably. At the UK threshold for willingness-to-pay, the probabilities of gabapentin or no treatment being cost-effective are similar. A pilot trial assessing gabapentin for CPP was feasible, but uncertainty remains, highlighting the need for a large definitive trial.

  4. Gabapentin for the Management of Chronic Pelvic Pain in Women (GaPP1): A Pilot Randomised Controlled Trial.

    Science.gov (United States)

    Lewis, Steff C; Bhattacharya, Siladitya; Wu, Olivia; Vincent, Katy; Jack, Stuart A; Critchley, Hilary O D; Porter, Maureen A; Cranley, Denise; Wilson, John A; Horne, Andrew W

    2016-01-01

    Chronic pelvic pain (CPP) affects 2.1-24% of women. Frequently, no underlying pathology is identified, and the pain is difficult to manage. Gabapentin is prescribed for CPP despite no robust evidence of efficacy. We performed a pilot trial in two UK centres to inform the planning of a future multicentre RCT to evaluate gabapentin in CPP management. Our primary objective was to determine levels of participant recruitment and retention. Secondary objectives included estimating potential effectiveness, acceptability to participants of trial methodology, and cost-effectiveness of gabapentin. Women with CPP and no obvious pelvic pathology were assigned to an increasing regimen of gabapentin (300-2700 mg daily) or placebo. We calculated the proportion of eligible women randomised, and of randomised participants who were followed up to six months. The analyses by treatment group were by intention-to-treat. Interviews were conducted to evaluate women's experiences of the trial. A probabilistic decision analytical model was used to estimate cost-effectiveness. Between September 2012-2013, 47 women (34% of those eligible) were randomised (22 to gabapentin, 25 to placebo), and 25 (53%) completed six-month follow-up. Participants on gabapentin had less pain (BPI difference 1.72 points, 95% CI:0.07-3.36), and an improvement in mood (HADS difference 4.35 points, 95% CI:1.97-6.73) at six months than those allocated placebo. The majority of participants described their trial experience favorably. At the UK threshold for willingness-to-pay, the probabilities of gabapentin or no treatment being cost-effective are similar. A pilot trial assessing gabapentin for CPP was feasible, but uncertainty remains, highlighting the need for a large definitive trial.

  5. Hormonal treatment for endometriosis associated pelvic pain

    Directory of Open Access Journals (Sweden)

    Wu Shun Felix Wong

    2011-01-01

    Full Text Available AbstractBackground: Endometriosis is a common gynecological problem associated with chronic pelvic pain. Objective: To evaluate the effectiveness of current hormonal treatments of endometriosis associated pain.Materials and Methods: Randomized Controlled studies identified from databases of Medline and Cochrane Systemic Review groups were pooled. 7 RCTs were recruited for evaluation in this review. Data from these studies were pooled and meta-analysis was performed in three comparison groups: 1 Progestogen versus GnRHa; 2 Implanon versus Progestogen (injection; 3 Combined oral contraceptive pills versus placebo and progestogen. Response to treatment was measured as a reduction in pain score. Pain improvement was defined as improvement ≥1 at the end of treatment. Results: There was no significant difference between treatment groups of progestogen and GnRHa (RR: 0.036; CI:-0.030-0.102 for relieving endometriosis associated pelvic pain. Long acting progestogen (Implanon and Mirena are not inferior to GnRHa and depot medroxy progesterone acetate (DMPA (RR: 0.006; CI:-0.142-0.162. Combined oral contraceptive pills demonstrated effective treatment of relieving endometriosis associated pelvic pain when compared with placebo groups (RR:0.321CI-0.066-0.707. Progestogen was more effective than combined oral contraceptive pills in controlling dysmenorrhea (RR:-0.160; CI:-0.386-0.066, however, progestogen is associated with more side effects like spotting and bloating than the combined contraceptive pills. Conclusion: Combined oral contraceptive pills (COCP, GnRHa and progestogens are equally effective in relieving endometriosis associated pelvic pain. COCP and progestogens are relatively cheap and more suitable for long-term use as compared to GnRHa. Long-term RCT of medicated contraceptive devices like Mirena and Implanon are required to evaluate their long-term effects on relieving the endometriosis associated pelvic pain

  6. A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome

    Science.gov (United States)

    Tripp, Dean A.; Nickel, J. Curtis; Katz, Laura; Krsmanovic, Adrijana; Ware, Mark A.; Santor, Darcy

    2014-01-01

    Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic pelvic pain condition largely refractory to treatment. Cannabis (marijuana) use has been reported for a wide variety of chronic pain conditions, but no study has examined prevalence of cannabis use, symptom benefit or side effects, or frequency in CP/CPPS. Methods: Participants were recruited from an outpatient CP/CPPS urology clinic (n = 98) and online through the Prostatitis Foundation website (n = 244). Participants completed questionnaires (demographics, CP/CPPS, depression, cannabis). Results: The clinic sample included Canadian patients and the online sample included primarily American patients. Due to differences, groups were examined separately. Almost 50% of respondents reported using cannabis (clinic n = 49; online n = 89). Of the cannabis users, 36.8% of clinic and 75% of online respondents reported that it improved their symptoms. Most of the respondents (from the clinic and online groups) reported that cannabis improved their mood, pain, muscle spasms, and sleep. However, they did not note any improvements for weakness, fatigue, numbness, ambulation, and urination. Overall, the effectiveness of cannabis for CP/CPPS was “somewhat/very effective” (57% clinic; 63% online). There were no differences between side effects or choice of consumption and most reported using cannabis rarely. Conclusions: These are the first estimates in men suffering from CP/CPPS and suggest that while cannabis use is prevalent, its medical use and benefit are unknown. This is an understudied area and the benefit or hazard for cannabis use awaits further study. PMID:25553163

  7. 慢性盆腔疼痛病因分析及临床诊治%Etiological Analysis, Diagnosis and Treatment of Chronic Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    吴文珍; 陈武

    2013-01-01

      目的:探讨引起慢性盆腔疼痛的病因、诊断标准及治疗原则.方法:回顾性分析2009年2月~2012年2月在我院收治的120例慢性盆腔疼痛病例的临床资料,总结分析病因、症状、体征及治疗方式.结果:引起慢性盆腔疼痛的前2位病因为慢性盆腔炎65例,占54.17%;子宫内膜异位症30例,占25.00%;其它疾病也占一定比例.结论:明确慢性盆腔疼痛病因,正确处理,运用多种方法综合治疗,可以提高治疗效果.%Objective:To investigate the cause of chronic pelvic pain, diagnostic criteria and ther-apeutic principle. Methods: Retrospective analyzed the information of 120 cases of chronic pelvic pain patients in our hospital from Feb 2009 to Feb 2012, then summarized and analyzed the cause, symptoms, signs and treatment. Results:The first two causes of chronic pelvic pain are:65 cases for chronic pelvic inflammatory disease accounting for 54.17%, 30 cases for endometriosis accounting for 25.00%; other diseases also account for a certain proportion. Conclusion: Clear the cause of chronic pelvic pain, treat it properly, use comprehensive treatment with variety of methods, can im-prove the therapeutic effect.

  8. 慢性盆腔痛病因及发病率分析%Analysis of causes and incidence of chronic pelvic pain

    Institute of Scientific and Technical Information of China (English)

    李伟娟; 王亚男; 马艳宏; 张燕宏; 梁丽华; 孙聪欣; 姜彩霞

    2012-01-01

    目的 探讨女性慢性盆腔痛的病因及其发病率.方法 对2010年5月~2011年5月到我院妇科就诊的1 017例慢性盆腔痛患者进行回顾性分析.结果 5 219例普通妇科疾病患者中,慢性盆腔痛就诊者1 017例,占19.5%.5 219例中20~40岁就诊者2 012例,慢性盆腔痛发病率为27.1%;41~55岁就诊者3 207例,慢性盆腔痛发病率为14.7%,两组比较,差异有统计学意义(P 0.05).慢性盆腔痛就诊者中既往有剖宫产手术史者占慢性盆腔痛患者53.0%,顺产者占19.5%,两组比较,差异有统计学意义(P 0.05). For patients with cesarean section group, the incidence rate of chronic pelvic pain was 53.0%. Patients with nature birth group, the incidence rate was 19.5%, with significant difference (P < 0.05). Conclusion Chronic pelvic pain often occurs in reproductive-aged female. The common etiologies are chronic pelvic inflammatory, endometriosis, pelvic mass and pelvic venous congestion syndrome, etc. Cesarean section may cause chronic pelvic pain. It should master the cesarean section indications on clinical treatments, and reduce the rate of cesarean sections.

  9. Treatment of intractable chronic pelvic pain syndrome by injecting a compound of Bupivacaine and Fentanyl into sacral spinal space

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zhan-song; SONG Bo; NIE Fa-chuan; CHEN Jin-mei

    2006-01-01

    Objective:To investigate the effect of injecting a compound of Bupivacaine and Fentanyl into sacral spinal space to treat chronic pelvic pain syndrome (CPPS). Methods: A total of 36 men with recalcitrant CPPS refractory to multiple prior therapies were treated with the injection of a compound of Bupivacaine and Fentanyl (10 ml of 0. 125% upivacaine, .05 mg Fentanyl, 5 mg Dexamethasone, 100 mg Vitamin B1 and 1 mg Vitamin B12) into sacral space once a week for 4 weeks. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), maximum and average flow rate were performed at the start and the end of 4 weeks' therapy. Results :Mean NIH-CPSI total score was decreased from 26.5±.6 to 13.4±2.0 (P<0. 001). Significant improvement was seen in each subscore domain. A total of 32 patients (89%) had at least 25% improvement on NIH-CPSI and 22 (61%) had at least 50% improvement. Maximal and average flow rate were increased from 19. 5±3.8 to 23. 6±4. 2 and 10. 9±2.6 to 14.3± 2.4 respectively. Conclusion: Injection of this compound of Bupivacaine, Fentanyl and Dexamethasone into sacral spinal space is an effective and safe approach for recalcitrant CPPS. Further study of the mechanisms and prospective placebo controlled trials are warranted.

  10. A randomised controlled trial to assess the efficacy of Laparoscopic Uterosacral Nerve Ablation (LUNA in the treatment of chronic pelvic pain: The trial protocol [ISRCTN41196151

    Directory of Open Access Journals (Sweden)

    2003-12-01

    Full Text Available Abstract Background Chronic pelvic pain is a common condition with a major impact on health-related quality of life, work productivity and health care utilisation. The cause of the pain is not always obvious as no pathology is seen in 40–60% of the cases. In the absence of pathology there is no established treatment. The Lee-Frankenhauser sensory nerve plexuses and parasympathetic ganglia in the uterosacral ligaments carry pain from the uterus, cervix and other pelvic structures. Interruption of these nerve trunks by laparoscopic uterosacral nerve ablation (LUNA may alleviate pain. However, the balance of benefits and risks of this intervention have not been reliably assessed. LUNA has, nevertheless, been introduced into practice, although there remains controversy regarding indications for LUNA. Hence, there is an urgent need for a randomised controlled trial to confirm, or refute, any worthwhile effectiveness. The principal hypothesis is that, in women with chronic pelvic pain in whom diagnostic laparoscopy reveals either no pathology or mild endometriosis (AFS score ≤ 5 LUNA alleviates pain and improves life quality at 12 months. Methods/Design The principal objective is to test the hypothesis that in women with chronic pelvic pain in whom diagnostic laparoscopy reveals either no pathology or mild endometriosis (AFS score ≤ 5 LUNA alleviates pain and improves life quality at 12 months. A multi-centre, prospective, randomised-controlled-trial will be carried out with blind assessment of outcomes in eligible consenting patients randomised at diagnostic laparoscopy to LUNA (experimental group or to no pelvic denervation (control group. Postal questionnaires including visual analogue scale for pain (primary outcome, an index of sexual satisfaction and the EuroQoL 5D-EQ instrument (secondary outcomes will be administered at 3, 6 and 12 months. The primary assessment of the effectiveness of LUNA will be from comparison of outcomes at the one

  11. Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome: a prospective, randomized and sham-controlled study

    Institute of Scientific and Technical Information of China (English)

    ZENG Xiao-yong; LIANG Chen; YE Zhang-qun

    2012-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum,pelvis,suprapubic area,or external genitalia and variable degrees of voiding and ejaculatory disturbance.The analgesic effect of extracorporeal shock wave treatment (ESWT) was an interesting phenomenon with an unclear mechanism discovered by chance in the applications for urolithiasis,on which ESWT has become an increasingly popular therapeutic approach as an alternative option for the treatment of a number of soft tissue complaints.In this study,we aimed to evaluate the feasibility and efficacy of ESWT in non-inflammatory (ⅢB) CP/CPPS.Methods Men diagnosed with ⅢB CP/CPPS were randomized to either ESWT (group 1,n=40) or the control (group 2,n=40).Group 1 received 20 000 shock wave impulses in 10 sessions over a two-week period,whereas group 2 received only a sham procedure.The total scores and sub-domain scores of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for both groups were assessed at baseline,mid-treatment,end-point,and 4-week and 12-week follow-up visits.Results The mean total NIH-CPSI score of group 1 was significantly decreased from baseline at all post-treatment time points (P <0.01 for all).Decreases in pain domain and quality of life (QOL) scores were also significant.In group 2,no significant decreases of total NIH-CPSI score and pain domain score were found at all post-treatment time points.At the end-point of treatment,71.1% of group 1 exhibited perceptible improvement in total NIH-CPSI compared with 27.0% of group 2 (P <0.001); additionally,28.9% of group 1 exhibited clinically significant improvement compared with 10.8% of group 2 (P <0.01).Moreover,a greater number of patients in group 1 at 4-week and 12-week follow-up were rated as responders (perceptible and clinically significant response) compared with group 2.Conclusion ESWT exhibits a potentially therapeutic

  12. Clinical study of duloxetine hydrochloride combined with doxazosin for the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome: An observational study.

    Science.gov (United States)

    Zhang, Mingxin; Li, Hanzhong; Ji, Zhigang; Dong, Dexin; Yan, Su

    2017-03-01

    To explore the safety and efficacy of the selective 5-serotonin and norepinephrine reuptake inhibitor duloxetine hydrochloride and alpha-adrenergic receptor blocker (alpha-blocker) doxazosin mesylate-controlled tablets in the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).In all, 150 patients were enrolled and 126 patients completed the study (41 patients in the doxazosin group, 41 patients in the sertraline group, and 44 patients in the duloxetine group). This was an open randomized 6-month study. CP/CPPS patients who met the diagnostic criteria were randomized into 3 groups. The patients in the duloxetine group received doxazosin 4 mg + duloxetine 30 mg once a day, and the dosage of duloxetine was increased to 60 mg after a week. The patients in the doxazosin group received doxazosin 4 mg once a day. The patients in the sertraline group received doxazosin 4 mg + sertraline 50 mg once a day. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, the short-form McGill Pain questionnaire (SF-MPQ), and the hospital anxiety and depression scale (HAD) were applied for evaluations during follow-up of 1, 3, and 6 months after treatment.There were slight positive significant correlations between NIH-CPSI scores and HAD scores, moderate positive significant correlations between the quality of life (QOL) and SF-MPQ, and slight positive significant correlations between HAD and QOL. The effective rate in the doxazosin group was 4.88%, 19.51%, and 56.10% after 1, 3, and 6 months, respectively (P < 0.05). The SF-MPQ score in the doxazosin group decreased to 1.80 ± 1.29, 2.66 ± 1.57, and 3.24 ± 1.67 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the doxazosin group decreased to 2.24 ± 2.17, 4 ± 2.11, and 4.90 ± 2.62 after 1, 3, and 6 months, respectively (P < 0.05). The effective rate in the sertraline group was 9.76%, 36.59%, and 63

  13. Clinical study of duloxetine hydrochloride combined with doxazosin for the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome

    Science.gov (United States)

    Zhang, Mingxin; Li, Hanzhong; Ji, Zhigang; Dong, Dexin; Yan, Su

    2017-01-01

    Abstract To explore the safety and efficacy of the selective 5-serotonin and norepinephrine reuptake inhibitor duloxetine hydrochloride and alpha-adrenergic receptor blocker (alpha-blocker) doxazosin mesylate-controlled tablets in the treatment of pain disorder in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In all, 150 patients were enrolled and 126 patients completed the study (41 patients in the doxazosin group, 41 patients in the sertraline group, and 44 patients in the duloxetine group). This was an open randomized 6-month study. CP/CPPS patients who met the diagnostic criteria were randomized into 3 groups. The patients in the duloxetine group received doxazosin 4 mg + duloxetine 30 mg once a day, and the dosage of duloxetine was increased to 60 mg after a week. The patients in the doxazosin group received doxazosin 4 mg once a day. The patients in the sertraline group received doxazosin 4 mg + sertraline 50 mg once a day. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, the short-form McGill Pain questionnaire (SF-MPQ), and the hospital anxiety and depression scale (HAD) were applied for evaluations during follow-up of 1, 3, and 6 months after treatment.There were slight positive significant correlations between NIH-CPSI scores and HAD scores, moderate positive significant correlations between the quality of life (QOL) and SF-MPQ, and slight positive significant correlations between HAD and QOL. The effective rate in the doxazosin group was 4.88%, 19.51%, and 56.10% after 1, 3, and 6 months, respectively (P < 0.05). The SF-MPQ score in the doxazosin group decreased to 1.80 ± 1.29, 2.66 ± 1.57, and 3.24 ± 1.67 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the doxazosin group decreased to 2.24 ± 2.17, 4 ± 2.11, and 4.90 ± 2.62 after 1, 3, and 6 months, respectively (P < 0.05). The effective rate in the sertraline group was 9.76%, 36

  14. Effects of a self-assessment device for pelvic position on chronic back pain and range of motion of the trunk.

    Science.gov (United States)

    Yoo, Won-Gyu

    2015-12-01

    [Purpose] The purpose of the present study was to investigate the effects of a self-assessment device for pelvic position in a computer user with back pain. [Subjects] A 37-year-old man who complained of low back pain at L3-5 levels was the participant. [Methods] In this study, a self-assessment device for the pelvic position was developed. The patient was instructed in self-assessment of the pelvic position and an exercise program for two months. Prior to this instruction, the visual analog scale score and range of motion of the trunk were assessed. [Results] After the instruction in self-assessment of the pelvic position and exercise program, the visual analog scale score decreased from 7 to 3, and trunk flexion, extension, and bilateral lateral flexion range of motion were increased compared to the initial assessment. [Conclusion] Therefore, use of self-anthropometers and measuring methods in patients with chronic back pain is considered an important area of study.

  15. Applying the RE-AIM Framework to Evaluate Integrative Medicine Group Visits Among Diverse Women with Chronic Pelvic Pain.

    Science.gov (United States)

    Chao, Maria T; Abercrombie, Priscilla D; Santana, Trilce; Duncan, Larissa G

    2015-12-01

    The purpose of this study was to evaluate group medical visits using an integrative health approach for underserved women with chronic pelvic pain (CPP). We implemented an integrative medicine program to improve quality of life among women with CPP using Centering, a group-based model that combines healthcare assessment, education, and social support. Patients were from university-affiliated and public hospital-affiliated clinics. We evaluated the program with qualitative and quantitative data to address components of the RE-AIM framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Participants of the Centering CPP Program participants (n = 26) were demographically similar to a sample of women with CPP who sought care at Bay Area hospitals (n = 701). Participants were on average 40 years of age, a majority of whom were racial/ethnic minorities with low household income (76%). Women who attended four or more sessions (n = 16) had improved health-related quality of life, including decreases in average number of unhealthy days in the past month (from 24 to 18, p < .05), depressive symptoms (from 11.7 to 9.0, p < .05), and symptom severity (from 4.2 to 3.1, p < .01). Sexual health outcomes also improved (30.5 to 50.3, p = .02). No improvements were observed for pain catastrophizing. Our pilot program provides preliminary data that an integrative health approach using a group-based model can be adapted and implemented to reach diverse women with CPP to improve physical and psychological well-being. Given these promising findings, rigorous evaluation of implementation and effectiveness of this approach compared with usual care is warranted.

  16. Management of patients with chronic pelvic pain associated with endometriosis refractory to conventional treatment.

    Science.gov (United States)

    Martínez, Blanca; Canser, Enrique; Gredilla, Elena; Alonso, Eduardo; Gilsanz, Fernando

    2013-01-01

    The literature contains numerous studies on the diagnosis, pathogenesis, atypical locations, and clinical (hormonal) and surgical management of the disorder. However, no information is available on the management of endometriosis involving pain refractory to the usual treatment from the perspective of a pain unit. Our hospital has a pain unit specifically dedicated to pain in gynecology and obstetrics. The unit has been functioning since December 2005, and 52% of the attended patients have CPP of different origins. Endometriosis is present in 48% of all patients with CPP and is the most prevalent pathology in our practice. It moreover poses an important challenge in view of its enormous complexity. A descriptive study was made of the management of 44 patients with endometriosis refractory to therapy, evaluated and treated over a period of 3 years in the Pain Unit of the Maternity Center of La Paz University Hospital (Madrid, Spain).

  17. The posterior medial cortex in urologic chronic pelvic pain syndrome: detachment from default mode network-a resting-state study from the MAPP Research Network.

    Science.gov (United States)

    Martucci, Katherine T; Shirer, William R; Bagarinao, Epifanio; Johnson, Kevin A; Farmer, Melissa A; Labus, Jennifer S; Apkarian, A Vania; Deutsch, Georg; Harris, Richard E; Mayer, Emeran A; Clauw, Daniel J; Greicius, Michael D; Mackey, Sean C

    2015-09-01

    Altered resting-state (RS) brain activity, as a measure of functional connectivity (FC), is commonly observed in chronic pain. Identifying a reliable signature pattern of altered RS activity for chronic pain could provide strong mechanistic insights and serve as a highly beneficial neuroimaging-based diagnostic tool. We collected and analyzed RS functional magnetic resonance imaging data from female patients with urologic chronic pelvic pain syndrome (N = 45) and matched healthy participants (N = 45) as part of an NIDDK-funded multicenter project (www.mappnetwork.org). Using dual regression and seed-based analyses, we observed significantly decreased FC of the default mode network to 2 regions in the posterior medial cortex (PMC): the posterior cingulate cortex (PCC) and the left precuneus (threshold-free cluster enhancement, family-wise error corrected P pain, sensory, motor, and emotion regulation processes (eg, insular cortex, dorsolateral prefrontal cortex, thalamus, globus pallidus, putamen, amygdala, hippocampus). The left precuneus demonstrated decreased FC to several regions of pain processing, reward, and higher executive functioning within the prefrontal (orbitofrontal, anterior cingulate, ventromedial prefrontal) and parietal cortices (angular gyrus, superior and inferior parietal lobules). The altered PMC connectivity was associated with several phenotype measures, including pain and urologic symptom intensity, depression, anxiety, quality of relationships, and self-esteem levels in patients. Collectively, these findings indicate that in patients with urologic chronic pelvic pain syndrome, regions of the PMC are detached from the default mode network, whereas neurological processes of self-referential thought and introspection may be joined to pain and emotion regulatory processes.

  18. Pelvic laparoscopy

    Science.gov (United States)

    ... nearby lymph nodes or tissue Chronic (long-term) pelvic pain, if no other cause has been found Ectopic ( ... pregnant or having a baby (infertility) Sudden, severe pelvic pain A pelvic laparoscopy may also be done to: ...

  19. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  20. The Influence of Dual Pressure Biofeedback Units on Pelvic Rotation and Abdominal Muscle Activity during the Active Straight Leg Raise in Women with Chronic Lower Back Pain.

    Science.gov (United States)

    Noh, Kyung-Hee; Kim, Ji-Won; Kim, Gyoung-Mo; Ha, Sung-Min; Oh, Jae-Seop

    2014-05-01

    [Purpose] This study was performed to assess the influence of applying dual pressure biofeedback units (DPBUs) on the angle of pelvic rotation and abdominal muscle activity during the active straight leg raise (ASLR). [Subjects] Seventeen patients with low-back pain (LBP) participated in this study. [Methods] The subjects were asked to perform an active straight leg raise (ASLR) without a PBU, with a single PBU, and with DPBUs. The angles of pelvic rotation were measured using a three-dimensional motion-analysis system, and the muscle activity of the bilateral internal oblique abdominis (IO), external oblique abdominis (EO), and rectus abdominis (RA) was recorded using surface electromyography (EMG). One-way repeated-measures ANOVA was performed to determine the rotation angles and muscle activity under the three conditions. [Results] The EMG activity of the ipsilateral IO, contralateral EO, and bilateral RA was greater and pelvic rotation was lower with the DPBUs than with no PBU or a single PBU. [Conclusion] The results of this study suggest that applying DPBUs during ASLR is effective in decreasing unwanted pelvic rotation and increasing abdominal muscle activity in women with chronic low back pain.

  1. Understanding the pelvic pain mechanism is key to find an adequate therapeutic approach.

    Science.gov (United States)

    Van Kerrebroeck, Philip

    2016-06-25

    Pain is a natural mechanism to actual or potential tissue damage and involves both a sensory and an emotional experience. In chronic pelvic pain, localisation of pain can be widespread and can cause considerable distress. A multidisciplinary approach is needed in order to fully understand the pelvic pain mechanism and to identify an adequate therapeutic approach.

  2. Social Determinants of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Related Lifestyle and Behaviors among Urban Men in China: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2016-01-01

    Full Text Available Purpose. In order to find key risk factors of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS among urban men in China, an age-matched case-control study was performed from September 2012 to May 2013 in Yichang, Hubei Province, China. Methodology. A total of 279 patients and 558 controls were recruited in this study. Data were collected by a self-administered questionnaire, including demographics, diet and lifestyle, psychological status, and a physical exam. Conditional logistic regression model was used to analyze collected data. Results. Chemical factors exposure, night shift, severity of mood, and poor self-health cognition were entered into the regression model, and result displayed that these four factors had odds ratios of 1.929 (95% CI, 1.321–2.819, 1.456 (95% CI, 1.087–1.949, 1.619 (95% CI, 1.280–2.046, and 1.304 (95% CI, 1.094–1.555, respectively, which suggested that these four factors could significantly affect CP/CPPS. Conclusion. These results suggest that many factors affect CP/CPPS, including biological, social, and psychological factors.

  3. Occupational lifting and pelvic pain during pregnancy:

    DEFF Research Database (Denmark)

    Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Juhl, Mette;

    2013-01-01

    OBJECTIVES: Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim...... of this study was to examine the association between occupational lifting and pelvic pain during pregnancy. METHODS: The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational lifting...... (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression. RESULTS: Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg...

  4. Clinical countermeasure of management for chronic pelvic pain%慢性盆腔疼痛临床处理对策

    Institute of Scientific and Technical Information of China (English)

    朱兰; 娄文佳

    2012-01-01

    慢性盆腔疼痛(chronic pelvic pain,CPP)由各种功能性或(和)器质性原因引起的以骨盆及其周围组织疼痛为主要症状,时间超过6个月的一组疾病或综合征.文章阐述了与CPP有关的妇科疾病,以及目前对CPP诊断方法的评价和治疗的有效方法.

  5. Emphasis on the diagnosis and treatment of chronic pelvic pain%重视慢性盆腔痛的诊治

    Institute of Scientific and Technical Information of China (English)

    冷金花

    2013-01-01

    Chronic pelvic pain (CPP) is a ubiquitous, yet enigmatic condition that mainly affects women of reproductive age. Pain symptoms and the associated infertility may significantly affect their physical, mental and social wellbeing, resulting in a considerable burden in terms of health care costs. Thus, there is a pressing need to update the current knowledge of CPP, and to evaluate the effect of treatment. Further, the need for a comprehensive treatment guideline is considered timely.%慢性盆腔痛(chronic pelvic pain,CPP)多见于育龄女性,自然病史复杂,病因不明确,治疗反应差,严重威胁患者的健康和生育能力、社会心理状况及家庭关系,其危害及防治消耗了大量的社会和卫生经济资源.重视CPP的诊治有利于深入了解疾病机制,提高疾病综合治疗水平,并形成全面的诊治指南和流程.

  6. Pelvic Inflammatory Disease (PID)

    Science.gov (United States)

    ... the ectopic pregnancy is not diagnosed early. Chronic pelvic pain —PID may lead to long-lasting pelvic pain. Who is at risk of PID? PID can ... lead to pelvic inflammatory disease and infertility. Chronic Pelvic Pain: Persistent pain in the pelvic region that has ...

  7. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center.

    Directory of Open Access Journals (Sweden)

    Yadong Zhang

    Full Text Available The aim of this study was to investigate the prevalence of erectile dysfunction (ED in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January-July 2014. ED was diagnosed as a score of<21 on the International Index of Erectile Function (IIEF-5. Patients from one center were evaluated by the UPOINT system and NIH-CPSI. Each patient was assessed using clinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ, the Pain Catastrophizing Scale (PCS, NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18-60 years were enrolled. ED was found in 638/1406 patients (45.4%, and was categorized as mild in 291(45.6%, moderate in 297(46.6% and severe in50(7.7%. 192 patients from one center(mean age,31.3 years; range 18-57 years were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251, PHQ (r = 0.355 and PCS (r = 0.322scores (P<0.001.PHQ score correlated positively with NIH-CPSI (r = 0.586 and PCS(r = 0.662 scores (P<0.001.NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS.

  8. Network Meta-Analysis of the Efficacy of Acupuncture, Alpha-blockers and Antibiotics on Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

    Science.gov (United States)

    Qin, Zongshi; Wu, Jiani; Tian, Jinhui; Zhou, Jing; Liu, Yali; Liu, Zhishun

    2016-10-19

    Alpha-blockers and antibiotics are most commonly used to treat chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in clinical practice. Currently, increasing evidence also suggests acupuncture as an effective strategy. This network meta-analysis intended to assess the comparative efficacy and safety of acupuncture, alpha-blockers and antibiotics for CP/CPPS. Twelve trials involving 1203 participants were included. Based on decreases in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, a network meta-analysis indicated that electro-acupuncture (standard mean difference [SMD]: 4.29; 95% credible interval [CrI], 1.96-6.65), acupuncture (SMD: 3.69; 95% CrI, 0.27-7.17), alpha-blockers (SMD: 1.85; 95% CrI, 1.07-2.64), antibiotics (SMD: 2.66; 95% CrI, 1.57-3.76), and dual therapy (SMD: 3.20; 95% CrI, 1.95-4.42) are superior to placebo in decreasing this score. Additionally, electro-acupuncture (SMD: 2.44; 95% CrI, 0.08-4.83) and dual therapy (SMD: 1.35; 95% CrI, 0.07-2.62) were more effective than alpha-blockers in decreasing the total NIH-CPSI total score. Other network meta-analyses did not show significant differences between interventions other placebo. The incidence of adverse events of acupuncture was relatively rare (5.4%) compared with placebo (17.1%), alpha-blockers (24.9%), antibiotics (31%) and dual therapy (48.6%). Overall, rank tests and safety analyses indicate that electro-acupuncture/acupuncture may be recommended for the treatment of CP/CPPS.

  9. Chronic pelvic pain.

    Science.gov (United States)

    Herbert, Bettina

    2010-01-01

    Though there are myriad etiologies of CPP, common therapeutic targets include inflammation, somatic dysfunction, and psychological disturbances. Inflammation may be addressed not only with dietary changes including nutritional and botanical supplements but also with mind-body therapies. Somatic dysfunction may respond to manipulative therapies provided by osteopaths, naturopaths, chiropractors, and some physical therapists. Therapists may also offer visceral, craniosacral, myofascial, and other whole-body therapies, as can highly trained massage therapists and bodyworkers. Mental health care may be key in many cases. Integrative medicine heralds the return to a sense of the human being's intrinsic capacity for healing, incorporating the vitalism of many of the therapies' origins (traditional Chinese medicine, indigenous medicine, ayurveda, osteopathy, chiropractic, etc) with the gains made by a more reductionistic tradition. Given the complexity and wide variation of etiologies and symptoms of CPP, using an integrative approach may offer expanded therapeutic solutions. We must expand our capacity to listen to each patient-with ears, eyes, mind, heart, and hands. Each treatment plan may then be tailored to the unique history and perspective that lie within the individual. Doing so requires the essential elements of time, skill, and love.

  10. The psychological profile of women presenting to a multidisciplinary clinic for chronic pelvic pain: high levels of psychological dysfunction and implications for practice

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    Bryant C

    2016-11-01

    Full Text Available Christina Bryant,1,2 Rebecca Cockburn,1 Anne-Florence Plante,3 Angela Chia4 1Centre for Women’s Mental Health, Royal Women’s Hospital, Parkville, 2Melbourne School of Psychological Sciences, University of Melbourne, 3Department of Physiotherapy, 4Department of Anaesthesia, Royal Women’s Hospital, Parkville, VIC, Australia Objective: Chronic pelvic pain (CPP is widely acknowledged as a common problem with significant consequences for those diagnosed with this condition. There is a lack of studies with good sample size that provide a comprehensive psychological profile of women presenting to specialist chronic pain clinics. Therefore, the objective of this study was to describe the psychological profile of a representative sample of women presenting with CPP at a tertiary referral center. Design: This was a cross-sectional study. Women were asked to complete a questionnaire assessing symptoms of anxiety and depression, pain severity and interference, pain self-efficacy and catastrophizing beliefs, and sexual functioning. Methods: One-hundred and seventy-five women with CPP were recruited when they attended their initial assessment at a specialist CPP clinic of the Royal Women’s Hospital, a public ­hospital in Melbourne, Australia. Results: Over 75% of the participants had experienced pain for longer than 2 years. Fifty-three percent of women experienced either moderate or severe anxiety, and 26.7% experienced moderate-to-severe depression. There were strong correlations between depressive symptoms and pain interference, pain catastrophizing and self-efficacy beliefs. Conclusion: Our findings confirm previous evidence for high levels of psychological distress and functional impairment associated with this condition, and extend these findings by including measures that are highly relevant to treatment planning, such as thinking styles and pain self-efficacy. Therefore, treatment of this complex condition needs to be holistic, and a multi

  11. Shared genetic factors underlie chronic pain syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Zavos, Helena M. S.; Lachance, Genevieve; Hammond, Christopher J.; Williams, Frances M. K.

    2014-01-01

    Chronic pain syndromes (CPS) are highly prevalent in the general population, and increasingly the evidence points to a common etiological pathway. Using a large cohort of twins (n = 8564) characterized for chronic widespread musculoskeletal pain (CWP), chronic pelvic pain (PP), migraine (MIG), dry e

  12. The psychological profile of women presenting to a multidisciplinary clinic for chronic pelvic pain: high levels of psychological dysfunction and implications for practice

    Science.gov (United States)

    Bryant, Christina; Cockburn, Rebecca; Plante, Anne-Florence; Chia, Angela

    2016-01-01

    Objective Chronic pelvic pain (CPP) is widely acknowledged as a common problem with significant consequences for those diagnosed with this condition. There is a lack of studies with good sample size that provide a comprehensive psychological profile of women presenting to specialist chronic pain clinics. Therefore, the objective of this study was to describe the psychological profile of a representative sample of women presenting with CPP at a tertiary referral center. Design This was a cross-sectional study. Women were asked to complete a questionnaire assessing symptoms of anxiety and depression, pain severity and interference, pain self-efficacy and catastrophizing beliefs, and sexual functioning. Methods One-hundred and seventy-five women with CPP were recruited when they attended their initial assessment at a specialist CPP clinic of the Royal Women’s Hospital, a public hospital in Melbourne, Australia. Results Over 75% of the participants had experienced pain for longer than 2 years. Fifty-three percent of women experienced either moderate or severe anxiety, and 26.7% experienced moderate-to-severe depression. There were strong correlations between depressive symptoms and pain interference, pain catastrophizing and self-efficacy beliefs. Conclusion Our findings confirm previous evidence for high levels of psychological distress and functional impairment associated with this condition, and extend these findings by including measures that are highly relevant to treatment planning, such as thinking styles and pain self-efficacy. Therefore, treatment of this complex condition needs to be holistic, and a multidisciplinary approach is likely to be the best way to achieve this. PMID:27895510

  13. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) on Semen Parameters in Human Males: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Fu, Weihua; Zhou, Zhansong; Liu, Shijian; Li, Qianwei; Yao, Jiwei; Li, Weibing; Yan, Junan

    2014-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the risk factors of impaired male fertility potential. Studies have investigated the effect of CP/CPPS on several semen parameters but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the association between CP/CPPS and basic semen parameters in adult men. Methods Systematic literature searches were conducted with PubMed, EMBASE and the Cochrane Library up to August 2013 for case-control studies that involved the impact of CP/CPSS on semen parameters. Meta-analysis was performed with Review Manager and Stata software. Standard mean differences (SMD) of semen parameters were identified with 95% confidence intervals (95% CI) in a random effects model. Results Twelve studies were identified, including 999 cases of CP/CPPS and 455 controls. Our results illustrated that the sperm concentration and the percentage of progressively motile sperm and morphologically normal sperm from patients with CP/CPPS were significantly lower than controls (SMD (95% CI) −14.12 (−21.69, −6.63), −5.94 (−8.63, −3.25) and −8.26 (−11.83, −4.66), respectively). However, semen volume in the CP/CPPS group was higher than in the control group (SMD (95% CI) 0.50 (0.11, 0.89)). There was no significant effect of CP/CPPS on the total sperm count, sperm total motility, and sperm vitality. Conclusions The present study illustrates that there was a significant negative effect of CP/CPPS on sperm concentration, sperm progressive motility, and normal sperm morphology. Further studies with larger sample sizes are needed to better illuminate the negative impact of CP/CPPS on semen parameters. PMID:24743301

  14. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) on Erectile Function: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Chen, Xiang; Zhou, ZhiRui; Qiu, XiaoChun; Wang, Bin; Dai, JiCan

    2015-01-01

    Background High prevalence of erectile dysfunction (ED) has been observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, whether or not CP/CPPS is a risk factor of ED remains unknown and controversial. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between CP/CPPS and ED. Methods PubMed, Embase, Web of Science, and The Cochrane Library were searched up to November 11, 2014 to identify studies reporting the association between CP/CPPS and ED. Case–control, cohort and cross-sectional studies were included. Quality of the included studies was assessed. The odds ratio of ED and the mean difference of five-item International Index of Erectile Function (IIEF-5) score were pooled using a random effects model. Subgroup analysis and sensitivity analyses were performed. Results Three cross-sectional studies, two case–control studies, and four retrospective studies with 31,956 participants were included to calculate the pooled odds ratio of ED, and two studies with 1499 participants were included to calculate the pooled mean difference of IIEF-5 scores. A strong correlation was found between CP/CPPS and ED (pooled odds ratio: 3.02, 95% CI: 2.18–4.17, P < 0.01), with heterogeneity across studies (I2 = 65%; P < 0.01). A significant decrease in the IIFE-5 score was observed in the CP/CPPS group (pooled mean difference: −4.54, 95% CI: −5.11–−3.98; P < 0.01). Conclusion Our study indicates that patients with CP/CPPS have an increased risk of suffering from ED. Assessment of erectile function is necessary for the therapy of patients with CP/CPPS. Further evidence is necessary to confirm the relationship between CP/CPPS and ED. PMID:26509575

  15. The Effect of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS on Erectile Function: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Xiang Chen

    Full Text Available High prevalence of erectile dysfunction (ED has been observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS. However, whether or not CP/CPPS is a risk factor of ED remains unknown and controversial. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between CP/CPPS and ED.PubMed, Embase, Web of Science, and The Cochrane Library were searched up to November 11, 2014 to identify studies reporting the association between CP/CPPS and ED. Case-control, cohort and cross-sectional studies were included. Quality of the included studies was assessed. The odds ratio of ED and the mean difference of five-item International Index of Erectile Function (IIEF-5 score were pooled using a random effects model. Subgroup analysis and sensitivity analyses were performed.Three cross-sectional studies, two case-control studies, and four retrospective studies with 31,956 participants were included to calculate the pooled odds ratio of ED, and two studies with 1499 participants were included to calculate the pooled mean difference of IIEF-5 scores. A strong correlation was found between CP/CPPS and ED (pooled odds ratio: 3.02, 95% CI: 2.18-4.17, P < 0.01, with heterogeneity across studies (I2 = 65%; P < 0.01. A significant decrease in the IIFE-5 score was observed in the CP/CPPS group (pooled mean difference: -4.54, 95% CI: -5.11--3.98; P < 0.01.Our study indicates that patients with CP/CPPS have an increased risk of suffering from ED. Assessment of erectile function is necessary for the therapy of patients with CP/CPPS. Further evidence is necessary to confirm the relationship between CP/CPPS and ED.

  16. The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS on semen parameters in human males: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Weihua Fu

    Full Text Available BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS is one of the risk factors of impaired male fertility potential. Studies have investigated the effect of CP/CPPS on several semen parameters but have shown inconsistent results. Hence, we performed a systematic literature review and meta-analysis to assess the association between CP/CPPS and basic semen parameters in adult men. METHODS: Systematic literature searches were conducted with PubMed, EMBASE and the Cochrane Library up to August 2013 for case-control studies that involved the impact of CP/CPSS on semen parameters. Meta-analysis was performed with Review Manager and Stata software. Standard mean differences (SMD of semen parameters were identified with 95% confidence intervals (95% CI in a random effects model. RESULTS: Twelve studies were identified, including 999 cases of CP/CPPS and 455 controls. Our results illustrated that the sperm concentration and the percentage of progressively motile sperm and morphologically normal sperm from patients with CP/CPPS were significantly lower than controls (SMD (95% CI -14.12 (-21.69, -6.63, -5.94 (-8.63, -3.25 and -8.26 (-11.83, -4.66, respectively. However, semen volume in the CP/CPPS group was higher than in the control group (SMD (95% CI 0.50 (0.11, 0.89. There was no significant effect of CP/CPPS on the total sperm count, sperm total motility, and sperm vitality. CONCLUSIONS: The present study illustrates that there was a significant negative effect of CP/CPPS on sperm concentration, sperm progressive motility, and normal sperm morphology. Further studies with larger sample sizes are needed to better illuminate the negative impact of CP/CPPS on semen parameters.

  17. The role of inflammatory cytokines and ERK1/2 signaling in chronic prostatitis/chronic pelvic pain syndrome with related mental health disorders.

    Science.gov (United States)

    Hu, Chao; Yang, Hualan; Zhao, Yanfang; Chen, Xiang; Dong, Yinying; Li, Long; Dong, Yehao; Cui, Jiefeng; Zhu, Tongyu; Zheng, Ping; Lin, Ching-Shwun; Dai, Jican

    2016-06-23

    Mental health disorders(MHD) in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been widely studied. However, the underlying role of inflammatory cytokines and their associated signaling pathways have not been investigated. Here, we report the potential role of cytokines and associated signaling pathways in CP/CPPS patients with MHD and in a CP/CPPS animal model. CP/CPPS patients (n = 810) and control subjects (n = 992) were enrolled in this case-control multicenter study, and serum cytokine levels were measured. Male Sprague-Dawley rats received multiple intracutaneous injections of an immuno-agent along with a pertussis-diphtheria-tetanus triple vaccine for autoimmune CP/CPPS development. The results revealed that, in CP/CPPS patients with significant MHD, elevated IL-1α, IL-1β, IL-4, IL-13, and TNF-α serum levels were observed. The above five cytokines in CP/CPPS rats were significantly elevated in prostate tissue (p < 0.05), and IL-1β levels were elevated in serum and cerebrospinal fluid. In behavioral tests, CP/CPPS rats showed anxiety- and depression-like symptoms, and impaired spatial and associative memory performance (p < 0.05). In the CP/CPPS group, ERK1/2 phosphorylation levels were increased in the amygdala and nucleus accumbens, and decreased in the hippocampus, but not caudate nucleus. Thus, prostate-derived cytokines, especially IL-1β, cross the blood brain barrier and may lead to enhanced ERK1/2 signaling in several brain areas, possibly underlying induction of CP/CPPS-related MHD.

  18. Characterisation of the bacterial community in expressed prostatic secretions from patients with chronic prostatitis/chronic pelvic pain syndrome and infertile men: a preliminary investigation

    Institute of Scientific and Technical Information of China (English)

    Dong-Sheng Hou; Wen-Min Long; Jian Shen; Li-Ping Zhao; Xiao-Yan Pang; Chen XU

    2012-01-01

    The expressed prostatic secretions (EPSs) of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS),infertile men and normal men were subjected to microbiological study.EPSs were collected from the subjects,which included 26 normal men,11 infertile patients and 51 CP/CPPS patients.DNA was extracted from each specimen,and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers.The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men,but without any difference among the three patient groups.The denaturing gradient gel electrophoresis (DGGE) method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues.Principal component analysis (PCA) and partial least squares (PLS) analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups.Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients (P<0.05).Two bands were identified as priority factors in the discrepancy of category ⅢA and category ⅢB prostatitis patients (P<0.05).According to this research,the ecological balance of the prostate and low urethra tract,when considered as a microenvironment,might play an important role in the maintenance of a healthy male reproductive tract.

  19. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study

    Science.gov (United States)

    Guan, Xiao; Zhao, Cheng; Ou, Zhen-Yu; Wang, Long; Zeng, Feng; Qi, Lin; Tang, Zheng-Yan; Dun, Jin-Geng; Liu, Long-Fei

    2015-01-01

    The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness (UPOINT) phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index (NIH-CPSI) was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores (r = 0.796, P < 0.001). Symptom duration was associated with a greater number of positive domains (r = 0.589, P < 0.001). With 6 months follow-up at least, 75.0% (105/140) had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P < 0.0001). Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy. PMID:25248659

  20. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome: a prospective study

    Directory of Open Access Journals (Sweden)

    Xiao Guan

    2015-02-01

    Full Text Available The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness (UPOINT phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index (NIH-CPSI was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores (r = 0.796, P< 0.001. Symptom duration was associated with a greater number of positive domains (r = 0.589, P< 0.001. With 6 months follow-up at least, 75.0% (105/140 had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P< 0.0001. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.

  1. Use of the UPOINT phenotype system in treating Chinese patients with chronic prostatitis/chronic pelvic pain syndrome:a prospective study

    Institute of Scientific and Technical Information of China (English)

    Xiao Guan; Cheng Zhao; Zhen-Yu Ou; Long Wang; Feng Zeng; Lin Qi; Zheng-Yan Tang; Jin-Geng Dun; Long-Fei Liu

    2015-01-01

    The urinary, psychosocial, organ‑specific, infection, neurological/systemic and tenderness (UPOINT) phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CP/CPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re‑examined after 6 months. A minimum 6‑point drop in National Institutes of Health‑Chronic Prostatitis Symptoms Index (NIH‑CPSI) was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH‑CPSI scores (r = 0.796, P < 0.001). Symptom duration was associated with a greater number of positive domains (r = 0.589, P < 0.001). With 6 months follow‑up at least, 75.0% (105/140) had at least a 6‑point improvement in NIH‑CPSI after taking the therapy. All NIH‑CPSI scores were significantly improved from original ones: pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ± 5.70 (all P < 0.0001). Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.

  2. The Comparison of The Efficacy of Three Different Treatment Protocols on The Type 3 Chronic Prostatitis (Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Fikret Erdemir

    2010-05-01

    Full Text Available  Aim: In this study, the effect of three different treatment protocols on the type 3 chronic prostatitis was evaluated. In addition to our knowledge, the comparative studies which related CPPS are limited in Turkish literature. Material and Methods: Between January 2004 and December 2008 a total of 87 male patients with diagnosed of type 3 chronic prostatitis, were evaluated in our clinic. According to treatment protocols patients with type 3 chronic prostatitis, were randomized into three groups as fallows group 1; antibiotic+antiinflammatory+ α-blocker, group 2; α-blocker and group 3; antibiotic+antiinflammatory. Pretreatment and post treatment results were compared. Results: The mean age of all patients was 34.14±7.68 years. The mean age of the patients was 34.13±7.39 years, 34.76±7.99 years, and 33.72±8.25 years in group 1, group 2 and group 3, respectively (p>0.05. While the improvement rates after treatment was detected 68% in group 1, these rates were found as 35.3% and 52% in group 2 and group 3, respectively.This difference was statitistically significant in combined group when  compared to other groups (p=0.047. Conclusion:Although alternative treatment researches have still been continue in type 3 chronic prostatitis which consist of 90-95% of all prostatitis. It is seen that combined treatment is beneficial. However, studies in larger, randomized and controlled series are needed to prove the effect of treatment on type 3 chronic prostatitis.

  3. Fighting Chronic Pain

    Science.gov (United States)

    ... leg pain from clogged arteries Stomach/Digestive: Gallstones, intestinal obstruction, diverticulitis, ulcers, severe indigestion, severe gas pain, inflammatory bowel disease, colitis Urinary/Reproductive: Kidney stones, pelvic pain, vulvodynia, ...

  4. 慢性盆腔疼痛症的中医治疗体会%The Experience of Traditional Chinese Medicine in Treatment of Chronic Pelvic Pain Syndrome

    Institute of Scientific and Technical Information of China (English)

    林丽波

    2015-01-01

    目的:对中医疗法治疗慢性盆腔疼痛症的临床治疗效果进行探究。方法选取我院于2014年1月~2014年9月收治的44例慢性盆腔疼痛症患者,随机分为对照组和治疗组各22例患者,对照组患者采用西医治疗,治疗组患者采用中医治疗,对两组患者的治疗效果进行对比分析。结果经过3个疗程的治疗,对照组和治疗组的治疗总有效率分别为77.3%和90.9%,两组治疗效果对比差异显著,治疗有统计学意义(P<0.05)。结论采用中医疗法治疗慢性盆腔疼痛症能够取得满意的效果,是治疗慢性盆腔疼痛症的一种极其有效的方法。%Objective The traditional Chinese medicine treatment efficacy in treatment of chronic pelvic pain syndrome is to be analyzed.Methods Choose 44 patients with chronic pelvic pain syndrome who are received and treated in hospital from January 2013 to September 2014 and separate them into control group and study group at random with 22 patients in each group. Patients in control group are given western medicine treatment,while patients in study group are given traditional chinese medicine treatment,and then observe and compare the treatment efficacy of the two groups.ResultsThe treatment efficiency in control group and study group is 77.3% and 90.9% respectively after three courses of treatment,there is a treatment differential between the two groups,and such a differential has statistic value(P<0.05).Conclusion The traditional chinese medicine is of efficiency to cure chronic pelvic pain syndrome with favorable result. Thus,such an effective treatment approach is quite worthwhile to be promoted and applied.

  5. The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes.

    Science.gov (United States)

    Everaert, K; Devulder, J; De Muynck, M; Stockman, S; Depaepe, H; De Looze, D; Van Buyten, J; Oosterlinck, W

    2001-01-01

    The aim of the study was to report our results of sacral nerve stimulation in patients with pelvic pain after failed conservative treatment. From 1992 to August 1998 we treated 111 patients (40 males, 71 females, ages 46 +/- 16 years) with chronic pelvic pain. All patients with causal treatment were excluded from this study. Pelvic floor training, transcutaneous electrical nerve stimulation (TENS) and intrarectal or intravaginal electrostimulation were applied and sacral nerve stimulation was used for therapy-resistant pain. The outcome of conservative treatment and sacral nerve stimulation (VAS 50% pain relief) was related to symptoms of voiding dysfunction and dyschezia, and urodynamic proof of dysfunctional voiding, not to the pain localization or treatment modality. Outcome was inversely related to neuropathic pain. When conservative treatment failed, a test stimulation of the S3 root was effective in 16/26 patients, and 11 patients were implanted successfully with a follow-up of 36 +/- 8 months. So far no late failures have been seen. A longer test stimulation is needed in patients with pelvic pain because of a higher incidence of initial false positive tests. Our conclusion is that sacral nerve stimulation is effective in the treatment of therapy-resistant pelvic pain syndromes linked to pelvic floor dysfunction.

  6. Unique Microstructural Changes in the Brain Associated with Urological Chronic Pelvic Pain Syndrome (UCPPS) Revealed by Diffusion Tensor MRI, Super-Resolution Track Density Imaging, and Statistical Parameter Mapping: A MAPP Network Neuroimaging Study.

    Science.gov (United States)

    Woodworth, Davis; Mayer, Emeran; Leu, Kevin; Ashe-McNalley, Cody; Naliboff, Bruce D; Labus, Jennifer S; Tillisch, Kirsten; Kutch, Jason J; Farmer, Melissa A; Apkarian, A Vania; Johnson, Kevin A; Mackey, Sean C; Ness, Timothy J; Landis, J Richard; Deutsch, Georg; Harris, Richard E; Clauw, Daniel J; Mullins, Chris; Ellingson, Benjamin M

    2015-01-01

    Studies have suggested chronic pain syndromes are associated with neural reorganization in specific regions associated with perception, processing, and integration of pain. Urological chronic pelvic pain syndrome (UCPPS) represents a collection of pain syndromes characterized by pelvic pain, namely Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS), that are both poorly understood in their pathophysiology, and treated ineffectively. We hypothesized patients with UCPPS may have microstructural differences in the brain compared with healthy control subjects (HCs), as well as patients with irritable bowel syndrome (IBS), a common gastrointestinal pain disorder. In the current study we performed population-based voxel-wise DTI and super-resolution track density imaging (TDI) in a large, two-center sample of phenotyped patients from the multicenter cohort with UCPPS (N = 45), IBS (N = 39), and HCs (N = 56) as part of the MAPP Research Network. Compared with HCs, UCPPS patients had lower fractional anisotropy (FA), lower generalized anisotropy (GA), lower track density, and higher mean diffusivity (MD) in brain regions commonly associated with perception and integration of pain information. Results also showed significant differences in specific anatomical regions in UCPPS patients when compared with IBS patients, consistent with microstructural alterations specific to UCPPS. While IBS patients showed clear sex related differences in FA, MD, GA, and track density consistent with previous reports, few such differences were observed in UCPPS patients. Heat maps illustrating the correlation between specific regions of interest and various pain and urinary symptom scores showed clustering of significant associations along the cortico-basal ganglia-thalamic-cortical loop associated with pain integration, modulation, and perception. Together, results suggest patients with UCPPS have extensive microstructural

  7. Laparoscope Diagnosis and Treatment to Chronic Pelvic Cavity Pain (CPP)%慢性盆腔痛腹腔镜诊治探讨

    Institute of Scientific and Technical Information of China (English)

    王芳

    2012-01-01

    [Objective] To explore the cure effect of laparoscope on CPP. [Method] Trace back and analyse the pathological change, treatment and clinical effect of 80 cases of CPP treated with laparoscope. [Result] 85.00% had definite pathological changes; endometriosis (37.5%) .chronic pelvic inflammation(27.5%) .pelvic adhesion(12.5%) were the main pathological changes of CPP, occupying 77.5%(62/80)of total cases. [Conclusion] Laparoscope is a quick, effective and optimized method for defining the causa morbi of chronic pelvic cavity pain. and can improve diagnosis rate and effective rate of CPP.%[目的]探讨腹腔镜在慢性盆腔痛(CPP)中的诊断治疗作用.[方法]回顾性分析使用腹腔镜进行诊治的80例慢性盆腔痛患者的病理改变、治疗方法及临床疗效.[结果]85.00%( 68/80)的CPP患者在腹腔镜使用下明确了其病理改变,子宫内膜异位症(37.5%)、慢性盆腔炎(27.5%)、盆腔粘连(125%)是 CPP的主要病理改变,占总病例的77.50%( 62/80).[结论]腹腔镜是明确慢性盆腔痛病理病因的一种快速、有效、优选的方法,能提高慢性盆腔痛诊治的确诊率和有效率.

  8. Medical treatments for endometriosis-associated pelvic pain.

    Science.gov (United States)

    Zito, Gabriella; Luppi, Stefania; Giolo, Elena; Martinelli, Monica; Venturin, Irene; Di Lorenzo, Giovanni; Ricci, Giuseppe

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  9. Medical Treatments for Endometriosis-Associated Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Gabriella Zito

    2014-01-01

    Full Text Available The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  10. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model.

    Science.gov (United States)

    Hu, Y; Niu, X; Wang, G; Huang, J; Liu, M; Peng, B

    2016-11-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is an independent risk factor for the development of erectile dysfunction (ED). But the molecular mechanisms underlying the relationship between CP/CPPS and ED are still unclear. The aim of this study was to investigate the effect of CP/CPPS on erectile function in a rat model and the possible mechanisms. A rat model of experimental autoimmune prostatitis (EAP) was established to mimic human CP⁄CPPS. Then twenty 2-month-old male Sprague-Dawley rats were divided into EAP group and control group. Intracavernosal pressure (ICP) and mean arterial pressure (MAP) were measured during cavernous nerve electrostimulation, the ratio of max ICP/MAP was calculated. Blood was collected to measure the levels of serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and testosterone, respectively. The expression of endothelial nitric oxide synthase (eNOS), cyclic guanosine monophosphate (cGMP) levels, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels in corpus cavernosum were detected. We also evaluated the smooth muscle/collagen ratio and apoptotic index (AI). The ratio of max ICP/MAP in EAP group were significantly lower than that in control group. The levels of serum CRP, TNF-α, IL-1β, and IL-6 in EAP group were all significantly higher than these in control group. The expression of eNOS and cGMP levels in corpus cavernosum of EAP rats were significantly downregulated. Furthermore, decreased SOD activity and smooth muscle/collagen ratio, increased MDA levels and AI were found in corpus cavernosum of EAP rats. In conclusion, CP/CPPS impaired penile erectile function in a rat model. The declines of eNOS expression and cGMP levels in corpus cavernosum may be an important mechanism of CP/CPPS-induced ED. CP/CPPS also increased oxidative stress, cell apoptosis and decreased smooth muscle/collagen ratio in corpus cavernosum of rats, which were

  11. AB129. The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on erectile function: a systematic review and meta-analysis

    Science.gov (United States)

    Dai, Jican

    2015-01-01

    Objective High prevalence of erectile dysfunction (ED) was observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, it is still unknown whether CP/CPPS is a risk factor of ED. This systematic review and meta-analysis was conducted to evaluate the relationship between CP/CPPS and ED. Methods PubMed, EMBASE, Web of Science and the Cochrane library were searched up to November 2014 to identify literatures that reported the association between CP/CPPS and ED. Case-control, cohort or cross-sectional studies were included. Newcastle-Ottawa Quality Assessment scale was used in assessing qualities of included case-control and cohort studies and an eleven item quality assessment table was used in cross-sectional studies. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Odds ratio of ED and mean difference of 5-item International Index of Erectile Function scores were pooled across studies and analyzed using random effect model. Results A total of 3 cross-sectional studies, 2 case-control studies and 4 retrospective studies with 31,956 participants were included to calculate pooled OR of ED, and 2 studies for pooled mean difference of IIEF-5 score. A strong correlation between CP/CPPS and ED (pooled OR: 3.02, 95% CI: 2.18-4.17, P<0.01) was found, with significant heterogeneity across studies (I2=65%, P<0.01). Also a significant decrease of IIFE-5 score in CP/CPPS group (pooled MD: –4.54, 95% CI: –5.11-–3.98, P<0.01) was observed. Conclusions Patients with CP/CPPS have a more increased risk of suffering from ED, but the mechanisms were unclear. Evidence of higher level is needed to further confirm this relationship. Physicians should pay more attention on erectile function of patients with CP/CPPS.

  12. Effect of Kangfu antiphlogistic suppository combined with pelvic inflammatory therapeutic equip-ment on chronic pelvic pain caused by pelvic inflammation%康妇消炎栓联合盆腔炎治疗仪治疗盆腔炎所致慢性疼痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    孙鲁芳; 杜仕秀; 贺秀华

    2015-01-01

    Objective To investigate the effect of Kangfu antiphlogistic suppository combined with pelvic inflammatory therapeutic equipment on chronic pelvic pain caused by pelvic inflammation. Methods The control group received Kangfu antiphlogistic suppository treatment, and the study group received Kangfu antiphlogistic suppository combined with pelvic inflammatory therapeutic apparatus.The clinical effects on chronic pain caused by pelvic inflammatory disease and incidences of adverse reactions were recorded.Results The clinical total efficiency of study group was 91.11%, which was signifi-cantly higher than that of the control group ( 71.11%) , there was significant difference ( P0.05 ) .Conclusions Kangfu antiphlogistic suppository com-bined with pelvic inflammatory therapeutic apparatus for chronic pain caused by pelvic inflammatory can significantly improve its clinical efficacy, and help protect the quality of life of patients.%目的:探讨康妇消炎栓联合盆腔炎治疗仪在盆腔炎所致慢性疼痛中的治疗效果。方法对照组给予康妇消炎栓治疗;研究组给予康妇消炎栓联合盆腔炎治疗仪治疗,记录两组盆腔炎所致慢性疼痛患者临床疗效及不良反应发生率。结果研究组临床治疗总有效率高达91.11%,显著高于对照组临床治疗总有效率(71.11%),差异有统计学意义(P <0.05)。研究组不良反应发生率为17.78%,对照组不良反应发生率为15.56%,差异未见统计学意义( P>0.05)。结论对盆腔炎所致慢性疼痛患者给予康妇消炎栓联合盆腔炎治疗仪治疗后可显著提高其临床疗效,有利于保障患者生活质量。

  13. 丹莪妇康煎膏治疗不同病因慢性盆腔痛122例分析%122 Cases Effect Analysis of Dan'e Fukang Decocted Extract on the Women Chronic Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    林松; 李云霞; 赵子菡

    2013-01-01

    目的 比较丹莪妇康煎膏对不同病因慢性盆腔痛的疗效.方法 收集我院门诊2007年10月-2011年6月就诊的慢性盆腔炎、子宫内膜异位症及其它原因所致的慢性盆腔痛患者122例,用丹莪妇康煎膏进行治疗,10~15g/次,每日2次,每月连续服用20d,3个月为1疗程,比较丹莪妇康煎膏对不同病因慢性盆腔痛的临床疗效.结果 丹莪妇康煎膏对慢性盆腔炎、子宫内膜异位症及其它原因所致的慢性盆腔痛总有效率分别为88.7%,95.8%、和80.9%,各组相比差异无统计学意义.结论 丹莪妇康煎膏对多种不同病因引起的女性慢性盆腔痛均有治疗作用.%Objective To investigate the therapeutic effect of Dan' e Fukang decocted extract on the women chronic pelvic pain caused by different reasons. Methods 122 cases with chronic pelvic pain caused by chronic pelvic inflammatory, endometrio-sis and other reasons were employed. All of the patients were treated with the Dan'e Fukang decocted extract and took orally, 10-15 grams each time,2 times a day,consecutively 20 days per month and the course of treatment is 3 months. Then comparative the clinical effect of Dan' e Fukang decocted extract in treating the chronic pelvic pain caused by different reasons. Results Total effective rate of the decoction on chronic pelvic pain caused by chronic pelvic inflammatory was 88. 7%,caused by endometriosis was 95. 8%, and caused by other reasons was 80. 9% separately. There were no statistical difference among each treated group. Conclusion Dan'e Fukang decocted extract has therapeutic effect on the chronic pelvic pain caused by different reasons.

  14. Postoperative pelvic pain: An imaging approach.

    Science.gov (United States)

    Farah, H; Laurent, N; Phalippou, J; Bazot, M; Giraudet, G; Serb, T; Poncelet, E

    2015-10-01

    Postoperative pelvic pain after gynecological surgery is a readily detected but unspecific sign of complication. Imaging as a complement to physical examination helps establish the etiological diagnosis. In the context of emergency surgery, vascular, urinary and digestive injuries constitute the most frequent intraoperative complications. During the follow-up of patients who had undergone pelvic surgery, imaging should be performed to detect recurrent disease, postoperative fibrosis, adhesions and more specific complications related to prosthetic material. Current guidelines recommend using pelvic ultrasonography as the first line imaging modality whereas the use of pelvic computed tomography and/or magnetic resonance imaging should be restricted to specific situations, depending on local availability of equipment and suspected disease.

  15. Clinical nursing effect of pelvic exercise combined with abdominal massage on the chronic pelvic pain%盆腔操锻炼联合腹部推拿在慢性盆腔痛的护理效果分析

    Institute of Scientific and Technical Information of China (English)

    黄其会

    2015-01-01

    目的:观察盆腔操锻炼联合腹部推拿对治疗慢性盆腔痛的临床效果。方法选择2013年3月~2014年6月收治的98例慢性盆腔痛患者,按数字表随机法分成对照组和观察组,其中对照组给予常规治疗,观察组在常规治疗的基础上同时进行盆腔操锻炼联合腹部推拿治疗,观察记录两组患者在入院时、治疗7 d 后以及治疗14 d 后的疼痛指数,并在治疗14 d 后对其临床疗效进行评定。结果两组患者在入院时的疼痛指数差异无统计学意义(P >0.05);与入院前比较,两组患者治疗7 d 后疼痛有明显缓解(P <0.05),与对照组比较,差异无统计学意义(P >0.05);治疗14 d 后观察组疼痛明显减轻,与对照组比较,差异有统计学意义(P <0.05)。治疗14 d 后,观察组总有效率为87.76%(43/49),高于对照组总有效率为69.39%(34/49),差异有统计学意义(χ2=4.91,P <0.05)。结论盆腔操锻炼联合腹部推拿能有效改善慢性盆腔痛患者的疼痛程度,疗效满意。%Objective To observe the clinical nursing effect of pelvic exercise combined with abdominal massage on the chronic pelvic pain. Methods 98 patients with chronic pelvic pain in our hospital from March 2013 to June 2014 were analyzed,and divided into control group and observation group randomly. The patients of control group were given conventional treatment and nursing care,while the patients of observation group were on pelvic exercise combined with abdominal massage on the basis of routine treatment and nursing care. Then the pain indexes and clinical efficacy rates were observed and recorded in the two groups at the time of admission/7 days later and 14 days later to evaluate the nursing effects. Results The pain index NRS score of the observation group was not significantly different from that of the control group at the time of admission/ 7 d later(P > 0.05),but was significantly

  16. Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis

    Directory of Open Access Journals (Sweden)

    Amir Moayednia

    2014-01-01

    Full Text Available Background: There is limited evidence about the chronic pelvic pain syndrome (CPPS treatment by shockwave therapy, and the aim of this study was to evaluate the effect of extracorporeal shockwave therapy on CPPS due to non bacterial prostatitis in a long-term period. Materials and Methods: In a follow-up survey, 40 patients with CPPS (that were randomly distributed into the treatment or sham groups were evaluated at 16, 20, and 24 weeks. In the treatment group, patients were treated by extracorporeal shock wave therapy (ESWT once a week for 4 weeks by a protocol of 3000 impulses, 0.25 mJ/m 2 and 3 Hz of frequency. 0.05 mJ/m 2 were added in each week. In the sham group, the same protocol was applied, but with the probe being turned off. The follow-up assessments were done by visual analog scale for pain and National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI. Data were compared using independent t-test or analysis of variences. Results: Three patients did not complete the study protocol, 37 patients were evlauated (19 patients in treatment and 18 patients in the sham group. At week 24, the mean of pain score, urinary score, quality-of-life and NIH-CPSI score between two groups were not statistically different. Conclusion: Although, ESWT therapy as a safe and effective therapy in CPPS in short-term follow-up has been established, its long-term efficacy was not supported by this study.

  17. Pharmacologic attenuation of pelvic pain in a murine model of interstitial cystitis

    Directory of Open Access Journals (Sweden)

    Schaeffer Anthony J

    2009-11-01

    Full Text Available Abstract Background Interstitial cystitis/painful bladder syndrome (IC/PBS is a bladder disease that causes debilitating pelvic pain of unknown origin, and IC/PBS symptoms correlate with elevated bladder lamina propria mast cell counts. Similar to IC/PBS patients, pseudorabies virus (PRV infection in mice induces a neurogenic cystitis associated with bladder lamina propria mast cell accumulation and pelvic pain. We evaluated several drugs to determine the effectiveness of reducing PRV-induced pelvic pain. Methods Neurogenic cystitis was induced by the injection of Bartha's strain of PRV into the abductor caudalis dorsalis tail base muscle of female C57BL/6 mice. Therapeutic modulation of pelvic pain was assessed daily for five days using von Frey filament stimulation to the pelvic region to quantify tactile allodynia. Results Significant reduction of PRV-induced pelvic pain was observed for animals treated with antagonists of neurokinin receptor 1 (NK1R and histamine receptors. In contrast, the H1R antagonist hydroxyzine, proton pump inhibitors, a histamine receptor 3 agonist, and gabapentin had little or no effect on PRV-induced pelvic pain. Conclusion These data demonstrate that bladder-associated pelvic pain is attenuated by antagonists of NK1R and H2R. Therefore, NK1R and H2Rrepresent direct therapeutic targets for pain in IC/PBS and potentially other chronic pain conditions.

  18. Clinical Study of Vitamin K3 Acupoint Injection In Treating Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wen-jie (赵文洁); WANG Li (王莉); WENG Jian'er (翁健儿); YU Jin (俞瑾)

    2003-01-01

    @@ Pelvic pain is one of the most common symptoms in gynecologic outpatients. Primary dysmenorrhea, acute or chronic pelvic inflammatory disease, endometriosis, post-operational pelvic adhesion, blood stagnation of pelvic vein, etc., are mentioned as the often encountered causes of pelvic pain. It has been reported in the recent ten or more years that intramuscular injection of vitamin K3 (Vit K3) could relieve pain induced by smooth muscle spasm(1,2). In order to evaluate the effect of Vit K3 administered by acupoint injection in relieving pelvic pain, 180 patients were treated and observed from April 1997 to April 1999 in our hospital, and good therapeutic effect was obtained. It was reported as follows.

  19. An Evaluation Model for a Multidisciplinary Chronic Pelvic Pain Clinic: Application of the RE-AIM Framework.

    Science.gov (United States)

    Chen, Innie; Money, Deborah; Yong, Paul; Williams, Christina; Allaire, Catherine

    2015-09-01

    Objectif : La douleur pelvienne chronique (DPC) est un trouble prévalent, débilitant et coûteux. Bien que des lignes directrices nationales et des données empiriques soutiennent l’utilisation d’un modèle de soins multidisciplinaires pour les patientes qui présentent des DPC, les cliniques canadiennes offrant un tel modèle sont peu nombreuses. Le BC Women’s Centre for Pelvic Pain and Endometriosis a été créé pour répondre à ce besoin et un intérêt a été manifesté à l’endroit des effets de ce modèle de soins sur le fardeau de la maladie en Colombie-Britannique. Nous avons cherché à créer une approche envers son évaluation en utilisant le cadre de référence RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) pour déterminer les effets de ce modèle de soins et pour orienter le processus décisionnel clinique et la formulation de politiques en la matière. Méthodes : Le cadre d’évaluation RE-AIM a été appliqué pour nous permettre d’envisager les diverses dimensions des effets du BC Centre. Les mesures proposées, les sources de données et les stratégies de gestion des données pour cette approche à méthodes mixtes ont été identifiées. Résultats : Les cinq dimensions des effets ont été prises en considération aux niveaux personnel et organisationnel, et des indicateurs correspondants ont été proposés pour en permettre l’intégration dans l’infrastructure de données existante, en vue de faciliter la collecte des données et l’évaluation précoce du programme. Conclusion : Le cadre RE-AIM peut être appliqué à l’évaluation d’une clinique multidisciplinaire visant la douleur pelvienne chronique. Cela permettra la tenue d’une meilleure évaluation des effets de modèles novateurs de soins chez les femmes qui connaissent des douleurs pelviennes chroniques.

  20. Avaliação postural em mulheres com dor pélvica crônica Postural evaluation in women with chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Renata Miranda

    2009-07-01

    Full Text Available OBJETIVO: avaliar por meio da fotogrametria as alterações posturais de mulheres com dor pélvica crônica. MÉTODOS: foram avaliadas 30 mulheres com queixa de dor pélvica crônica e 37 sem essa queixa, totalizando 67 mulheres. A avaliação constituiu de anamnese, colocação de marcadores fixos em pontos anatômicos definidos e obtenção de fotografias em vista frontal, posterior, lateral esquerda e direita. A análise das fotos foi realizada com o software CorelDraw®, versão 11.0. Foram identificados valores para as variáveis de análise postural de tornozelo, joelho no plano sagital, pelve, lordose lombar, cifose torácica, escápula aduzida/abduzida, ombros, cabeça e teste do terceiro dedo ao chão. As variáveis qualitativas estudadas foram joelho (varo, valgo ou normal, presença ou não de escápula alada e de nivelamento de ombros. Para as análises estatísticas utilizamos o Statistical Package for Social Sciences, versão 16.0. Para a comparação entre as variáveis qualitativas foi utilizado o teste exato de Fisher e método de Monte-Carlo e, para a comparação de dados quantitativos foi utilizado o teste t ou o de Mann-Whitney. As comparações entre os dados contínuos corrigidos para possíveis variáveis de confusão foram feitas pela análise de covariância univariada. O nível de significância foi estabelecido como 0,05 ou 5%. RESULTADOS: foi observada diferença significante entre casos e controles para cabeça protusa (47,5 e 52,0º, respectivamente; pOBJECTIVE: to evaluate by photogrammetry, postural changes in women with chronic pelvic pain. METHODS: thirty women with complaint of chronic pelvic pain and 37 without it, in a total of 67 women, were evaluated. The evaluation was realized through anamnesis, fixed markers in defined anatomical sites, and frontal, posterior, left and right lateral photographies. Photo analysis has been done by the software CorelDraw®, version 11.0. Quantitative values for postural

  1. 腹腔镜诊治慢性盆腔痛72例临床分析%Clinical Analysis of 72 Cases of Laparoscopic Diagnosis and Treatment of Chronic Pelvic Pain

    Institute of Scientific and Technical Information of China (English)

    许苏华; 蒯国林; 虞丽相

    2012-01-01

      Objective We sought to evaluate the effects of laparoscopy for women who suffered from chronic pelvic pain. Methods We retrospectively analysed 72 patients who underwent laparoscopy for chronic pelvic pain, and compare the clinical manifestation, the presentation during the surgery, the detailed surgery, the detailed surgery procedure and the follow-up. Results It turns out that 70 patients, taking up 97.22%, had pathologic or anatomic changed which is identified by laparoscopy. Among them, 35 patents (48.61%) suffered from endometriosis, 23 patients(31.94%) suffered from pelvic adhesion,9 patients(12.5%) suffered from sequelae of chronic pelvic inflammation, 3 patients(4.17%) suffered pelvic hyperemia syndrome, 2 patients(2.78%) had no obvious changed. 37 patients(51.39%) were completely alleviated, 29 patients (40.28%) were partially alleviated, 6 patients (8.33%)got no alleviation. Conclusion The diagnosis and treatment of chronic pelvic pain with laparoscopy manifests much advantage, thus we advocate the wider use of laparoscopy for chronic pelvic pain.%  目的评价腹腔镜诊治慢性盆腔痛的效果.方法对腹腔镜诊治的72例慢性盆腔痛的患者进行回顾分析,比较其临床表现、术中所见、腹腔镜下实施的手术及术后随访资料.结果72例患者中,腹腔镜证实有病理改变和解剖改变的70例,占97.22%;其中,子宫内膜异位症有35例(48.61%),盆腔粘连23例(31.94%),慢性盆腔炎后遗症9例(12.50%),盆腔静脉淤血症3例(4.17%),盆腔未发现病变2例(2.78%).术后疼痛症状完全缓解37例(51.39%),部分缓解29例(40.28%),未缓解6例(8.33%).结论腹腔镜诊断慢性盆腔痛是一种较优越的方法,在寻找病因的同时可给予适当的治疗,值得推广使用.

  2. Progress on Clinical Study of Acupuncture Treatment for Chronic Pelvic Inflammation

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wen-jie; HUANG Guo-qi

    2008-01-01

    @@ Chronic pelvic inflammation is mostly caused byincomplete treatment of acute pelvic inflammation orby transference from pathologic condition due to poorbody constitution, including chronic endometritis,chronic salpingo-oophoritis and chronic inflammationof connective tissue, and is a commonly andfrequently encountered disease in the gynecologydepartment. Due to long duration, intractablecondition and high recurrent rate, it is also acommonly encountered reason to induce heterotopicpregnancy, sterility, pelvic pain and pelvic adhesivediseases. In the investigative study on the domesticliterature about acupuncture treatment of chronicpelvic inflammation in the recent five years, theauthor hopes to summarize the information forreference in the clinical treatment and to point outsome issues existing in the current clinical study.

  3. More effects of extracorporeal magnetic innervation and terazosin therapy than terazosin therapy alone for non-inflammatory chronic pelvic pain syndrome: a pilot study.

    Science.gov (United States)

    Paick, J-S; Lee, S C; Ku, J H

    2006-01-01

    The objective of this study was to evaluate whether extracorporeal magnetic innervation (ExMI) combined with alpha-blocker therapy is more effective than alpha-blocker monotherapy for patients with non-inflammatory chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS), category IIIB. Patients were randomized to either terazosin monotherapy (group 1, n=21) or terazosin combined with ExMI therapy (group 2, n=19). Patients in group 2 had 12 treatment sessions of ExMI twice a week during 6 weeks. None of the patients experienced any side effects from treatment. The changes in each domain of the National Institutes of Health (NIH)-Chronic Prostatitis Symptom Index (CPSI) measured on week 6 were not significantly different between the groups. However, the difference (median, 25-75th percentiles) between the two groups in total NIH-CPSI scores was -4 (-11.5, -2) for group 1 and -12 (-17.3, -2.3) for group 2, respectively (P=0.047). At 6 weeks, 47.6% (10 of 21) of group 1 had a >25% decrease in total NIH-CPSI compared with 78.9% (15 of 19) of group 2 (P=0.041). Also, more patients in group 2 (78.9%) were rated as responders with a 6-point decrease in NIH-CPSI compared with group 1 (47.6%) (P=0.041). The early results suggest that ExMI combined with alpha-blocker therapy has better effect than alpha-blocker monotherapy for the treatment of CP/CPPS.

  4. IL17 Mediates Pelvic Pain in Experimental Autoimmune Prostatitis (EAP.

    Directory of Open Access Journals (Sweden)

    Stephen F Murphy

    Full Text Available Chronic pelvic pain syndrome (CPPS is the most common form of prostatitis, accounting for 90-95% of all diagnoses. It is a complex multi-symptom syndrome with unknown etiology and limited effective treatments. Previous investigations highlight roles for inflammatory mediators in disease progression by correlating levels of cytokines and chemokines with patient reported symptom scores. It is hypothesized that alteration of adaptive immune mechanisms results in autoimmunity and subsequent development of pain. Mouse models of CPPS have been developed to delineate these immune mechanisms driving pain in humans. Using the experimental autoimmune prostatitis (EAP in C57BL/6 mice model of CPPS we examined the role of CD4+T-cell subsets in the development and maintenance of prostate pain, by tactile allodynia behavioral testing and flow cytometry. In tandem with increased CD4+IL17A+ T-cells upon EAP induction, prophylactic treatment with an anti-IL17 antibody one-day prior to EAP induction prevented the onset of pelvic pain. Therapeutic blockade of IL17 did not reverse pain symptoms indicating that IL17 is essential for development but not maintenance of chronic pain in EAP. Furthermore we identified a cytokine, IL7, to be associated with increased symptom severity in CPPS patients and is increased in patient prostatic secretions and the prostates of EAP mice. IL7 is fundamental to development of IL17 producing cells and plays a role in maturation of auto-reactive T-cells, it is also associated with autoimmune disorders including multiple sclerosis and type-1 diabetes. More recently a growing body of research has pointed to IL17's role in development of neuropathic and chronic pain. This report presents novel data on the role of CD4+IL17+ T-cells in development and maintenance of pain in EAP and CPPS.

  5. IL17 Mediates Pelvic Pain in Experimental Autoimmune Prostatitis (EAP)

    Science.gov (United States)

    Murphy, Stephen F.; Schaeffer, Anthony J.; Done, Joseph; Wong, Larry; Bell-Cohn, Ashlee; Roman, Kenny; Cashy, John; Ohlhausen, Michelle; Thumbikat, Praveen

    2015-01-01

    Chronic pelvic pain syndrome (CPPS) is the most common form of prostatitis, accounting for 90–95% of all diagnoses. It is a complex multi-symptom syndrome with unknown etiology and limited effective treatments. Previous investigations highlight roles for inflammatory mediators in disease progression by correlating levels of cytokines and chemokines with patient reported symptom scores. It is hypothesized that alteration of adaptive immune mechanisms results in autoimmunity and subsequent development of pain. Mouse models of CPPS have been developed to delineate these immune mechanisms driving pain in humans. Using the experimental autoimmune prostatitis (EAP) in C57BL/6 mice model of CPPS we examined the role of CD4+T-cell subsets in the development and maintenance of prostate pain, by tactile allodynia behavioral testing and flow cytometry. In tandem with increased CD4+IL17A+ T-cells upon EAP induction, prophylactic treatment with an anti-IL17 antibody one-day prior to EAP induction prevented the onset of pelvic pain. Therapeutic blockade of IL17 did not reverse pain symptoms indicating that IL17 is essential for development but not maintenance of chronic pain in EAP. Furthermore we identified a cytokine, IL7, to be associated with increased symptom severity in CPPS patients and is increased in patient prostatic secretions and the prostates of EAP mice. IL7 is fundamental to development of IL17 producing cells and plays a role in maturation of auto-reactive T-cells, it is also associated with autoimmune disorders including multiple sclerosis and type-1 diabetes. More recently a growing body of research has pointed to IL17’s role in development of neuropathic and chronic pain. This report presents novel data on the role of CD4+IL17+ T-cells in development and maintenance of pain in EAP and CPPS. PMID:25933188

  6. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B.; Nikolajsen, L.; Kehlet, H.;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies Udgivelsesdato: 2008/3...

  7. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  8. Magnetic resonance neurography-guided nerve blocks for the diagnosis and treatment of chronic pelvic pain syndrome.

    Science.gov (United States)

    Fritz, Jan; Chhabra, Avneesh; Wang, Kenneth C; Carrino, John A

    2014-02-01

    Magnetic resonance (MR) neurography - guided nerve blocks and injections describe a techniques for selective percutaneous drug delivery, in which limited MR neurography and interventional MR imaging are used jointly to map and target specific pelvic nerves or muscles, navigate needles to the target, visualize the injected drug and detect spread to confounding structures. The procedures described, specifically include nerve blocks of the obturator nerve, lateral femoral cutaneous nerve, pudendal nerve, posterior femoral cutaneous nerve, sciatic nerve, ganglion impar, sacral spinal nerve, and injection into the piriformis muscle.

  9. Conscious pain mapping by laparoscopy in women with chronic pelvic pain%腹腔镜清醒疼痛定位在慢性盆腔痛诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    许洪梅; 张震宇

    2013-01-01

    慢性盆腔痛在女性各个年龄阶段均可发病,严重影响患者身心健康.清醒疼痛定位指在局部麻醉下患者清醒,在患者的配合下了解疼痛位置和范围.腹腔镜清醒疼痛定位可以明确慢性盆腔痛疼痛部位和病因,避免不必要的手术,应用清醒疼痛定位指导腹腔镜保守性手术可以有效缓解慢性盆腔痛.%Chronic pelvic pain is a common and significant disorder of women. Conscious laparoscopic pain mapping (CLPM) is a diagnostic laparoscopy under local anesthesia directed at the identification of sources of pain. Diagnosis of an etiological lesion or organ is based on CLPM. CLPM can decrease unnecessary surgical interventions and improve pain relief.

  10. Pelvic pain after childbirth: a longitudinal population study.

    Science.gov (United States)

    Bjelland, Elisabeth Krefting; Owe, Katrine Mari; Pingel, Ronnie; Kristiansson, Per; Vangen, Siri; Eberhard-Gran, Malin

    2016-03-01

    In this longitudinal population study, the aims were to study associations of mode of delivery with new onset of pelvic pain and changes in pelvic pain scores up to 7 to 18 months after childbirth. We included 20,248 participants enrolled in the Norwegian Mother and Child Cohort Study (1999-2008) without preexisting pelvic pain in pregnancy. Data were obtained by 4 self-administered questionnaires and linked to the Medical Birth Registry of Norway. A total of 4.5% of the women reported new onset of pelvic pain 0 to 3 months postpartum. Compared to unassisted vaginal delivery, operative vaginal delivery was associated with increased odds of pelvic pain (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.06-1.59). Planned and emergency cesarean deliveries were associated with reduced odds of pelvic pain (adjusted OR: 0.48; 95% CI: 0.31-0.74 and adjusted OR: 0.65; 95% CI: 0.49-0.87, respectively). Planned cesarean delivery, young maternal age, and low Symptom Checklist-8 scores were associated with low pelvic pain scores after childbirth. A history of pain was the only factor associated with increased pelvic pain scores over time (P = 0.047). We conclude that new onset of pelvic pain after childbirth was not commonly reported, particularly following cesarean delivery. Overall, pelvic pain scores were rather low at all time points and women with a history of pain reported increased pelvic pain scores over time. Hence, clinicians should follow up women with pelvic pain after a difficult childbirth experience, particularly if they have a history of pain.

  11. Pelvic inflammatory disease and pelvic pain%盆腔炎性疾病与盆腔痛

    Institute of Scientific and Technical Information of China (English)

    秦君璞; 张帝开

    2013-01-01

    Pelvic inflammatory disease (PID) has remarkably influenced female reproductive health. There is significant relationship between the incidence of PID outbreaking and its further sequela, such as chronic pelvic pain. Diagnostic Laparoscopy is a gold standard in evaluation of chronic pelvic pain. The patients who underwent a laparoscopic operation would have a decrease in the amount of pelvic pain. Besides, application of oral drugs and physical therapy are also infective ways in treatment of chronic pelvic pain.%盆腔炎性疾病严重影响广大女性的生殖健康,若不能及时治疗,易引起后遗病变.慢性盆腔痛是盆腔炎性疾病所引起的后遗病变之一.诊断性腹腔镜是目前评价慢性盆腔痛原因的有效方法,可在进行诊断同时对盆腔病变进行手术治疗.此外,口服药物、理疗等方法也可有效缓解盆腔疼痛.

  12. Treating 52 cases of gynecological chronic pelvic pain (qi stagnation and blood stasis type) by herbal penetration therapy%中药外治法治疗妇科慢性盆腔痛(气滞血瘀型)52例

    Institute of Scientific and Technical Information of China (English)

    陈琰; 王赛莉; 赵燕宁

    2012-01-01

      Objective: To observe the clinical curative effects of herbal enema and herbal penetration therapy in treating gynecological chronic pelvic pains and investigate the mechanism of relieving pains. Methods: 52 cases of patients with gynecological chronic pelvic pains were selected and treated with herbal enema and herbal penetration therapy. The variation of pain scores before and after treatment was observed to evaluate the improvement of chronic pelvic pains by herbal enema and herbal penetration therapy, while the TCM syndromes scores and Hamilton depression scores (24 items) were observed to evaluate the improvement of TCM syndromes of chronic pelvic pain and the affection of depressed emotion by herbal enema and herbal penetration therapy. Results: Syndromes of chronic pelvic pain improved obviously after treatment. The total effective rate was 88.46%. There was a significant difference between the pain scores before and after treatment (P<0.01). The depressed emotion of patients improved a lot along with the relieving of pains. There was a significant difference between the Hamilton depressed scores before and after treatment (P<0.01). Conclusion: The herbal enema and herbal penetration therapy had an obvious effect in dispersing the depressed liver-energy, promoting Qi, warming meridians, activating blood circulation, removing blood stasis and pains. It was worthy of wide application because it could relieve the syndromes of chronic pelvic pain and improve the depressed emotion of patients, and in addition it was convenient, effective and with little side effects.%  目的:观察中药灌肠、中药外敷治疗气滞血瘀型妇科慢性盆腔痛的临床疗效,探讨其缓解疼痛的作用机理.方法:选择妇科慢性盆腔痛(气滞血瘀型)患者52例,予中药保留灌肠、中药外敷治疗两个疗程,通过观察治疗前后数字疼痛评分(NRS)的变化,评价中药灌肠、外敷对妇科慢性盆腔疼痛的改善情

  13. Painful Intercourse Is Significantly Associated with Evoked Pain Perception and Cognitive Aspects of Pain in Women with Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Meryl J. Alappattu, DPT, PhD

    2015-03-01

    Conclusions: Differences in local pain ratings suggest that women with pelvic pain perceive stimuli in this region as more painful than pain-free women although the magnitude of stimuli does not differ. Alappattu MJ, George SZ, Robinson ME, Fillingim RB, Moawad N, LeBrun EW, and Bishop MD. Painful intercourse is significantly associated with evoked pain perception and cognitive aspects of pain in women with pelvic pain. Sex Med 2015;3:14–23.

  14. Physical exercise and pelvic girdle pain in pregnancy

    DEFF Research Database (Denmark)

    Andersen, Linda Kahr; Backhausen, Mette; Hegaard, Hanne Kristine

    2015-01-01

    OBJECTIVE: Pelvic girdle pain is a frequent cause of sick leave among pregnant women in Denmark. Studies regarding prevention of pelvic girdle pain are sparse. The aim of this study was to examine the association between physical exercise and pelvic girdle pain in pregnancy. STUDY DESIGN: A nested...... case-control study within the Danish National Birth Cohort (n = 5304). METHODS: This study used self-reported data on pelvic girdle pain obtained from an interview six months after childbirth. Information on physical exercise was obtained from the pregnancy interview around gestational week 16....... The association was estimated using logistic regression analysis. RESULTS: Physical exercise in pregnancy was associated with decreased risk of overall pelvic girdle pain (OR = 0.87; 95% CI: 0.77-0.99, p = 0.028). Tests for trend indicated decreasing odds for pelvic girdle pain with increasing number of hours per...

  15. Objective Measures for Pregnancy Related Low Back and Pelvic Pain

    NARCIS (Netherlands)

    M. de Groot (Mirthe)

    2005-01-01

    textabstractPain in the lumbar spine and pelvic region is a frequent complication of pregnancy and delivery. The prevalence of pregnancy related low back and pelvic pain (PLBP) varies between 14.2 and 56%. In 6 to 15% the pain is so severe that it impedes daily life activities. The symptoms of PL

  16. Pregnancy Related Low Back and Pelvic Pain: a surgical approach

    NARCIS (Netherlands)

    C.M.A. Zwienen

    2005-01-01

    textabstractMore than half of all pregnant women experience low back and/or pelvic pain of whom one-third has severe complaints. In most cases the pelvic pain disap­pears within a few months after delivery, either spontaneously or after con­servative treatment. In a minority of patients the pain per

  17. Chronic pelvic pain (pelvic congestion syndrome)

    Science.gov (United States)

    ... RESIDENCY IR TRAINING PATHWAYS FELLOWSHIP ESIR INDEPENDENT RESIDENCY INTEGRATED RESIDENCY Advocacy and Outreach ADVOCACY AND OUTREACH SIRPAC CORPORATE RELATIONS AMBASSADORS MEETINGS AND EXHIBITS ADVERTISING GLOBAL OUTREACH INTERNATIONAL MEMBERSHIP RECOGNITION AND NETWORKING INTERNATIONAL ...

  18. 14A. Pelvic Pain and Headache in an Adolescent Female: A Case of Self-determination and Healthful Recovery

    OpenAIRE

    Daut, Alexys

    2013-01-01

    Focus Areas: Integrative Approaches to Care, Pediatrics, Alleviating Pain A 16-year-old previously healthy white female presented to our office with complaints of a 1-year history of chronic severe pelvic pain, leg pain, and severe daily headaches that were adversely affecting her school performance. Her leg and pelvic pain caused weakness and discomfort to the point that she used a walker or a wheelchair when she had to ambulate distances longer than 20 feet. She had been disenrolled from sc...

  19. Pelvic Inflammatory Disease (For Parents)

    Science.gov (United States)

    ... ovaries, and uterus, which can lead to chronic pelvic pain and serious damage to the reproductive system . PID ... the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had ...

  20. 子宫内膜异位症慢性盆腔痛中西医治疗研究进展%Research Advance in the Treatment of Endometriosis Chronic Pelvic Pain Treated with Integrated Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    李萍; 孙建萍

    2011-01-01

    @@ 慢性盆腔痛(chronic pelvic pain,CPP)是指非月经期的盆腔疼痛持续6个月以上,产生功能性障碍或需要药物或手术治疗[1]的病症.它是妇科常见病之一,其病因复杂,涉及多个系统,其中子宫内膜异位症是其因为之一.

  1. Clinical assessment of the impact of pelvic pain on women.

    Science.gov (United States)

    Chalmers, K Jane; Catley, Mark J; Evans, Susan F; Moseley, G Lorimer

    2017-03-01

    We aimed to develop a questionnaire that assesses the impact of pelvic pain on women, regardless of diagnosis, that has high utility, sound psychometric performance, easy scoring, and high reliability. Two studies, with 3 separate cohorts, were undertaken. Both studies were completed online. Studies included women with self-reported pelvic pain. Women were eligible to participate regardless of whether their pelvic pain was undiagnosed, self-diagnosed, or diagnosed by a clinician. Study 1 used a 3-round "patient-as-expert" Delphi technique. These rounds defined the 10 aspects of life with the self-reported greatest impact on the lives of women with pelvic pain, which formed the questionnaire. Study 2 used Rasch analysis to assess the psychometric properties of the resultant 10-item questionnaire. To assess its reliability, a subgroup completed the questionnaire 3 times over a 3-week period. In study 1, 443 women with pelvic pain participated. The resultant 10-item questionnaire consisted of 8 Likert questions and 2 supplemental, nonscored questions. In study 2, 1203 women with pelvic pain completed the questionnaire. Rasch analysis showed that the questionnaire targeted the pelvic pain population well, had appropriate Likert categories, constituted a unidimensional scale, and showed internal consistency. Twenty-seven women with pelvic pain completed the reliability trial. Test-retest reliability was high (intraclass correlation coefficient 0.91, P Pelvic Pain Impact Questionnaire assesses the life impact of pelvic pain. It uses patient-generated language, is easily administered and scored, has very strong psychometric properties, and it is suitable for research and clinical settings across primary, secondary, and tertiary care.

  2. Laparoscopy and ultrasound examination in women with acute pelvic pain

    DEFF Research Database (Denmark)

    Mikkelsen, A L; Felding, C

    1990-01-01

    The results of preoperative pelvic examination and eventual ultrasound examination were correlated with the laparoscopic findings in 316 women with acute pelvic pain. The predictive values of normal and abnormal findings at pelvic examination were 46.9 and 82.1%, respectively. 42.1% of the women...... had ultrasound examination performed. This investigation showed to be helpful especially in patients with normal findings at pelvic examination. If ultrasonic findings were abnormal the results at laparoscopy were also abnormal in 90%. On the contrary, normal findings at ultrasound examination did...... not exclude abnormal pelvic findings. The predictive value of normal results at ultrasound examination was 50.0%. This discrepancy between ultrasonic and pelvic findings can be explained by the size of the pelvic masses. Ultrasound examination is a valuable tool in the evaluation of patients with acute pelvic...

  3. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction.

    NARCIS (Netherlands)

    Pool-Goudzwaard, A.; Slieker ten Hove, M.C.; Vierhout, M.E.; Mulder, P.H.M. de; Pool, J.; Snijders, C.J.; Stoeckart, R.

    2005-01-01

    To assess the occurrence of pelvic floor dysfunction (PFD) in pregnancy- related low back and pelvic pain (PLBP) patients, a cross-sectional study was performed, comprising 77 subjects. Each subject underwent physical assessment, and filled in the Urogenital Distress Inventory completed with gynaeco

  4. Triple pelvic ring fixation in patients with severe pregnancy-related low back and pelvic pain.

    NARCIS (Netherlands)

    Zwienen, C.M. van; Bosch, E.W. van den; Snijders, C.J.; Vugt, A.B. van

    2004-01-01

    STUDY DESIGN: Single-group prospective follow-up study. OBJECTIVES: To assess the functional outcome of internal fixation of the pelvic ring in patients with severe pregnancy-related low back and pelvic pain (PLBP) in whom all other treatments failed. BACKGROUND DATA: More than half of all pregnant

  5. Low Back Pain and Pelvic Girdle Pain in Pregnancy.

    Science.gov (United States)

    Casagrande, Danielle; Gugala, Zbigniew; Clark, Shannon M; Lindsey, Ronald W

    2015-09-01

    Pregnancy has a profound effect on the human body, particularly the musculoskeletal system. Hormonal changes cause ligamentous joint laxity, weight gain, and a shift in the center of gravity that leads to lumbar spine hyperlordosis and anterior tilting of the pelvis. In addition, vascular changes may lead to compromised metabolic supply in the low back. The most common musculoskeletal complaints in pregnancy are low back pain and/or pelvic girdle pain. They can be diagnosed and differentiated from each other by history taking, clinical examination, provocative test maneuvers, and imaging. Management ranges from conservative and pharmacologic measures to surgical treatment. Depending on the situation, and given the unique challenges pregnancy places on the human body and the special consideration that must be given to the fetus, an orthopaedic surgeon and the obstetrician may have to develop a plan of care together regarding labor and delivery or when surgical interventions are indicated.

  6. Age at menarche and pregnancy-related pelvic pain

    DEFF Research Database (Denmark)

    Kirkeby, Mette J; Biering, Karin; Olsen, Jørn

    2013-01-01

    AIM: Menarcheal age is a predictor of several complications related to pregnancy and diseases later in life. We aimed to study if menarcheal age is a risk factor for pregnancy-related pelvic pain. MATERIAL AND METHODS: A nested case-control study was conducted within the Danish National Birth...... Cohort, a cohort of pregnant women, recruited during 1996-2002, and their children. In the second trimester of pregnancy the women provided information about age at menarche and potential confounders. Selection of cases (n = 2227) was based on self-reported pelvic pain during pregnancy from an interview...... done 6 months post-partum. The controls (n = 2588) were randomly selected among women who did not report pelvic pain. We used logistic regression analysis to calculate odds ratios (OR) for pregnancy-related pelvic pain according to age at menarche. RESULTS: In the cohort, 18.5% of all pregnant women...

  7. 腹腔镜诊治子宫内膜异位症相关性慢性盆腔痛的临床研究%Combined Treatment of Endometriosis-Related Chronic Pelvic Pain with Laparoscopy

    Institute of Scientific and Technical Information of China (English)

    胡碧洪; 李莉芳; 王帅; 黄浩

    2011-01-01

    Objective: To evaluate the diagnosis and treatment of endometriosis-related chronic pelvic pain (EMT-related CPP) by laparoscope. Methods:The relationship between site, stage of endometriosis (EMT) and the effect of laparoscope, as well as the pain degree in 86 cases of endometriosis-related chronic pelvic pain patients were retrospectively analyzed. Results;The remission rate of EMT-related CPP by laparoscopic surgery was 90. 7%. Ⅰ degree of pain in n stage by rAFS was 71.4%, more than II degree of pain in 1 and IV stage was 95. 5%. I and U degree of pain in simple ovarian chocolate cysts and (or) pelvic peritoneum EMT pain was 88.4%. II to 1 degree of pain in EMT patients with ectopic lesions invasion of uterosacral ligaments, Douglas pouch, posterior wall of uterus and deep infiltrating was 93. 0%. Conclusions;The main causes of EMT-related CPP are invasion of uetrosacral ligament, Douglas pouch, posterior wall of uterus and deep infiltrating in pelvic endometriosis. Laparoscopy can confirm the diagnosis and treat EMT-related CPP, the therapy is satisfactory.%目的:评价腹腔镜在子宫内膜异位症(EMT)相关性慢性盆腔痛诊断及治疗中的应用价值.方法:回顾性分析86例EMT相关性慢性盆腔痛患者行腹腔镜手术治疗的效果及疼痛程度与EMT分期及部位的关系.结果:腹腔镜手术治疗EMT相关性慢性盆腔痛疼痛缓解率90.7%.rAFS分期Ⅱ期患者Ⅰ度疼痛占71.4%,Ⅲ期和Ⅳ期患者Ⅱ度以上疼痛占95.5%.单纯卵巢巧克力囊肿和(或)盆腔腹膜EMT患者Ⅰ、Ⅱ度疼痛占88.4%,病灶侵犯宫骶韧带、直肠子宫陷凹和子宫后壁以及深部浸润的EMT患者Ⅱ、Ⅲ度疼痛占93.0%.结论:盆腔子宫内膜异位病灶侵犯宫骶韧带、直肠子宫陷凹、子宫后壁和深部浸润是引起EMT相关性慢性盆腔痛的主要原因,腹腔镜能明确诊断及治疗EMT相关性慢性盆腔痛,治疗效果满意.

  8. Pelvic Inflammatory Disease (For Teens)

    Science.gov (United States)

    ... lead to internal scarring that might cause ongoing pelvic pain, infertility, or an ectopic pregnancy. What Are the ... the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had ...

  9. Analysis of the Traditional Chinese Medicine Treatment Effect of the Gynecologic Chronic Pelvic Pain Syndrome%浅析中医治疗妇科慢性盆腔疼痛症临床效果

    Institute of Scientific and Technical Information of China (English)

    信长华

    2015-01-01

    Objective To analyze the traditional Chinese medicine treatment experience of the gynecologic chronic pelvic pain syndrome. Methods Selected 80 cases of patients with chronic pelvic pain syndrome in our hospital from January 2014 to December 2014,randomly divided into western medicine group and Chinese medicine group. 40 cases in western medicine group with conventional western medicine treatment,the others in treatment group by traditional Chinese medicine formula,compared the clinical efficacies of two groups of patients after a period of treatment. Results The effectiveness of Chinese medicine treatment group was 90%. The effectiveness of western medicine treatment group was 80%. There was efficient difference obvious between the two groups. It was statistical y significant,P<0.05. Conclusion The traditional Chinese medicine treatment of the gynecologic chronic pelvic pain syndrome has the very high clinical value,with remarkable effct.%目的:分析总结中医治疗妇科慢性盆腔疼痛症的临床经验。方法选取我院2014年1~12月收治的80例慢性盆腔疼痛症患者,将其随机分为西医组和中医组,每组患者各40例。西医组患者采取常规西医方法治疗,中医组患者采用中药方剂治疗,一个疗程后,对比分析两组患者的临床疗效。结果中医组治疗有效率是90%,西医组治疗有效率是80%。两组患者的治疗有效率差异有统计学意义,P<0.05。结论中医治疗妇科慢性盆腔疼痛效果显著。

  10. Observation on Chronic Pelvic Pain Syndrome (186 cases) Treated by Capsule for Relieving Blood Stasis%前列通淤胶囊治疗慢性盆腔疼痛综合征186例观察

    Institute of Scientific and Technical Information of China (English)

    孙中明; 鲍严钟

    2003-01-01

    @@ 慢性前列腺炎是影响成年男性生活质量的常见病,估计全球男性的发病率为9%~14%[1].据美国国家卫生研究院(NIH)分类标准(1995年),慢性前列腺炎分为慢性细菌性前列腺炎(Ⅱ类),慢性非细菌性前列腺炎/慢性盆腔疼痛综合征(chronic pelvic pain syndrome,CPPS)(Ⅲ类)以及无症状炎症性前列腺炎(Ⅳ类)三类[2].

  11. Extracorporeal Shock-Wave Therapy in Treating Chronic Pelvic Pain Syndrome in Males%体外冲击波治疗在男性慢性骨盆疼痛综合征中的应用进展

    Institute of Scientific and Technical Information of China (English)

    童亮; 吕军

    2012-01-01

    Category Ⅲ prostatitis is also called chronic pelvic pain syndrome ( CPPS ), accounting for about 90% of chronic prostatitis, and studies have suggested that its age range was from 20 to 83 years, and its incidence is between 4% to 16%. The clinical manifestations of CPPS include long - term and reduplicated pelvic region pain or discomfort, and it can last for more than 3 months. Furthermore, it may be associated with some degrees of micturition symptoms and sexual dysfunction, which seriously reduced the quality of life of the patients. At present, the etiology and pathogenesis of CPPS are unclear, and there has been no standard treatments. Extracorporeal shock - wave therapy has been used clinically in treating CPPS in males and has received good clinical effects.%Ⅲ型前列腺炎又称为慢性骨盆疼痛综合征(CPPS),约占慢性前列腺炎的90%,20~83岁男性均可发病,发病率为4%~16%.临床表现为长期、反复的骨盆区域疼痛或不适,持续时间超过3个月,可伴有不同程度的排尿症状和性功能障碍,严重影响患者的生活质量.目前,CPPS的发病机制和病因尚不明确,尚没有标准的治疗方法.临床运用体外冲击波治疗男性CPPS,收到良好的临床效果.

  12. Anatomical distribution of pelvic deep infiltrating endometriosis and its relationship with pain symptoms

    Institute of Scientific and Technical Information of China (English)

    DAI Yi; LENG Jin-hua; LANG Jing-he; LI Xiao-yan; ZHANG Jun-ji

    2012-01-01

    Background Endometriosis is a controversial and enigmatic disease.Deep infiltrating endometriosis (DIE) is responsible for painful symptoms and is the least understood type of endometriosis.Little work has been devoted to define the location of DIE lesions and its relationships with pain.The aim of the study was to investigate the relationship between the anatomical distribution of DIE lesions and pain symptoms.Methods Clinical data from 354 patients between May 2003 and December 2007 with laparoscopically diagnosed endometriosis were collected including 177 DIE patients and 177 non-DIE patients.The pain symptoms,including dysmenorrhea (DM),chronic pelvic pain (CPP,defined as intermittent or permanent pelvic pain,not related to the menstruation and longer than 6 months),deep dyspareunia (pelvic pain at intercourse) and dyschezia (pelvic pain with defecation),were recorded for every patient before operation.Endometriotic lesions were recorded by their anatomical distributions,the depth of infiltration and lesion colors.And the relationship between the anatomical distribution of DIE lesions and pain symptoms was analyzed.Pearson's chi-square test or Fisher's exact test,one-way analysis of variance (ANOVA) and linear regression and binary Logistic regression were used for statistical analysis.Results The duration ((13.79±3.94) years) of pain suffering in DIE patients was much longer than that of non-DIE patients (P <0.01).In DIE patients,60.7% of the uterosacral ligament (USL) nodules were bilateral (P <0.01); 44.6% of the cul-de-sacs were completely blocked.Rectum invasion was observed in 19.9% of DIE patients (P=0.03); pelvic adhesion was also more common.Up to 98.41% of the deep infiltrative lesions were located in the posterior pelvic compartment.DIE lesions were also found in bladder (1.58%),USL (67.08%),cul-de-sac (12.02%),recto-vaginal septum (12.66%),rectum and rectosigmoid junction (2.85%) and ureter (3.80%).The odds ratio of USL

  13. Pelvic pain in endometriosis: painkillers or sport to alleviate symptoms?

    Science.gov (United States)

    Koppan, A; Hamori, J; Vranics, I; Garai, J; Kriszbacher, I; Bodis, J; Rebek-Nagy, G; Koppan, M

    2010-06-01

    To assess potential individual factors influencing quality of life and pain scores of patients suffering from histologically confirmed endometriosis. Study using a questionnaire among patients of reproductive age undergoing laparoscopy with a presumed diagnosis of endometriosis. Details of fertility, previous treatments and quality of life, sexual activity, as well as linear pain scores for several symptoms, were recorded. Details of intraoperative findings were also collected and only those data were used where endometriosis was intraoperatively and histologically proven. A questionnaire before surgery gathered information from women on the following groups of variables: age, marital status, education, reproductive and medical history including previous pregnancies and parity, knowledge of accompanying pelvic disorders, regular sport activity, as well as general quality of life estimates including self-image. Pelvic pain was scored using a visual analogue scale. Data were statistically evaluated. Eighty-one patients complaining about persistent pelvic pain were later intraoperatively and histologically proven to have endometriosis. Thirty-one of them (38.2%) reported regular sport as part of their daily life schedule while 50 of them (61.8%) performed no physical activity at all. Fourteen patients among regular exercisers and 33 patients among those without physical activity reported the effectiveness of painkillers for pelvic pain, corresponding to 45.1% and 66% of these subgroups, respectively (difference statistically significant, ppainkillers might be less effective among endometriosis patients performing regular daily sport activities, and, thus it might impose them to an unnecessary burden of possible side-effects.

  14. 慢性盆腔炎疼痛与焦虑状况相关性分析及护理%Correlation Analysis and Nursing of the Pain and Anxiety of Chronic Pelvic Inflammatory Disease

    Institute of Scientific and Technical Information of China (English)

    何锋云; 刘瑶; 陈少英

    2014-01-01

    Objective To investigate the correlation analysis and nursing of the pain and anxiety of chronic pelvic inflammatory disease. Methods The pain level of 87 cases of patients with chronic pelvic inflammatory disease treated in our hospital from Jan-uary, 2011 to October, 2013 was evaluated by visual analogue scale, the anxiety of the patients was evaluated by Hamilton Anxiety Scale, and the correlation of these two groups of scores was compared. Results The pain level of the patients was evaluated by vi-sual analogue scale, patients with the score below 4 points accounted for 54.02%, those with the score between 4 points to 6 points accounted for 35.63%, and those with the score over 6 points accounted for 10.35%. The anxiety state of the patients was evaluat-ed by Hamilton Anxiety Scale, patients whose score more than 30 points accounted for 8.05%,those whose score between 29 points to 14 points accounted for 28.73%,and those whose score between 13 points to 7 points accounted for 35.63%, those whose score below 7 points accounted for 27.59%. The correlation between pain and anxiety conditions was analyzed. The average anxi-ety score of patients whose pain score below 4 points was (8.51±1.92)points, and that of the patients whose pain score between 4 points to 6 points was (14.27±1.83) points, that of the patients whose pain score more than 6 points was (20.62±2.57) points, which showed that there was a positive correlation between pain and anxiety conditions (P6分患者占总患者数的10.35%。根据汉密尔顿焦虑量表对患者的焦虑状况进行评分,得分>30分患者占总患者数的8.05%,得分29分~14分患者占总患者数的28.73%,得分为13分~7分患者占总患者数的35.63%,得分6分患者的焦虑平均得分(20.62±2.57)分。疼痛与焦虑状况呈现正相关(P<0.05)。结论慢性盆腔炎患者的疼痛和焦虑状况呈现相关性,疼痛强患者的焦虑状况也随之升高,在临床护理过程中应加

  15. 关于盆腔疼痛与妇科疾病的探讨%Discussion on pelvic pain and gynecological diseases

    Institute of Scientific and Technical Information of China (English)

    黄阳玲

    2015-01-01

    Chronic pelvic pain (Chronic Pelvie Pain, CPP) occurred in the pelvic cavity within the scope of the chronic non periodic, recurrent attacks of over six for 6 months, causing pain symptoms of dysfunction or drug oroperation treatment, is a common gynecological disorder. In order tofind the way to relieve women pelvic pain, this paper discusses the causes of chronic pelvic pain, pelvic pain and analyzes the relationship between thedisease of Department of gynaecology, thus draws the conclusion:chronic pelvic pain is very common, but the cause of chronic pelvic pain in women is very complex, involving many gynecological diseases, should be targeted to patients with chronic the specific causes of pelvic pain fortargeted prevention and control.%慢性盆腔疼痛(Chronic Pelvie Pain,CPP)是发生在盆腔范围内的慢性无周期性的、反复发作超六6个月,产生功能障碍或需要药物或手术治疗的疼痛症状,是一种常见的妇科症状。为了找到缓解女性朋友盆腔疼痛的方法,本文探讨了慢性盆腔疼痛的病因,分析了盆腔疼痛与妇科疾病的关系,从而得出结论:慢性盆腔疼痛十分常见,而引起女性慢性盆腔疼痛的原因也十分复杂,涉及妇科中的诸多疾病,应针对具体病因对慢性盆腔疼痛患者进行有针对性的防治。

  16. Acetaminophen for Chronic Pain

    DEFF Research Database (Denmark)

    Ennis, Zandra Nymand; Dideriksen, Dorthe; Vaegter, Henrik Bjarke;

    2016-01-01

    strategies for acetaminophen use in chronic pain in both Embase and PubMed, 1,551 hits were obtained. Following cross-reference searches of both trials and 38 reviews, seven studies comparing acetaminophen in continuous dosing regimens of more than two weeks with placebo were included. The review...

  17. Pregnancy-related pelvic girdle pain: an update.

    Science.gov (United States)

    Kanakaris, Nikolaos K; Roberts, Craig S; Giannoudis, Peter V

    2011-02-15

    A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. This syndrome refers to a musculoskeletal type of persistent pain localised at the anterior and/or posterior aspect of the pelvic ring. The pain may radiate across the hip joint and the thigh bones. The symptoms may begin either during the first trimester of pregnancy, at labour or even during the postpartum period. The physiological processes characterising this clinical entity remain obscure. In this review, the definition and epidemiology, as well as a proposed diagnostic algorithm and treatment options, are presented. Ongoing research is desirable to establish clear management strategies that are based on the pathophysiologic mechanisms responsible for the escalation of the syndrome's symptoms to a fraction of the population of pregnant women.

  18. [Chronic pain in geriatrics].

    Science.gov (United States)

    Kennes, B

    2001-06-01

    Pain is frequent in communicative or no-communicative, ambulatory, institutionalized or hospitalized veterans. It is associated with severe comorbidity so much more than chronic pain could be neglected and expressed of atypical manner or masked by the absence of classical symptoms in particular in case of dementia or of sensory disorders. Pain detection by clinic examination or by pain assessment's methods and adequate approach by pharmacological and non pharmacological therapies are essential for correct pain management. On pharmacological plan, the strategy of the O.M.S. landings is applicable owing to a more particular attention to secondary effects and drugs interactions. AINS must be manipulated with prudence. There are no reasons to exclude opioides from the therapeutic arsenal but with a reduction of the starting doses, a regular adaptation and a very attentive survey. In drugs of landing 2, tramadol reveals itself as efficient and better tolerated as the codeine and dextropropoxyphene has to be to avoid. The obtaining of a satisfactory result depends on a regular assessment of the pain in a context of polydisciplinar approach (physicians, nurses, paramedicals, other care givers).

  19. Pelvic Inflammatory Disease

    Science.gov (United States)

    ... a sexually active woman with lower abdominal pain. Pregnancy (including ectopic pregnancy) must also be excluded, as PID can occur ... include Tubo-ovarian abscess (TOA) Tubal factor infertility Ectopic pregnancy Chronic pelvic pain Recurrent episodes of PID and ...

  20. Chronic pelvic ischemia: etiology, pathogenesis, clinical presentation and management.

    Science.gov (United States)

    Kapoor, H; Gupta, E; Sood, A

    2014-06-01

    Overactive bladder (OAB) and bladder pain syndrome (BPS) although common, are vaguely defined and difficult to diagnose and manage etiologies of storage-type lower urinary tract symptoms (LUTS). The lack of optimal management options is a direct consequence of deficient understanding of the pathophysiologic mechanisms underlying these conditions. These conditions are especially prevalent in females, and cumulative contemporary epidemiological, clinical and laboratory evidence implicates ischemia as one of the key players in the pathophysiologic foundation of both these disorders. Taken together they make up "the" diagnostic as well as therapeutic black-hole in urologic practice. Much akin to chronic ischemic heart disease, chronic ischemia-reperfusion has been shown to cause degenerative changes at cellular and subcellular level in the bladder mucosa, smooth muscle fibers, and vesical neural and microvascular structures leading to a hypersensitive, hyperactive bladder initially, which with time invariably progresses into a failed, fibrotic and pressurized bladder. Diagnosis and management of these diseases are currently symptom focused and remains a source of much frustration. Consideration of role of ischemia connotates hope and could lead to a paradigm shift in the management of these patients with a completely new therapeutic armamentarium attacking the pathology itself. The aim of the current review is to provide a clinical thought perspective on the etiology/pathophysiology of chronic pelvic ischemia and its role as a precursor to the aforementioned conditions, and shed some light upon the potential management strategies to consider.

  1. Tratamiento farmacológico en el dolor pélvico urogenital crónico: revisión de la evidencia disponible Drug therapy for chronic pelvic urogenital pain: a review of available evidence

    Directory of Open Access Journals (Sweden)

    S. Fernández

    2011-02-01

    Full Text Available La falta de consenso en las definiciones y de conocimiento de la fisiopatología del dolor crónico del aparato genitourinario son algunos de los factores que explican la multitud de fármacos ensayados para su tratamiento y la carencia de terapias definitivas. Existen muchas patologías orgánicas y funcionales de la vejiga urinaria, el tracto reproductor y la musculatura del suelo pélvico capaces de generar dolor. En esta revisión nos centraremos en los desórdenes funcionales en los que el dolor no puede ser explicado por una patología estructural demostrable. Las estrategias terapéuticas actuales van desde la acupuntura y la terapia física pasando por la terapia psicológica, los fármacos sistémicos y locales, los bloqueos nerviosos y la neuromodulación de raíces sacras. Centrándonos en la terapia farmacológica es llamativa la multitud de fármacos ensayados en el tratamiento de estas entidades. Muchos estudios clínicos fracasan en su intento de demostrar la eficacia de los tratamientos actualmente en uso quizás porque muchas terapias son efectivas en subgrupos de pacientes. El esfuerzo debería centrarse pues en identificar a esos subgrupos de pacientes respondedores a determinadas terapias y orientar el tratamiento en este sentido. Por otro lado, teniendo en cuenta que en el dolor pélvico y urogenital crónico pueden coexistir diferentes mecanismos patogénicos del dolor, va a ser necesaria la combinación de agentes farmacológicos con diferentes dianas terapéuticas y la asociación de diferentes modalidades terapéuticas para obtener un resultado óptimo.Lack of consensus in definitions and scarce knowledge about urogenital system chronic pain physiopathology are some factors that explain the use of dozens of drugs, tested for its treatment and the lack of definitive therapy. There are many urinary bladder, reproductive tract and pelvic floor organic and functional pathologies that may be origin of pain. In this review we

  2. Acupuncture for pelvic and back pain in pregnancy: a systematic review.

    Science.gov (United States)

    Ee, Carolyn C; Manheimer, Eric; Pirotta, Marie V; White, Adrian R

    2008-03-01

    The objective of our study was to review the effectiveness of needle acupuncture in treating the common and disabling problem of pelvic and back pain in pregnancy. Two small trials on mixed pelvic/back pain and 1 large high-quality trial on pelvic pain met the inclusion criteria. Acupuncture, as an adjunct to standard treatment, was superior to standard treatment alone and physiotherapy in relieving mixed pelvic/back pain. Women with well-defined pelvic pain had greater relief of pain with a combination of acupuncture and standard treatment, compared to standard treatment alone or stabilizing exercises and standard treatment. We used a narrative synthesis due to significant clinical heterogeneity between trials. Few and minor adverse events were reported. We conclude that limited evidence supports acupuncture use in treating pregnancy-related pelvic and back pain. Additional high-quality trials are needed to test the existing promising evidence for this relatively safe and popular complementary therapy.

  3. Pain perception and modulation in acute and chronic pain states

    NARCIS (Netherlands)

    Oudejans, L.C.J.

    2016-01-01

    This thesis describes the evaluation of pain perception in acute and chronic pain patients and the strength of the endogenous pain modulation system in chronic pain patients. Additionally, pain phenotypes are determined in patients with chronic pain. The ability of patients with acute pain after sur

  4. Qualidade de vida de mulheres com dor pélvica crônica: um estudo de corte transversal analítico Quality of life of women with chronic pelvic pain: a cross-sectional analytical study

    Directory of Open Access Journals (Sweden)

    Priscilla Rodrigues Barcelos

    2010-05-01

    Full Text Available OBJETIVOS: comparar a qualidade de vida (QV de mulheres com e sem dor pélvica crônica (DPC e investigar os fatores associados à QV de mulheres com DPC. MÉTODOS: conduziu-se estudo de corte transversal, incluindo 30 mulheres com DPC e 20 sem DPC. Foram avaliadas características sociodemográficas e clínicas. A QV foi investigada pelo questionário SF-36, que apresenta oito domínios: capacidade funcional, aspectos físicos, dor, estado geral de saúde, vitalidade, aspectos sociais, aspectos emocionais e saúde mental. Esses domínios podem ser resumidos em dois sumários: sumário do componente físico (SCF e sumário do componente mental (SCM. A intensidade da dor foi pesquisada, aplicando-se a escala visual analógica. Utilizou-se análise de regressão linear para comparação dos escores de QV entre mulheres com e sem DPC e para identificação dos fatores associados à QV de mulheres com DPC. RESULTADOS: a média de idade das mulheres com e sem DPC foi de 35,2±7,5 e de 36±9,3 anos (p=0,77, respectivamente. Mulheres com DPC apresentaram menor renda familiar mensal (p=0,04 e maior prevalência de dismenorreia (87 versus 40%; pPURPOSE: to compare the quality of life (QL of women with and without chronic pelvic pain (CPP and to investigate the factors associated with QL in women with CPP. METHODS: a cross-sectional study was conducted on 30 women with CPP and 20 women without CPP. Sociodemographic and clinical characteristics were evaluated. QL was investigated by applying the SF-36 questionnaire, which contains eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. These domains can be summarized into two groups: physical component summary (PCS and mental component summary (MCS. Pain intensity was investigated by applying the visual analogue scale. Linear regression analysis was used to compare QL scores between women with and without CPP and to

  5. Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs.

    Science.gov (United States)

    Gutke, Annelie; Hansson, Eva Roos; Zetherström, Gunilla; Ostgaard, Hans Christian

    2009-07-01

    The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.

  6. Clinical Study on Abdominal Acupuncture plus Herbal Medicine for Chronic Pelvic Pain Due to Qi Stagnation and Blood Stasis%腹针配合中药治疗气滞血瘀型慢性盆腔痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋玉娟; 张殿全; 苏丹萍

    2015-01-01

    Objective To observe the clinical efficacy of abdominal acupuncture plus herbal medicine in treating chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.Method Sixty patients with chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture plus herbal medicine, while the control group was by herbal medicine alone. After 3 menstrual cycles, the Visual Analogue Scale (VAS) for abdominal pain and McCormack scale were observed.Result After intervention, the abdominal VAS score and McCormack score were changed significantly in both groups (P<0.01,P<0.05). After intervention, there were significant differences in comparing the VAS score and McCormack score between the two groups (P<0.01).Conclusion Abdominal acupuncture plus herbal medicine can reduce chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.%目的:观察腹针配合中药治疗盆腔炎性疾病后气滞血瘀型慢性盆腔痛的临床疗效。方法将60例盆腔炎性疾病后气滞血瘀型慢性盆腔痛患者随机分为治疗组和对照组,每组30例。治疗组采用腹针配合中药治疗,对照组采用单纯中药治疗。治疗3个月经周期后,观察两组治疗前后腹痛VAS评分及McCormack量表评分变化。结果两组治疗后腹痛VAS评分及McCormack量表评分与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后腹痛VAS评分及McCormack量表评分与对照组比较,差异均具有统计学意义(P<0.01)。结论腹针配合中药能够减轻盆腔炎性疾病后气滞血瘀型慢性盆腔痛。

  7. Pelvic girdle pain and low back pain in pregnancy: a review.

    Science.gov (United States)

    Vermani, Era; Mittal, Rajnish; Weeks, Andrew

    2010-01-01

    Pregnancy-related pelvic girdle pain (PGP) and pregnancy-related low back pain (PLBP) are common problems with significant physical, psychological, and socioeconomic implications. There are several management options that are underutilized because of lack of comprehensive knowledge by health-care professionals and fear of harmful effects of treatment on the developing fetus. Interventions such as patient education, the use of pelvic belts, acupuncture, and aquatic and tailored postpartum exercises can be of some benefit to these patients. This article will focus on the diagnosis and management of PGP and PLBP, with discussion of terminology, epidemiology, risk factors, pathophysiology, and prognosis.

  8. Tai chi and chronic pain.

    Science.gov (United States)

    Peng, Philip W H

    2012-01-01

    In the last 2 decades, a growing body of research aimed at investigating the health benefits of Tai Chi in various chronic health conditions has been recognized in the literature. This article reviewed the history, the philosophy, and the evidence for the role of Tai Chi in a few selected chronic pain conditions. The ancient health art of Tai Chi contributes to chronic pain management in 3 major areas: adaptive exercise, mind-body interaction, and meditation. Trials examining the health benefit of Tai Chi in chronic pain conditions are mostly low quality. Only 5 pain conditions were reviewed: osteoarthritis, fibromyalgia, rheumatoid arthritis, low back pain, and headache. Of these, Tai Chi seems to be an effective intervention in osteoarthritis, low back pain, and fibromyalgia. The limitations of the Tai Chi study design and suggestions for the direction of future research are also discussed.

  9. Management of chronic visceral pain

    DEFF Research Database (Denmark)

    Olesen, Anne E; Farmer, Adam D; Olesen, Søren S

    2016-01-01

    ' symptoms, adopting an empathic approach and taking time to educate patients. To optimize treatment and outcomes in chronic visceral pain we need to move away from approaches exclusively based on dealing with peripheral nociceptive input toward more holistic strategies, taking into account alterations......Despite marked differences in underlying pathophysiology, the current management of visceral pain largely follows the guidelines derived from the somatic pain literature. The effective management of patients with chronic visceral pain should be multifaceted, including both pharmacological...... in central pain processing....

  10. [Pharmacological treatment of chronic pain].

    Science.gov (United States)

    Willimann, Patrick

    2011-09-01

    The pharmacological treatment of chronic pain differs from acute pain management. In chronic non-cancer pain patients pharmacological treatment is only one element of an interdisciplinary approach. Not pain reduction only but gain in physical and social functioning is mandatory for continuation of therapy. The developpement of a strategy is the most important and difficult step toward an individual and sustained pharmacological pain treatment. Simple practical guidelines can help to find an individual therapeutic straight. Outcome parameters have to be determined. Check-ups for discontinuation of the therapy have to be done periodically. Exact documentation of effect and side effects prevents ungrateful and potential dangerous treatments. The WHO ladder remains the cornerstone of pharmacological pain treatment. Further analgesics as antidepressants and anticonvulsants are important in treatment of neuropathic or mixed pain states. Special considerations have to be done in opioid treatment of non-cancer pain regarding the lack of evidence in long term outcome and possible side effects and risks.

  11. Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

    OpenAIRE

    2015-01-01

    Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold hea...

  12. [Neurosurgical treatment of chronic pain].

    Science.gov (United States)

    Fontaine, D; Blond, S; Mertens, P; Lanteri-Minet, M

    2015-02-01

    Neurosurgical treatment of pain used two kind of techniques: 1) Lesional techniques interrupt the transmission of nociceptive neural input by lesionning the nociceptive pathways (drezotomy, cordotomy, tractotomy…). They are indicated to treat morphine-resistant cancer pain and few cases of selected neuropathic pain. 2) Neuromodulation techniques try to decrease pain by reinforcing inhibitory and/or to limit activatory mechanisms. Chronic electrical stimulation of the nervous system (peripheral nerve stimulation, spinal cord stimulation, motor cortex stimulation…) is used to treat chronic neuropathic pain. Intrathecal infusion of analgesics (morphine, ziconotide…), using implantable pumps, allows to increase their efficacy and to reduce their side effects. These techniques can improve, sometimes dramatically, selected patients with severe and chronic pain, refractory to all other treatments. The quality of the analgesic outcome depends on the relevance of the indications.

  13. Multimodal Treatment of Chronic Pain.

    Science.gov (United States)

    Dale, Rebecca; Stacey, Brett

    2016-01-01

    Most patients with chronic pain receive multimodal treatment. There is scant literature to guide us, but when approaching combination pharmacotherapy, the practitioner and patient must weigh the benefits with the side effects; many medications have modest effect yet carry significant side effects that can be additive. Chronic pain often leads to depression, anxiety, and deconditioning, which are targets for treatment. Structured interdisciplinary programs are beneficial but costly. Interventions have their place in the treatment of chronic pain and should be a part of a multidisciplinary treatment plan. Further research is needed to validate many common combination treatments.

  14. Chronic perineal pain: current pathophysiological aspects, diagnostic approaches and treatment.

    Science.gov (United States)

    Andromanakos, Nikolaos P; Kouraklis, Grigorios; Alkiviadis, Kostakis

    2011-01-01

    Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. A variety of neuromuscular disorders of the pelvic floor lead to the different pathological conditions such as anorectal incontinence, urinary incontinence and constipation of obstructed defecation, sexual dysfunction and pain syndromes. The most common functional disorders of the pelvic floor muscles, accompanied by perineal pain are levator ani syndrome, proctalgia fugax, myofascial syndrome and coccygodynia. In the diagnosis of these syndromes, contributing to a thorough history, physical examination, selected specialized investigations and the exclusion of organic disease with proctalgia is carried out. Accurate diagnosis of the syndromes helps in choosing an appropriate treatment and in avoiding unnecessary and ineffective surgical procedures, which often are performed in an attempt to alleviate the patient's symptoms.

  15. Neurovascular Unit in Chronic Pain

    Science.gov (United States)

    Radu, Beatrice Mihaela; Bramanti, Placido; Osculati, Francesco; Flonta, Maria-Luisa; Radu, Mihai; Bertini, Giuseppe; Fabene, Paolo Francesco

    2013-01-01

    Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU) has been recently proposed. In particular, the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB), two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment. PMID:23840097

  16. Neurovascular Unit in Chronic Pain

    Directory of Open Access Journals (Sweden)

    Beatrice Mihaela Radu

    2013-01-01

    Full Text Available Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU has been recently proposed. In particular, the blood-brain barrier (BBB and blood-spinal cord barrier (BSCB, two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment.

  17. Chronic pain management: nonpharmacological therapies for chronic pain.

    Science.gov (United States)

    Chang, Ku-Lang; Fillingim, Roger; Hurley, Robert W; Schmidt, Siegfried

    2015-05-01

    Nonpharmacologic therapies have become a vital part of managing chronic pain (CP). Although these can be used as stand-alone therapies, nonpharmacologic treatments often are used to augment and complement pharmacologic treatments (ie, multimodal therapy). Nonpharmacologic approaches can be classified as behavioral, cognitive, integrative, and physical therapies. Core principles in developing a treatment plan are explaining the nature of the CP condition, setting appropriate goals, and developing a comprehensive treatment approach and plan for adherence. Clinicians should become familiar with these interventions so that they can offer patients flexibility in the pain management approach. Effective noninvasive treatment modalities for CP include behavioral therapy for short-term pain relief; cognitive behavioral therapy for reducing long-term pain and disability; hypnosis as adjunctive therapy; guided imagery, diaphragmatic breathing, and muscle relaxation, especially for cancer-related pain; mindfulness-based stress reduction for patients with chronic low back pain; acupuncture for multiple pain conditions; combination manipulation, manual therapy, endurance exercise, stretching, and strengthening for chronic neck pain; animal-assisted therapy; and S-adenosyl-L-methionine for joint pain. Guidelines for use of these treatment modalities are based on expert panel recommendations in combination with data from randomized controlled trials.

  18. Efficacy of biofeedback and electrical stimulation combined with drugs for chronic prostatitis/chronic pelvic pain syndrome%生物反馈电刺激联合药物治疗慢性前列腺炎/慢性骨盆疼痛综合征的临床研究

    Institute of Scientific and Technical Information of China (English)

    唐荣; 安瑞华

    2012-01-01

    目的 探讨生物反馈电刺激联合药物治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的效果.方法 符合入选标准的患者随机分为药物组(A组)、药物+生物反馈电刺激组(B组),每组25例,另单设一单纯药物治疗无效组(C组)25例.B、C两组均采用生物反馈电刺激治疗仪治疗,B组加常规药物治疗,A组应用常规药物治疗.结果 A组和B组治疗后患者的临床症状较治疗前均有显著改善(P<0.05);且B组优于A组.C组治疗后的临床症状亦较治疗前有显著改善(P<0.05).结论 生物反馈电刺激治疗能明显改善慢性前列腺炎/慢性盆底疼痛综合征患者的临床症状及性功能,且能改善药物治疗无效的顽固性前列腺炎症状.%Objective To investigate the effect of biofeedback and electrical stimulation combined with drugs on chronic prostatitis/chronic pelvic pain syndrome ( CP/CPPS). Methods Seventy five eligible patients were randomly divided into 3 groups (each 25 patients) ; group A received routine drugs, group B received biofeedback and electrical stimulation combined with ' routine drugs. Patients in group C were treated ineffectively with routine drugs,and received biofeedback and electrical stimulation therapy only. Results The clinical symptoms of patients in group A and group B after treatment were both significantly improved than before treatment (P <0.05), clinical symptoms of patients in group B were better than in group A. The clinical symptoms of patients in group C after treatment compared with that before treatment were significantly improved (P < 0. 05). Conclusion Biofeedback electrical stimulation therapy may significantly improve the clinical symptoms and sexual function of patients with chronic prostatitis/chronic pelvic pain syndrome. It also can improve the clinical symptoms of patients with refractory prostatitis who were treated ineffectively with routine drugs.

  19. Comparison of National Institutes of Health-Chronic Prostatitis Symptom Index with International Index of Erectile Function 5 in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Large Cross-Sectional Study in China

    Directory of Open Access Journals (Sweden)

    Jingjing Gao

    2015-01-01

    Full Text Available The purpose of the study is to evaluate the relationship between NIH-CPSI and IIEF-5 in Chinese men with CP/CPPS. A large cross-sectional and multicenter survey was conducted from July 2012 to January 2014. Men were recruited from urology clinics which were located at the five cities in China. All men participated in the survey by completing a verbal questionnaire (consisted of sociodemographics, past medical history, sexual history, and self-estimated scales. The results showed that 1,280 men completed the survey. Based on the CP/CPPS definition, a total of 801 men were diagnosed as having CP/CPPS. Men with CP/CPPS reported higher scores of NIH-CPSI and lower scores of IIEF-5 than men without CP/CPPS. NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. The total scores of NIH-CPSI were significantly more strongly correlated with question 5 than other questions of IIEF-5. The total scores of IIEF-5 were significantly more strongly correlated with pain symptoms scores of NIH-CPSI. Strongest correlation was found between QoL impact and question 5 of IIEF-5. The findings suggested that NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. Strongest correlation was found between QoL impact and question 5 of IIEF-5.

  20. Comparison of National Institutes of Health-Chronic Prostatitis Symptom Index with International Index of Erectile Function 5 in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Large Cross-Sectional Study in China

    Science.gov (United States)

    Gao, Jingjing; Gao, Pan; Hao, Zongyao; Zhou, Zengrong; Liu, Jihong; Li, Hongjun; Xing, Junping; Zhou, Zhansong; Deng, Chunhua; Deng, Liwen; Wei, Qiang; Zhang, Xiansheng; Zhou, Jun; Fan, Song; Tai, Sheng; Yang, Chen; Shi, Kai; Huang, Yuanyuan; Ye, Zhangqun; Liang, Chaozhao

    2015-01-01

    The purpose of the study is to evaluate the relationship between NIH-CPSI and IIEF-5 in Chinese men with CP/CPPS. A large cross-sectional and multicenter survey was conducted from July 2012 to January 2014. Men were recruited from urology clinics which were located at the five cities in China. All men participated in the survey by completing a verbal questionnaire (consisted of sociodemographics, past medical history, sexual history, and self-estimated scales). The results showed that 1,280 men completed the survey. Based on the CP/CPPS definition, a total of 801 men were diagnosed as having CP/CPPS. Men with CP/CPPS reported higher scores of NIH-CPSI and lower scores of IIEF-5 than men without CP/CPPS. NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. The total scores of NIH-CPSI were significantly more strongly correlated with question 5 than other questions of IIEF-5. The total scores of IIEF-5 were significantly more strongly correlated with pain symptoms scores of NIH-CPSI. Strongest correlation was found between QoL impact and question 5 of IIEF-5. The findings suggested that NIH-CPSI scores were significantly negatively correlated with IIEF-5 scores. Strongest correlation was found between QoL impact and question 5 of IIEF-5. PMID:26273630

  1. Pregabalin for Pain Treatment in Chronic Pancreatitis

    DEFF Research Database (Denmark)

    Olesen, Søren Schou; Bowense, S; Wilder-Smith, Oliver

    2011-01-01

    Intractable pain usually dominates the clinical presentation of chronic pancreatitis (CP). Slowing of electroencephalogram (EEG) rhythmicity has been associated with abnormal cortical pain processing in other chronic pain disorders. The aim of this study was to investigate the spectral distribution...

  2. [Gout as an unusual cause of pelvic pain].

    Science.gov (United States)

    van den Berge, M; Vrugt, B; Holt, C; Smit, C J; Hoogenberg, K

    2006-01-21

    An 89-year-old woman was admitted for high fever and debilitating pelvic pain, notably in the pubic area. Physical examination revealed multiple gouty tophi in her hands and feet. Laboratory investigation revealed severe leukocytosis and a sharply increased C-reactive protein level. The patient was treated with broad-spectrum antibiotics in view of the possibility of a serious bacterial infection, but there was no clinical effect. CT of the pelvis revealed an osteolytic process and a mass anterior to the pubic symphysis. Histological investigation of a biopsy revealed an inflammatory infiltrate with signs of gout. Culture of the biopsy specimen was negative. The diagnosis was confirmed by the finding ofneedle-like urate crystals under the polarizing microscope. After treatment with colchicine and later with prednisone, the symptoms disappeared. She was given uric acid-lowering therapy with allopurinol as a preventive measure.

  3. 腹腔镜检查慢性盆腔疼痛与社会心理因素的相关分析%Analysis on correlation between chronic pelvic pain checked by laparoscope and social-psychological factor

    Institute of Scientific and Technical Information of China (English)

    温坚; 张震; 殷新明

    2012-01-01

    目的:探讨慢性盆腔疼痛(CPP)与社会心理因素的相关性;方法:以212例CPP患者和295例子宫肌瘤患者为实验对象,对CPP患者142例行腹腔镜检查,自编社会心理变量调查表,人组时完成精神卫生自评量表(SCL-90)的测评,以各社会心理变量及简明精神病评定量表(SCL-90)的抑郁和焦虑因子标准分作为观察数据,采用美国SPSS 11.0版进行独立样本的t检验、x2检验和逐步回归分析.结果:腹腔镜检查结果阴性的CPP患者的婚姻状况、性伤害史、诊治次数、诱因及SCL-90抑郁因子标准分、焦虑因子标准分与对照组比较差异有统计学意义(P<0.05);而与文化程度、总病程无相关性,差异无统计学意义(P>0.05).腹腔镜检查结果阴性的CPP患者经心理咨询或抗抑郁治疗后疼痛症状有所减轻.结论:对于腹腔镜检查结果阴性的CPP患者而言,社会心理因素可能是导致其发病的成因之一,提示在诊疗CPP无效时,结合腹腔镜检查对患者实施充分的心理评估、恰当的心理治疗及抗抑郁、抗焦虑治疗是非常有必要的.%Objective: To explore the correlation between chronic pelvic pain (CPP) and social -psychological factor. Methods; A total of 212 CPP patients and 295 patients with uterine myoma were selected as experimental objects, 142 CPP patients received laparosco-py, a self - designed social - psychological variable questionnaire was used in the study, SCL - 90 was finished when the objects entered into group, various social - psychological variables and standard scores of depression and anxiety from SCL - 90 were obtained as observation data, SPSS 11. 0 software was used to conduct t test, χ2 test and stepwise regression analysis of independent sample. Results; There were statistically significant differences in marital status, sexual damage history, times of diagnosis and treatment, inducing factors, standard scores of depression and anxiety between CPP patients

  4. Intravenous phenytoin in the management of crescendo pelvic cancer-related pain.

    Science.gov (United States)

    Chang, V T

    1997-04-01

    Rapidly progressive pain, or "crescendo" pain, can be a difficult management problem. A cancer patient is presented who experienced crescendo neuropathic pain due to progressive pelvic disease. This patient reported significant pain relief with the administration of intravenous phenytoin. The case illustrates the type of therapeutic approach that may be considered for crescendo pain and highlights a potential role for intravenous phenytoin in the management of patients with crescendo cancer-related neuropathic pain.

  5. Management of chronic visceral pain.

    Science.gov (United States)

    Olesen, Anne E; Farmer, Adam D; Olesen, Søren S; Aziz, Qasim; Drewes, Asbjørn M

    2016-10-01

    Despite marked differences in underlying pathophysiology, the current management of visceral pain largely follows the guidelines derived from the somatic pain literature. The effective management of patients with chronic visceral pain should be multifaceted, including both pharmacological and psychological interventions, thereby providing a mechanism-orientated approach to treatment. Patients can frequently become disenfranchised, and subsequently disengaged, with healthcare providers leading to repeated consultations. Thus, a key aspect of management is to break this cycle by validating patients' symptoms, adopting an empathic approach and taking time to educate patients. To optimize treatment and outcomes in chronic visceral pain we need to move away from approaches exclusively based on dealing with peripheral nociceptive input toward more holistic strategies, taking into account alterations in central pain processing.

  6. Managing your chronic pain

    Science.gov (United States)

    ... hanging from above or are stored at waist height. If your back pain is worse at work, talk to your boss. It may be that ... strong. If walking is too hard for you, work with a physical therapist to develop ... decrease your risk of being overweight, which can cause back pain. ...

  7. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  8. Chronic Low Back Pain due to Retroperitoneal Cystic Lymphangioma

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2014-03-01

    Full Text Available   Abdominal cystic lymphangioma is a rare benign neoplasm. Less than 1% of lymphangiomas is in the retroperitoneum. Lymphangioma is mostly asymptomatic. Chronic symptoms were reported in retroperitoneal type more than others. Acute symptoms due to complications like infection, cyst rupture or hemorrhage may occur. We report an 18-years-old girl with low back pain from 6 months ago with huge pelvic mass and diagnosis of retroperitoneal cystic lymphangioma.

  9. Fibromyalgia and Chronic Pain Syndromes

    Science.gov (United States)

    Choy, Ernest; Clauw, Daniel J.; Goldenberg, Don L.; Harris, Richard E.; Helfenstein, Milton; Jensen, Troels Staehelin; Noguchi, Koichi; Silverman, Stuart L.; Ushida, Takahiro; Wang, Guochun

    2016-01-01

    This manuscript, developed by a group of chronic pain researchers and clinicians from around the world, aims to address the state of knowledge about fibromyalgia (FM) and identify ongoing challenges in the field of FM and other chronic pain syndromes that may be characterized by pain centralization/amplification/hypersensitivity. There have been many exciting developments in research studies of the pathophysiology and treatment of FM and related syndromes that have the potential to improve the recognition and management of patients with FM and other conditions with FM-like pain. However, much of the new information has not reached all clinicians, especially primary care clinicians, who have the greatest potential to use this new knowledge to positively impact their patients’ lives. Furthermore, there are persistent misconceptions about FM and a lack of consensus regarding the diagnosis and treatment of FM. This paper presents a framework for future global efforts to improve the understanding and treatment of FM and other associated chronic pain syndromes, disseminate research findings, identify ways to enhance advocacy for these patients, and improve global efforts to collaborate and reach consensus about key issues related to FM and chronic pain in general. PMID:27022674

  10. Pain management in chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Cathia Gachago; Peter V Draganov

    2008-01-01

    Abdominal pain is a major clinical problem in patients with chronic pancreatitis.The cause of pain is usually multifactorial with a complex interplay of factors contributing to a varying degree to the pain in an individual patient and,therefore,a rigid standardized approach for pain control tends to lead to suboptimal results.Pain management usually proceeds in a stepwise approach beginning with general lifestyle recommendations,low fat diet,alcohol and smoking cessation are encouraged.Analgesics alone are needed in almost all patients.Maneuvers aimed at suppression of pancreatic secretion are routinely tried.Patients with ongoing symptoms may be candidates for more invasive options such as endoscopic therapy,and resective or drainage surgery.The role of pain modifying agents (antidepressants,gabapentin,peregabalin),celiac plexus block,antioxidants,octreotide and total pancreatectomy with islet cell auto transplantation remains to be determined.

  11. Low back pain - chronic

    Science.gov (United States)

    ... as scoliosis or kyphosis Medical problems, such as fibromyalgia or rheumatoid arthritis Piriformis syndrome, a pain disorder ... used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed ...

  12. Vaginal diazepam use with urogenital pain/pelvic floor dysfunction: serum diazepam levels and efficacy data.

    Science.gov (United States)

    Carrico, Donna J; Peters, Kenneth M

    2011-01-01

    Vaginal diazepam is used off-label for pelvic floor dysfunction and urogenital pain, but serum levels with efficacy have not been reported until now. One clinician evaluated 21 women for overall, levator, and vulvar pain pre- and one-month post-daily diazepam treatment. One-month post-treatment assessments and serum diazepam levels were done; 62% were moderately or markedly improved. Levator examination pain scores were significantly improved, and vulvar pain scores decreased post-treatment. Serum diazepam levels were within normal limits. Vaginal diazepam may be helpful in treating pelvic floor/urogenital pain conditions.

  13. How consistent are lordosis, range of movement and lumbo-pelvic rhythm in people with and without back pain?

    DEFF Research Database (Denmark)

    Laird, Robert A; Kent, Peter; Keating, Jennifer L

    2016-01-01

    BACKGROUND: Comparing movements/postures in people with and without lower back pain (LBP) may assist identifying LBP-specific dysfunction and its relationship to pain or activity limitation. This study compared the consistency in lumbo-pelvic posture and movement (range and pattern) in people...... with and without chronic LBP (>12 week's duration). METHODS: Wireless, wearable, inertial measurement units measured lumbar lordosis angle, range of movement (ROM) and lumbo-pelvic rhythm in adults (n = 63). Measurements were taken on three separate occasions: two tests on the same day with different raters...... and a third (intra-rater) test one to two weeks later. Participants performed five repetitions of tested postures or movements. Test data were captured automatically. Minimal detectable change scores (MDC90) provided estimates of between-test consistency. RESULTS: There was no significant difference between...

  14. Psychosocial and physical work environment, and risk of pelvic pain in pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Per Kragh; Olsen, Jørn;

    2005-01-01

    night shift) had odds ratios for pelvic pain in pregnancy of 1.76 (95% confidence intervals 1.04 to 2.96) and 1.65 (1.22 to 2.24), respectively, compared with women with day work. Physically strenuous work was associated with an almost 50% increased risk of pelvic pain in pregnancy (1.47; 1.17 to 1...

  15. Self-administered tests as a screening procedure for pregnancy-related pelvic girdle pain.

    Science.gov (United States)

    Fagevik Olsén, Monika; Gutke, Annelie; Elden, Helen; Nordenman, Charlotte; Fabricius, Lina; Gravesen, Melissa; Lind, Anette; Kjellby-Wendt, Gunilla

    2009-08-01

    The aim of this study was to investigate sensitivity and specificity of self-administrated tests aimed at pain provocation of posterior and/or anterior pelvis pain and to investigate pain intensity during and after palpation of the symphysis. A total of 175 women participated in the study, 100 pregnant women with and 25 pregnant women without lumbopelvic back pain and 50 non-pregnant women. Standard pain provocation tests were compared with self assessed tests. All women were asked to estimate pain during and after palpation of the symphysis. For posterior pelvic pain, the self-test of P4 and Bridging test had the highest sensitivity of 0.90 versus 0.97 and specificity of 0.92 and 0.87. Highest sensitivity for self-test for anterior pelvic pain was pulling a mat 0.85. Palpation of symphysis was painful and persistency of pain was the longest among women who fulfilled the criteria for symphyseal pain. There were overall significant differences between the groups concerning intensity and persistency of pain (P < 0.001). Our results indicate that pregnant women can perform a screening by provocation of posterior pelvic pain by self-tests with the new P4 self-test and the Bridging test. Palpation of the symphysis is painful and should only be used as a complement to history taking, pain drawing and pulling a MAT-test.

  16. Urinary incontinence and pelvic girdle pain during pregnancy: a clinical trial

    Directory of Open Access Journals (Sweden)

    Reihaneh Pirjani

    2016-07-01

    Full Text Available Background: To examine the association among pelvic girdle pain (PGP, urinary incontinence (UI and pelvic floor muscle (PFM function in pregnant women in second and third trimester. Methods: 300 pregnant women who admitted for standard pregnancy care were enrolled in the study. Urinary incontinency was measured via the international consultation on incontinence questionnaire short form. Pelvic girdle pain was diagnosed according to existing guidelines. Vaginal examination assessed pelvic muscles contract- relax patterns and muscle strength. The software stata version 13 (Stata Corp., TX, USA was used for data analysis. Results: Overall 300 women (150 with PGP and 150 without PGP were included in final analyses. There was not significant differences between the demographic data including, body mass index before pregnancy, maternal age, mode of delivery. Prevalence of urinary incontinence in women with pelvic girdle pain was 41.5 percent (CI 95%: 32.01- 51.48 while the prevalence of urinary incontinence in women without pain was 21.9 percent (CI 95%: 14.99-30.03. Using logistic regression, the relationship between urinary incontinence and pelvic girdle pain was significant. (CI 95%: 1.07-3.31, P=0.02. Multivariate logistic regression analysis was used to evaluate the relationship between PGP and pelvic floor muscle function and results showed that pelvic floor muscle strength in women with PGP was significantly lower than women without PGP. (CI 95%: 0.24-0.68, OR= 0.4, P<0.001. The duration of the contraction of the pelvic floor muscles in patients with PGP was significantly shorter than women without PGP. (CI 95%: 0.21-0.60, OR =0.35, P<0.001. Conclusion: There was a significant association between pelvic girdle pain and urinary incontinence during the second and third trimesters of pregnancy and also the pelvic floor muscle strength and duration of the contraction of the pelvic floor muscles in women with pelvic girdle pain was significantly

  17. Hip and groin pain in a cyclist resolved after performing a pelvic floor fascial mobilization.

    Science.gov (United States)

    Navot, Sivan; Kalichman, Leonid

    2016-07-01

    Pelvic floor muscle assessment in situations of hip/groin pain in both male and female patients can be a key element in treatment success. We present herein, a 32 year old male professional cyclist, exhibiting right hip and groin pain during cycling and prolonged sitting. The pain commenced after the patient suffered a right hip severe contusion in 2013 causing a tear in the tensor fascia lata and gluteus medius muscle. The patient did not complain of pelvic floor dysfunctions. After receiving several series of conventional physical therapy for the hip/groin pain, the patient experienced partial pain relief and slight improvement of hip range of motion. His pelvic floor muscles and fascial involvement were subsequently assessed. Two sessions of Pelvic Floor Fascial Mobilization (PFFM) were performed and the patient fully recovered. The authors suggest that PFFM, a novel fascial-oriented manual therapy of the pelvic floor approach, can be used for both hip/groin and pelvic floor pain or dysfunction.

  18. Evidence based practice of chronic pain

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2012-01-01

    Full Text Available The patients with chronic pain are increasingly reporting to the physicians for its management. Chronic pain are associated with head, neck and shoulder pain, spinal pain, pain in the joints and extremities, complex regional pain syndrome and phantom pain. The chronic pain is being managed worldwide. The different specialty of medicine is producing a lot of evidence through the published literature but the same is not being published in the field of chronic pain management. Though some evidence is being reported as to different aspects of pain management from different parts of the world but same is lacking from Indian subcontinent. This is in contrast to much done clinical work in this field as well. We present here the available evidence in relation to chronic pain management.

  19. Effects of Mindfulness Meditation on Chronic Pain

    DEFF Research Database (Denmark)

    la Cour, Peter; Petersen, Marian

    2015-01-01

    OBJECTIVE: This randomized controlled clinical trial investigated the effects of mindfulness meditation on chronic pain. DESIGN: A total of 109 patients with nonspecific chronic pain were randomized to either a standardized mindfulness meditation program (mindfulness-based stress reduction [MBSR...

  20. Managing painful chronic wounds: the Wound Pain Management Model

    DEFF Research Database (Denmark)

    Price, Patricia; Fogh, Karsten; Glynn, Chris;

    2007-01-01

    document persistent wound pain and not to develop a treatment and monitoring strategy to improve the lives of persons with chronic wounds. Unless wound pain is optimally managed, patient suffering and costs to health care systems will increase. Udgivelsesdato: 2007-Apr......Chronic wound pain is not well understood and the literature is limited. Six of 10 patients venous leg ulcer experience pain with their ulcer, and similar trends are observed for other chronic wounds. Chronic wound pain can lead to depression and the feeling of constant tiredness. Pain related...... to the wound should be handled as one of the main priorities in chronic wound management together with addressing the cause. Management of pain in chronic wounds depends on proper assessment, reporting and documenting patient experiences of pain. Assessment should be based on six critical dimensions...

  1. Effect of Individual Strengthening Exercises for Anterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROMs of a LBP Patient with Flat Back.

    Science.gov (United States)

    Yoo, Won-Gyu

    2013-10-01

    [Purpose] The purpose of this paper is to report the effect of individual strengthening exercises for the anterior pelvic tilt muscles on back pain, pelvic tilt angle, and lumbar ROM of a low back pain (LBP) patient with flat back. [Subject] A 37 year-old male, who complained of LBP pain at L3-5 levels with flat back, participated. [Methods] He performed the individual strengthening exercises for anterior pelvic tilt muscles (erector spinae,iliopsoas, rectus femoris). [Results] Pelvic tilt angles of the right and left sides were recovered to normal ranges. His lumbar ROMs increased, and low back pain decreased. [Conclusion] We suggest that individual resistance exercises are a necessary approach for effective and fast strengthening of pelvic anterior tilt muscles in LBP with flat back.

  2. 盆腔脏器术后致盆腔痛%Postoperative pelvic pain due to pelvic organs surgery

    Institute of Scientific and Technical Information of China (English)

    车艳辞; 戴淑真

    2013-01-01

    各种盆腔脏器术后均有可能引起盆腔疼痛,其中部分患者在术后短时间内即表现为疼痛,主要原因有:术后感染、盆腔血肿、肠梗阻等;另外一部分患者可能造成慢性盆腔痛,主要原因有:粘连、残余卵巢综合征、卵巢残余综合征.文章分别进行阐述.%Pelvic pain is one of the chief complaints of women who have a history of pelvic surgery. Many diseases can lead to pelvic pain. Here we talk about some causes of pelvic surgery including infection, hematoma, intestinal obstruction, adhesion, residual o-vary syndrome and ovarian remnant syndrome. How to prevent and treat these cases is the key point.

  3. A STUDY TO INVESTIGATE THE ROLE OF PELVIC FLOOR MUSCLE IN CHRONIC NONRESPONSIVE BACK ACHE IN FEMALES

    Directory of Open Access Journals (Sweden)

    Sadaf Subhi

    2016-02-01

    Full Text Available Background: Chronic low back pain remains a major health problem. Unfortunately, the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. At present, however, there are no guidelines regarding the best treatment to help clinicians. As a result, time and money are wasted on treatment which ultimately fail to help the patient. A backache is described as annoying and gripping pain. It can be caused by poor posture, lack of manual handling skills, change in the center of gravity due to expanding abdomen, lack of exercise, or the weight of the baby and the stretching ligaments. Pelvic floor muscle weakness is one of the major cause of chronic backache. Weakness in the pelvic floor muscles is common in females which can lead to debilitating urinary symptoms, affect sexual function and cause chronic backache. Methods: In 3 months, 31 female subjects with mean age of 28 who had taken treatment for their chronic backache, were improvised with pelvic floor strength at our setup, with dramatically good results. 31 subjects with non-responsive chronic back pain who had taken conventional physiotherapy were included in the study. Both married and unmarried were included. Any sign of radiculopathy or inflammation were excluded. After assessing pain using Visual Analogue Scale, the Dr Glazer’s program and Kegel’s contractions were taught. Results: There was significant improvement by 50% on reassessment after 7 days. Then exercises for transverse abdominals were included to get a better response. On completion of the treatment sessions, reduction in pain was 92% on VAS and functional abilities increased by 89%. There was a significant improvement in the quality of life and in pelvic-floor muscle strength. Conclusion: Non-responsive chronic back pain in females when treated with pelvic floor muscle strengthening program showed 40

  4. Comprehensive management of chronic pain in haemophilia.

    Science.gov (United States)

    Young, G; Tachdjian, R; Baumann, K; Panopoulos, G

    2014-03-01

    Chronic pain, most often due to haemophilic arthropathy, is a pervasive problem in persons with haemophilia (PWH) that adversely impacts function and quality of life. PWH with inhibitors and older PWH may be especially vulnerable to progressive arthropathy and resulting chronic pain. The development of chronic pain from acute pain involves a complex interplay of biological and psychosocial factors that may all contribute to the perpetuation of chronic pain and the outcome of therapy. In the absence of evidence-based guidelines, an individualized, multimodal approach to chronic pain management is proposed, as it is in individuals without haemophilia who have chronic pain. Pharmacological treatment is central to the management of chronic pain and must be modified based on pain intensity, ongoing response to therapy and the risk for adverse events. Non-pharmacological interventions, including physiotherapy, complementary treatments and surgical (e.g. orthopaedic) or other invasive procedures, may be integral to chronic pain management in this population. Ongoing psychosocial assessment is critical to identify those factors that may be contributing to the perpetuation of chronic pain or acting as barriers to effective management. Additional study is needed to identify optimal pharmacological treatments for chronic pain in PWH based on the unique pathophysiology of haemophilic arthropathy and on risk profile. Systematic determination of the particular psychosocial factors impacting the experience and management of chronic pain in PWH would likewise add value to the treatment of this pervasive problem.

  5. The curative effect analysis of intractable chronic pelvic pain syndrome by ureteroscopy dredging the seminal duct and lavaging seminal vesicle%小儿输尿管镜下精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎的治疗分析

    Institute of Scientific and Technical Information of China (English)

    高本敏; 黎勇林; 唐正严; 王桂林; 曾铭强; 薛睿智

    2015-01-01

    目的 评价小儿输尿管镜下行精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎的治疗效果.方法 收集45例难治性Ⅲ型前列腺炎患者,随机分为两组,手术组行小儿输尿管镜下精道疏通加精囊灌洗手术,对照组服用前列腺相关药物治疗4周以上,治疗后随访1年并评价其临床疗效.结果 难治性Ⅲ型前列腺炎患者45例,手术组20例,其中伴有血精2例,精囊结石1例,术后20例患者临床症状均有改善,其中显著改善者13例(65%).对照组药物治疗后25例患者临床症状中18例(72%)有改善,显著改善者6例(24%),随访1年,18例改善者中有7例(39%)临床症状反复.结论 手术治疗与药物治疗对难治性前列腺炎临床症状都有一定效果,但是小儿输尿管镜下精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎疗效将更加显著.%Objectives To evaluate the efficacy of intractable chronic pelvic pain syndrome by ureteroscopy dredging the seminal duct and lavaging seminal vesicle.Methods 45 cases of intractable chronic pelvic pain syndrome were collected,which were divided into two groups randomly,Operation group executed operation by ureteroscopy dredging the seminal duct and lavaging seminal vesicle,Control group continued to receive the medication more than 4 weeks.Followed up 1 year and evaluated the curative effect.Results 45 cases of intractable chronic pelvic pain syndrome,In Operation group 20 cases clinlcal symptom was improved and significant improvement was found in 13 cases (65 %) of them.In Control group,18 cases (72%) clinlcal symptom were improved and significant improvement was found in 6 cases(24%).Followed up 1 year,7 cases (39%) recurrent attacks.Conclusions Both operation and medication are effective to intractable chronic pelvic pain syndrome.But the operation by ureteroscopy dredging the seminal duct and lavaging seminal vesicle is more effective.

  6. Study on treatment of chronic prostatitis/chronic pelvic pain syndrome using stepwise therapy(report of 147 cases)%阶梯式治疗慢性前列腺炎/慢性盆底疼痛综合征的疗效观察(附147例报告)

    Institute of Scientific and Technical Information of China (English)

    李青; 刘俊敏; 李明川

    2011-01-01

    Objective To evaluate the treatment of chronic prostatitis/chronic pelvic pain syndrome using stepwise therapy.Methods A total of 271 patients were assessed by the NIH-CPSI and SGA.The sequence modality therapy was as follow: antibiotics, anti-inflammatory phytotherapy, α -blockers and antianxiety &antidepressant.Results Mean age of patients was 42 years old and median symptom history was 1.6 years.Based on results of bacterial culture and routine examination of urine and prostatic fluid, 11.8% of the cases were type Ⅱ prostatitis, other 88.2% were type Ⅲ prostatitis including 42.4% type Ⅲa and 45.8% Ⅲb.The score on the NIH-CPSI were changed from (23.2±5.6) to (12.5±8.7) (P<0.001).Based on SGA score, 82% of the cases were better,12% were the same and 6% were worse.Conclusion Stepwise modality therapy with antibiotics, anti-inflammatory phytotherapy, α -blockers and antianxiety & antidepressant was effective for treatment of most patients with chronic prostatitis/chronic pelvic pain syndrome.%目的 探索慢性前列腺炎/慢性盆底疼痛综合征的阶梯式治疗手段的结果.方法 全部147例病人使用慢性前列腺炎症状积分指数(NIH-CPSI)评分和SGA(全球主观症状评估)评分进行评估,治疗方法依次为:抗生素、抗炎药、α受体阻滞剂和抗焦虑抑郁药.结果 患者平均年龄42岁,病程平均1.6年.根据尿与前列腺液的培养和常规检查,11.8%为Ⅱ型前列腺炎;另外88.2%是Ⅲ型前列腺炎,这其中42.4%属于Ⅲa,其余45.8%属于Ⅲb.这些病人(147例)的NIH-CPSI评分从最初的(23.2±5.6)下降到(12.5±8.7)(P<0.001),根据SGA评分,其中82%为好转,12%无变化,6%恶化.结论 阶梯式应用抗生素、抗炎药、α受体阻滞剂和抗焦虑抑郁药可以成功地治愈绝大多数的慢性前列腺炎/慢性盆底疼痛综合症的病人.

  7. Chronic pain: cytokines, lymphocytes and chemokines.

    Science.gov (United States)

    de Miguel, Marcia; Kraychete, Durval Campos; Meyer Nascimento, Roberto Jose

    2014-01-01

    Chronic pain is a debilitating condition and, in most cases, difficult to treat. A prominent example of this is neuropathic pain. Understanding pathophysiological mechanisms of pain and, therefore, making this knowledge into an effective treatment is still a challenge to experts. Pain can now be considered as a neuro-immune disorder, since recent data indicate critical involvement of innate and adaptive immune responses following injury, and this interaction plays an important role in the onset and perpetuation of chronic pain. The aim of this article is to review the relationship between immune system and chronic pain, especially about neuropathic pain, and focusing on cytokines, chemokines and lymphocytes.

  8. The Genito-Pelvic Pain/Penetration Disorder Paradigm and Beyond : Theoretical and empirical perspectives

    NARCIS (Netherlands)

    Spoelstra, Symen Kornelis

    2017-01-01

    In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)the female sexual pain disorders vaginismus and dyspareunia have been merged into the genito-pelvic pain/penetration disorder (GPPPD). The major reason behind this merging is that in clinical practice it always

  9. [Association between chronic pain and depression].

    Science.gov (United States)

    Alonso Fernández, Francisco

    2005-01-01

    The comorbidity integrated by chronic pain and depression is very common. The somatoform depressive symptoms appear often as diferent types of pain. Amon them premenstrual pain and fibromialgia are some of the most important clinical pictures. Chronic pain leads to depression as a consequence of these three kinds of factors: biomedical, psychosocial (passive attitude, disability) and pharmacological agents. Copping and acceptance of chronic pain is associated with lower pain intensity, less depression and less psychosocial disability. The appropriate use of analgesics in the management of chronic pain demands individualization. Several antidepressants have possitive effects on pain syndrom. Depression is underrecognized ad undertreated above all in patients with chronic pain. In order screening the depression seven ways are described here: personal and family history, type of the personality, clinic and evolutive aspects of somatoform symptom, search of other depressive symptoms and positive therapeutic effect determinated by an antidepressant.

  10. Chronic pain after inguinal hernia repair

    OpenAIRE

    2008-01-01

    : BACKGROUND: Chronic post herniorrhaphy groin pain is defined as pain lasting > 6 months after surgery, which is one of the most important complication occurring after inguinal hernia repair, occurs with greater frequency than previously thought. Chronic groin pain is one of the most significant complications following inguinal hernia repair, and majority of chronic pain has been attributed to ilioinguinal nerve entrapment. Various other factors are involved in development of...

  11. Pharmacological pain management in chronic pancreatitis

    OpenAIRE

    2013-01-01

    Intense abdominal pain is a prominent feature of chronic pancreatitis and its treatment remains a major clinical challenge. Basic studies of pancreatic nerves and experimental human pain research have provided evidence that pain processing is abnormal in these patients and in many cases resembles that seen in neuropathic and chronic pain disorders. An important ultimate outcome of such aberrant pain processing is that once the disease has advanced and the pathophysiological processes are firm...

  12. Chronic widespread pain in spondyloarthritis

    Directory of Open Access Journals (Sweden)

    F. Atzeni

    2014-06-01

    Full Text Available The pain associated with spondyloarthritis (SpA can be intense, persistent and disabling. It frequently has a multifactorial, simultaneously central and peripheral origin, and may be due to currently active inflammation, or joint damage and tissue destruction arising from a previous inflammatory condition. Inflammatory pain symptoms can be reduced by non-steroidal anti-inflammatory drugs, but many patients continue to experience moderate pain due to alterations in the mechanisms that regulate central pain, as in the case of the chronic widespread pain (CWP that characterises fibromyalgia (FM. The importance of distinguishing SpA and FM is underlined by the fact that SpA is currently treated with costly drugs such as tumour necrosis factor (TNF inhibitors, and direct costs are higher in patients with concomitant CWP or FM than in those with FM or SpA alone. Optimal treatment needs to take into account symptoms such as fatigue, mood, sleep, and the overall quality of life, and is based on the use of tricyclic antidepressants or selective serotonin reuptake inhibitors such as fluoxetine, rather than adjustments in the dose of anti-TNF agents or disease-modifying drugs.

  13. Mechanisms of chronic pain from whiplash injury.

    Science.gov (United States)

    Davis, Charles G

    2013-02-01

    This article is to provide insights into the mechanisms underlying chronic pain from whiplash injury. Studies show that injury produces plasticity changes of different neuronal structures that are responsible for amplification of nociception and exaggerated pain responses. There is consistent evidence for hypersensitivity of the central nervous system to sensory stimulation in chronic pain after whiplash injury. Tissue damage, detected or not by the available diagnostic methods, is probably the main determinant of central hypersensitivity. Different mechanisms underlie and co-exist in the chronic whiplash condition. Spinal cord hyperexcitability in patients with chronic pain after whiplash injury can cause exaggerated pain following low intensity nociceptive or innocuous peripheral stimulation. Spinal hypersensitivity may explain pain in the absence of detectable tissue damage. Whiplash is a heterogeneous condition with some individuals showing features suggestive of neuropathic pain. A predominantly neuropathic pain component is related to a higher pain/disability level.

  14. Pharmacological management of pain in chronic pancreatitis.

    NARCIS (Netherlands)

    Esch, A.A.J.; Wilder-Smith, O.H.G.; Jansen, J.B.M.J.; Goor, H. van; Drenth, J.P.H.

    2006-01-01

    Pain is the major presenting symptom of chronic pancreatitis. Patients with chronic pancreatitis experience substantial impairments in health-related quality of life. Pain may be considered as the most important factor affecting the quality of life. The pathogenesis of pancreatic pain is poorly unde

  15. Future perspectives: pathogenesis of chronic muscle pain.

    Science.gov (United States)

    Staud, Roland

    2007-06-01

    Chronic painful muscle conditions include non-inflammatory and inflammatory illnesses. This review is focused on chronic non-inflammatory pain conditions such as myofascial pain syndrome (MPS) and fibromyalgia syndrome (FM), and will not discuss metabolic, genetic or inflammatory muscle diseases such as McArdle's disease, muscular dystrophy, polymyositis, dermatomyositis, or inclusion body myositis.

  16. Chronic Pain after Inguinal Hernia Repair.

    Science.gov (United States)

    Manangi, Mallikarjuna; Shivashankar, Santhosh; Vijayakumar, Abhishek

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P = 0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P = 0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

  17. Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women

    Directory of Open Access Journals (Sweden)

    Carolyn S. Dupuis

    2015-10-01

    Full Text Available Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention.

  18. Pregnancy related pelvic pain is more frequent in women with increased body mass index

    DEFF Research Database (Denmark)

    Biering, Karin; Nøhr, Ellen Aagaard; Olsen, Jørn

    2011-01-01

    Objective. To investigate the association between pre-pregnancy overweight/obesity and pregnancy-related pelvic pain. Design: Nested case-control study. Setting and population. The Danish National Birth Cohort, a cohort of pregnant women and their children recruited 1996–2002. Methods. The women...... had not given birth before. Conclusion. The risk of pregnancy-related pelvic pain increasedwith pre-pregnancy BMI in an exposure–response relation and potentially adds another maternal complication to obesity....... were interviewed twice during pregnancy and twice after childbirth. The first pregnancy interview provided information on self-reported pre-pregnancy body mass index (BMI) and possible confounders, while data on pregnancy-related pelvic pain came from an interview sixmonths postpartum. Cases (n=2 271...

  19. Efficacy of the Technique of Ganglion Impar Modulation for Treating Chronic Abacterial Prostatitis/Chronic Pelvic Pain Syndrome%奇神经节调制技术在治疗慢性非细菌性前列腺炎/慢性盆腔疼痛综合征中的临床应用与疗效观察

    Institute of Scientific and Technical Information of China (English)

    吕小平; 徐群; 张杭杭; 徐新建; 陈磊; 周智恒

    2016-01-01

    Objective To evaluate the efficacy of the technique of ganglion impar modulation for treating Chronic abacterial prostatitis/ chronic pelvic pain syndrome(CNP/ CPPS). Methods A total of 46 cases who were treated in Department of Andrology in Shaoxing Xinchang County Hospital of Traditional Chinese Medicine during Febrary 2013 to March 2015,met CNP/ CPPS inclusion and exclusion criteria,they were divided into group Ⅰ(treated with terazosin)and group Ⅱ(treated with ganglion Impar modulation technique )equally by the sequence of seeing a doctor,all cases were treated for a treatment course. The score of the national institute health - chronic prostatits symptom index( NIH-CPSI),score of VAS,and score of leukocyte count in the expressed prostate secretion(EPS)were recorded before and after treatment. The adverse reactions were also observed. Results There was no significant difference in score of NIH-CPSI,score of VAS,and score of leukocyte count in the EPS between the two groups before treatment(P > 0. 05). The score of NIH-CPSI,score of VAS,and score of leukocyte count in the EPS in group Ⅱ was significantly lower than that in group Ⅰ after treatment,respectively(P 0.05)。治疗后Ⅱ组NIH-CPSI评分、VAS 评分、EPS 常规镜检白细胞变化情况评分均低于Ⅰ组(P <0.05)。两组临床疗效比较,差异有统计学意义(P <0.05)。治疗期间,Ⅰ组患者均无体位性低血压及心悸情况发生,仅有1例出现轻度腹泻,另有1例出现一过性轻微头晕,未经特殊处理,3 d 内自行缓解;Ⅱ组无一例发生运动/感觉功能障碍、会阴部感觉异常、排尿和/或排便功能障碍、穿刺部位感染/出血等。结论奇神经节调制技术治疗 CNP/ CPPS 疗效显著、安全,值得临床推广应用。

  20. CHRONIC PAIN AFTER INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-09-01

    Full Text Available : BACKGROUND: Chronic post herniorrhaphy groin pain is defined as pain lasting > 6 months after surgery, which is one of the most important complication occurring after inguinal hernia repair, occurs with greater frequency than previously thought. Chronic groin pain is one of the most significant complications following inguinal hernia repair, and majority of chronic pain has been attributed to ilioinguinal nerve entrapment. Various other factors are involved in development of chronic pain. MATERIAL AND METHODS: Patients undergoing elective inguinal hernioplasty in Victoria hospital from November2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for follow up at end of six months. A detailed preoperative, intraoperative and post-operative details of cases were recorded according to proforma. The postoperative pain and pain at two, seven days and at end of six months were recorded on a VAS scale. RESULTS: Chronic pain at six month follow up was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7 % of patients with preoperative pain developed chronic pain. Patients with significant preoperative pain had higher chances of developing chronic pain (p<.0001. Preemptive analgesia failed to show statistical significance in development of chronic pain (p=0.079. Nerve injury were present in 22 of cases it was found that nerve injury significantly affected development of chronic pain (p=0.001.Post-operative infiltration of local anesthesia was practiced in 16.3 % of cases and it was found that local infiltration at incision site significantly reduced incidence of chronic pain (p=0.001.Postoperative complications in the form of hematoma, seroma or infection was present in 8.5 % of cases. It was found that post-operative complication not only increased early post-operative pain

  1. Orthotopic ureterocele masquerading as a bladder tumor in a woman with pelvic pain

    Directory of Open Access Journals (Sweden)

    David D. Thiel

    2005-12-01

    Full Text Available Single system orthotopic ureteroceles often present in adulthood are associated with characteristic radiographic findings. We present the case of a 54 year old woman with 8 months of urgency/frequency and pelvic pain that has the cystoscopic appearance of a bladder tumor. Cystoscopic images, radiographs and intraoperative photos demonstrate the work-up, evaluation, and treatment of this unique single system orthotopic ureterocele containing a calculus. This patient demonstrates the need for cystoscopy accompanied by upper tract imaging in patients with new onset pelvic pain, urgency/frequency, and frequent urinary tract infections.

  2. Chronic pain and invasive therapy

    Directory of Open Access Journals (Sweden)

    Alessandro Rocco

    2009-05-01

    Full Text Available The chronic pain “three-step” OMS ladder is likely to be revised, in order to introduce a “fourth step” including clinical indications for the invasive analgesic procedures. The number of patients who undergo such procedures is likely to increase, as well as modern oncology and palliative medicine development. Most of invasive approaches include central (spinal neuromodulation and peripheral (gangliar neurolysis, percutaneous vertebral reduction techniques, as well as pharmacological (opioids and adiuvants, chemical (alcohol and physical (electrical stimulation, thermic neurolysis means. Rarely effective as unique therapies, invasive procedures have to be accurately patient-selected and considered supplementary to conservative approaches, in order to minimize the adverse events deriving from a long term opioid therapy. In the near future, the development of both pain science and biomedical technology will probably be accompanied by the improvement of the knowledge regarding the recourse to invasive analgesic procedures.

  3. Mindfulness, acceptance and catastrophizing in chronic pain.

    Directory of Open Access Journals (Sweden)

    Maaike J de Boer

    Full Text Available OBJECTIVES: Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to examine the influence of mindfulness and general psychological acceptance on pain-related catastrophizing in patients with chronic pain. METHODS: A cross-sectional survey was conducted, including 87 chronic pain patients from an academic outpatient pain center. RESULTS: The results show that general psychological acceptance (measured with the AAQ-II is a strong predictor of pain-related catastrophizing, independent of gender, age and pain intensity. Mindfulness (measured with the MAAS did not predict levels of pain-related catastrophizing. DISCUSSION: Acceptance of psychological experiences outside of pain itself is related to catastrophizing. Thus, acceptance seems to play a role in the pain experience and should be part of the treatment of chronic pain. The focus of the ACT treatment of chronic pain does not necessarily have to be on acceptance of pain per se, but may be aimed at acceptance of unwanted experiences in general. Mindfulness in the sense of "acting with awareness" is however not related to catastrophizing. Based on our research findings in comparisons with those of other authors, we recommend a broader conceptualization of mindfulness and the use of a multifaceted questionnaire for mindfulness instead of the unidimensional MAAS.

  4. 坦索罗辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征的疗效观察%Observing the effectiveness of tamsulosin for treating chronic prostatitis/chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    杨肖波; 潘铁军; 谢旭敏

    2014-01-01

    Objectives To observe the validity and the safety of tamsulosin treating chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS).Methods One hundred patients who were confirmed as CPPS and treated in the department of urology of Wuhan general hospital of Guangzhou Command were enrolled from January 2011 to June 2013.ALL patients were accessed the NIH-Chronic prostatitis symptom index (NIH-CPSI) before the treatment,and they were divided into 3 groups by NIH-CPSI.Group A,group Band group C were classified as the scores of 1 ~ 14,15 ~ 29 and 30 ~ 43 respectively.ALL patients took 200mg tamsulosin every night,and re-evaluated the NIH-CPSI after 8 weeks.All side-effects were recorded.And all data was collected and the variables were compared.Results All average NIH-CPSI scores of three groups had declined from 24.3 to 13.4 (P < 0.01).The pain score and the life quality score had significantly declined,while the urination score hadnt.Moreover,with the symptom increased,the rate of validity of tamsulosin decreased.Conclusions Tarnsulosin can modify pain and evaluate the life quality,and it is safe with little side effect.We recommend using tamsulosin as the main therapy for CP/CPPS.%目的 观察评价坦索罗辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征的有效性及安全性.方法 收集2011年1月至2013年6月广州军区武汉总医院泌尿外科确诊为Ⅲ型前列腺炎患者100例,治疗前进行症状指数(NIH-CPSI)评分,按轻度(1~14)、中度(15 ~29)、重度(30 ~43)分成A、B、C三组.所有患者均给予坦索罗辛0.2mg,每晚睡前口服,连服8周,用药后第8周再次评估NIH-CPSI,记录不良反应,并进行统计学分析.结果 A、B、C三组平均NIH-CPSI评分由原来的24.3降至13.4(P<0.01).治疗后疼痛不适评分与生活质量评分明显下降(P<0.01),而排尿症状评分则下降不明显.三组患者随着症状严重程度的增加,坦索罗辛治疗的有效率逐渐递减,C组有

  5. Beyond Acute Pain: Understanding Chronic Pain in Infancy

    Directory of Open Access Journals (Sweden)

    Miranda DiLorenzo

    2016-11-01

    Full Text Available This topical review presents the current challenges in defining chronic pain in infants, summarizes evidence from animal and human infant studies regarding the biological processes necessary for chronic pain signaling, and presents observational/experiential evidence from clinical experts. A literature search of four databases (CINAHL, EMBASE, PsycINFO, and MEDLINE was conducted, along with hand searches of reference lists. Evidence from animal studies suggest that important neurophysiological mechanisms, such as the availability of key neurotransmitters needed for maintenance of chronic pain, may be immature or absent in the developing neonate. In some cases, human infants may be significantly less likely to develop chronic pain. However, evidence also points to altered pain perception, such as allodynia and hyperalgesia, with significant injury. Moreover, clinicians and parents in pediatric intensive care settings describe groups of infants with altered behavioral responses to repeated or prolonged painful stimuli, yet agreement on a working definition of chronic pain in infancy remains elusive. While our understanding of infant chronic pain is still in the rudimentary stages, a promising avenue for the future assessment of chronic pain in infancy would be to develop a clinical tool that uses both neurophysiological approaches and clinical perceptions already presented in the literature.

  6. [Post-operative pain therapy of a chronic pain patient].

    Science.gov (United States)

    Pawlik, Michael T; Ittner, Karl Peter

    2006-11-01

    Post-operative pain therapy of chronic pain patients poses a challenge. Here we report the perioperative management of a 39-year-old male under chronic therapy with oxycodon, gabapentin and tolperison. Particular the pharmacointeractions regarding premedication and postoperative dose finding of opioids with intravenous PCIA are discussed.

  7. Preliminary study of saw palmetto extract in treatment of chronic prostatitis/chronic pelvic pain syndrome%锯叶棕果实提取物治疗慢性前列腺炎/慢性骨盆疼痛综合征的初步研究

    Institute of Scientific and Technical Information of China (English)

    吴小军; 周占松; 张恒; 沈文浩; 何鹏; 李为兵; 陈志文; 卢根生

    2014-01-01

    目的 探讨锯叶棕果实提取物治疗慢性前列腺炎/慢性骨盆疼痛综合征(chronic prostatitis/chronic pelvic pain syndrome,CP/CPPS)的疗效.方法 选择我科门诊2011年3月至2013年5月收治的Ⅲ型前列腺炎患者118例,包括ⅢA型46例,ⅢB型72例.口服锯叶棕果实提取物,160 mg/次,2次/d,8周一疗程.以美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)、前列腺液常规白细胞计数和国际勃起功能评分问卷(international conventional erectile function score questionnaire,IIEF-5)评分为疗效评价指标,进行治疗前后比较.结果 115例患者完成治疗和随访,包括ⅢA型CP45例,ⅢB型CP 70例.患者口服锯叶棕果实提取物后,NIH-CPSI评分及前列腺液白细胞计数均显著降低(P<0.05).治愈23例(20.0%),显效32例(27.8%),有效42例(36.5%),无效18例(15.7%),总有效率84.3%.IIEF-5评分有所升高(P>0.05).未发生明显不良反应.结论 锯叶棕果实提取物单独用于治疗前列腺炎(尤CP/CPPS),对减轻患者疼痛、改善排尿症状及提高生活质量有较好疗效,且没有明显不良反应.

  8. Pharmacological pain management in chronic pancreatitis.

    Science.gov (United States)

    Olesen, Søren S; Juel, Jacob; Graversen, Carina; Kolesnikov, Yuri; Wilder-Smith, Oliver H G; Drewes, Asbjørn M

    2013-11-14

    Intense abdominal pain is a prominent feature of chronic pancreatitis and its treatment remains a major clinical challenge. Basic studies of pancreatic nerves and experimental human pain research have provided evidence that pain processing is abnormal in these patients and in many cases resembles that seen in neuropathic and chronic pain disorders. An important ultimate outcome of such aberrant pain processing is that once the disease has advanced and the pathophysiological processes are firmly established, the generation of pain can become self-perpetuating and independent of the initial peripheral nociceptive drive. Consequently, the management of pain by traditional methods based on nociceptive deafferentation (e.g., surgery and visceral nerve blockade) becomes difficult and often ineffective. This novel and improved understanding of pain aetiology requires a paradigm shift in pain management of chronic pancreatitis. Modern mechanism based pain treatments taking into account altered pain processing are likely to increasingly replace invasive therapies targeting the nociceptive source, which should be reserved for special and carefully selected cases. In this review, we offer an overview of the current available pharmacological options for pain management in chronic pancreatitis. In addition, future options for pain management are discussed with special emphasis on personalized pain medicine and multidisciplinarity.

  9. Pregnancy-related severe pelvic girdle pain caused by unilateral noninfectious sacroiliitis. A case report and literature review.

    Science.gov (United States)

    Mahovic, D; Laktasic-Zerjavic, N; Tudor, K I; Mercep, I; Prutki, M; Anic, B

    2014-09-01

    Pelvic girdle pain during and after pregnancy is the clinical syndrome of persistent musculoskeletal pain localized in the posterior and/or anterior aspect of the pelvis originating from sacroiliac joints and/or pubic symphysis due to dynamic instability. We report the case of severe and disabling postpartum pelvic girdle pain caused by unilateral noninfectious sacroiliitis which resolved after 2 months by nonsteroidal anti-inflammatory drug and physical therapy. A short literature review is given on epidemiology, etiology, clinical presentation, therapy, and prognosis of pregnancy-related pelvic girdle pain.

  10. Chronic pain after childhood groin hernia repair

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Kehlet, Henrik

    2007-01-01

    BACKGROUND: In contrast to the well-described 10% risk of chronic pain affecting daily activities after adult groin hernia repair, chronic pain after childhood groin hernia repair has never been investigated. Studies of other childhood surgery before the age of 3 months suggest a risk of increased...... pain responsiveness later in life, but its potential relationship to chronic pain in adult life is unknown. METHODS: This was a nationwide detailed questionnaire study of chronic groin pain in adults having surgery for a groin hernia repair before the age of 5 years (n = 1075). RESULTS: The response...... the age of 3 months (n = 122) did not report groin pain more often or with higher intensity than other patients did. CONCLUSIONS: Groin pain in adult patients operated on for a groin hernia in childhood is uncommon and usually mild and occurs in relation to physical activity. Operation before the age of 3...

  11. Disabling pelvic pain following open surgery for rectal prolapse: a case report

    Directory of Open Access Journals (Sweden)

    Romy Sébastien

    2009-09-01

    Full Text Available Abstract Introduction Iatrogenic inferior hypogastric plexus neuropathy is a well-reported side effect of rectal prolapse surgery. This case report emphasizes the importance of careful evaluation of surgical strategy in pelvic surgery. Case presentation A 60-year-old Swiss Caucasian woman developed disabling pelvic pain in the right iliac fossa, radiating to the upper posterior side of the right thigh and right labium majus characterized by electric feelings. This followed resection and bilateral rectal fixation to the sacral promontory as treatment for rectal prolapse. Investigations included a multidisciplinary neurological pain evaluation. A computed tomography scan did not reveal any cause. Revision surgery was performed and a foreign body, a thread, was found wrapped around the inferior hypogastric plexus and was removed. Four years later, the patient remains asymptomatic. Conclusion This case emphasizes the importance of careful identification of the inferior hypogastric plexus during primary pelvic surgery.

  12. An unusual case of pelvic pain: retention of fetal bone after abortion.

    Science.gov (United States)

    Samraj, S; Crawford, S; Singh, N; Patel, R; Rowen, D

    2008-05-01

    We present a 21-year-old woman with a short history of pelvic pain. The history was unremarkable apart from that of undergoing a surgical termination of pregnancy (TOP) some three-and-half years ago. Examination revealed a foreign body at the cervical os. Subsequent investigations revealed more foreign bodies within the cervical canal and uterine cavity, which were removed. Histologically these were found to be bones. Removal of the bone fragment initially discovered lead to an improvement of symptoms. Although the patient was treated for pelvic-inflammatory disease, no infective cause could be established. The condition of intrauterine retained fetal bones is recognized, but rare. Patients experiencing pelvic pain usually present sooner after TOP than did this patient. Although rare, it is an important condition to diagnose as it represents a treatable cause of infertility.

  13. Laparoscopic treatment of acute abdominal/pelvic pain for gynaecological condition in young female

    Directory of Open Access Journals (Sweden)

    Nicola Zampieri

    2014-10-01

    Full Text Available The aim of this study was to report our experience with acute abdominal/pelvic pain in young female. We recorded the cases of female patients aged between 3 and 16 years treated at our Institution for acute abdominal/pelvic pain between January 2005 and December 2013. During the study period data of 24 patients were considered. The overall mean age in our series was 10.6 years (range 3-16 years with a mean time of symptoms of 2.7 days (range 1-10 days. Pelvic abdominal ultrasound was used for all patients; only one patient had magnetic resonance imaging. Surgical findings: 7 (29% patients had a paraovarian/tubal cyst torsion, 3(12,5% patients had ovarian cyst torsion, 11 (46% patients had ovarian/tubal complex torsion and 3(12,5% patients had isolated tubal torsion.

  14. Interpersonal Goals and Well-Being in Couples Coping with Genito-Pelvic Pain

    NARCIS (Netherlands)

    Rosen, Natalie O; Dewitte, Marieke; Merwin, Kathleen; Bergeron, Sophie

    2016-01-01

    In the context of genito-pelvic pain, consideration of interpersonal goals is particularly relevant given that couples' distress is often predicated upon the relational setting. However, relationship goals have not been examined in this population. We investigated (1) the associations between relati

  15. Comparing lumbo-pelvic kinematics in people with and without back pain

    DEFF Research Database (Denmark)

    Laird, Robert A; Gilbert, Jayce; Kent, Peter

    2014-01-01

    back pain (LBP). This systematic review examined studies that compared biomechanical aspects of lumbo-pelvic movement in people with and without LBP. METHODS: MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2014 for relevant...

  16. Laxity measurements of the Sacroiliac joints in women with pregnancy-related pelvic pain

    NARCIS (Netherlands)

    L. Damen (Léonie)

    2002-01-01

    textabstractThe review of the origin, the diagnosis and treatment of pregnancy-related pelvic pain led to the conclusion that laxity of the S!Js may play a central role in the understanding of this syndrome. The department of Biomedical Physics and Technology and the department of Rehabilitation hav

  17. Predictors for postpartum pelvic girdle pain in working women: the Mom@Work cohort study

    NARCIS (Netherlands)

    Stomp-van den Berg, G.M.; Hendriksen, I.J.M.; Bruinvels, D.J.; Twisk, J.W.R.; Mechelen, W. van; Poppel, M.N.M. van

    2012-01-01

    The objective of this study was to examine which factors during pregnancy and postpartum predict pelvic girdle pain (PGP) at 12 weeks postpartum among working women. A total of 548 Dutch pregnant employees were recruited in 15 companies, mainly health care, child care, and supermarkets. The definiti

  18. Neuroanatomy of the female abdominopelvic region: A review with application to pelvic pain syndromes.

    Science.gov (United States)

    Shoja, Mohammadali M; Sharma, Amit; Mirzayan, Nadine; Groat, Chris; Watanabe, Koichi; Loukas, Marios; Tubbs, R Shane

    2013-01-01

    Pelvic pain can be a life altering disease. Multiple pathologies can affect this region resulting in neurologic issues. Therefore, a thorough understanding of the nerve supply to this region is important for the clinician who treats such patients. The current review outlines the anatomy of the nervous system of the abdominopelvic region with special attention to this anatomy in the female.

  19. Gait in pregnancy-related pelvic girdle pain: Amplitudes, timing, and coordination of horizontal trunk rotations

    NARCIS (Netherlands)

    Wu, Wen Hua; Meijer, Onno G.; Bruijn, Sjoerd M.; Hu, Hai; Van Dieën, Jaap H.; Lamoth, Claudine J. C.; Van Royen, Barend J.; Beek, Peter J.

    2008-01-01

    Walking is impaired in Pregnancy-related Pelvic girdle Pain (PPP). Walking velocity is reduced, and in postpartum PPP relative phase between horizontal pelvis and thorax rotations was found to be lower at higher velocities, and rotational amplitudes tended to be larger. While attempting to confirm t

  20. The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain.

    NARCIS (Netherlands)

    Damen, L.; Buyruk, H.M.; Guler-Uysal, F.; Lotgering, F.K.; Snijders, C.J.; Stam, H.J.

    2002-01-01

    STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine the prognostic value of asymmetric laxity of the sacroiliac joints during pregnancy on pregnancy-related pelvic pain postpartum. SUMMARY OF BACKGROUND DATA: In a previous study, we observed a significant relation between asymmetric laxi

  1. An unusual cause of pelvic pain: struma ovarii.

    LENUS (Irish Health Repository)

    Halpenny, D F

    2009-09-01

    A 22 year old female patient presented with a three month history of pelvic discomfort and dysmenorrhoea. A pelvic MRI demonstrated a large mass measuring 10 x 6 cm in size. On T1 and T2 weighted images the mass was noted to be predominantly cystic. The mass also contained peripheral solid components as well as a large fat fluid level. Following excision, histological examination revealed a lesion with mature teratomatous elements but with a significant component (> 50%) being composed of mature thyroid tissue. A 2cm area within the lesion had the morphological pattern of a classical papillary thyroid carcinoma. A diagnosis of struma ovarii was made. Struma ovarii is a rare ovarian neoplasm generally arising in a teratoma and accounts for less than 1% all ovarian neoplasms. Here we present the above case of struma ovarii in a young patient and discuss the radiological characteristics of the disease.

  2. Intravenous infusions in chronic pain management.

    Science.gov (United States)

    Kosharskyy, Boleslav; Almonte, Wilson; Shaparin, Naum; Pappagallo, Marco; Smith, Howard

    2013-01-01

    In the United States, millions of Americans are affected by chronic pain, which adds heavily to national rates of morbidity, mortality, and disability, with an ever-increasing prevalence. According to a 2011 report titled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research by the Institute of Medicine of the National Academies, pain not only exacts its toll on people's lives but also on the economy with an estimated annual economic cost of at least $560 - 635 billion in health care costs and the cost of lost productivity attributed to chronic pain. Intravenous infusions of certain pharmacologic agents have been known to provide substantial pain relief in patients with various chronic painful conditions. Some of these infusions are better, and although not necessarily the first therapeutic choice, have been widely used and extensively studied. The others show promise, however are in need of further investigations. This article will focus on non-opiate intravenous infusions that have been utilized for chronic painful disorders such as fibromyalgia, neuropathic pain, phantom limb pain, post-herpetic neuralgia, complex regional pain syndromes (CRPS), diabetic neuropathy, and central pain related to stroke or spinal cord injuries. The management of patients with chronic pain conditions is challenging and continues to evolve as new treatment modalities are explored and tested. The following intravenous infusions used to treat the aforementioned chronic pain conditions will be reviewed: lidocaine, ketamine, phentolamine, dexmedetomidine, and bisphosphonates. This overview is intended to familiarize the practitioner with the variety of infusions for patients with chronic pain. It will not, however, be able to provide guidelines for their use due to the lack of sufficient evidence.

  3. Assessment of patients with chronic pain.

    Science.gov (United States)

    Dansie, E J; Turk, D C

    2013-07-01

    Chronic pain is a public health concern affecting 20-30% of the population of Western countries. Although there have been many scientific advances in the understanding of the neurophysiology of pain, precisely assessing and diagnosing a patient's chronic pain problem is not straightforward or well-defined. How chronic pain is conceptualized influences how pain is evaluated and the factors considered when making a chronic pain diagnosis. There is no one-to-one relationship between the amount or type of organic pathology and pain intensity, but instead, the chronic pain experience is shaped by a myriad of biomedical, psychosocial (e.g. patients' beliefs, expectations, and mood), and behavioural factors (e.g. context, responses by significant others). Assessing each of these three domains through a comprehensive evaluation of the person with chronic pain is essential for treatment decisions and to facilitate optimal outcomes. This evaluation should include a thorough patient history and medical evaluation and a brief screening interview where the patient's behaviour can be observed. Further assessment to address questions identified during the initial evaluation will guide decisions as to what additional assessments, if any, may be appropriate. Standardized self-reported instruments to evaluate the patient's pain intensity, functional abilities, beliefs and expectations, and emotional distress are available, and can be administered by the physician, or a referral for in depth evaluation can be made to assist in treatment planning.

  4. Nonspecificity of Chronic Soft Tissue Pain Syndromes

    Directory of Open Access Journals (Sweden)

    Eldon Tunks

    1997-01-01

    Full Text Available Persistent (or chronic pain occurs with a prevalence of about 10% in the adult population, and chronic soft tissue pain is especially problematic. Criteria for diagnosis of these soft tissue pain disorders appear to suffer from specificity problems, even though they appear to be sensitive in distinguishing normal from soft tissue pain sufferers. A few decades ago the term 'neuraesthenia' was used as a diagnosis in individuals who now would probably be diagnosed as suffering from fibromyalgia, chronic fatigue and anxiety disorders with fatigue. Soft tissue pain provokes skepticism, especially among third-party payers, and controversy among clinicians. Recent epidemiological studies have demonstrated sex differences in the prevalence of widespread pain and multiple tender points, which are distributed variably throughout the adult population and tend to be correlated with subjective symptoms. Although there is a tendency for these syndromes to persist, follow-up studies show that they tend to vary in extent and sometimes show remissions over longer follow-up, casting doubt about the distinctions between chronic diffuse pains and localized chronic soft tissue pains. Because both accidents and soft tissue pains are relatively prevalent problems, the possibility of chance coincidence of accident and chronic soft tissue pain in an individual creates the need to be cautious in attributing these syndromes to specific accidents in medicolegal situations. At the same time, the available evidence does not support a generally dismissive attitude towards these patients.

  5. Muscle strength in patients with chronic pain

    NARCIS (Netherlands)

    van Wilgen, C.P.; Akkerman, L.; Wieringa, J.; Dijkstra, P.U.

    2003-01-01

    Objective: To analyse the influence of chronic pain on muscle strength. Design: Muscle strength of patients with unilateral nonspecific chronic pain, in an upper or lower limb, were measured according to a standardized protocol using a hand-held dynamometer. Before and after muscle strength measurem

  6. Counseling Adult Clients Experiencing Chronic Pain

    Science.gov (United States)

    Burns, Stephanie T.

    2010-01-01

    Chronic pain affects 35% to 57% of the adult population in the United States and results in billions of dollars spent annually in direct health-care costs and lost productivity. Extensive research confirms the considerable role psychological factors play in the experience and expression of chronic pain. The author discusses implications for…

  7. Botulinum neurotoxin type A injection of the pelvic floor muscle in pain due to spasticity: a review of the current literature.

    Science.gov (United States)

    Bhide, Alka A; Puccini, Federica; Khullar, Vik; Elneil, Suzy; Digesu, G Alessandro

    2013-09-01

    The role of muscle spasm is not a new concept in the genesis of pain. Botulinum neurotoxin type A (BoNTA) has been successfully employed in a variety of muscular and inflammatory conditions. The aim of our study was to review the published literature on the role of BoNTA injection of the pelvic floor muscle in the management of women with chronic pelvic pain (CPP). A systematic search of the literature published up to June 2012 on the use of BoNTA in the treatment of female pelvic floor muscle spasm was carried out using relevant search terms in MEDLINE and EMBASE databases. The results were limited to full-text English language articles. Relevant trials as well as relevant reviews were selected and analyzed by two independent reviewers. Five studies (2 case reports, 1 prospective pilot study, 1 retrospective study and 1 randomised double-blind placebo controlled study) were included in this systematic review. Overall, BoNTA has shown to be beneficial in relieving CPP related to pelvic floor spasm. The role of BoNTA as a treatment of CPP has been recognized for more than 10 years. Although data are still scarce preliminary results are encouraging. BoNTA is an attractive option for refractory CPP related to pelvic floor muscle spasm, but further studies using validated and reproducible outcome measures are needed, to establish its effectiveness, safeness, technique, optimal dosage, and duration of symptom relief.

  8. Pharmacological pain management in chronic pancreatitis

    NARCIS (Netherlands)

    Olesen, S.S.; Juel, J.; Graversen, C.; Kolesnikov, Y.; Wilder-Smith, O.H.G.; Drewes, A.M.

    2013-01-01

    Intense abdominal pain is a prominent feature of chronic pancreatitis and its treatment remains a major clinical challenge. Basic studies of pancreatic nerves and experimental human pain research have provided evidence that pain processing is abnormal in these patients and in many cases resembles th

  9. Yoga on chronic non-bacterial prostatitis/chronic pelvic pain rehabilitation assistance syndrome%瑜伽锻炼对慢性非细菌性前列腺炎/慢性骨盆疼痛综合征的辅助康复治疗效果

    Institute of Scientific and Technical Information of China (English)

    唐锋; 刘花云; 孙洪涛; 连天; 李源湘

    2011-01-01

    目的:探讨瑜伽锻炼对慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(CAP/CPPS)的辅助康复治疗效果.方法:将2008年4月~2010年4月期间符合CAP/CPPS诊断标准的200名患者,随机分为对照组和实验组.对照组采用常规治疗方法,实验组采用在常规治疗的基础上辅以瑜伽锻炼,每周5次,每次40 min左右,以患者不感疲劳为限.采用问卷调查方式,二组患者在治疗前、治疗1个月、治疗3个月予前列腺炎症状指数评分;测定二组患者在治疗前、治疗1个月、治疗3个月的最大尿流率及精浆IL-1、TNF-α水平;统计治愈率、总有效率.结果:实验组患者治疗1个月、治疗3个月前列腺炎症状指数评分、最大尿流率及精浆IL-1、TNF-α水平,与对照组比较具有统计学意义(P<0.05).实验组治愈率(67%)和总有效率(82%)均明显高于对照组治愈率(67%)、总有效率(68呦,P<0.05.结论:CAP/CPPS患者在常规治疗的基础上辅以瑜伽体育锻炼,效果显著.%Objective To explore Yoga in assisted rehabilitation therapy on chronic non-bacterial prostatitis / chronic pelvic pain syndrome. Methods 200 patients were randomly divided into control and experimental groups from April 2008 to April 2010. Experimental group, on the basis of routine treatment, were supplemented by Yoga exercise, every 40 minutes and 5 times a week. The patients do not feel the fatigue limit. A questionnaire survey method, the control group and experimental group of patients before treatment, 1 month, 3 months for treatment of chronic prostatitis symptom index score;determination of the control group and experimental group patients before treatment, 1 month, treatment 3. Results In the control group and experimental group patients 1 month,3 months treatment of chronic prostatitis symptom index score, maximum flow rate and the seminal plasma IL-1, TNF-α levels, statistical test between two groups P <0.05, there statistically

  10. Review of occupational therapy for people with chronic pain.

    LENUS (Irish Health Repository)

    Robinson, Katie

    2011-04-01

    Chronic pain is a significant health-care problem. This review aims to critically analyse occupational therapy services for people with chronic pain and identify significant factors influencing the future development of occupational therapy services for people with chronic pain.

  11. Multicystic benign mesothelioma of the pelvic peritoneum presenting as acute abdominal pain in a young woman.

    Science.gov (United States)

    Hong, Jung-Hee; Jeon, Seob; Lee, Ji-Hye; Nam, Kye-Hyun; Bae, Dong-Han

    2013-03-01

    Multicystic benign mesothelioma (MBM) of the peritoneum is a very rare condition. Since the first description of MBM in 1979, approximately 100 cases have been reported. This is a case report of MBM of the pelvic peritoneum presenting as acute abdominal pain in a young woman. Laparoscopy confirmed multiple grapelike clusters of cysts that originated in the peritoneum of the rectouterine pouch and histopathologic diagnosis was confirmed as MBM of the pelvic peritoneum. We hope to alert gynaecologists of the diagnostic and therapeutic approaches to MBM which can be accomplished by laparoscopy.

  12. Disposition and adjustment to chronic pain.

    Science.gov (United States)

    Ramírez-Maestre, Carmen; Esteve, Rosa

    2013-03-01

    Several empirical studies have shown that personal characteristics act as differential variables, which determine how pain is experienced and how the chronic pain patient adjusts to pain. The main aim of the present research is to review the relationships between some dispositional characteristics and pain adjustment. Taking into account the empirical literature, 6 personality traits that are relevant to the pain experience have been selected: neuroticism, anxiety sensitivity, and experiential avoidance as risk factors that increase the probability of patients experiencing a disability; and extraversion, optimism, and resilience as personal resources that increase their capacity to manage pain effectively. The results suggest that it would be useful to include an assessment of normal personality structure during the multi-dimensional evaluation of a person with chronic pain. Understanding these individual personality characteristics will aid in designing pain intervention programs and help predict possible treatment outcomes.

  13. The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain

    Science.gov (United States)

    Hall, Helen; Cramer, Holger; Sundberg, Tobias; Ward, Lesley; Adams, Jon; Moore, Craig; Sibbritt, David; Lauche, Romy

    2016-01-01

    Abstract Background: Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms. Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain. Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions. Results: Out of 348 nonduplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions. Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during

  14. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain

    Science.gov (United States)

    Hauser, Ross A.; Lackner, Johanna B.; Steilen-Matias, Danielle; Harris, David K.

    2016-01-01

    OBJECTIVE The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. DATA SOURCES Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. STUDY SELECTION Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. DATA EXTRACTION Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. DATA SYNTHESIS Fourteen RCTs, 1 case–control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood–Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive

  15. Osteomalacia as a Cause of Chronic Pain

    Directory of Open Access Journals (Sweden)

    Robert W Teasell

    1996-01-01

    Full Text Available Osteomalacia is a form of metabolic bone disease that can present as chronic pain. A 36-year-old woman presented with a three-year history of bilateral leg and back pain, and proximal leg weakness. Repeated consultations and investigations failed to discover a cause for her pain, and a diagnosis of chronic benign pain was made. She was admitted to hospital where the bone scan, laboratory investigation and bone biopsy established a diagnosis of renal phosphate-wasting adult-onset rickets (osteomalacia. Radiographs of the hip and magnetic resonance imaging revealed bilateral femoral neck fractures and segmental, avascular necrosis of the femoral heads. The patient was treated with high dose phosphate and vitamin D with marked relief of pain. Osteomalacia should be considered in unusual cases of intractable chronic pain.

  16. Prevalence of cervical facet joint pain in chronic neck pain.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Rivera, Jose; Pampati, Vidyasagar

    2002-07-01

    Neck pain is considered to be one of the most common chronic pain conditions in modern society. Various structures identified as capable of transmitting pain in the cervical spine include facet joints, intervertebral discs, nerve root dura, ligaments, fascia, and muscles. The prevalence of cervical facet joint pain in patients with chronic pain after whiplash has been determined as 54% to 60%. However, the prevalence of chronic cervical facet joint pain has not yet been determined in a heterogenous population or in patients with cervical spine pain of idiopathic origin in a controlled environment. This study evaluated 160 patients seen in one interventional pain management practice in a non-university setting. Cervical facet joints were investigated with diagnostic blocks using lidocaine 1% preservative free initially, followed by bupivacaine 0.25%, usually 2 to 4 weeks apart. The study population consisted of 76 women and 30 men aged 43 +/- 13 years of age (mean +/- SD). Mode of onset of neck pain was determined as following a traumatic incident in 48% of the patients, whereas it was with gradual onset without an identifiable specific incident in the remaining 55 patients (52%). Eighty-one or 70% of the patients (70%) reported a definite response to lidocaine blocks. Confirmatory blocks with bupivacaine were performed in 81 patients with 64 patients with 60% of the total sample, or 79%, of the lidocaine-positive group reporting definite response with improvement in their pain. Thus, a prevalence rate of facet joint pain in chronic neck pain was determined to be 60% (95% CI, 50%-70%), with a false positive rate of controlled diagnostic blocks of 40% (95% CI, 34%-46%).

  17. Hostility and Anger in Chronic Pain

    Directory of Open Access Journals (Sweden)

    Lúcia Ribeiro

    2012-06-01

    Full Text Available Introduction: The affective component of pain incorporates various emotions, primarily negative in quality. A great emphasis has been traditionally given to the role of depression and anxiety in chronic pain. More recently, the focus has been directed towards hostility and anger, as fundamental components of the emotional experience of chronic pain. Objective: The aim of this article is to present a literature’s review about the association between chronic pain, anger and hostility. Discussion: Patients with several chronic disorders are characterized by high levels of trait anger and hostility. On the other hand, the manner in which angry feelings are typically handled (anger management style, especially the marked tendency to suppress or express angry feelings, is a particularly important determinant of the chronic pain severity. Conclusion: Hostility and anger are involved in the development, maintenance and treatment of chronic pain. Further research is needed to clarify its relationship with chronic pain and to evaluate the effects of anger management on treatment outcomes.

  18. Hostility and Anger in Chronic Pain

    Directory of Open Access Journals (Sweden)

    Sara Oliveira

    2013-11-01

    Full Text Available Introduction: The affective component of pain incorporates various emotions, primarily negative in quality. A great emphasis has been traditionally given to the role of depression and anxiety in chronic pain. More recently, the focus has been directed towards hostility and anger, as fundamental components of the emotional experience of chronic pain. Objective: The aim of this article is to present a literature’s review about the association between chronic pain, anger and hostility. Discussion: Patients with several chronic disorders are characterized by high levels of trait anger and hostility. On the other hand, the manner in which angry feelings are typically handled (anger management style, especially the marked tendency to suppress or express angry feelings, is a particularly important determinant of the chronic pain severity. Conclusion: Hostility and anger are involved in the development, maintenance and treatment of chronic pain. Further research is needed to clarify its relationship with chronic pain and to evaluate the effects of anger management on treatment outcomes.

  19. Combination therapy of non-intrusive ultrasound with integrated Chinese-western medcine for chronic prostatitis/chronic pelvic pain syndrome%非介入式前列腺超声联合中西药治疗慢性前列腺炎/慢性骨盆疼痛综合征

    Institute of Scientific and Technical Information of China (English)

    迟凯凯; 王瑞; 崔勇; 陈铸; 何伟; 王锁刚; 张卫星; 王光策

    2014-01-01

    目的:探讨非介入式前列腺超声联合中西药治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的临床效果。方法收集临床诊断为CP/CPPS且符合研究标准的患者105例,随机分为3组,每组35例。A组采用非介入式前列腺超声联合中西药治疗方法;B组为中西药物治疗组;C组单用非介入式前列腺超声治疗。观察各组治疗前后前列腺炎症状指数(NIH-CPSI)疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分及各组治疗总有效率。结果3组治疗前后NIH-CPSI疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分差异比较有统计学意义(P<0.05)。治疗后,A组分别与B组、C组比较,NIH-CPSI疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分差异均具有统计学意义(P<0.05);B组与C组比较差异无统计学意义(P>0.05)。治疗总有效率,A组为88.6%,B组为68.6%,C组为74.3%,A组总有效率最高,A组与B组C组比较差异均具统计学意义(P<0.05)。结论非介入式前列腺超声与中西药在临床治疗CP/CPPS中具有协同作用,非介入式前列腺超声联合中西药治疗方法能明显改善CP/CPPS患者的NIH-CPSI疼痛或不适症状、排尿症状,提高生活质量。%Objective To investigate the clinical effects of combination therapy of non-intrusive ultrasound with integrated Chinese-western medcine for patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods A total of 105 cases withCP/CPPS were randomly divided into a combined non-intrusive ultrasound with integrated Chinese-western medcine group (group A, n=35), a Chinese-western medcine group (group B, n=35) and a non-intrusive ultrasound group (group C, n=35). The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were obtained before and after treatment

  20. Myofascial Pain Syndrome in Chronic Back Pain Patients

    Science.gov (United States)

    Nizar, Abd Jalil

    2011-01-01

    Background Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS (χ2 = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome. PMID:21716607

  1. Diagnostic Role of Hyperechoic Fatty Tissue at Ultrasonography in Women with Acute Pelvic Pain

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seong Jin; Yi, Boem Ha; Lee, Hae Kyung; Hong, Hyun Sook [Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Kim, Hyun Cheol [Kyung Hee University East-West Neo-medicine Hospital, Seoul (Korea, Republic of)

    2009-12-15

    The aim of this study was to determine whether hyperechoic fatty tissue (HFT) at transabdominal and transvaginal ultrasonography in women with acute pelvic pain has a diagnostic role. We studied 201 women (mean age, 32 years) with acute pelvic and lower abdominal pain; we performed ultrasonography (US) in all them. Of the 201, 94 with gynecological problems were included., They were divided into two groups: with pelvic inflammatory disease (PID: n = 45) and without PID (n = 49). We evaluated the presence and distribution of HFT and its role in differential diagnosis between PID and non-PID groups. We found, using US, HFT in 36/45 (80%) patients with PID by US. Of the 36, single-center HFT was observed in 12/36 (33.3%) patients and multicentric HFT was detected in 24/36 (66.7%). HFT was present adjacent to inflammatory foci, tuboovarian abscesses or inflamed salpinx in 30 women: HFT was present outside the pelvic cavity in 24. Among the latter 24, HFT was present only in the lower abdomen, and not in the pelvic cavity in 6. In the non-PID group, HFT was found in the lower abdomen and pelvic cavity in 7 women. Four of the seven were misdiagnosed with PID. One of seven women with a hemorrhagic corpus luteal cyst rupture with underlying PID and two with ectopic pregnancy with HFT were correctly diagnosed. The presence of HFT may be a reliable US finding for the diagnosis of PID. HFT distinguishes PID from other acute gynecological problems

  2. Goal Pursuit in Youth with Chronic Pain

    Science.gov (United States)

    Fisher, Emma; Palermo, Tonya M.

    2016-01-01

    Children and adolescents frequently experience chronic pain that can disrupt their usual activities and lead to poor physical and emotional functioning. The fear avoidance model of pain with an emphasis on the maladaptive behaviors that lead to activity avoidance has guided research and clinical practice. However, this model does not take into consideration variability in responses to pain, in particular the active pursuit of goals despite pain. This review aims to introduce a novel conceptualization of children’s activity engagement versus avoidance using the framework of goal pursuit. We propose a new model of Goal Pursuit in Pediatric Chronic Pain, which proposes that the child’s experience of pain is modified by child factors (e.g., goal salience, motivation/energy, pain-related anxiety/fear, and self-efficacy) and parent factors (e.g., parent expectations for pain, protectiveness behaviors, and parent anxiety), which lead to specific goal pursuit behaviors. Goal pursuit is framed as engagement or avoidance of valued goals when in pain. Next, we recommend that research in youth with chronic pain should be reframed to account for the pursuit of valued goals within the context of pain and suggest directions for future research. PMID:27879686

  3. Goal Pursuit in Youth with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Emma Fisher

    2016-11-01

    Full Text Available Children and adolescents frequently experience chronic pain that can disrupt their usual activities and lead to poor physical and emotional functioning. The fear avoidance model of pain with an emphasis on the maladaptive behaviors that lead to activity avoidance has guided research and clinical practice. However, this model does not take into consideration variability in responses to pain, in particular the active pursuit of goals despite pain. This review aims to introduce a novel conceptualization of children’s activity engagement versus avoidance using the framework of goal pursuit. We propose a new model of Goal Pursuit in Pediatric Chronic Pain, which proposes that the child’s experience of pain is modified by child factors (e.g., goal salience, motivation/energy, pain-related anxiety/fear, and self-efficacy and parent factors (e.g., parent expectations for pain, protectiveness behaviors, and parent anxiety, which lead to specific goal pursuit behaviors. Goal pursuit is framed as engagement or avoidance of valued goals when in pain. Next, we recommend that research in youth with chronic pain should be reframed to account for the pursuit of valued goals within the context of pain and suggest directions for future research.

  4. 慢性前列腺炎/慢性骨盆疼痛综合征的发病相关危险因素分析%Analysis on related dangerous factors of morbidity of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

    Institute of Scientific and Technical Information of China (English)

    李春弟; 崔崑; 蒋聿瑛

    2015-01-01

    Objective To discuss the related dangerous factors of morbidity of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods A total of 200 cases of clinical information of patients with CP/CPPS were analyzed, re-ceived and cured, who were selected as observation group, and 200 cases of male urinary systerm infection patients, who given the medical treatment at the same time were selected as control group. The circumstances of urethritis, unre-strained sexual life, frequent masturbation, urinary injury, anxious psychology, infection of sexual partner, long-time withholding urine, frequent stay up and long-term fixed position of patients in two groups were observed. The multi-variate Logistic regression analysis on patients with CP/CPPS were observed. Results The circumstances of unrestrained sexual life, frequent masturbation, anxious psychology, long-time withholding urine, frequent stay up and long-term fixed position of patients in two groups, statistical differences were appeared (P<0.05), which were the dangerous fac-tors to induce CP/CPPS by multivariate Logistic regression analysis on patients with CP/CPPS (P<0.05). Conclusion Healthy living habit, regular and moderate sexual life, positive psychology and suitable self healthy care are the basis to decrease occurrences of CP/CPPS.%目的:探讨慢性前列腺炎/慢性骨盆疼痛综合征的发病相关危险因素情况。方法分析收治的200例慢性前列腺炎/慢性骨盆疼痛综合征患者的临床资料,选取慢性前列腺炎/慢性骨盆疼痛综合征患者作为观察组,同时选取同期收治的男性泌尿系感染患者200例作为对照组。观察两组患者尿道炎、无节制性生活、频繁手淫、泌尿损伤、焦虑心理、性伴侣感染、长时间憋尿、经常熬夜、长期固定体位情况。观察慢性前列腺炎/慢性骨盆疼痛综合征患者多因素Logistic回归分析情况。结果两组患者无节制性生活、频繁手淫、焦虑

  5. Neuroimmunological mechanisms of chronic pain syndrome

    Directory of Open Access Journals (Sweden)

    I. A. Vyshlova

    2016-01-01

    Full Text Available The article considers the mechanisms of chronic low back pain. Three pathophysiological mechanisms: nociceptive, neurogenic (neuropathic, and psychogenic are noted to be involved in the development of pain syndrome. The role of cellular and molecular changes in the posterior horn and in the somatosensory dysregulated mechanism of neuropathic pain is shown. Immunological processes, including neurohumoral (serotoninergic and hormonal (sex hormones and specific proteins ones, play an important role in the development of pain. The generalization and further study of these mechanisms are embodied in approaches to therapy for pain syndromes and hence these require analysis and further investigation. 

  6. Acute and chronic low back pain.

    Science.gov (United States)

    Patrick, Nathan; Emanski, Eric; Knaub, Mark A

    2014-07-01

    Low back pain is an extremely common presenting complaint that occurs in upward of 80% of persons. Treatment of an acute episode of back pain includes relative rest, activity modification, nonsteroidal anti-inflammatories, and physical therapy. Patient education is also imperative, as these patients are at risk for further future episodes of back pain. Chronic back pain (>6 months' duration) develops in a small percentage of patients. Clinicians' ability to diagnose the exact pathologic source of these symptoms is severely limited, making a cure unlikely. Treatment of these patients should be supportive, the goal being to improve pain and function.

  7. Nordic walking and chronic low back pain

    DEFF Research Database (Denmark)

    Morsø, Lars; Hartvigsen, Jan; Puggaard, Lis;

    2006-01-01

    Low Back Pain is a major public health problem all over the western world. Active approaches including exercise in the treatment of low back pain results in better outcomes for patients, but it is not known exactly which types of back exercises are most beneficial or whether general physical....... Until now no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to low back pain. The primary aim of this study is to investigate whether supervised Nordic Walking can reduce pain and improve function in a population of chronic low back pain patients...

  8. Transdermal fentanyl in chronic nonmalignant pain

    Directory of Open Access Journals (Sweden)

    Vittorio Iorno

    2006-09-01

    Full Text Available Chronic non malignant pain is always a therapeutic challenge of great significance because a inappropriate and insufficient treatment is able to reduce the life’s quality of the patients. Many therapeutic strategies were used to solve these issues, no one exhaustive. In the treatment of cancer pain, opiates use is common, is not the same for the chronic non-malignant pain. The fear of possible side effects (addiction, tolerance, respiratory depression restrain the therapist to apply this remedy. The aim of our work is to demonstrate how a correct application of the opiates in patients with chronic benign pain is not only possible but also desirable to relieving the pain and improving the quality of life.

  9. [Local invasive treatment of chronic pain].

    Science.gov (United States)

    Medvedeva, L A; Zagorul'ko, O I; Gnezdilov, A V

    2014-01-01

    The literature on methods of invasive local treatment of chronic pain was analyzed. We reviewed 14 publications including meta-analyses and systematic reviews. The use of regional anesthesia conducted by anesthesiologists in pain clinics demonstrated the evidence based efficacy of different types of peridural injections of local anesthetics with steroids in patients with root pain syndromes at cervical and lumbar levels. Therapeutic blockades of the occipital nerve is effective method of treatment of cervicogenic and cluster headache as well as occipital nerve neuralgia. There are clear indications of the efficacy of local injections in primary chronic cephalgia (migraine and headache of tension). The possibility of the abortion of the pain information flow in peripheral nociceptive pathways and, as a consequence, breaking the vicious circle is emphasized. Issues on the efficacy of local injections at trigger points in the treatment of chronic pain are highlighted.

  10. Effect of Surgical Removal of Endometriomas on Cyclic and Non-cyclic Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Murat Api

    2015-07-01

    Full Text Available Background: Endometriosis is a complex disease with a spectrum of pain symptoms from mild dysmenorrhea to debilitating pelvic pain. There is no concrete evidence in the literature whether endometriotic cyst per se, causes pain spectrum related to the disease. The aim of the present study was to evaluate the effect of surgical removal of endometriomas on pain symptoms. Materials and Methods: In this prospective, observational, before-after study, which was conducted between March 2012 and January 2013 in Training and Research Hospital,Adana, Turkey, a total of 23 patients including 16 sexually active and 7 virgin symptomatic women were questioned for non-cyclic pelvic pain (NCPP, intensity of the NCPP, presence of cyclic dysmenorrhea, and dyspareunia before and after the endometrioma operation. Participants who were sonographically diagnosed and later pathologically confirmed as having endometrioma without sign and symptoms of deep infiltrative endometriosis (DIE were also questioned for pain symptoms before and after the laparoscopic removal of cyst wall. Patients with intraabdominal adhesions, history of pelvic inflammatory disease, and pathological diagnosis other than endometrioma were excluded. No ancillary procedures were applied for pain management, but if pain was present, pelvic peritoneal endometriotic lesions were ablated beside the removal of ovarian endometriotic cysts. Results: Out of 23 cases with endometrioma, 91 and 78% reported to have NCPP and dysmenorrhea, respectively, before the operation, while 60 and 48%, respectively, after the operation (McNemar’s test, P=0.016 for both figures. Among the sexually active cases, 31% (5/16 had dyspareunia before the operation and only 1 case reported the pain relief after the operation (McNemar’s test, P=1. Intensity of NCPP were reported to be none (8.7%, moderate (21.7%, severe (56.5% and unbearable (13% before the operation and decreased to none (43.5%, mild (43.5%, moderate (4

  11. Spino-pelvic-rhythm with forward trunk bending in normal subjects without low back pain.

    Science.gov (United States)

    Hasebe, Kiyotaka; Sairyo, Koichi; Hada, Yasushi; Dezawa, Akira; Okubo, Yu; Kaneoka, Koji; Nakamura, Yoshio

    2014-07-01

    A strong correlation between low back pain and tight hamstrings has been reported. However, the effect of tight hamstrings on spinal biomechanics remains unclear. The purpose of the study was to investigate spino-pelvic-rhythm during forward bending of the trunk and to clarify the rhythm features with regard to hamstrings tightness. Eighteen healthy male adults with no history of low back pain volunteered to participate. First, we measured the finger-to-floor distance (FFD) in the upright position and set this parameter to 100 %. Using a spinal mouse, spinal alignment was measured in the following four positions: (1) upright posture—100 % FFD; (2) forward bending—50 % FFD; (3) forward bending—25 % FFD; and (4) forward bending—0 % FFD (fingers in contact with the floor). Changes of the angle of the thoracic and lumbar spine as well as the pelvis were calculated. As an indicator of tight hamstrings, we measured straight leg raising (SLR) angle. From positions 1–2 (phase I), the entire spino-pelvic angle moved in 104°. During this phase, the lumbar spine mainly moved. In the second phase (positions 2–3), it moved in 16°. Interestingly, all but 2 subjects showed a negative angle in the thoracic motion, meaning that the thoracic spine extended 4° during trunk flexion, thus exhibiting paradoxical motion. During this phase, lumbopelvic rhythm showed 2 patterns. In 7 subjects, pelvic motion was greater than lumbar motion, while the remaining subjects showed the opposite. In subjects without tight hamstrings, 83 % showed a pelvis-dominant pattern. Only 7 subjects were capable of position 4. During this phase, only slight motion was noted in the spine, and the majority of the motion occurred in the pelvis. Lumbar and pelvic motion correlated negatively in all phases. SLR angle and pelvic motion correlated strongly during phase III, indicating dominant pelvic movement in flexible subjects. The lumbo-pelvic-rhythm comprises 2 patterns—lumbar dominant and

  12. Etiology and prognosis of pregnancy-related pelvic girdle pain; design of a longitudinal study

    Directory of Open Access Journals (Sweden)

    Kroese Mariëlle EAL

    2005-01-01

    Full Text Available Abstract Background Absence of knowledge of pregnancy-related pelvic girdle pain (PPGP has prompted the start of a large cohort study in the Netherlands. The objective of this study was to investigate the prevalence and incidence of PPGP, to identify risk factors involved in the onset and to determine the prognosis of pregnancy-related pelvic girdle pain. Methods/design 7,526 pregnant women of the southeast of the Netherlands participated in a prospective cohort study. During a 2-year period, they were recruited by midwives and gynecologists at 14 weeks of pregnancy. Participants completed a questionnaire at baseline, at 30 weeks of pregnancy, at 2 weeks after delivery, at 6 months after delivery and at 1 year after delivery. The study uses extensive questionnaires with questions ranging from physical complaints, limitations in activities, restriction in participation, work situation, demographics, lifestyle, pregnancy-related factors and psychosocial factors. Discussion This large-scale prospective cohort study will provide reliable insights in incidence, prevalence and factors related to etiology and prognosis of pregnancy-related pelvic girdle pain.

  13. [Physical and psychic elements in chronic pain].

    Science.gov (United States)

    Callegari, Camilla; Salvaggio, Fabio; Gerlini, Anna; Vender, Simone

    2007-04-01

    Chronic pain is a widespread problem in general medicine and in psychiatry. It consists in physical and psychic elements. The pain has a specific role, a different frequency and a different intensity in each mental illness. Medical treatments can get benefit from psychiatric drugs.

  14. Mindfulness, Acceptance and Catastrophizing in Chronic Pain

    NARCIS (Netherlands)

    de Boer, Maaike J.; Steinhagen, Hannemike E.; Versteegen, Gerbrig J.; Struys, Michel M. R. F.; Sanderman, Robbert

    2014-01-01

    Objectives: Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT) suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to exami

  15. Neuroimaging revolutionizes therapeutic approaches to chronic pain

    Directory of Open Access Journals (Sweden)

    Borsook David

    2007-09-01

    Full Text Available Abstract An understanding of how the brain changes in chronic pain or responds to pharmacological or other therapeutic interventions has been significantly changed as a result of developments in neuroimaging of the CNS. These developments have occurred in 3 domains : (1 Anatomical Imaging which has demonstrated changes in brain volume in chronic pain; (2 Functional Imaging (fMRI that has demonstrated an altered state in the brain in chronic pain conditions including back pain, neuropathic pain, and complex regional pain syndromes. In addition the response of the brain to drugs has provided new insights into how these may modify normal and abnormal circuits (phMRI or pharmacological MRI; (3 Chemical Imaging (Magnetic Resonance Spectroscopy or MRS has helped our understanding of measures of chemical changes in chronic pain. Taken together these three domains have already changed the way in which we think of pain – it should now be considered an altered brain state in which there may be altered functional connections or systems and a state that has components of degenerative aspects of the CNS.

  16. Personality factors and disorders in chronic pain.

    Science.gov (United States)

    Weisberg, J N; Vaillancourt, P D

    1999-07-01

    It has long been recognized that there is a relationship between certain personality types and personality disorders (PD) and chronic nonmalignant pain (CP). The relationship, however, is far from understood and the physiological and psychological mechanisms that underlie it are unclear. Those who treat chronic pain face many challenges when dealing with individuals who have personality disorders and they often become frustrated when interacting with these patients. Patients with certain traits and personality disorders may continue to worry and ruminate about their symptoms long after the tissue pathology has resolved. Other individuals may overly rely on the clinician and assume a passive role in their treatment, thereby decreasing the likelihood for a positive outcome. Moreover, patients with personality disorders may be demanding (eg, borderline), self-absorbed (eg, narcissistic), or substance seeking (eg, antisocial, borderline). In an attempt to improve management of such patients, pain specialists have attempted to better understand the complex relationship between personality and chronic pain. In this article, we will review the predominant historical and current theories of pain and personality, discuss aspects of the gate-control theory of pain that may relate to personality, and discuss the diathesis-stress model of personality disorders in pain. Last, we will review studies of personality and personality disorders in chronic pain and their treatment implications. We conclude that, based on the underlying neurochemistry, there may be a direct or indirect link between PD and CP, but further prospective research, both on the biological and psychological relationship, should be conducted.

  17. [Hypnosis for chronic pain of children].

    Science.gov (United States)

    Célestin-Lhopiteau, Isabelle

    2014-01-01

    A child or adolescent can suffer from chronic pain. Whatever the causes, it can trap the child in a specific process whereby they focus on the pain, fearing that it will appear and experiencing anxiety. Hypno-analgesia and hypnotherapy enable them to escape this process and find within themselves the capacity to face up to the pain. Moreover, these techniques offer them an autonomy which they can use in all areas of their life.

  18. Mediterranean Diet May Ease Chronic Pain of Obesity

    Science.gov (United States)

    ... html Mediterranean Diet May Ease Chronic Pain of Obesity Study suggests eating fish, plant-based proteins is ... eating these foods might reduce pain associated with obesity. Because obese people with chronic pain usually also ...

  19. One is the loneliest number: a review of the ganglion impar and its relation to pelvic pain syndromes.

    Science.gov (United States)

    Walters, Andrew; Muhleman, Mitchel; Osiro, Stephen; Bubb, Kathleen; Snosek, Michael; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios

    2013-10-01

    The ganglion impar is often overlooked as a component of the sympathetic nervous system. Despite its obscurity, this ganglion provides a pathway for neurons by accommodating postganglionic sympathetics, visceral afferents, and somatic fibers traveling to and from the pelvis. Its classic anatomic location as described in the 1720's held up until recently, with the current literature now revealing a great deal of anatomical variability. This variation becomes important when the ganglion impar is used as a treatment target for patients with chronic pelvic pain - its primary clinical implication. The aim of this review was to provide a better understanding of the anatomy of ganglion impar, accounting for variation in size, shape, and location. In addition, the clinical importance and treatment modalities associated with the ganglion impar are outlined.

  20. TMD and chronic pain: A current view

    Science.gov (United States)

    Furquim, Bruno D'Aurea; Flamengui, Lívia Maria Sales Pinto; Conti, Paulo César Rodrigues

    2015-01-01

    This review aims at presenting a current view on the physiopathologic mechanisms associated with temporomandibular disorders (TMDs). While joint pain is characterized by a well-defined inflammatory process mediated by tumor necrosis factor-α and interleukin, chronic muscle pain presents with enigmatic physiopathologic mechanisms, being considered a functional pain syndrome similar to fibromyalgia, irritable bowel syndrome, interstitial cystitis and chronic fatigue syndrome. Central sensitization is the common factor unifying these conditions, and may be influenced by the autonomic nervous system and genetic polymorphisms. Thus, TMDs symptoms should be understood as a complex response which might get worse or improve depending on an individual's adaptation. PMID:25741834

  1. TMD and chronic pain: A current view

    Directory of Open Access Journals (Sweden)

    Bruno D'Aurea Furquim

    2015-02-01

    Full Text Available This review aims at presenting a current view on the physiopathologic mechanisms associated with temporomandibular disorders (TMDs. While joint pain is characterized by a well-defined inflammatory process mediated by tumor necrosis factor-α and interleukin, chronic muscle pain presents with enigmatic physiopathologic mechanisms, being considered a functional pain syndrome similar to fibromyalgia, irritable bowel syndrome, interstitial cystitis and chronic fatigue syndrome. Central sensitization is the common factor unifying these conditions, and may be influenced by the autonomic nervous system and genetic polymorphisms. Thus, TMDs symptoms should be understood as a complex response which might get worse or improve depending on an individual's adaptation.

  2. Abnormal endogenous pain modulation is a shared characteristic of many chronic pain conditions

    OpenAIRE

    Staud,Roland

    2012-01-01

    The intensity of acute and chronic pain depends on interactions between peripheral impulse input and CNS pain mechanisms, including facilitation and inhibition. Whereas tonic pain inhibition is a characteristic of most pain-free individuals, pain facilitation can be detected in many chronic pain patients. The capability to inhibit pain is normally distributed along a wide continuum in the general population and can be used to predict chronic pain. Accumulating evidence suggests that endogenou...

  3. The Long Road of Pain: Chronic Pain Increases Perceived Distance

    Science.gov (United States)

    Witt, Jessica K.; Linkenauger, Sally A.; Bakdash, Jonathan Z.; Augustyn, Jason S.; Cook, Andrew J.; Proffitt, Dennis R.

    2011-01-01

    Spatial perception is sensitive to the energetic costs required to perform intended actions. For example, hills look steeper to people who are fatigued or burdened by a heavy load. Similarly, perceived distance is also influenced by the energy required to walk or throw to a target. Such experiments demonstrate that perception is a function, not just of optical information, but also of the perceiver’s potential to act and the energetic costs associated with the intended action. In the current paper, we expand on the notion of “cost” by examining perceived distance in patients diagnosed with chronic pain, a multifactorial disease, which is experienced while walking. We found that chronic pain patients perceive target distances to be farther away than a control group. These results indicate the physical, and perhaps emotional, costs of chronic pain affect spatial perceptions. PMID:18949471

  4. Anxiety and Related Factors in Chronic Pain

    Directory of Open Access Journals (Sweden)

    Gordon JG Asmundson

    2002-01-01

    Full Text Available Clinicians often encounter patients who present with both chronic pain and elevated levels of anxiety. In some cases, the source of the anxiety is vague and diffuse. For others, there is an identifiable precipitating object, event or situation. For example, some patients with chronic pain are able to attribute their anxiety to the possibility of not regaining lost functional abilities, financial difficulties, feelings of social inadequacy, or uncertainty about the meaning and consequences of pain. The association between chronic pain and anxiety may not be particularly surprising when one considers that, in the acute phase, both pain and target-oriented anxiety (or fear motivate actions that serve to minimize the threat and maximize the likelihood of successful escape. As well, their neurobiology, while distinct, interacts in the reticular system (1. Evaluations of the association between chronic pain and fear-relevant constructs were initiated in the 1960s and 1970s (2,3. It has only been of late, however, that theorists and researchers have begun to focus their attention on delineating the precise nature of the relationship and its specific implications for the assessment and management of pain.

  5. Frida Kahlo: Portrait of Chronic Pain.

    Science.gov (United States)

    Courtney, Carol A; O'Hearn, Michael A; Franck, Carla C

    2016-08-25

    The Mexican artist Frida Kahlo (1907-1954) is one of the most celebrated artists of the 20th century. Although famous for her colorful self-portraits and associations with celebrities Diego Rivera and Leon Trotsky, less known is the fact that she had lifelong chronic pain. Frida Kahlo developed poliomyelitis at age 6 years, was in a horrific trolley car accident in her teens, and would eventually endure numerous failed spinal surgeries and, ultimately, limb amputation. She endured several physical, emotional, and psychological traumas in her lifetime, yet through her art, she was able to transcend a life of pain and disability. Of her work, her self-portraits are conspicuous in their capacity to convey her life experience, much of which was imbued with chronic pain. Signs and symptoms of chronic neuropathic pain and central sensitization of nociceptive pathways are evident when analyzing her paintings and medical history. This article uses a narrative approach to describe how events in the life of this artist contributed to her chronic pain. The purpose of this article is to discuss Frida Kahlo's medical history and her art from a modern pain sciences perspective, and perhaps to increase our understanding of the pain experience from the patient's perspective.

  6. Review on Chronic Pelvic Inflammatory Disease Treated by Traditional Chinese Medicine%慢性盆腔炎中医药治疗概述

    Institute of Scientific and Technical Information of China (English)

    姬丽丽

    2012-01-01

    Chronic pelvic inflammatory disease is a common gynecological disease, frequently-occurring. The main clinical manifestations include lower abdominal pain, lumbosacral pain, leucorrhea increase, many accompanied by menstrual disorders, dysmenorrhea, sexual intercourse or defecation before and after pain and infertility. Many TCM therapy of chronic pelvic inflammatory disease are obviously effective, and have advantages. TCM treatment for chronic pelvic inflammatory disease has a broad developing prospect.%慢性盆腔炎是妇科常见病、多发病.临床主要表现为下腹部疼痛,腰骶部酸痛,带下增多,多伴有月经失调、痛经、性交或排便前后疼痛及不孕等症.慢性盆腔炎的中医药治疗方法较多,疗效明显,优势凸现,中医药治疗慢性盆腔炎具有广阔的发展前景.

  7. Chronic Abdominal Pain in Children

    NARCIS (Netherlands)

    C.F.M. Gijsbers (Carolien)

    2012-01-01

    textabstractRecurrent abdominal pain (RAP) was first defined in 1958 by Apley as “at least 3 bouts of pain, severe enough to affect activities, over a period of at least 3 months” (1). This was a landmark publication with great impact, showing, that emotional disturbances played a role in many patie

  8. An Overiew of Treatment of Chronic Pelvic Ache with Integrated Traditional Chinese and Western Medicine%中西医结合治疗慢性盆腔疼痛概述

    Institute of Scientific and Technical Information of China (English)

    卢永霞

    2008-01-01

    慢性盆腔疼痛是妇科常见症状之一,指持续六个月或以上,且不完全与月经周期及性交有关的盆腔疼痛.在育龄妯女的发病率为3.8%.慢性盆腔疼痛在临床上常见,难处理且易复发,严重影响妇女的工作及性生活质量.目前,越来越多的证据表明中西医结合治疗女性慢性盆腔疼痛有着很好的效果.%Chronic pelvic pain is a common disease in women,manifested by more than six months pain in the lower abdominal area,which is not entirely associated with the menstrual cycle or sexual intercourse.Chronic pelvic pain has a prevalence of 3.8% among women of reproductive age.It is commonly seen in clinic,but difficult to be treated and easily relapses.Chronic pelvic pain may have profound effects on women's work and quality of sexual life.In recent years,more and more evidence suggest that integrated traditional Chinese and western medicine has a great efficancy in treating patients with Chronic pelvic pain.

  9. Biopsychosocial model of chronic recurrent pain

    Directory of Open Access Journals (Sweden)

    Zlatka Rakovec-Felser

    2009-07-01

    Full Text Available Pain is not merely a symptom of disease but a complex independent phenomenon where psychological factors are always present (Sternberg, 1973. Especially by chronic, recurrent pain it's more constructive to think of chronic pain as a syndrome that evolves over time, involving a complex interaction of physiological/organic, psychological, and behavioural processes. Study of chronic recurrent functional pain covers tension form of headache. 50 suffering persons were accidentally chosen among those who had been seeking medical help over more than year ago. We tested their pain intensity and duration, extent of subjective experience of accommodation efforts, temperament characteristics, coping strategies, personal traits, the role of pain in intra- and interpersonal communication. At the end we compared this group with control group (without any manifest physical disorders and with analyse of variance (MANOVA. The typical person who suffers and expects medical help is mostly a woman, married, has elementary or secondary education, is about 40. Pain, seems to appear in the phase of stress-induced psychophysical fatigue, by persons with lower constitutional resistance to different influences, greater irritability and number of physiologic correlates of emotional tensions. Because of their ineffective style of coping, it seems they quickly exhausted their adaptation potential too. Through their higher level of social–field dependence, reactions of other persons (doctor, spouse could be important factors of reinforcement and social learning processes. In managing of chronic pain, especially such as tension headache is, it's very important to involve bio-psychosocial model of pain and integrative model of treatment. Intra- and inter-subjective psychological functions of pain must be recognised as soon as possible.

  10. Supporting Teens with Chronic Pain to Obtain High School Credits: Chronic Pain 35 in Alberta

    Directory of Open Access Journals (Sweden)

    Kathy Reid

    2016-11-01

    Full Text Available Chronic pain is a significant problem in children and teens, and adolescents with chronic pain often struggle to attend school on a regular basis. We present in this article a novel program we developed that integrates attendance at a group cognitive-behavioural chronic pain self-management program with earning high school credits. We collaborated with Alberta Education in the development of this course, Chronic Pain 35. Adolescents who choose to enroll are invited to demonstrate their scientific knowledge related to pain, understanding of and engagement with treatment homework, and demonstrate their creativity by completing a project, which demonstrates at least one concept. Integrating Chronic Pain 35 into an adolescent’s academic achievements is a creative strategy that facilitates the engagement of adolescents in learning and adopting pain coping techniques. It also helps teens to advocate for themselves in the school environment and improve their parents’ and teachers’ understanding of adolescent chronic pain. This is one of the first successful collaborations between a pediatric health program and provincial education leaders, aimed at integrating learning and obtaining school credit for learning about and engaging in health self-management for teens. The authors hope this paper serves as an effective reference model for any future collaborating programs aimed at supporting teens with chronic pain to obtain high school credits.

  11. Supporting Teens with Chronic Pain to Obtain High School Credits: Chronic Pain 35 in Alberta.

    Science.gov (United States)

    Reid, Kathy; Simmonds, Mark; Verrier, Michelle; Dick, Bruce

    2016-11-19

    Chronic pain is a significant problem in children and teens, and adolescents with chronic pain often struggle to attend school on a regular basis. We present in this article a novel program we developed that integrates attendance at a group cognitive-behavioural chronic pain self-management program with earning high school credits. We collaborated with Alberta Education in the development of this course, Chronic Pain 35. Adolescents who choose to enroll are invited to demonstrate their scientific knowledge related to pain, understanding of and engagement with treatment homework, and demonstrate their creativity by completing a project, which demonstrates at least one concept. Integrating Chronic Pain 35 into an adolescent's academic achievements is a creative strategy that facilitates the engagement of adolescents in learning and adopting pain coping techniques. It also helps teens to advocate for themselves in the school environment and improve their parents' and teachers' understanding of adolescent chronic pain. This is one of the first successful collaborations between a pediatric health program and provincial education leaders, aimed at integrating learning and obtaining school credit for learning about and engaging in health self-management for teens. The authors hope this paper serves as an effective reference model for any future collaborating programs aimed at supporting teens with chronic pain to obtain high school credits.

  12. Supporting Teens with Chronic Pain to Obtain High School Credits: Chronic Pain 35 in Alberta

    Science.gov (United States)

    Reid, Kathy; Simmonds, Mark; Verrier, Michelle; Dick, Bruce

    2016-01-01

    Chronic pain is a significant problem in children and teens, and adolescents with chronic pain often struggle to attend school on a regular basis. We present in this article a novel program we developed that integrates attendance at a group cognitive-behavioural chronic pain self-management program with earning high school credits. We collaborated with Alberta Education in the development of this course, Chronic Pain 35. Adolescents who choose to enroll are invited to demonstrate their scientific knowledge related to pain, understanding of and engagement with treatment homework, and demonstrate their creativity by completing a project, which demonstrates at least one concept. Integrating Chronic Pain 35 into an adolescent’s academic achievements is a creative strategy that facilitates the engagement of adolescents in learning and adopting pain coping techniques. It also helps teens to advocate for themselves in the school environment and improve their parents’ and teachers’ understanding of adolescent chronic pain. This is one of the first successful collaborations between a pediatric health program and provincial education leaders, aimed at integrating learning and obtaining school credit for learning about and engaging in health self-management for teens. The authors hope this paper serves as an effective reference model for any future collaborating programs aimed at supporting teens with chronic pain to obtain high school credits. PMID:27869766

  13. Expectations predict chronic pain treatment outcomes.

    Science.gov (United States)

    Cormier, Stéphanie; Lavigne, Geneviève L; Choinière, Manon; Rainville, Pierre

    2016-02-01

    Accumulating evidence suggests an association between patient pretreatment expectations and numerous health outcomes. However, it remains unclear if and how expectations relate to outcomes after treatments in multidisciplinary pain programs. The present study aims at investigating the predictive association between expectations and clinical outcomes in a large database of chronic pain patients. In this observational cohort study, participants were 2272 patients treated in one of 3 university-affiliated multidisciplinary pain treatment centers. All patients received personalized care, including medical, psychological, and/or physical interventions. Patient expectations regarding pain relief and improvements in quality of life and functioning were measured before the first visit to the pain centers and served as predictor variables. Changes in pain intensity, depressive symptoms, pain interference, and tendency to catastrophize, as well as satisfaction with pain treatment and global impressions of change at 6-month follow-up, were considered as treatment outcomes. Structural equation modeling analyses showed significant positive relationships between expectations and most clinical outcomes, and this association was largely mediated by patients' global impressions of change. Similar patterns of relationships between variables were also observed in various subgroups of patients based on sex, age, pain duration, and pain classification. Such results emphasize the relevance of patient expectations as a determinant of outcomes in multimodal pain treatment programs. Furthermore, the results suggest that superior clinical outcomes are observed in individuals who expect high positive outcomes as a result of treatment.

  14. Opioid Therapy for Chronic Nonmalignant Pain

    Directory of Open Access Journals (Sweden)

    Russell K Portenoy

    1996-01-01

    Full Text Available Long term administration of an opioid drug for chronic nonmalignant pain continues to be controversial, but is no longer uniformly rejected by pain specialists. This is true despite concerns that the regulatory agencies that oversee physician prescribing of opioid drugs continue to stigmatize the practice. The changing clinical perspective has been driven, in part, by widespread acknowledgement of the remarkably favourable outcomes achieved during opioid treatment of cancer pain. These outcomes contrast starkly with popular teaching about chronic opioid therapy and affirm the potential for prolonged efficacy, tolerable side effects, enhanced function associated with improved comfort and minimal risk of aberrant drug-related behaviours consistent with addiction. A large anecdotal experience in populations with nonmalignant pain suggests that these patients are more heterogeneous and that opioid therapy will greatly benefit some and will contribute to negative outcomes for others. The few controlled clinical trials that have been performed support the safety and efficacy of opioid therapy, but have been too limited to ensure generalization to the clinical setting. A critical review of the medical literature pertaining to chronic pain, opioid pharmacology and addiction medicine can clarify misconceptions about opioid therapy and provide a foundation for patient selection and drug administration. The available data support the view that opioids are no panacea for chronic pain, but should be considered in carefully selected patients using clinically derived guidelines that stress a structured approach and ongoing monitoring of efficacy, adverse effects, functional outcomes and the occurrence of aberrant drug-related behaviours.

  15. Mechanism for chronic pain generation

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Neuropathic pain and the other abnormalities of sensation induced by axon injury or by peripheral nerve inflammation should result from functional compensations of the injured neurons during their regeneration. Ectopic distribution of proteins related to Na+, K+ and Ca2+ channels as well as of receptors on both membranes of injured axon and its cell body becomes a main pacemaker from which spontaneous ectopic afferent of primary sensatory neurons and crosstalk between neurons occur. Abnormal ectopic afferent activities lead to disorders of the sensation, such as hyperalgesia, allodynia, spontaneous pain and paraesthesia. Administration of some ion channel agents and/or α2-adrenergic blockers has shown efficiency in preventing neuropathic pain development and in relieving neuropathic pain.

  16. Research design considerations for chronic pain prevention clinical trials

    DEFF Research Database (Denmark)

    Gewandter, Jennifer S; Dworkin, Robert H; Turk, Dennis C

    2015-01-01

    , outcomes, timing of assessment, and adjusting for risk factors in the analyses. We provide a detailed examination of 4 models of chronic pain prevention (ie, chronic postsurgical pain, postherpetic neuralgia, chronic low back pain, and painful chemotherapy-induced peripheral neuropathy). The issues...

  17. Chronic Pain: The Impact on Academic, Social, and Emotional Functioning

    Science.gov (United States)

    Parkins, Jason M.; Gfroerer, Susan D.

    2009-01-01

    Chronic pain is persistent and recurrent pain that tends to fluctuate in severity, quality, regularity, and predictability. It can occur in a single or multiple body regions or organ systems. Some of the most frequently reported types of chronic pain include headaches, recurrent abdominal pain (RAP), and musculoskeletal pain. In contrast to acute…

  18. Electronic diary assessment of pain-related fear, attention to pain, and pain intensity in chronic low back pain patients.

    NARCIS (Netherlands)

    Roelofs, J.; Peters, M.L.; Patijn, J.; Schouten, E.G.; Vlaeyen, J.W.

    2004-01-01

    The present study investigated the relationships between pain-related fear, attention to pain, and pain intensity in daily life in patients with chronic low back pain. An experience sampling methodology was used in which electronic diary data were collected by means of palmtop computers from 40 chro

  19. ROLE OF DIAGNOSTIC LAPAROSCOPY IN NONSPECIFIC CHRONIC ABDOMINAL PAIN: EXPERIENCE OF 100 CASES

    Directory of Open Access Journals (Sweden)

    Abhay

    2015-08-01

    Full Text Available ABSTRACT: BACKGROUND : Chronic idiopathic pain syndromes are among the most challeng ing and demanding conditions to treat across the whole age spectrum. Potentially it can be unrewarding for both the patients and the medical team. Patients with chronic abdominal pain (CAP can undergo numerous diagnostic tests with failure to detect any s tructural or biochemical abnormality. This study was undertaken to assess the diagnostic and therapeutic role of laparoscopy in patients with unexplained chronic abdominal pain (UCAP. PATIENTS AND METHODS: Diagnostic laparoscopy was performed for 100 pati ents with UCAP not diagnosed by usual clinical examination and investigations . The pain in all patients was of unclear etiology despite all the investigative procedures. All patients were subjected to laparoscopic evaluation for their conditions. The findi ngs and outcomes of the laparoscopy were recorded and analyzed. RESULTS: UCAP is common in females (62% than in males. The most frequent laparoscopic findings detected were abdominal adhesions ( 30% , followed by pelvic inflammatory disease ( 25%, abdomina l tuberculosis (12%, chronic appendicitis (8%, mesenteric lymphadenitis (5% and diverticulosis (2%. In 18% of cases no identifiable cause could be found. Follow after 2 months revealed pain relief in 84% irrespective of cause of pain. CONCLUSION: Lapa r oscopy is an effective diagnostic and therapeutic modality in the management of patients with chronic abdominal pain.

  20. Role of CD4+ CDhigh25 regulatory T cells and relative cytokines on the pathogenesis of chronic abacterial pros-tatitis/chronic pelvic pain syndrome%慢性非细菌性前列腺炎/慢性骨盆疼痛综合征患者外周血T调节细胞检测及与临床症状的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王少刚; 白剑; 席启林; 胡东亮; 苏世强; 刘继红; 叶章群

    2008-01-01

    Objective To explore the role of CD4+ CDhigh25 regulatory T cells in the pathogenesis of chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS).Methods The percentage of CD4+ CD+25 and CD4+ CDhigh25 regulatory T cells was detected by flow cytometry from 45 CAP/CPPS pa-tients and 18 normal controls.The levels of interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α) and transforming growth factor-β1 (TGF-β1) in serum and seminal plasma were measured by ELISA in the same cohort.Results There was no significant difference in the percentage of peripheral blood CD4+CD+25 and CD4+Cdhigh+ cells between CAP/CPPS patients and normal control (P>0.05).The ser-CD4+CD+25 and CD4+Cdhigh+ cells between CAP/CPPS patients and normal control (P>0.05>.The ser-um levels of TGF-β1 in patients with CAP/CPPS were markedly lower than those in controls (P0.05);与正常对照组比较,CAP/CPPS患者血清中TNF-α水平增加[(0.34±0.01)ng/ml与(0.11±0.01)ng/ml,P0.05;r-=0.506,P>0.05;r=-0.112,P>0.05).结论 外周血CD4+ CDhigh25 T调节细胞数量与CAP/CPPS的发病无明显关联,其功能缺陷可能导致CAP/CPPS发病,细胞因子在CAP/CPPS的发病过程中起重要作用,并且与临床症状密切相关.

  1. Surgical treatment of pain in chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Stefanović Dejan

    2006-01-01

    Full Text Available INTRODUCTION: The principal indication for surgical intervention in chronic pancreatitis is intractable pain. Depending upon the presence of dilated pancreatic ductal system, pancreatic duct drainage procedures and different kinds of pancreatic resections are applied. OBJECTIVE: The objective of the study was to show the most appropriate procedure to gain the most possible benefits in dependence of type of pathohistological process in chronic pancreatitis. METHOD: Our study included 58 patients with intractable pain caused by chronic pancreatitis of alcoholic genesis. The first group consisted of 30 patients with dilated pancreatic ductal system more than 10 mm. The second group involved 28 patients without dilated pancreatic ductal system. Pain relief, weight gain and glucose tolerance were monitored. RESULTS: All patients of Group I (30 underwent latero-lateral pancreaticojejunal - Puestow operation. 80% of patients had no pain after 6 month, 13.6% had rare pain and 2 patients, i.e. 6.4%, who continued to consume alcohol, had strong pain. Group II consisting of 28 patients was without dilated pancreatic ductal system. This group was subjected to various types of pancreatic resections. Whipple procedure (W was done in 6 patients, pylorus preserving Whipple (PPW in 7 cases, and duodenum preserving cephalic pancreatectomy (DPCP was performed in 15 patients. Generally, 89.2% of patients had no pain 6 month after the operation. An average weight gain was 1.9 kg in W group, 2.8 kg in PPW group and 4.1 kg in DPCP group. Insulin-dependent diabetes was recorded in 66.6% in W group, 57.1% in PPW group and 0% in DPCP group. CONCLUSION: According to our opinion, DPCP may be considered the procedure of choice for surgical treatment of pain in chronic pancreatitis in patients without dilatation of pancreas ductal system because of no serious postoperative metabolic consequences.

  2. Chronic Pain after Inguinal Hernia Repair

    OpenAIRE

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of ...

  3. Clinical Observation in 102 Cases of Chronic Pelvic Inflammation Treated with Qi Jie Granules

    Institute of Scientific and Technical Information of China (English)

    章勤; 何嘉琳; 何少山; 许萍

    2004-01-01

    Objective: To observe the therapeutic effects of Qi Jie Granule (芪竭颗粒) on chronic pelvic inflammation. Method: The therapeutic effect, T-lymphocytic subgroups and indexes of blood rheology were observed when 102 cases of chronic pelvic inflammation in the treatment group were treated with Qi Jie Granule, and another 70 cases were treated with Qian Jin Pian as the controls. Results: The total effective rate was 96.08% in the treatment group, but 84.29% in the control group with a significant difference between the two groups (P<0.01). Qi Jie Granule was also found effective in improving blood viscosity and regulating T-lymphocytic subgroups, and the difference before and after the treatment was also very significant (P<0.05 or P<0.01). Conclusion: The nature of chronic pelvic inflammation is qi deficiency and blood stasis in accordance with the theory of traditional Chinese medicine (TCM). As a drug that is indicated for chronic pelvic inflammation, its mechanism may be related to the improved blood circulation, accelerated inflammatory absorption and regulated immune function.

  4. Cotyledonoid dissecting leiomyoma as a possible cause of chronic lower back pain.

    Science.gov (United States)

    Onu, David O; Fiorentino, Lisa M; Bunting, Michael W

    2013-10-11

    Uterine fibroids having the distinct pathological and immunohistochemical features of cotyledonoid dissecting leiomyoma have been reported infrequently. We describe a postmenopausal woman with an incidental finding of an abdominopelvic mass arising from the uterine fundus on routine radiological imaging of the lumbar spine. The imaging was performed for the investigation of chronic radicular lower back pain refractory to usual pain management. However, the woman did not manifest any gynaecological symptoms. Intraoperatively, the pelvic mass appeared malignant and a frozen section suggested uterine sarcoma. As such, the mass was radically resected, resulting in significant resolution of the back pain. To the authors' knowledge, this is the first report of cotyledonoid dissecting leiomyoma presenting solely as chronic lower back pain, and also the first report of this fibroid variant in Australasia. We discuss the diagnostic and operative challenges, emphasising the role of radiological imaging and immunohistopathology in such cases and review current literature.

  5. Stabilization of lumbar-pelvic region in the syndrome of inespecific lumbar pain

    OpenAIRE

    Kock Schulz, Alejandro; Morales Osorio, Marco Antonio; Mejia Mejia, Johana Milena

    2013-01-01

    Objective. To learn about the various tissues which may contribute to stabilization of lumbar-pelvic region and integrate them to treatment of non-specific lumbar pain syndrome. Methodology. An electronic sear was carried out at PEDro, Cochrane, MEDLINE, CINAHL, EMBASE y  ScienceDirect data bases, of articles published between January 01, 1990, through December 31, 201. 105 potentially eligible articles were identified, selected in function of the title, and summary; 20 primary documents of w...

  6. Beyond pain: modeling decision-making deficits in chronic pain

    Science.gov (United States)

    Hess, Leonardo Emanuel; Haimovici, Ariel; Muñoz, Miguel Angel; Montoya, Pedro

    2014-01-01

    Risky decision-making seems to be markedly disrupted in patients with chronic pain, probably due to the high cost that impose pain and negative mood on executive control functions. Patients’ behavioral performance on decision-making tasks such as the Iowa Gambling Task (IGT) is characterized by selecting cards more frequently from disadvantageous than from advantageous decks, and by switching often between competing responses in comparison with healthy controls (HCs). In the present study, we developed a simple heuristic model to simulate individuals’ choice behavior by varying the level of decision randomness and the importance given to gains and losses. The findings revealed that the model was able to differentiate the behavioral performance of patients with chronic pain and HCs at the group, as well as at the individual level. The best fit of the model in patients with chronic pain was yielded when decisions were not based on previous choices and when gains were considered more relevant than losses. By contrast, the best account of the available data in HCs was obtained when decisions were based on previous experiences and losses loomed larger than gains. In conclusion, our model seems to provide useful information to measure each individual participant extensively, and to deal with the data on a participant-by-participant basis. PMID:25136301

  7. Beyond pain: modeling decision-making deficits in chronic pain

    Directory of Open Access Journals (Sweden)

    Leonardo Emanuel Hess

    2014-08-01

    Full Text Available Risky decision-making seems to be markedly disrupted in patients with chronic pain, probably due to the high cost that impose pain and negative mood on executive control functions. Patients’ behavioral performance on decision-making tasks such as the Iowa Gambling Task (IGT is characterized by selecting cards more frequently from disadvantageous than from advantageous decks, and by switching often between competing responses in comparison with healthy controls. In the present study, we developed a simple heuristic model to simulate individuals’ choice behavior by varying the level of decision randomness and the importance given to gains and losses. The findings revealed that the model was able to differentiate the behavioral performance of patients with chronic pain and healthy controls at the group, as well as at the individual level. The best fit of the model in patients with chronic pain was yielded when decisions were not based on previous choices and when gains were considered more relevant than losses. By contrast, the best account of the available data in healthy controls was obtained when decisions were based on previous experiences and losses loomed larger than gains. In conclusion, our model seems to provide useful information to measure each individual participant extensively, and to deal with the data on a participant-by-participant basis.

  8. Chronic prostatitis

    OpenAIRE

    Le, Brian; Schaeffer, Anthony J.

    2011-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  9. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  10. Acupuncture for patients with chronic neck pain.

    Science.gov (United States)

    Witt, Claudia M; Jena, Susanne; Brinkhaus, Benno; Liecker, Bodo; Wegscheider, Karl; Willich, Stefan N

    2006-11-01

    Acupuncture is widely used by patients with neck pain, but there is a lack of information about its effectiveness in routine medical care. The aim was to investigate the effectiveness of acupuncture in addition to routine care in patients with chronic neck pain compared to treatment with routine care alone. We performed a randomized controlled multicentre trial plus non-randomized cohort in general practices in Germany. 14,161 patients with chronic neck pain (duration >6 months). Patients were randomly allocated to an acupuncture group or a control group receiving no acupuncture. Patients in the acupuncture group received up to 15 acupuncture sessions over three months. Patients who did not consent to randomization received acupuncture treatment. All subjects were allowed to receive usual medical care in addition to study treatment. Neck pain and disability (NPAD Scale by Wheeler) after three months. Of 14,161 patients (mean age 50.9+/-13.1 years, 68% female) 1880 were randomized to acupuncture and 1886 to control, and 10,395 included into the non-randomized acupuncture group. At three months, neck pain and disability improved by 16.2 (SE: 0.4) to 38.3 (SE: 0.4); and by 3.9 (SE: 0.4) to 50.5 (SE: 0.4), difference 12.3 (pacupuncture and control group, respectively. Treatment success was essentially maintained through six months. Non-randomized patients had more severe symptoms at baseline and showed higher neck pain and disability improvement compared to randomized patients. Treatment with acupuncture added to routine care in patients with chronic neck pain was associated with improvements in neck pain and disability compared to treatment with routine care alone.

  11. Neurodegenerative Properties of Chronic Pain: Cognitive Decline in Patients with Chronic Pancreatitis

    NARCIS (Netherlands)

    Jongsma, M.L.A.; Postma, S.A.E.; Souren, P.M.; Arns, M.W.; Gordon, E.; Vissers, K.C.P.; Wilder-Smith, O.H.G.; Rijn, C.M. van; Goor, H. van

    2011-01-01

    Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance),

  12. Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre

    DEFF Research Database (Denmark)

    Sjøgren, Per; Christrup, Lona Louring; Petersen, Morten Aa

    2005-01-01

    The aim of the study was to investigate the influence of pain, sedation, pain medications and socio-demographics on cognitive functioning in chronic non-malignant pain patients. Chronic non-malignant pain patients (N=91) treated in a multidisciplinary pain centre were compared with age and sex ma...

  13. The characteristics of chronic central pain after traumatic brain injury.

    Science.gov (United States)

    Ofek, Hadas; Defrin, Ruth

    2007-10-01

    Central pain following traumatic brain injury (TBI) has not been studied in depth. Our purpose was to conduct a systematic study of patients with TBI suffering from chronic central pain, and to describe the characteristics of the central pain. Groups were TBI patients with (TBIP) and without central pain (TBINP) and healthy controls. TBI patients with other pain mechanisms were excluded from the study. Participants underwent quantitative somatosensory testing in the painful and pain-free body regions. Thresholds for warmth, cold, heat-pain, touch and graphesthesia were measured and pathologically evoked pain (allodynia, hyperpathia and wind-up pain) evaluated. Chronic pain was mapped and characterized. Chronic pain developed at a relatively late onset (6.6+/-9 months) was almost exclusively unilateral and reported as pricking, throbbing and burning. Although both TBIP and TBINP exhibited a significant reduction in thermal and tactile sensations compared to controls, thermal sensations in the painful regions of TBIP were significantly more impaired than pain-free regions in the same patients (p<0.01) and in TBINP (p<0.01). Painful regions also exhibited very high rates of allodynia, hyperpathia and exaggerated wind-up. The characteristics of the chronic pain resembled those of other central pain patients although TBIP displayed several unique features. The sensory profile indicated that damage to the pain and temperature systems is a necessary but not sufficient condition for the development of chronic central pain following TBI. Neuronal hyperexcitability may be a contributing factor to the chronic pain.

  14. Chronic neck pain and masticatory dysfunction.

    Science.gov (United States)

    Catanzariti, Jean-François; Debuse, Thierry; Duquesnoy, Bernard

    2005-12-01

    Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain.

  15. Spinal cord stimulation in chronic pain syndromes

    NARCIS (Netherlands)

    ten Vaarwerk, IAM; Staal, MJ

    1998-01-01

    Spinal cord stimulation (SCS) has been used for more than 30 years now, and although it has shown to be effective under certain well-described conditions of chronic pain, conclusive evidence on its effectiveness is still sparse. There is a need for more prospective and methodological good studies, i

  16. Performance improvement CME: managing chronic pain.

    Science.gov (United States)

    Fishman, Scott M

    2010-12-01

    Performance Improvement CME (PI CME) is an educational activity in which clinicians retrospectively assess their current clinical practice, choose areas for improvement and implement interventions based on treatment guidelines and health care standards, and then re-evaluate their clinical practice to assess the improvements made. This PI CME activity focuses on improving the safety and efficacy of treating chronic pain with opioid medications.

  17. Antioxidants for pain in chronic pancreatitis

    NARCIS (Netherlands)

    Ahmed Ali, Usama; Jens, Sjoerd; Busch, Olivier R C; Keus, Frederik; van Goor, Harry; Gooszen, Hein G; Boermeester, Marja A

    2014-01-01

    BACKGROUND: Reduced intake and absorption of antioxidants due to pain and malabsorption are probable causes of the lower levels of antioxidants observed in patients with chronic pancreatitis (CP). Improving the status of antioxidants might be effective in slowing the disease process and reducing pai

  18. Abdominal epilepsy in chronic recurrent abdominal pain

    Directory of Open Access Journals (Sweden)

    V Y Kshirsagar

    2012-01-01

    Full Text Available Background: Abdominal epilepsy (AE is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG abnormalities and favorable response to the introduction of anti-epileptic drugs (AED. We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74% children with an abnormal EEG and 39 (26% children with normal EEG. All children were subjected to AED (Oxcarbazepine and 139 (92% children responded to AED out of which 111 (74% children had an abnormal EEG and 27 (18% had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74% of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56% were females and 36 (32.43% were male, majority of children were in the age of group of 9

  19. Art Therapy for Chronic Pain: Applications and Future Directions

    Science.gov (United States)

    Angheluta, Anne-Marie; Lee, Bonnie K.

    2011-01-01

    Chronic pain is acknowledged as a phenomenological experience resulting from biological, psychological, and social interactions. Consequently, treatment for this complex and debilitating health phenomenon is often approached from multidisciplinary and biopsychosocial perspectives. One approach to treating chronic pain involves implementing…

  20. Chronic Pain in Canada: Have We Improved Our Management of Chronic Noncancer Pain?

    Directory of Open Access Journals (Sweden)

    Aline Boulanger

    2007-01-01

    Full Text Available BACKGROUND: Chronic noncancer pain (CNCP is a global issue, not only affecting individual suffering, but also impacting the delivery of health care and the strength of local economies.

  1. Fibromyalgia, chronic fatigue syndrome, and myofascial pain.

    Science.gov (United States)

    Bennett, R

    1998-03-01

    Epidemiologic studies continue to provide evidence that fibromyalgia is part of a spectrum of chronic widespread pain. The prevalence of chronic widespread pain is several times higher than fibromyalgia as defined by the 1990 American College of Rheumatology guidelines. There is now compelling evidence of a familial clustering of fibromyalgia cases in female sufferers; whether this clustering results from nature or nature remains to be elucidated. A wide spectrum of fibromyalgia-associated symptomatology and syndromes continues to be described. During the past year the association with interstitial cystitis has been explored, and neurally mediated hypotension has been documented in both fibromyalgia and chronic fatigue syndrome. Abnormalities of the growth hormone-insulin-like growth factor-1 axis have been also documented in both fibromyalgia and chronic fatigue syndrome. The commonly reported but anecdotal association of fibromyalgia with whiplash-type neck trauma was validated in a report from Israel. However, unlike North America, 100% of Israeli patients with posttraumatic fibromyalgia returned to work. Basic research in fibromyalgia continues to pinpoint abnormal sensory processing as being integral to understanding fibromyalgia pain. Drugs such as ketamine, which block N-methyl-D-aspartate receptors (which are often upregulated in central pain states) were shown to benefit fibromyalgia pain in an experimental setting. The combination of fluoxetine and amitriptyline was reported to be more beneficial than either drug alone in patients with fibromyalgia. A high prevalence of autoantibodies to cytoskeletal and nuclear envelope proteins was found in chronic fatigue syndrome, and an increased prevalence of antipolymer antibodies was found in symptomatic silicone breast implant recipients who often have fibromyalgia.

  2. Does caesarean section negatively influence the post-partum prognosis of low back pain and pelvic pain during pregnancy?

    Science.gov (United States)

    Mogren, Ingrid M

    2007-01-01

    Low back and pelvic pain (LBPP) is prevalent during pregnancy and also post-partum. The aetiology is poorly understood. The aim of this study was to investigate possible associations between epidural or spinal anaesthesia and caesarean section (CS) with persistent LBPP half a year after pregnancy. In a previous questionnaire study (n=891) altogether 639 (72%) women had reported LBPP during pregnancy. We sent these respondents a second questionnaire at approximately 6 months post-delivery. The response rate was 72.6% (n=464). The respondents were divided into three groups reporting 'no pain', 'recurrent pain' and 'continuous pain' in relation to LBPP 6 months after delivery. Pearson's chi-square test was used to test the difference between groups and logistic regression analysis was performed. Forty percent of the respondents had received epidural anaesthesia (EDA) or spinal anaesthesia during delivery and 18.5% of women had been delivered by CS. Epidural or spinal anaesthesia was not associated with persistent LBPP. There was no significant difference in CS rates between different sub-groups. The risk of persistent LBPP was increased three- to fourfold in women delivered by elective CS compared with women delivered by emergency CS. Epidural or spinal anaesthesia was not associated with risk of persistent LBPP. Elective CS was associated with an increased risk of persistent LBPP. However, the results must be interpreted with caution because of a relatively small study sample.

  3. Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress.

    Science.gov (United States)

    Outcalt, Samantha D; Ang, Dennis C; Wu, Jingwei; Sargent, Christy; Yu, Zhangsheng; Bair, Matthew J

    2014-01-01

    Chronic pain and posttraumatic stress disorder (PTSD) co-occur at high rates, and Veterans from recent wars in Iraq and Afghanistan may be particularly vulnerable to both conditions. The objective of this study was to identify key aspects of chronic pain, cognitions, and psychological distress associated with comorbid PTSD among this sample of Veterans. Baseline data were analyzed from a randomized controlled trial testing a stepped-care intervention for chronic musculoskeletal pain. Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans with chronic pain only (n = 173) were compared with those with chronic pain and clinically significant posttraumatic stress symptoms (n = 68). Group differences on pain characteristics, pain cognitions, and psychological distress were evaluated. Results demonstrated that OIF/OEF Veterans with comorbid chronic musculoskeletal pain and PTSD experienced higher pain severity, greater pain-related disability and increased pain interference, more maladaptive pain cognitions (e.g., catastrophizing, self-efficacy, pain centrality), and higher affective distress than those with chronic pain alone. Veterans of recent military conflicts in Iraq and Afghanistan may be particularly vulnerable to the compounded adverse effects of chronic pain and PTSD. These results highlight a more intense and disabling pain and psychological experience for those with chronic pain and PTSD than for those without PTSD.

  4. Electronic momentary assessment in chronic pain (II): pain and psychological pain responses as predictors of pain disability.

    NARCIS (Netherlands)

    Sorbi, M.J.; Peters, M.L.; Kruise, D.A.; Maas, C.J.M.; Kerssens, J.J.; Verhaak, P.F.M.; Bensing, J.M.

    2006-01-01

    Objectives and Methods: More than 7,100 electronic diaries from 80 patients with chronic pain (mean: 89.3, range 30-115) entered multilevel analyses to establish the statistical prediction of disability by pain intensity and by psychological functioning (fear avoidance, cognitive, and spousal pain r

  5. The Effect of Chronic Pelvic Inflammatory Disease by Ultrashort Wave Therapy Apparatus and Nursing%慢性盆腔炎经超短波治疗仪治疗的效果与护理

    Institute of Scientific and Technical Information of China (English)

    吴建丽

    2015-01-01

    Objective To investigate the effect of ultrashort wave treatment of chronic pelvic inflammatory disease and care. Methods Through the 52 cases of chronic pelvic inflammatory disease treatment using ultrashort. Results 47 cases of patients with effective,efficient and 90%. Conclusion Ultrashort wave therapy for the treatment of chronic pelvic inflammatory disease,Effect, no pain, easy to accept, it is worth promoting.%目的:探讨超短波治疗慢性盆腔炎的效果与护理。方法通过对52例慢性盆腔炎患者采用超短波治疗。结果47例患者有效,有效率90%。结论超短波治疗仪治疗慢性盆腔炎,效果好,无痛苦,易接受。

  6. Acupuncture For Severe Chronic Perineal Pain

    Institute of Scientific and Technical Information of China (English)

    W. Watere

    2004-01-01

    @@ A 42-year-old man (1.8 m, 80 kg), a postal employee, presented to our TCM-Centre, Elisabeth Hospital, Recklinghausen, Germany, with severe chronic perineal pain and hyperhidrosis, especially head, forehead, hand plains, and foot soles. Due to pain, the patient was unable to sit, unable to work for 3 months,and was depressed and fearful. He had bronchial asthma with no complaints under medication. The patient smoked 20 cigarettes daily; he reported no alcohol usage.During a 3-month period (summer 2002), he had consulted an urologist, internist, neurologist, psychiatrist, and radiologist.

  7. Psychosocial factors associated with chronic pain in adolescents.

    Science.gov (United States)

    Merlijn, Vivian P B M; Hunfeld, Joke A M; van der Wouden, Johannes C; Hazebroek-Kampschreur, Alice A J M; Koes, Bart W; Passchier, Jan

    2003-01-01

    A number of psychosocial factors have been associated with the onset, exacerbation and/or maintenance of chronic pain in adolescents. The present study was conducted to evaluate the relative importance of vulnerability, reinforcement, and modeling. We compared 222 adolescents with chronic pain and no documented physiological etiology (headache, back, limb and abdominal pain) with 148 controls and their (respectively 183 vs. 127) parents. Analyses showed that adolescents with chronic pain are more vulnerable in terms of neuroticism, negative fear of failure, and (less) experienced social acceptance. Contrary to our expectations, the chronic pain group experienced less reinforcement for their pain behavior by both parents and peers than the control group. While the number of pain models was higher in the chronic pain group, no differences were found between their parents and those of the adolescents without chronic pain in pain experience, pain parameters, and pain coping. Regression analyses on the contribution of psychosocial factors to chronic pain and its parameters sustained the positive relation between vulnerability, (less) pain reinforcement, pain models and coping with pain. Furthermore, we also found evidence that gender differences have to be taken into account.

  8. Chronic pain following total hip arthroplasty: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Nikolajsen, Lone; Brandsborg, Birgitte; Lucht, Ulf;

    2006-01-01

    BACKGROUND: Chronic post-operative pain is a well-recognized problem after various types of surgery, but little is known about chronic pain after orthopedic surgery. Severe pre-operative pain is the primary indication for total hip arthroplasty (THA). Therefore, we examined the prevalence...... was 93.6%. Two hundred and ninety-four patients (28.1%) had chronic ipsilateral hip pain at the time of completion of the questionnaire, and pain limited daily activities to a moderate, severe or very severe degree in 12.1%. The chronic pain state was related to the recalled intensity of early post...

  9. Assessing and Managing Sleep Disturbance in Patients with Chronic Pain.

    Science.gov (United States)

    Cheatle, Martin D; Foster, Simmie; Pinkett, Aaron; Lesneski, Matthew; Qu, David; Dhingra, Lara

    2016-06-01

    Chronic pain is associated with symptoms that may impair a patient's quality of life, including emotional distress, fatigue, and sleep disturbance. There is a high prevalence of concomitant pain and sleep disturbance. Studies support the hypothesis that sleep and pain have a bidirectional and reciprocal relationship. Clinicians who manage patients with chronic pain often focus on interventions that relieve pain, and assessing and treating sleep disturbance are secondary or not addressed. This article reviews the literature on pain and co-occurring sleep disturbance, describes the assessment of sleep disturbance, and outlines nonpharmacologic and pharmacologic treatment strategies to improve sleep in patients with chronic pain.

  10. Chronic pain, perceived stress, and cellular aging: an exploratory study

    Directory of Open Access Journals (Sweden)

    Sibille Kimberly T

    2012-02-01

    Full Text Available Abstract Background Chronic pain conditions are characterized by significant individual variability complicating the identification of pathophysiological markers. Leukocyte telomere length (TL, a measure of cellular aging, is associated with age-related disease onset, psychosocial stress, and health-related functional decline. Psychosocial stress has been associated with the onset of chronic pain and chronic pain is experienced as a physical and psychosocial stressor. However, the utility of TL as a biological marker reflecting the burden of chronic pain and psychosocial stress has not yet been explored. Findings The relationship between chronic pain, stress, and TL was analyzed in 36 ethnically diverse, older adults, half of whom reported no chronic pain and the other half had chronic knee osteoarthritis (OA pain. Subjects completed a physical exam, radiographs, health history, and psychosocial questionnaires. Blood samples were collected and TL was measured by quantitative polymerase chain reaction (qPCR. Four groups were identified characterized by pain status and the Perceived Stress Scale scores: 1 no pain/low stress, 2 no pain/high stress, chronic pain/low stress, and 4 chronic pain/high stress. TL differed between the pain/stress groups (p = 0.01, controlling for relevant covariates. Specifically, the chronic pain/high stress group had significantly shorter TL compared to the no pain/low stress group. Age was negatively correlated with TL, particularly in the chronic pain/high stress group (p = 0.03. Conclusions Although preliminary in nature and based on a modest sample size, these findings indicate that cellular aging may be more pronounced in older adults experiencing high levels of perceived stress and chronic pain.

  11. Analysis of the relation between the pelvic pain and the lesion features in patients with endometriosis%宫内膜异位症患者盆腔疼痛与病灶特点的相关性分析

    Institute of Scientific and Technical Information of China (English)

    陈京亭

    2012-01-01

    Objective To investigate the relation between pelvic pain and lesion features in patients with endometriosis. Methods 153 patients with endometriosis diagnosed by laparoscopy and pathology from Feb 2007 to Dec 2010 were analyzed retrospectively and the relationship between pelvic pain and lesion features was evaluated. Results In 153 patients with endometriosis, the pelvic pain was not found in 22 patients with simple endometrial cyst and 131 patients with simple endometrial cyst complicated peritoneal lesion, pelvic adhesion and deeply infiltrating nodules suffered from chronic pelvic pain on the contrary. The incidence rates of chronic pelvic pain in 48 cases with infiltrating lesion in uterosacral ligaments and 53 cases with deeply infiltrating nodules in rectouterine pouch were significantly higher than those in other cases. Moreover, the incidence rates of pelvic pain in 83 cases with moderate or serious pelvic adhesion and in 85 cases with deeply infiltrating lesions were remarkably higher than those in 38 cases with mild pelvic adhesion and 46 cases with superficial infiltrating lesions, respectively ( P<0.05 ). Conclusion The pelvic pain of endometriosis is notably related to endometriotic lesion features, and pelvic adhesion and deeply infiltrating lesions in uterosacral ligaments and rectouterine pouch are the most frequent reasons resulting in pelvic pain.%目的 探讨子宫内膜异位症(内异症)患者盆腔疼痛与病变特点的关系.方法 选择2007年2月至2010年12月经腹腔镜及病理检查确诊的子宫内膜异位症患者153例,回顾性分析其盆腔疼痛与病灶特点的关系.结果 153例内异症患者中,22例单纯子宫内膜异位囊肿者无盆腔痛,131例子宫内膜异位囊肿合并腹膜病灶、盆腔粘连及深部浸润型结节者均有不同程度的盆腔痛.在盆腔痛的发生率上,48例病变位于子宫骶韧带及53例病变位于子宫直肠凹的患者盆腔痛发生率明显高

  12. Chronic low back pain in housewives

    Directory of Open Access Journals (Sweden)

    Mehmet Bulut

    2011-09-01

    Full Text Available Objectives: The aim of this study is to investigate low back pain of housewives and to deteremine relationships between psychological status, education and physical health in housewives.Materials and methods: Thirty premenopausal housewives aged 33-45 years with chronic low back pain were included and the control group consisted of 30 healthy premenopausal housewives. Physical examinations were performed. Age, height, weight, educational level, number of children, consumption of cigarettes and alcohol were recorded. The body mass index (BDI was measured. The severity of back pain was measured by the Oswestry Disability Index (ODI, psychological status was evaluated by the Beck Depression Inventory (BDI and muscle strength by manual technique.Results: There was no difference between demographic data of patients and controls. BDI scores of patients were significantly higher than the controls (p<0,01. Abdominal and dorsal muscle strength were higher in the control group but different was not significant. OBAS values in the patient group, were positively correlated with BDI and BMI (p= 0.011; p= 0.001, respectively, and negatively correlated with abdominal and dorsal muscle strength (p= 0.006 and p= 0.001. Significant correlations were found between abdominal and dorsal muscle strength and the BMI, ODI and BDI scores and high educational level positively affected the ODI and the BDI scores in patients.Conclusion: The housewives with chronic back pain and do not exercise regularly limit activities of daily living. Because of higher BDI scores of patients with chronic low back pain, these patients should also undergo psychiatric examination. J Clin Exp Invest 2011; 2 (3: 295-298.

  13. Early visceral pain predicts chronic pain after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, Morten Rune; Ording, Helle; Andersen, Claus;

    2014-01-01

    , and 3, 6, and 12months postoperatively for pain, psychological factors, and signs of hypersensitivity. Overall pain, incisional pain (somatic pain component), deep abdominal pain (visceral pain component), and shoulder pain (referred pain component) were registered on a 100-mm visual analogue scale...

  14. 慢性非细菌性前列腺炎/慢性骨盆疼痛综合征患者外周血CD4+CD25+T调节细胞功能检测及意义%TGF-β1The role of CD4+CD25+ regulatory T cells in the pathogenesis of chronic abacterial prostatitis/ chronic pelvic pain syndrome

    Institute of Scientific and Technical Information of China (English)

    王少刚; 白剑; 席启林; 胡东亮; 刘继红; 叶章群

    2008-01-01

    Objective To explore the role of CD4+CD25+ regulatory T cells in the pathogenesis of chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS). Methods Peripheral blood samples were collected from 45 CAP/CPPS patients and 18 healthy age-matched male persons. Peripheral blood mononuclear cells (PBMCs) were isolated. The percentages of CD4+CD25+ and CD4+ CD25high regulatory T cells were detected by flow cytometry. PCR was used to examine the mRNA expression of Foxp3, a transcription factor expressed in the CD4+ CD25+ cells. ELISA was used to examine the plasma level of tumor growth factor (TGF)-β1. Results There were no significant differences in the percentages of peripheral blood CD4+ CD25+ and CD4+ CD25highT cells between the CAP/CPPS patients and normal control group(both P>0.05). The Foxp3 mRNA in the PBMCs of the CAP/CPPS ⅢA and CAP/CPPS ⅢB patients were (0.69±0. 23) and (0.44±0.18) respectively, both significantly lower than that of the control group [(1.37±0.19), P 0.05);CAP/CPPSⅢA、ⅢB组患者外周血单个核细胞(PBMC)中Foxp3mRNA表达水平[(0.69±0.23)、(0.44±0.18)]较对照组(1.37±0.19)明显降低(P=0.035,P=0.014);CAP/CPPSⅢA、ⅢB组患者血清中TGF-β1水平[(18.09±10.45)pg/ml、(14.06±6.22)pg/ml]较对照组[(27.01±13.29)pg/ml]降低(P=0.041,P=0.024).结论 外周血CD44CD25+调节性T细胞数量与CAP/CPPS的发病无明显关联,CD4+CD25+调节性T细胞功能障碍可能参与CAP/CPPS发病机制;Foxp3基因与TGF-β1在CAP/CPPS的发病过程中起重要作用.

  15. 'Postconcussive' symptoms in persons with chronic pain.

    Science.gov (United States)

    Iverson, G L; McCracken, L M

    1997-11-01

    The purpose of this study was to examine the base rate of cognitive and neurobehavioural complaints in patients with chronic pain (N = 170) who had not sustained a head injury. The patients completed a packet of questionnaires that contained numerous questions regarding physical, cognitive, and psychological symptoms. The 'postconcussive-like' symptoms were selected and analysed. Specific symptom endorsement rates ranged from 5% to 76.5%. Disturbed sleep, fatigue, and irritability were reported by the majority of chronic pain patients. Cognitive complaints relating to forgetfulness (29%), difficulty maintaining attention (18%), and difficulty with concentration or thinking (16.5%) were endorsed by a significant minority of patients. Most patients (80.6%) endorsed three or more symptoms from Category C of the DSM-IV Postconcussional Disorder research criteria. This study further illustrates that postconcussive-like symptoms are not unique sequelae of mild head injury, and the presence of chronic pain should be considered when interpreting patients' physical, cognitive, and psychological complaints following closed head injury.

  16. AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain.

    Science.gov (United States)

    Dampier, Carlton; Palermo, Tonya M; Darbari, Deepika S; Hassell, Kathryn; Smith, Wally; Zempsky, William

    2017-01-05

    Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria.

  17. Pain management mini-series. Part II. Chronic opioid drug therapy: implications for perioperative anesthesia and pain management.

    Science.gov (United States)

    Fisher, Robert B; Johnson, Quinn L; Reeves-Viets, Joseph L

    2013-01-01

    In the U.S., there is a growing percentage of chronic pain patients requiring surgery. Chronic pain patients require careful evaluation and planning to achieve appropriate acute pain management. Peri-surgical pain management often requires continuation of previously prescribed chronic pain modalities and careful selection of multimodal acute pain interventions. This article will provide a broad overview of chronic pain, definitions, and current recommendations for the treatment of perioperative pain in patients maintained on opioid therapy.

  18. Current understanding of the neuropathophysiology of pain in chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Amporn; Atsawarungruangkit; Supot; Pongprasobchai

    2015-01-01

    Chronic pancreatitis(CP) is a chronic inflammatory disease of the pancreas. The main symptom of patients with CP is chronic and severe abdominal pain. However, the pathophysiology of pain in CP remains obscure.Traditionally, researchers believed that the pain was caused by anatomical changes in pancreatic structure. However, treatment outcomes based on such beliefs are considered unsatisfactory. The emerging explanations of pain in CP are trending toward neurobiological theories. This article aims to review current evidence regarding the neuropathophysiology of pain in CP and its potential implications for the development of new treatments for pain in CP.

  19. Positive emotions and brain reward circuits in chronic pain.

    Science.gov (United States)

    Navratilova, Edita; Morimura, Kozo; Xie, Jennifer Y; Atcherley, Christopher W; Ossipov, Michael H; Porreca, Frank

    2016-06-01

    Chronic pain is an important public health problem that negatively impacts the quality of life of affected individuals and exacts enormous socioeconomic costs. Chronic pain is often accompanied by comorbid emotional disorders including anxiety, depression, and possibly anhedonia. The neural circuits underlying the intersection of pain and pleasure are not well understood. We summarize recent human and animal investigations and demonstrate that aversive aspects of pain are encoded in brain regions overlapping with areas processing reward and motivation. We highlight findings revealing anatomical and functional alterations of reward/motivation circuits in chronic pain. Finally, we review supporting evidence for the concept that pain relief is rewarding and activates brain reward/motivation circuits. Adaptations in brain reward circuits may be fundamental to the pathology of chronic pain. Knowledge of brain reward processing in the context of pain could lead to the development of new therapeutics for the treatment of emotional aspects of pain and comorbid conditions.

  20. Cortical plasticity as a new endpoint measurement for chronic pain

    Directory of Open Access Journals (Sweden)

    Zhuo Min

    2011-07-01

    Full Text Available Abstract Animal models of chronic pain are widely used to investigate basic mechanisms of chronic pain and to evaluate potential novel drugs for treating chronic pain. Among the different criteria used to measure chronic pain, behavioral responses are commonly used as the end point measurements. However, not all chronic pain conditions can be easily measured by behavioral responses such as the headache, phantom pain and pain related to spinal cord injury. Here I propose that cortical indexes, that indicate neuronal plastic changes in pain-related cortical areas, can be used as endpoint measurements for chronic pain. Such cortical indexes are not only useful for those chronic pain conditions where a suitable animal model is lacking, but also serve as additional screening methods for potential drugs to treat chronic pain in humans. These cortical indexes are activity-dependent immediate early genes, electrophysiological identified plastic changes and biochemical assays of signaling proteins. It can be used to evaluate novel analgesic compounds that may act at peripheral or spinal sites. I hope that these new cortical endpoint measurements will facilitate our search for new, and more effective, pain medicines, and help to reduce false lead drug targets.

  1. Cognitive function in patients with chronic pain treated with opioids

    DEFF Research Database (Denmark)

    Kurita, G P; de Mattos Pimenta, C A; Braga, P E;

    2012-01-01

    The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...... with opioids....

  2. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy.

    Science.gov (United States)

    Moldwin, Robert M; Fariello, Jennifer Yonaitis

    2013-10-01

    Myofascial trigger points (MTrP), or muscle "contraction knots," of the pelvic floor may be identified in as many as 85 % of patients suffering from urological, colorectal and gynecological pelvic pain syndromes; and can be responsible for some, if not all, symptoms related to these syndromes. Identification and conservative treatment of MTrPs in these populations has often been associated with impressive clinical improvements. In refractory cases, more "aggressive" therapy with varied trigger point needling techniques, including dry needling, anesthetic injections, or onabotulinumtoxinA injections, may be used, in combination with conservative therapies.

  3. Irritable bowel syndrome in women with chronic pelvic pain in a Northeast Brazilian city Síndrome do intestino irritável em mulheres com dor pélvica crônica em uma cidade do Nordeste Brasileiro

    Directory of Open Access Journals (Sweden)

    Lígia Maria Montenegro Lessa

    2013-02-01

    Full Text Available PURPOSES: To determine the prevalence of irritable bowel syndrome (IBS in women with chronic pelvic pain (CPP and its associated features; to determine whether IBS and CPP constitute the same syndrome. METHODS: Cross-sectional population survey with systematic sequential sampling according to census districts in which 1470 women were interviewed with respect to the sample calculation. The participants resided in their own homes, were at least 14 years of age, experienced menarche and presented CPP according to the American College of Obstetrics and Gynaecology. The dependent variable was IBS based on Rome III criteria in women with CPP, and the following independent variables were possibly associated with IBS: age, schooling, duration of pain, sedentary lifestyle, migraine, depression, insomnia, back pain, dysmenorrhea, dyspareunia, depression, history of violence, and intestinal symptoms. The sample was subdivided into groups with and without IBS. After the descriptive analysis of the variables was performed, the respective frequencies were evaluated using GraphPad Prism 5 software. To evaluate the association between the dependent variable and the independent variables, the χ² test was used with a significance level of 5%. RESULTS: The prevalence of IBS in women with CPP was 19,5%. Pain duration (p=0.03, back pain (p=0.002, history of physical or sexual abuse (p=0.002, and intestinal complaints were more prevalent in the group with IBS and CPP. There was no difference between the groups regarding other criteria. CONCLUSION: The data confirmed the literature, identified several aspects that were shared between the pathologies and supported the hypothesis that both pathologies can constitute the same syndrome.OBJETIVOS: Verificar a prevalência da síndrome do intestino irritável (SII em mulheres com dor pélvica crônica (DPC e as características associadas; analisar se SII e DPC constituem a mesma síndrome. MÉTODOS: Estudo transversal do

  4. Family dysfunction: A comparison of chronic widespread pain and chronic localized pain.

    Science.gov (United States)

    Hayaki, Chie; Anno, Kozo; Shibata, Mao; Iwaki, Rie; Kawata, Hiroshi; Sudo, Nobuyuki; Hosoi, Masako

    2016-12-01

    Previous studies have shown differences in the psychosocial factors related to chronic localized pain (CLP) and chronic widespread pain (CWP). However, no studies have done an evaluation of differences between CLP and CWP from the viewpoint of family functioning. We did a cross-sectional study in a tertiary care setting to investigate possible differences in the relation of CWP and CLP to family functioning.Patients with CLP (N = 126) or CWP (N = 75) were assessed for family functioning by the Family Assessment Device (FAD) and a comparison was done. Logistic regression analysis was used to estimate associations of family functioning subscales with pain status (CWP vs CLP), controlling for demographic variables, pain variables; pain duration, pain ratings, pain disability, and psychological factors; depression, anxiety, and catastrophizing. The odds ratios (ORs) for the presence of CWP were calculated.Compared to patients with CLP, patients with CWP showed a lower functional status for Roles and Affective Involvement. The ORs for CWP were significantly higher in lower functioning Roles (OR: 2.38, 95% CI: 1.21-4.65) and Affective Involvement (OR: 2.86, 95% CI: 1.56-5.24) after adjusting for demographic variables. The significant association of CWP to Roles and Affective Involvement remained after controlling for the pain variables and psychological factors.This study shows that the families of patients with CWP have poorer family functioning than those with CLP. Our findings suggest that early identification and interventions for the family dysfunction of chronic pain patients are important to the treatment and prevention of CWP.

  5. Chronic Pain: Symptoms, Diagnosis, & Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Chronic Pain Chronic Pain: Symptoms, Diagnosis, & Treatment Past Issues / Spring 2011 Table of Contents Symptoms Chronic pain is often defined as any pain lasting ...

  6. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy.

    Science.gov (United States)

    Mogren, Ingrid M

    2006-07-01

    Low back pain and pelvic pain (LBPP) is common during pregnancy and up to 40% of women still have symptoms half a year after delivery. The aim of the study was to investigate determinants and the prevalence of persistent LBPP after pregnancy in a Swedish cohort. In a previous study 891 women had responded to a questionnaire on risk factors and prevalence of LBPP during pregnancy. Altogether 72% (n=639) of the women had reported LBPP during pregnancy. These respondents were sent a second questionnaire at approximately 6 months after delivery. The response rate was 72.6% (n=464). Independent t-test and Pearson's chi-squared test were used to test the difference between the two groups. In response to the questionnaire, 43.1% of the women reported persistent LBPP 6 months after delivery. Women with persistent LBPP after pregnancy had had significantly earlier onset of pain during pregnancy, higher maternal age, higher body mass index (BMI), and assessed a higher level of pain due to LBPP during pregnancy and after pregnancy, and included a higher proportion of women with joint hyper-mobility. In summary, recurrent or continuous LBPP is prevalent after pregnancy. BMI as well as hyper-mobility are prominent determinants of persistent LBPP after pregnancy. Level and onset of pain during pregnancy were strong predictors of persistent LBPP.

  7. Altered central sensitization and pain modulation in the CNS in chronic joint pain

    DEFF Research Database (Denmark)

    Arendt-Nielsen, Lars; Skou, Søren Thorgaard; Nielsen, Thomas Arendt

    2015-01-01

    and central pain mechanisms are not fully understood, and safe and efficient analgesic drugs are not available. The pain associated with joint pain is highly individual, and features from radiological imaging have not demonstrated robust associations with the pain manifestations. In recent years, a variety......Musculoskeletal pain disorders are the second largest contributor to global disability underlining the significance of effective treatments. However, treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the underlying peripheral...... of human quantitative pain assessment tools (quantitative sensory testing (QST)) have been developed providing new opportunities for profiling patients and reaching a greater understanding of the mechanisms involved in chronic joint pain. As joint pain is a complex interaction between many different pain...

  8. Correlates of Improvement in Multidisciplinary Treatment of Chronic Pain.

    Science.gov (United States)

    Jensen, Mark P.; And Others

    1994-01-01

    Chronic pain patients (n=94) completed measures of physical and psychological functioning, health care utilization, pain beliefs, and use of pain coping strategies at admission and three to six months after inpatient pain treatment. Improved functioning and decreased health care use were associated with changes in both beliefs and cognitive coping…

  9. Central sensitization in chronic low back pain: A narrative review.

    Science.gov (United States)

    Sanzarello, Ilaria; Merlini, Luciano; Rosa, Michele Attilio; Perrone, Mariada; Frugiuele, Jacopo; Borghi, Raffaele; Faldini, Cesare

    2016-11-21

    Low back pain is one of the four most common disorders in all regions, and the greatest contributor to disability worldwide, adding 10.7% of total years lost due to this health state. The etiology of chronic low back pain is, in most of the cases (up to 85%), unknown or nonspecific, while the specific causes (specific spinal pathology and neuropathic/radicular disorders) are uncommon. Central sensitization has been recently recognized as a potential pathophysiological mechanism underlying a group of chronic pain conditions, and may be a contributory factor for a sub-group of patients with chronic low back pain. The purposes of this narrative review are twofold. First, to describe central sensitization and its symptoms and signs in patients with chronic pain disorders in order to allow its recognition in patients with nonspecific low back pain. Second, to provide general treatment principles of chronic low back pain with particular emphasis on pharmacotherapy targeting central sensitization.

  10. Medical marijuana use for chronic pain: risks and benefits.

    Science.gov (United States)

    Greenwell, Garth T

    2012-01-01

    Questions from patients about medical marijuana use for chronic pain are becoming more common. The information in this report will help patients understand the potential risks and benefits of using this substance for painful conditions.

  11. Seniors and Chronic Pain | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... their own and 75-85 percent of the elderly in care facilities suffer from chronic pain. Yet, pain among older adults is largely undertreated, with serious health consequences, such as depression, anxiety, decreased mobility, social isolation, poor sleep, and ...

  12. Physical activity and persistent low back pain and pelvic pain post partum

    Directory of Open Access Journals (Sweden)

    Mogren Ingrid M

    2008-12-01

    Full Text Available Abstract Background The aims of this study were (i to investigate the potential influence of pre-pregnancy regular leisure-time physical activity (PA on the risk of persistent LBPP half a year after pregnancy, and (ii to explore the starting time and prevalence of PA among women experiencing LBPP during pregnancy, in relation to remission or persistent LBPP half a year after pregnancy. Methods This study is a follow-up study of 639 women who reported LBPP during pregnancy. These women were sent a questionnaire at approximately six months after delivery. The respondents were divided into three groups: 'no pain', 'recurrent pain', and 'continuous pain'. Data were analysed using an independent samples t-test, Pearson's chi-squared test, and univariate and multivariate logistic regression analyses. Results 44.5% of subjects reported current PA at six months post partum. The mean starting time of PA was 2.6 months post partum and the mean number of current, weekly events of PA was 3.4; there were no differences between the groups. 82.2% reported previous PA at some period in life. Women with BMI ≥ 30 reported current PA to a lesser extent. The number of years of pre-pregnancy PA did not influence the risk of persistent LBPP. Conclusion Almost half of women who had experienced LBPP during pregnancy reported PA at six months post partum. The number of years of pre-pregnancy PA did not influence the risk of persistent LBPP. Obesity was a risk factor for not practising PA.

  13. Epidemiology of chronic pain in Denmark: an update

    DEFF Research Database (Denmark)

    Sjøgren, Per; Ekholm, Ola; Peuckmann, Vera;

    2008-01-01

    The most recent Danish health survey of 2005 is based on a region-stratified random sample of 10.916 individuals. Data were collected via personal interviews and self-administrated questionnaires. Respondents suffering from chronic pain were identified through the question 'Do you have chronic....../long-lasting pain lasting 6 months or more?' The prevalence of chronic pain among individuals with a present or earlier cancer diagnosis was also assessed. In all, 7275 individuals (66.6%) completed a personal interview and 5552 individuals (50.9% of the original sample) completed and returned the self......-administrated questionnaire. The same questions were included in the survey in 2000 and, hence, it was possible to evaluate the trends in the past five years. In all, 20.2% of the adult Danish population has chronic pain. From year 2000-2005 the prevalence of chronic pain has remained stable. Generally, chronic pain...

  14. Sleep disorders and chronic craniofacial pain: Characteristics and management possibilities.

    Science.gov (United States)

    Almoznino, Galit; Benoliel, Rafael; Sharav, Yair; Haviv, Yaron

    2017-06-01

    Chronic craniofacial pain involves the head, face and oral cavity and is associated with significant morbidity and high levels of health care utilization. A bidirectional relationship is suggested in the literature for poor sleep and pain, and craniofacial pain and sleep are reciprocally related. We review this relationship and discuss management options. Part I reviews the relationship between pain and sleep disorders in the context of four diagnostic categories of chronic craniofacial pain: 1) primary headaches: migraines, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs) and hypnic headache, 2) secondary headaches: sleep apnea headache, 3) temporomandibular joint disorders (TMD) and 4) painful cranial neuropathies: trigeminal neuralgia, post-herpetic trigeminal neuropathy, painful post-traumatic trigeminal neuropathy (PTTN) and burning mouth syndrome (BMS). Part II discusses the management of patients with chronic craniofacial pain and sleep disorders addressing the factors that modulate the pain experience as well as sleep disorders and including both non-pharmacological and pharmacological modalities.

  15. Breakthrough pain in chronic non-cancer pain: fact, fiction, or abuse.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Caraway, David L; Benyamin, Ramsin M

    2011-01-01

    Treatment of chronic non-cancer pain with opioid therapy has escalated in recent years, resulting in exploding therapeutic use and misuse of prescription opioids and multiple adverse drug events. Breakthrough pain is defined as a transient exacerbation of pain experienced by individuals who have relatively stable and adequately controlled baseline cancer pain. Further, the definition of breakthrough pain, prevalence, characteristics, implications, and treatment modalities have been extensively described for chronic cancer pain. However, the literature for breakthrough pain in chronic non-cancer pain including its terminology, prevalence, relevance, characteristics, and treatments, have been poorly described and continue to be debated. The philosophy of breakthrough pain in chronic non-cancer pain raises multiple issues leading almost all patients to be on high dose long-acting opioids, followed by supplementing with short-acting drugs, instead of treating the patients with only short-acting drugs as required. Consequently, the subject of breakthrough pain in chronic non-cancer pain is looked at with suspicion due to the lack of evidence and inherent bias associated with its evaluation, followed by escalating use and abuse of opioids. Multiple issues related to the concept of breakthrough pain in chronic non-cancer pain evolve around extensive use, overuse, misuse, and abuse of opioids. In the era of eliminating opioids or significantly curtailing their use to only appropriate indications, the concept of breakthrough pain raises multiple questions without any scientific evidence. This review illustrates that there is no significant evidence for any type of breakthrough pain in chronic non-cancer pain based on available literature, methodology utilized, and response to opioids in chronic non-cancer pain. The advocacy for increased usage of opioids in the treatment of chronic pain dates back to the liberalization of laws governing opioid prescription for the treatment

  16. Pain in patients with chronic fatigue syndrome: time for specific pain treatment?

    NARCIS (Netherlands)

    Nijs, J.; Crombez, G.; Meeus, M.; Knoop, H.; Damme, S.V.; Cauwenbergh, V.; Bleijenberg, G.

    2012-01-01

    BACKGROUND: Besides chronic fatigue, patients with chronic fatigue syndrome (CFS) have debilitating widespread pain. Yet pain from CFS is often ignored by clinicians and researchers. OBJECTIVES: To examine whether pain is a unique feature of CFS, or does it share the same underlying mechanisms as ot

  17. An update on the management of chronic lumbar discogenic pain.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2015-09-01

    Lumbar degenerative disc disease without disc herniation, also known as discogenic pain, is an elusive diagnosis of chronic low back pain. Lumbar provocation discography and fusion surgery have been frequently utilized for several decades as the gold standards for the diagnosis and treatment of symptomatic lumbar discogenic pain, though controversial, based on conjecture, rather than evidence. In addition to lumbar fusion, various other operative and nonoperative modalities of treatments are available in managing chronic lumbar discogenic pain. This review provides an updated assessment of the management of chronic lumbar discogenic pain with a critical look at the many modalities of treatments that are currently available.

  18. Commentary on the use of acupuncture in chronic pediatric pain.

    Science.gov (United States)

    Waterhouse, Michael; Tsao, Jennie C I; Zeltzer, Lonnie K

    2009-02-01

    The use of acupuncture for pain in pediatrics is a long-standing practice in Eastern cultures. Despite growing interest in the West, there has been relatively little systematic research on acupuncture for chronic pediatric pain. In particular, there is a paucity of randomized clinical trials testing the efficacy of acupuncture for chronic pain problems in pediatric populations. This commentary briefly reviews the history of acupuncture for pain and includes a summary of extant findings regarding potential mechanisms of its analgesic effects. Key areas for future research to advance the application of acupuncture to chronic pediatric pain problems are outlined.

  19. Treatment effect of pelvic floor treating chronic pelvic inflammatory disease%盆底治疗在慢性盆腔炎中的治疗效果

    Institute of Scientific and Technical Information of China (English)

    蒋艳华

    2015-01-01

    Objective To explore the treatment effect of pelvic floor treating chronic pelvic inflammatory disease. Methods Selecting 100 cases of chronic pelvic inflammation patients admitted our hospital from November 2010 to November 2013,they were randomly divided into the 50 control group and 50 observation group.Simple drug treats control group patients,pelvic therapy instrument combined with pelvic floor muscle training treat observation group. Finally,observing the clinical condition of two groups of patients. Results The effective rate of observation group therapy was 96%,and recurrence rate was 8%,significantly higher than 80% of the control group and 48% (P < 0.05). At the same time,VSA score of after treatment was significantly lower than the control group (P < 0.05). Conclusion Pelvic floor treat patients with chronic pelvic inflammatory disease,the treatment effect is significant,and the recurrence rate is lower,it is high clinical value in using.%目的:探究盆底治疗在慢性盆腔炎中的治疗效果。方法选取我科在2010年11月~2013年11月收治的100例慢性盆腔炎患者,将其随机分为50例对照组和50例观察组。其中,单纯药物治疗对照组患者,盆底治疗仪联合盆底肌锻炼治疗观察组。最后观察两组患者的临床情况。结果观察组治疗有效率、复发率分别为96%、8%,明显优于对照组的80%、48%(P <0.05)。同时,治疗后,与对照组相比,观察组患者盆腔 VSA 评分明显较低(P <0.05)。结论盆底治疗慢性盆腔炎效果显著,复发率低,具有较高的临床利用价值。

  20. Chronic Neck Pain and Cervicogenic Headaches.

    Science.gov (United States)

    Feng, Frank L.; Schofferman, Jerome

    2003-11-01

    Chronic axial neck pain and cervicogenic headache are common problems, and there have been significant advances in the understanding of the etiology and treatment of each. The severity and duration of pain drives the process. For patients who have had slight to moderate pain that has been present for less than 6 months and have no significant motor loss, strength training of anterior, posterior, and interscapular muscle groups coupled with body mechanics training is prescribed. After 8 weeks, if the patient is better, exercises are continued at home or in a gym. If the patient is not better, physical therapy is continued for up to 8 more weeks. In patients with motor loss or severe pain, radiographs and magnetic resonance imaging (MRI) should be ordered at the initial visit. In patients with slight to moderate pain who are not better by 4 to 6 months, plain radiographs of the neck and MRI should be ordered. Based on the results, a spinal injection is usually prescribed. If MRI reveals spinal stenosis of the central or lateral canal, or a disc herniation, an epidural corticosteroid injection should be ordered. If the epidural provides good relief, the patient can be referred for more aggressive physical therapy and repeat the epidural as needed up to a maximum of three times. If there is no pathology within the canal, medial branch blocks and intra-articular steroid injections can be ordered based on the joints that are most tender or where disc space narrowing is greatest, or MRI or radiographs are recommended. If there is excellent relief from the medial branch block and joint injections, repeat when the steroids wear off. If there is good relief again, but pain recurs, medial branch radiofrequency neurotomy is recommended. For patients with one or two level disc degeneration that has not responded, a psychologic evaluation and discography is recommended. If there are no significant psychologic abnormalities, and one or two (rarely three) painful discs, surgical

  1. Cognitive processes in comorbid poor sleep and chronic pain.

    Science.gov (United States)

    Byers, Haley D; Lichstein, Kenneth L; Thorn, Beverly E

    2016-04-01

    We examined the unique and shared contributions of pain catastrophizing, cognitive pre-sleep arousal, and somatic pre-sleep arousal, to the prediction of insomnia severity in chronic pain. Forty-eight adults with chronic pain completed self-report measures of these study variables, health, and mood. Hierarchical regression showed that pain catastrophizing accounted for unique variance in insomnia severity, independent of pain intensity, depression, restless legs symptoms, and demographics. However, when cognitive and somatic pre-sleep arousal were also taken into account, the significance of cognitive pre-sleep arousal rendered pain catastrophizing non-significant. We identify research and clinical implications of this study.

  2. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    , incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non-malignant pain...... treatment as addiction may result in poor pain control. Several screening tools were identified, but only a few were thoroughly validated with respect to validity and reliability. Most of the identified guidelines mention addiction as a potential problem. The guidelines in cancer pain management...... long-term opioid treatment, and specialised treatment facilities for pain management or addiction medicine should be consulted in these cases....

  3. Pelvic ultrasound - abdominal

    Science.gov (United States)

    ... tubes Abnormal vaginal bleeding Menstrual problems Problems becoming pregnant (infertility) Normal pregnancy Ectopic pregnancy , a pregnancy that occurs outside the uterus Pelvic pain Pelvic ultrasound is also used during ...

  4. Basolateral amygdala lesion inhibits the development of pain chronicity in neuropathic pain rats.

    Directory of Open Access Journals (Sweden)

    Zheng Li

    Full Text Available BACKGROUND: Chronicity of pain is one of the most interesting questions in chronic pain study. Clinical and experimental data suggest that supraspinal areas responsible for negative emotions such as depression and anxiety contribute to the chronicity of pain. The amygdala is suspected to be a potential structure for the pain chronicity due to its critical role in processing negative emotions and pain information. OBJECTIVE: This study aimed to investigate whether amygdala or its subregions, the basolateral amygdala (BLA and the central medial amygdala (CeA, contributes to the pain chronicity in the spared nerve injury (SNI-induced neuropathic pain model of rats. METHODOLOGY/PRINCIPAL FINDINGS: (1 Before the establishment of the SNI-induced neuropathic pain model of rats, lesion of the amygdaloid complex with stereotaxic injection of ibotenic acid (IBO alleviated mechanical allodynia significantly at days 7 and 14, even no mechanical allodynia at day 28 after SNI; Lesion of the BLA, but not the CeA had similar effects; (2 however, 7 days after SNI when the neuropathic pain model was established, lesion of the amygdala complex or the BLA or the CeA, mechanical allodynia was not affected. CONCLUSION: These results suggest that BLA activities in the early stage after nerve injury might be crucial to the development of pain chronicity, and amygdala-related negative emotions and pain-related memories could promote pain chronicity.

  5. Association between chronic pain and the sperm motion characteristics

    DEFF Research Database (Denmark)

    Dardmeh, Fereshteh; Alipour, Hiva; Nielsen, Hans Ingolf

    2015-01-01

    valuable, prognostic indicators of successful fertilization. Maturation of sperm motility occurs during their transit through the epididymis and vas deferens regulated by androgens. As male gonadal hormones have an inhibitory, adaptive effect on the behavioral and neuronal responses to repeated nociceptive...... stimulation, it can be speculated that the observed difference in sperm kinematic parameters could be related to the alterations in serum sex hormone levels emanating from the chronic pain. Further studies are required to explain the possible mechanism of action of chronic pain on male fertility.......Sex hormones play an important role in pain in many chronic pain conditions. Relationship between chronic pain and sperm quality has not been investigated thoroughly and may provide an insight to better understanding, management and treatment of cases where chronic pain and male sub-fertility co...

  6. Pelvic pain from a giant presacral Tarlov cyst successfully obliterated using aneurysm clips in a patient with Marfan syndrome.

    Science.gov (United States)

    Wang, Bonnie; Moon, Seong-Jin; Olivero, William C; Wang, Huan

    2014-11-01

    Patients with Marfan syndrome used to succumb early in life from cardiovascular complications. With the current rapid advance in medical and surgical care, such patients may now have near-normal longevities. Consequently, rare late-life complications are emerging in these patients and represent challenges to clinicians for their diagnoses and treatments. The authors report a rare case of pelvic pain and genital prolapse from a giant presacral Tarlov cyst in a 67-year-old patient with Marfan syndrome. This 67-year-old Caucasian female presented with progressively severe pelvic pain, intermittent explosive diarrhea, and dysuria. Physical and bimanual examination demonstrated genital prolapse and a nontender, cyst-like mass fixed in the midline. She underwent ultrasound, CT, and eventually MRI evaluations that led to the diagnosis of a giant (6.7 × 6.4 × 6.6 cm) Tarlov cyst originating from the right S-2 nerve root sleeve/sacral foramen with intrapelvic extension. She underwent S1-S2 and S2-S3 laminectomy with obliteration of the Tarlov cyst using aneurysm clips. Postoperatively, her pelvic pain and bowel symptoms resolved and the bladder symptoms improved. The 3-month follow-up CT of abdomen/pelvis demonstrated resolution of the cyst. The present case illustrates that clinicians caring for elderly patients with Marfan syndrome need to increasingly recognize such unusual late-life complications. Also, these large Tarlov cysts can be simply and effectively obliterated with aneurysm clips.

  7. Chronic Pain Following Spinal Cord Injury: The Role of Immunogenetics and Time of Injury Pain Treatment

    Science.gov (United States)

    2015-10-01

    central sensitization to nociceptive stimuli culminates in profound debilitating pain that serves no adaptive purpose for the sufferer. It is now...Award Number: W81XWH-11-1-0806 TITLE: Chronic Pain Following Spinal Cord Injury: The Role of Immunogenetics and Time of Injury Pain Treatment...29Sep2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-1-0806 Chronic Pain Following Spinal Cord Injury: The Role of Immunogenetics and Time

  8. Are emotion regulation skills related to adjustment among people with chronic pain, independent of pain coping?

    Science.gov (United States)

    Agar-Wilson, M; Jackson, T

    2012-01-01

    Although emotion regulation capacities have been linked to adjustment among people with chronic pain, researchers have yet to determine whether these capacities are related to functioning independent of established facets of pain coping. The present study was designed to address this gap. A sample 128 Australian adults with chronic pain (44 men, 84 women) completed self-report measures of adjustment (quality of life, negative affect, and pain-related disability), pain coping, and features of emotion regulation (emotion appraisal, perceived efficacy in emotion regulation, emotion utilization). Hierarchical multiple regression analyses indicated that efficacy in emotion regulation was related to quality of life and reduced negative affect even after statistically controlling for effects of other measures of adjustment, pain coping efficacy, and pain coping. Conversely, features of emotion regulation did not improve the prediction model for pain-related disability. Findings suggest emotion regulation capacities may have a unique role in the prediction of specific facets of adjustment among people with chronic pain.

  9. Relief of Urinary Urgency, Hesitancy, and Male Pelvic Pain with Pulse Radiofrequency Ablation of the Pudendal Nerve: A Case Presentation

    OpenAIRE

    Christopher Bui; Sanjog Pangarkar; Zeitlin, Scott I.

    2013-01-01

    Background and Aims. This report demonstrates the utility of a pudendal nerve block by pulsed radiofrequency ablation (RFA) for the treatment of male pelvic pain and urinary urgency and hesitancy. Methods. The patient is an 86-year-old gentleman with a 30-year history of urinary hesitancy and urgency. The patient also had pain in the area of the perineum but considered it a secondary issue. The patient was seen by a number of specialists, tried various medications, and underwent a variety of ...

  10. Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

    Science.gov (United States)

    Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

    2015-12-01

    The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p treatment outcome (odds ratio = 0.55, p treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain.

  11. Respiratory weakness in patients with chronic neck pain.

    Science.gov (United States)

    Dimitriadis, Zacharias; Kapreli, Eleni; Strimpakos, Nikolaos; Oldham, Jacqueline

    2013-06-01

    Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P Neck muscle strength (r > 0.5), kinesiophobia (r neck pain and disability (r Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.

  12. Mechanism of Chronic Pain in Rodent Brain Imaging

    Science.gov (United States)

    Chang, Pei-Ching

    Chronic pain is a significant health problem that greatly impacts the quality of life of individuals and imparts high costs to society. Despite intense research effort in understanding of the mechanism of pain, chronic pain remains a clinical problem that has few effective therapies. The advent of human brain imaging research in recent years has changed the way that chronic pain is viewed. To further extend the use of human brain imaging techniques for better therapies, the adoption of imaging technique onto the animal pain models is essential, in which underlying brain mechanisms can be systematically studied using various combination of imaging and invasive techniques. The general goal of this thesis is to addresses how brain develops and maintains chronic pain in an animal model using fMRI. We demonstrate that nucleus accumbens, the central component of mesolimbic circuitry, is essential in development of chronic pain. To advance our imaging technique, we develop an innovative methodology to carry out fMRI in awake, conscious rat. Using this cutting-edge technique, we show that allodynia is assoicated with shift brain response toward neural circuits associated nucleus accumbens and prefrontal cortex that regulate affective and cognitive component of pain. Taken together, this thesis provides a deeper understanding of how brain mediates pain. It builds on the existing body of knowledge through maximizing the depth of insight into brain imaging of chronic pain.

  13. Role of Alternative Therapies for Chronic Pain Syndromes.

    Science.gov (United States)

    Thomas, Donna-Ann; Maslin, Benjamin; Legler, Aron; Springer, Erin; Asgerally, Abbas; Vadivelu, Nalini

    2016-05-01

    There is increasing interest in the use of complimentary and alternative medicine (CAM) for the treatment of chronic pain. This review examines alternative and complimentary therapies, which can be incorporated as part of a biopsychosocial approach in the treatment of chronic pain syndromes. In the present investigation, literature from articles indexed on PubMed was evaluated including topics of alternative therapies, complimentary therapies, pain psychology, biofeedback therapy, physical exercise therapies, acupuncture, natural and herbal supplements, whole-body cryotherapy, and smartphone technologies in the treatment of chronic pain syndromes. This review highlights the key role of psychology in the treatment of chronic pain. Cognitive behavior therapy appears to be the most impactful while biofeedback therapy has also been shown to be effective for chronic pain. Exercise therapy has been shown to be effective in short-, intermediate-, and long-term pain states. When compared to that in sham controls, acupuncture has shown some benefit for neck pain immediately after the procedure and in the short term and improvement has also been demonstrated in the treatment of headaches. The role of smartphones and whole-body cryotherapy are new modalities and further studies are needed. Recent literature suggests that several alternate therapies could play a role in the treatment of chronic pain, supporting the biopsychosocial model in the treatment of pain states.

  14. The efficacy of adhesiolysis on chronic abdominal pain

    DEFF Research Database (Denmark)

    Gerner-Rasmussen, Jonas; Burcharth, Jakob; Gögenur, Ismail

    2015-01-01

    INTRODUCTION: Abdominal adhesions are a frequent reason for chronic abdominal pain. The purpose of this systematic review was to investigate the evidence of performing laparoscopic adhesiolysis as a treatment for patients with chronic abdominal pain. METHODS: Medline, Embase, and The Cochrane Cen...

  15. Classification of chronic orofacial pain using an intravenous diagnostic test

    NARCIS (Netherlands)

    Tjakkes, G. -H. E.; De Bont, L. G. M.; van Wijhe, M.; Stegenga, B.

    2009-01-01

    The aim of this study was to evaluate the ability of a preliminary intravenous diagnostic test to classify chronic orofacial pain patients into different subgroups. Patients with chronic orofacial pain conditions that could not be unambiguously diagnosed. A retrospective evaluation of series of cond

  16. Chronic pain in children and adolescents: observational studies

    NARCIS (Netherlands)

    C.W. Perquin (Christel)

    2002-01-01

    textabstractIn adults, chronic pain is by most people involved considered to be a serious disorder. Although chronic pain in adults is in general not life-threatening, a considerable amount of literature elucidates the large number of sufferers, the high cost to the person in question and to the soc

  17. Psychosocial assessment and self-management of chronic pain

    NARCIS (Netherlands)

    J.S. Voerman (Jessica)

    2015-01-01

    markdownabstractAbstract Chronic pain is prevalent in both children and adults and has major negative consequences for their daily life, e.g. reduced participation in activities and depressive and anxious feelings. Therefore, it is important to early signal and treat chronic pain. This thesis aimed

  18. Dimensions of "unidimensional" ratings of pain and emotions in patients with chronic musculoskeletal pain.

    Science.gov (United States)

    Huber, Alexa; Suman, Anna Lisa; Rendo, Carmela Anna; Biasi, Giovanni; Marcolongo, Roberto; Carli, Giancarlo

    2007-08-01

    The use of unidimensional scales to measure pain intensity has been criticised because of the multidimensional nature of pain. We conducted multiple linear regression analyses to determine which dimensions of pain--sensory versus affective--predicted scores on unidimensional scales measuring pain intensity and emotions in 109 Italian women suffering from chronic, non-malignant musculoskeletal pain. We then compared the results with earlier findings in two groups of cancer patients suffering from acute post-operative pain and chronic cancer-related pain, respectively. Age, physical capacity and scores on the multidimensional affect and pain survey (MAPS) were used to predict patients' ratings on one visual analogue scale (VAS) and three numerical rating scales (NRS) measuring pain intensity, anxiety and depressed mood. Unidimensional pain intensity ratings were predicted better from sensory than from affective pain predictors, and the affective predictors made no unique contribution (NRS), or only a very small one (VAS). Both sensory and emotional pain aspects were unique predictors of NRS anxiety and depression. Therefore, in contrast to earlier findings in two different types of cancer patients, in subjects affected by chronic non-malignant musculoskeletal pain, the scores on unidimensional pain intensity scales mainly reflect sensory pain dimensions, supporting the discriminant validity of the NRS and VAS used. However, the patients had some difficulty in distinguishing between sensory and emotional information. For this reason, several unidimensional scales to rate pain intensity and emotions separately should be used to obtain a complete picture of the status and needs of any given patient.

  19. Application of CUA Guidelines on Prostatitis in the management of chronic pelvic pain syndrome: A nationwide survey%泌尿男科医师应用《CUA前列腺炎诊断治疗指南》诊疗CPPS的调查

    Institute of Scientific and Technical Information of China (English)

    张凯; 白文俊; 商学军; 肖云翔; 刘继红; 李铮; 邓春华; 王怀鹏

    2013-01-01

    目的:了解中华医学会泌尿外科学分会(CUA)《前列腺炎诊断治疗指南》(以下简称《指南》)的推广和应用效果,及其对我国泌尿男科医师诊断、治疗CPPS的观念和实践的影响. 方法:在全国21个城市173家医院泌尿男科发放问卷,回收问卷后,对有效问卷进行统计分析. 结果:发放问卷1056份,回收有效问卷851份(80.6%).答卷者中,71.6%来自三级医院,高级和中级职称的医师占80.7%,97.5%的医师学习过《指南》.绝大多数医师认同Ⅲ型前列腺炎是一种临床综合征,诊断需要排除其他引起类似症状的疾病,治疗目标是缓解疼痛、改善排尿症状、提高生活质量.在学过或没学过指南的医师中,对部分观点的认同也有差异.在临床实际工作中,泌尿男科医师给CPPS患者最常选用的治疗方法(多选)是心理治疗(80.7%)、药物治疗(80.4%)、调整生活方式(79.6%);最常用的前3类药物是植物药(80.0%)、α受体阻滞剂(68.9%)和抗生素(61.0%). 结论:CUA《前列腺炎诊断治疗指南》得到了广泛的推广,其主要内容得到了深入的领会和应用,推动了我国泌尿男科医师规范化诊治CPPS的进程.%Objective: To investigate the application of the Chinese Urological Association (CUA) Guidelines on Prostatitis and its effects on the clinical practice patterns of diagnosing and treating chronic pelvic pain syndrome (CPPS) among Chinese urologists and andrologists. Methods; We conducted a questionnaire investigation on the application of the CUA Guidelines on Prostatitis among the urologists and andrologists of 173 hospitals in 21 cities of China, and performed statistical analyses on all the eligible questionnaires collected. Results: Of the 1 056 questionnaires distributed, 851 (80. 6% ) were eligible, of which 71. 6% were from the urologists or andrologists in grade 3 hospitals, 80. 7% of them with senior or intermediate professional titles and 97

  20. Chronic pain: the role of learning and brain plasticity.

    Science.gov (United States)

    Mansour, A R; Farmer, M A; Baliki, M N; Apkarian, A Vania

    2014-01-01

    Based on theoretical considerations and recent observations, we argue that continued suffering of chronic pain is critically dependent on the state of motivational and emotional mesolimbic-prefrontal circuitry of the brain. The plastic changes that occur within this circuitry in relation to nociceptive inputs dictate the transition to chronic pain, rendering the pain less somatic and more affective in nature. This theoretical construct is a strong departure from the traditional scientific view of pain, which has focused on encoding and representation of nociceptive signals. We argue that the definition of chronic pain can be recast, within the associative learning and valuation concept, as an inability to extinguish the associated memory trace, implying that supraspinal/cortical manipulations may be a more fruitful venue for adequately modulating suffering and related behavior for chronic pain. We briefly review the evidence generated to date for the proposed model and emphasize that the details of underlying mechanisms remain to be expounded.

  1. Control Beliefs, Coping Efforts, and Adjustment to Chronic Pain.

    Science.gov (United States)

    Jensen, Mark P.; Karoly, Paul

    1991-01-01

    Examined adaptation to chronic pain in 118 patients. Control appraisals, ignoring pain, using coping self-statements, and increasing activities were positively related to psychological functioning. Control appraisals, diverting attention, ignoring pain, and using coping self-statements were positively related to activity level for patients…

  2. Systematic mechanism-orientated approach to chronic pancreatitis pain

    NARCIS (Netherlands)

    Bouwense, S.A.W.; Vries, M. de; Schreuder, L.T.W.; Olesen, S.S.; Frokjaer, J.B.; Drewes, A.M.; Goor, H. van; Wilder-Smith, O.H.G.

    2015-01-01

    Pain in chronic pancreatitis (CP) shows similarities with other visceral pain syndromes (i.e., inflammatory bowel disease and esophagitis), which should thus be managed in a similar fashion. Typical causes of CP pain include increased intrapancreatic pressure, pancreatic inflammation and pancreatic/

  3. Psychological Processing in Chronic Pain: A Neural Systems Approach

    Science.gov (United States)

    Simons, Laura; Elman, Igor; Borsook, David

    2014-01-01

    Our understanding of chronic pain involves complex brain circuits that include sensory, emotional, cognitive and interoceptive processing. The feed-forward interactions between physical (e.g., trauma) and emotional pain and the consequences of altered psychological status on the expression of pain have made the evaluation and treatment of chronic pain a challenge in the clinic. By understanding the neural circuits involved in psychological processes, a mechanistic approach to the implementation of psychology-based treatments may be better understood. In this review we evaluate some of the principle processes that may be altered as a consequence of chronic pain in the context of localized and integrated neural networks. These changes are ongoing, vary in their magnitude, and their hierarchical manifestations, and may be temporally and sequentially altered by treatments, and all contribute to an overall pain phenotype. Furthermore, we link altered psychological processes to specific evidence-based treatments to put forth a model of pain neuroscience psychology. PMID:24374383

  4. Disability and borderline personality disorder in chronic pain patients

    OpenAIRE

    2010-01-01

    BACKGROUND AND OBJECTIVE: Few studies have examined the relationship between disability and borderline personality symptomatology, and, among those that have, findings have been inconsistent. In the present study, the relationship between medical disability and borderline personality symptomatology was examined in a sample of chronic pain patients.METHODS: In a consecutive insured sample of male and female chronic pain patients (n=117), who were being initially evaluated by an outpatient pain...

  5. Investigation of Chronic Pain Following Traumatic Brain Injury

    Science.gov (United States)

    2014-03-01

    to those in other chronic pain states such as migraine and fibromyalgia when controlled for co-morbid insomnia, depression and PTSD. The study groups...to be compared for this work include patients with chronic migraine, fibromyalgia , post-traumatic pain post mTBI, asymptomatic individuals post mTBI...migraine, fibromyalgia , post-traumatic pain post mTBI, asymptomatic individuals post mTBI, and normal controls. The understanding of the

  6. Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Burns LC

    2015-01-01

    Full Text Available Lindsay C Burns,1–3 Sarah E Ritvo,1 Meaghan K Ferguson,1 Hance Clarke,3–5 Ze’ev Seltzer,3,5 Joel Katz1,3–5 1Department of Psychology, York University, Toronto, ON, Canada; 2Arthritis Research Centre of Canada, Vancouver, BC, Canada; 3Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; 4Department of Anesthesia, University of Toronto, Toronto, ON, Canada; 5Centre for the Study of Pain, Faculties of Dentistry and Medicine, University of Toronto, Toronto, ON, Canada Background: Total knee arthroplasty (TKA is a common and costly surgical procedure. Despite high success rates, many TKA patients develop chronic pain in the months and years following surgery, constituting a public health burden. Pain catastrophizing is a construct that reflects anxious preoccupation with pain, inability to inhibit pain-related fears, amplification of the significance of pain vis-à-vis health implications, and a sense of helplessness regarding pain. Recent research suggests that it may be an important risk factor for untoward TKA outcomes. To clarify this impact, we systematically reviewed the literature to date on pain catastrophizing as a prospective predictor of chronic pain following TKA. Methods: We searched MEDLINE, EMBASE, and PsycINFO databases to identify articles related to pain catastrophizing, TKA, risk models, and chronic pain. We reviewed titles and abstracts to identify original research articles that met our specified inclusion criteria. Included articles were then rated for methodological quality. including methodological quality. Due to heterogeneity in follow-up, analyses, and outcomes reported across studies, a quantitative meta-analysis could not be performed. Results: We identified six prospective longitudinal studies with small-to-mid-sized samples that met the inclusion criteria. Despite considerable variability in reported pain outcomes, pain catastrophizing was identified as a significant

  7. Do illness perceptions of people with chronic low back pain differ from people without chronic low back pain?

    NARCIS (Netherlands)

    van Wilgen, C. Paul; van Ittersum, Miriam W.; Kaptein, Ad A.

    2013-01-01

    Objectives To determine why some people develop chronic low back pain, and whether illness perceptions are an important risk factor in the transition from acute to chronic low back pain. Design Cross-sectional study. Participants Four hundred and two members of the general Dutch population, with and

  8. Midgut malrotation with chronic abdominal pain

    Directory of Open Access Journals (Sweden)

    Anil K Wanjari

    2012-01-01

    Full Text Available Abnormalities in midgut rotation occur during the physiological herniation of midgut between the 5 th and 10 th week of gestation. The most significant abnormality is narrow small bowel mesentery which is prone to volvulus. This occurs most frequently in the neonatal period, less commonly midgut malrotation presents in adulthood with either acute volvulus or chronic abdominal symptoms. It is the latter group that represents a diagnostic challenge. We report a case of a 17-year-old male patient who presented with 10-year history of nonspecific gastro-intestinal symptoms. After extensive investigation the patient was diagnosed with midgut malrotation following computed tomography of abdomen. The patient was treated with a laparoscopic Ladd′s procedure and at 3 months he was gaining weight and had stopped vomiting. A laparoscopic Ladd′s procedure is an acceptable alternative to the open technique in treating symptomatic malrotation in adults. Midgut malrotation is a rare congenital anomaly which may present as chronic abdominal pain. Abdominal CT is helpful for diagnosis.

  9. Management of chronic pain in osteoporosis: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Paolucci T

    2016-04-01

    Full Text Available Teresa Paolucci,* Vincenzo Maria Saraceni, Giulia Piccinini* Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy *These authors contributed equally to this work Abstract: Osteoporosis (OP is a pathological condition that manifests clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care. Chronic pain is a multidimensional experience with sensory, affective, and cognitive aspects. Age can affect each of these dimensions and the pain that is experienced. In OP, chronic pain appears to have sensory characteristics and properties of nociceptive and neuropathic pain. Its evaluation and treatment thus require a holistic approach that focuses on the specific characteristics of this population. Pain management must therefore include pharmacological approaches, physiotherapy interventions, educational measures, and, in rare cases, surgical treatment. Most rehabilitative treatments in the management of patients with OP do not evaluate pain or physical function, and there is no consensus on the effects of rehabilitation therapy on back pain or quality of life in women with OP. Pharmacological treatment of pain in patients with OP is usually insufficient. The management of chronic pain in patients with OP is complicated with regard to its diagnosis, the search for reversible secondary causes, the efficacy and duration of oral bisphosphonates, and the function of calcium and vitamin D. The aim of this review is to discuss the most appropriate solutions in the management of chronic pain in OP. Keywords: physical therapy, exercise, pharmacological treatment, posture and balance

  10. [The place of pelvic adhesions in gynecology. Possibilities of prevention].

    Science.gov (United States)

    Inovay, J; Szendei, G

    1997-10-05

    The authors review the recent international literature dealing with the role of pelvic adhesions in gynaecologic surgery. They point out that pelvic adhesions can be detected via laparatomy or laparoscopy in every third patient suffering from chronic pelvic pain, whereas abdominal adhesions revealed rarely correlate with anamnestic chronic pelvic pain. Correlation of pelvic pain and adhesions is neither consequent nor mutual. Lacking more detailed information on the pathomechanism of pain, the role of the vegetative innervation of the visceral and parietal peritoneum and of the excitation of the nerve fibers in the neoformed-and vascularized adhesions can only be postulated. According to the attractive but not well established theory extensive adhesions can directly provoke pain through fixing the pelvic organs hampering their motility and mobility. It is generally accepted, that lysis of adhesions in symptomatic patients can resolve or reduce the complaints. However the duration of the beneficial effect and its transitoric or definitive nature cannot be predicted in advance. Subsequently the authors review the adjuvant methods complementary to microsurgical techniques possibly preventing the formation and neoformation of pelvic adhesions. Despite of general acceptance and widespread usage, the effectiveness of crystalloids, macromolecular solutions, intraperitoneal heparin and steroids in the prevention of adhesions cannot be scientifically supported. The encouraging results already achieved by mechanical barriers (intercede, Gore-Tex) can hopefully be surpassed by biodegradable barriers actually studied in animal models.

  11. AMELOTEX IN THE TREATMENT OF CHRONIC BACK PAIN SYNDROMES

    Directory of Open Access Journals (Sweden)

    Irina Yuryevna Suvorova

    2010-01-01

    Full Text Available Recently there has been a considerable increase in the number of patients with lingering recurrent and chronic pain syndromes of various origin. Forty-one patients with dorsopathies were examined. Two types of pain were identified; these were vertebrogenic and nonvertebrogenic pains. The appropriateness of this identification was confirmed by instrumental studies. Treatment was performed using a selective nonsteroidal antiinflammatory drug (Amelotex. Pain syndrome relief was noted during the therapy

  12. A neural model for chronic pain and pain relief by extracorporeal shock wave treatment.

    Science.gov (United States)

    Wess, Othmar J

    2008-12-01

    The paper develops a new theory of chronic pain and pain relief by extracorporeal shock wave treatment. Chronic pain without underlying anatomical disorder is looked at as a pathological control function of memory. Conditioned reflexes are considered to be engraved memory traces linking sensory input of afferent signals with motor response of efferent signals. This feature can be described by associative memory functions of the nervous system. Some conditioned reflexes may cause inappropriate or pathological reactions. Consequently, a circulus vitiosus of pain sensation and muscle and/or vessel contraction is generated when pain becomes chronic (pain spiral). The key feature is a dedicated engram responsible for a pathological (painful) reaction. The pain memory may be explained by the concept of a holographic memory model published by several authors. According to this model it is shown how nervous systems may generate and recall memory contents. The paper shows how extracorporeal shock wave treatment may reorganize pathologic memory traces, thus giving cause to real and permanent pain relief. In a generalized manner, the idea of associative memory functions may help in the understanding of conditioning as a learning process and explain extracorporeal shock wave application as an efficient treatment concept for chronic pain. This concept may open the door for new treatment approaches to chronic pain and several other disorders of the nervous system.

  13. Comparison between children and adolescents with and without chronic benign pain: consultation rate and pain characteristics

    NARCIS (Netherlands)

    F.C. van Eekelen; C.W. Perquin (Christel); J.A.M. Hunfeld (Joke); A.A.J.M. Hazebroek-Kampschreur (Alice); L.W.A. van Suijlekom-Smit (Lisette); B.W. Koes (Bart); J. Passchier (Jan); J.C. van der Wouden (Hans)

    2002-01-01

    textabstractThe aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was

  14. Could stress contribute to pain-related fear in chronic pain?

    Directory of Open Access Journals (Sweden)

    Sigrid eElsenbruch

    2015-12-01

    Full Text Available Learning to predict pain based on internal or external cues constitutes a fundamental and highly adaptive process aimed at self-protection. Pain-related fear is an essential component of this response, which is formed by associative and instrumental learning processes. In chronic pain, pain-related fear may become maladaptive, drive avoidance behaviors and contribute to symptom chronicity. Pavlovian fear conditioning has proven fruitful to elucidate associative learning and extinction involving aversive stimuli, including pain, but studies in chronic pain remain scarce. Stress demonstrably exerts differential effects on emotional learning and memory processes, but this has not been transferred to pain-related fear. Within this perspective, we propose that stress could contribute to impaired pain-related associative learning and extinction processes and call for interdisciplinary research. Specifically, we suggest to test the hypotheses that (1 extinction-related phenomena inducing a re-activation of maladaptive pain-related fear (e.g., reinstatement, renewal likely occur in everyday life of chronic pain patients and may alter pain processing, impair perceptual discrimination and favour overgeneralization; (2 acute stress prior to or during acquisition of pain-related fear may facilitate the formation and/or consolidation of pain-related fear memories, (3 stress during or after extinction may impair extinction efficacy resulting in greater reinstatement or context-dependent renewal of pain-related fear; and (4 these effects could be amplified by chronic stress due to early adversity and/or psychiatric comorbidity such as depression or anxiety in patients with chronic pain.

  15. Enhanced Brain Responses to Pain-Related Words in Chronic Back Pain Patients and Their Modulation by Current Pain

    Science.gov (United States)

    Ritter, Alexander; Franz, Marcel; Puta, Christian; Dietrich, Caroline; Miltner, Wolfgang H. R.; Weiss, Thomas

    2016-01-01

    Previous functional magnetic resonance imaging (fMRI) studies in healthy controls (HC) and pain-free migraine patients found activations to pain-related words in brain regions known to be activated while subjects experience pain. The aim of the present study was to identify neural activations induced by pain-related words in a sample of chronic back pain (CBP) patients experiencing current chronic pain compared to HC. In particular, we were interested in how current pain influences brain activations induced by pain-related adjectives. Subjects viewed pain-related, negative, positive, and neutral words; subjects were asked to generate mental images related to these words during fMRI scanning. Brain activation was compared between CBP patients and HC in response to the different word categories and examined in relation to current pain in CBP patients. Pain-related words vs. neutral words activated a network of brain regions including cingulate cortex and insula in subjects and patients. There was stronger activation in medial and dorsolateral prefrontal cortex (DLPFC) and anterior midcingulate cortex in CPB patients than in HC. The magnitude of activation for pain-related vs. negative words showed a negative linear relationship to CBP patients’ current pain. Our findings confirm earlier observations showing that pain-related words activate brain networks similar to noxious stimulation. Importantly, CBP patients show even stronger activation of these structures while merely processing pain-related words. Current pain directly influences on this activation. PMID:27517967

  16. Pelvic actinomycosis.

    Science.gov (United States)

    Gorisek, B; Rebersek-Gorisek, H; Kavalar, R; Krajnc, I; Zavrsnik, S

    1999-08-20

    Pelvic actinomycosis is a rare chronic infection caused by bacteria of the family Actinomycetaceae. Prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor. We report six patients with pelvic actinomycosis, all of whom had an IUD inserted for over six years. Diagnostic problems necessitated a laparotomy in all patients. The pathohistological diagnosis was based on the characteristic microscopic image and specific staining. The patients were treated with penicillin and amoxycillin for several months.

  17. Emerging roles of microRNAs in chronic pain.

    Science.gov (United States)

    Sakai, Atsushi; Suzuki, Hidenori

    2014-11-01

    Chronic pain is a debilitating syndrome caused by a variety of disorders, and represents a major clinical problem because of the lack of adequate medication. In chronic pain, massive changes in gene expression are observed in a variety of cells, including neurons and glia, in the overall somatosensory system from the sensory ganglia to the higher central nervous system. The protein expressions of hundreds of genes are thought to be post-transcriptionally regulated by a single type of microRNA in a sequence-specific manner. Recently, critical roles of microRNAs in the pathophysiology of chronic pain have been emerging. Genome-wide screenings of microRNA expression changes have been reported in a variety of painful conditions, including peripheral nerve injury, inflammatory diseases, cancer and spinal cord injury. The data obtained suggest that a wide range of microRNAs change their expressions in individual pain conditions, although the pathological significance of individual microRNAs as causal mediators in distinct pain conditions remains to be revealed for a limited number of microRNAs. Insights into the roles of microRNAs in chronic pain will enhance our understanding of the pathophysiology of chronic pain and allow prompt therapeutic application of microRNA-related drugs against intractable persistent pain.

  18. Psychological Neuromodulatory Treatments for Young People with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Jordi Miró

    2016-12-01

    Full Text Available The treatment of young people with chronic pain is a complex endeavor. Many of these youth do not obtain adequate relief from available interventions. Psychological neuromodulatory treatments have been shown to have potential benefit for adults with chronic pain. Here, we review and summarize the available information about the efficacy of three promising psychological neuromodulatory treatments—neurofeedback, meditation and hypnosis—when provided to young people with chronic pain. A total of 16 articles were identified and reviewed. The findings from these studies show that hypnotic treatments are effective in reducing pain intensity for a variety of pediatric chronic pain problems, although research suggests variability in outcomes as a function of the specific pain problem treated. There are too few studies evaluating the efficacy of neurofeedback or meditation training in young people with chronic pain to draw firm conclusions regarding their efficacy. However, preliminary data indicate that these treatments could potentially have positive effects on a variety of outcomes (e.g., pain intensity, frequency of pain episodes, physical and psychological function, at least in the short term. Clinical trials are needed to evaluate the effects of neurofeedback and meditation training, and research is needed to identify the moderators of treatment benefits as well as better understand the mechanisms underlying the efficacy of all three of these treatments. The findings from such research could enhance overall treatment efficacy by: (1 providing an empirical basis for better patient-treatment matching; and (2 identifying specific mechanisms that could be targeted with treatment.

  19. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions

    Directory of Open Access Journals (Sweden)

    Pampati Vidyasagar

    2004-05-01

    Full Text Available Abstract Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine, in accordance with the criteria established by the International Association for the Study of Pain (IASP. The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% – 61%, with thoracic spine pain was 42% (95% CI, 30% – 53%, and in with lumbar spine pain was 31% (95% CI, 27% – 36%. The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% – 72% in the cervical spine, 55% (95% CI, 39% – 78% in the thoracic spine, and 27% (95% CI, 22% – 32% in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain.

  20. Improvement and care seeking for temporomandibular-pain complaints: The complexity of chronic pain

    NARCIS (Netherlands)

    Rollman, A.

    2013-01-01

    "Temporomandibular disorders" (TMD) is a collective term used to describe a group of musculoskeletal conditions occurring in the temporomandibular region. TMD shares features with other chronic musculoskeletal syndromes (such as low back pain and neck pain) including pain, limited range of motion an

  1. Multiple faces of pain : effects of chronic pain on the brain regulation of facial expression

    NARCIS (Netherlands)

    Vachon-Presseau, Etienne; Roy, Mathieu; Woo, Choong-Wan; Kunz, Miriam; Martel, Marc-Olivier; Sullivan, Michael J.; Jackson, Philip L.; Wager, Tor D.; Rainville, Pierre

    2016-01-01

    Pain behaviors are shaped by social demands and learning processes, and chronic pain has been previously suggested to affect their meaning. In this study, we combined functional magnetic resonance imaging with in-scanner video recording during thermal pain stimulations and use multilevel mediation a

  2. MECHANISMS OF CHRONIC PAIN AT OSTEOARTHROSIS OF THE KNEE

    Directory of Open Access Journals (Sweden)

    E. F. Turovskaya

    2014-01-01

    Full Text Available The main symptom of osteoarthritis (OA is pain. Mechanisms of chronic pain in OA have not been fully investigated yet.Objective: to study key mechanisms of chronic pain in patients with knee OA.Subjects and methods. Authors examined 80 women aged 45–65 years, with chronic pain due to OA of the knee. Clinical rheumatologic and neurologic examinations, screening for neuropathic pain (PainDETECT and DN4 questionnaires, estimation of duration and intensity of pain, WOMAC assessment and evaluation of affective disorders (HADS questionnaire were performed. X-ray and ultrasonography were used to assess destructive changes of theknee.Results. According to DN4 questionnaire, 25 (30% patients scored 4 and more, i. e. had signs of neuropathic pain, whereas 55 (70% did not (scored less than 4. Although neurologic examination did not reveal lesions of somatosensory system in neither of groups, assessment of the pain sensitivity showed hyperalgesia in 60% of cases. Patients with signs of neuropathic pain typically have secondary hyperalgesia propagating far from the damaged joint.Conclusion. 30% of patients with osteoarthritis have pain of different intensity determined by nociceptive and neuropathic mechanisms. At the same time the absence of lesions of somatosensory system does not let us to consider the pain neuropathic and indicates that it has dysfunctional nature. Signs of neuropathic pain associated with secondary hyperalgesia may be a clinical symptom of central sensitization. Due to this fact, reasonable therapy of osteoarthritis-associated chronic pain should include, besides NSAIDs, central acting drugs for neuropathic pain treatment.

  3. Effect of diosmin on chronic nonbacterial prostatitis caused by pelvic congestion in rats

    Directory of Open Access Journals (Sweden)

    Gong-ting CUI

    2014-08-01

    Full Text Available Objective To explore the effect of diosmin on chronic nonbacterial prostatitis (CNP in rats and its possible mechanisms. Methods Thirty-two healthy adult male SD rats were randomly divided into 4 groups: Sham-operated group (SO group, chronic prostatitis model group (CPM group, chronic prostatitis model + prostat treatment group (CPM-P group, and chronic prostatitis model + diosmin treatment group (CPM-D group. Rats in SO group underwent laparotomy only to expose the prostate, and those in other groups received prostatic vein ligation to reproduce pelvic congestion. HE staining was used for the examination of the prostate 35 days after the operation. 80mg/(kg.d of diosmin was given to the rats in CPM-D group, and 60mg/(kg.d of diosmin to the rats in CPM-P group twice a day by gavage for 7 days. Same volume of 5% acacia gum was given to rats in SO and CPM groups. All of the rats were sacrificed 1h after the last administration, and the serum levels of interleukin-10 (IL-10, IL-8, IL-1β, malondialdehyde (MDA, nitric oxide (NO were determined by ELISA, and the pathological changes in the prostate tissue were observed after HE staining and compared between the groups. Results The serum levels of IL-1β, IL-8 and NO were significantly lower in CPM-D group and CPM-P group than in CPM group (P<0.05, the serum level of IL-10 was significantly higher in CPM-D group and CPM-P group than in CPM group (P<0.05, and the serum MDA level was similar between the 3 groups. HE staining showed that chronic inflammatory changes in rats' prostate were reduced more significantly in CPM-P group and CPM-D group than in CPM group. Conclusion The therapeutic effect of diosmin on pelvic-congestion-induced chronic prostatitis is similar to that of prostat tablets, and its mechanism may be related to the alleviation of local inflammatory response by reducing the IL-1β, IL-8 and NO levels and increasing the IL-10 content in serum. DOI: 10.11855/j.issn.0577-7402.2014.06.04

  4. Molecular Signatures of Chronic Pain Subtypes

    Science.gov (United States)

    2013-01-01

    problematic; patients experience not only nociceptive pain but also acute neuralgia and occasion- ally the immediate onset of phantom limb pain .8...post-thoracotomy pain have been initiated preoperatively.69 This preemptive effect is designed to reduce nociceptive traffic to the spinal cord and... nociceptive and inflammatory pain and has been linked to temporomandibular joint pain syndromes [50]. Even studies of COMT, however, have demonstrated

  5. Somatic focus/awareness: Relationship to negative affect and pain in chronic pain patients

    OpenAIRE

    O’Brien, Erin M; Atchison, James W.; Gremillion, Henry A.; Waxenberg, Lori B.; Robinson, Michael E.

    2007-01-01

    Somatic focus refers to the tendency to notice and report physical symptoms, and has been investigated in relation to chronically painful conditions. This study investigated the relationship between somatic focus, as measured by the Pennebaker Inventory of Limbic Languidness (PILL), negative affect and pain. A secondary purpose of the present study was to examine sex differences in these relationships. Participants included 280 chronic pain patients (69.6% females, 88.9% Caucasian), who compl...

  6. Validity of electrical stimulus magnitude matching in chronic pain

    DEFF Research Database (Denmark)

    Persson, Ann L; Westermark, Sofia; Merrick, Daniel

    2009-01-01

    OBJECTIVE: To examine the validity of the PainMatcher in chronic pain. DESIGN: Comparison of parallel pain estimates from visual analogue scales with electrical stimulus magnitude matching. PATIENTS: Thirty-one patients with chronic musculoskeletal pain. METHODS: Twice a day ongoing pain was rated...... on a standard 100-mm visual analogue scale, and thereafter magnitude matching was performed using a PainMatcher. The sensory threshold to electrical stimulation was tested twice on separate occasions. RESULTS: In 438 observations visual analogue scale ranged from 3 to 95 (median 41) mm, and Pain......Matcher magnitudes from 2.67 to 27.67 (median 6.67; mean 7.78) steps. There was little correlation between visual analogue scale and magnitude data (r = 0.29; p

  7. Temperament traits and chronic pain: the association of harm avoidance and pain-related anxiety.

    Directory of Open Access Journals (Sweden)

    Peter Knaster

    Full Text Available OBJECTIVE: Anxiety symptoms are common in chronic pain patients. High levels of anxiety are associated with increased pain experience and disability. Proneness to anxiety has a large interindividual variation. The aim of the study was to determine whether the anxiety-related temperament trait Harm Avoidance (HA, is associated with pain-related anxiety. METHODS: One hundred chronic pain patients in a multidisciplinary pain clinic participated in the study. The patients were assessed using the HA scale of the Temperament and Character Inventory (TCI of Cloninger and Pain Anxiety Symptoms Scale-20 (PASS-20. Both the HA total score and the four subscales of HA were analyzed. Current pain intensity was measured using the Visual Analogue Scale (VAS. The Beck Depression Inventory (BDI was used to control for the influence of depression on the personality measurement. RESULTS: The HA total score was associated with PASS-20, but the association became non-significant after controlling for depression. The HA4 Fatigability subscale was associated with the PASS scales. Depression did not influence this association. Pain intensity was not correlated with HA or the PASS scales. However, the association between HA4 Fatigability and PASS was influenced by pain intensity. Higher pain intensity was associated with stronger association between the scales. CONCLUSION: Harm Avoidance, representing temperament and trait-related anxiety, has relevance in pain-related anxiety. Assessing personality and temperament may deepen the clinician's understanding of the pain experience and behavior in chronic pain patients.

  8. Update on managing chronic pain in the elderly.

    Science.gov (United States)

    Malanga, Gerard; Paster, Zorba

    2007-12-01

    People aged 65 years and over make up the fastest growing demographic in the United States. By the year 2040 they will comprise approximately one fourth of the US population. The elderly patient in need of chronic pain therapy presents challenges best met with an enlightened and effective treatment strategy. Practice standards must include a thorough pain assessment and formation of a multimodal care plan, which applies knowledge of pain management in an objective and scientific manner. In this article, a patient case study illustrates how the appropriate management of chronic pain in an elderly patient can lead to better clinical outcomes.

  9. The persistence of pain behaviors in patients with chronic back pain is independent of pain and psychological factors.

    Science.gov (United States)

    Martel, M O; Thibault, P; Sullivan, M J L

    2010-11-01

    The primary purpose of the present study was to examine the temporal stability of communicative and protective pain behaviors in patients with chronic back pain. The study also examined whether the stability of pain behaviors could be accounted for by patients' levels of pain severity, catastrophizing, or fear of movement. Patients (n=70) were filmed on two separate occasions (i.e., baseline, follow-up) while performing a standardized lifting task designed to elicit pain behaviors. Consistent with previous studies, the results provided evidence for the stability of pain behaviors in patients with chronic pain. The analyses indicated that communicative and protective pain behavior scores did not change significantly from baseline to follow-up. In addition, significant test-retest correlations were found between baseline and follow-up pain behavior scores. The results of hierarchical multiple regression analyses further showed that pain behaviors remained stable over time even when accounting for patients' levels of pain severity. Regression analyses also showed that pain behaviors remained stable when accounting for patients' levels of catastrophizing and fear of movement. Discussion addresses the potential contribution of central neural mechanisms and social environmental reinforcement contingencies to the stability of pain behaviors. The discussion also addresses how treatment interventions specifically aimed at targeting pain behaviors might help to augment the overall impact of pain and disability management programs.

  10. Treatment of 15 Cases of Chronic Pelvic Inflammation by Acupuncture plus Herbal Enema

    Institute of Scientific and Technical Information of China (English)

    SHEN Jian

    2005-01-01

    Fifteen cases of chronic pelvic inflammation were treated by needling Guanyuan (CV 4), Qihai (CV 6), Sanyinjiao (SP 6), Zhongji (CV 3), Shidao (ST 28), Diji (SP 8), Zusanli (ST 36), Shenshu (BL 23), Dachangshu (BL 25) and Ciliao(BL 32) in combination with herbal enema effective to clear heat and relieve toxin, activate blood and resolve stagnant blood.After 2-course treatment, 13 cases were cured and 2 cases were improved.%针刺关元,气海,三阴交,中极,水道,地机,足三里,肾俞,大肠俞和次髎穴,同时用清热解毒和活血化瘀中药进行保留灌肠,治疗了15例慢性盆腔炎患者,经过2个疗程治疗,13例痊愈,2例有效.

  11. Health care costs, work productivity and activity impairment in non-malignant chronic pain patients

    DEFF Research Database (Denmark)

    Kronborg, Christian; Handberg, Gitte; Axelsen, Flemming

    2009-01-01

    This study explores the costs of non-malignant chronic pain in patients awaiting treatment in a multidisciplinary pain clinic in a hospital setting. Health care costs due to chronic pain are particular high during the first year after pain onset, and remain high compared with health care costs...... before pain onset. The majority of chronic pain patients incur the costs of alternative treatments. Chronic pain causes production losses at work, as well as impairment of non-work activities....

  12. Duloxetine in the management of chronic musculoskeletal pain

    Directory of Open Access Journals (Sweden)

    Smith EJ

    2012-06-01

    Full Text Available Howard S Smith,1 Eric J Smith,2 Benjamin R Smith21Department of Anesthesiology, Albany Medical College, Albany, NY; 2The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USAAbstract: Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United States. It is a chronic degenerative disorder characterized by a loss of cartilage, and occurs most often in older persons. The management of osteoarthritis and chronic low back pain may involve both nonpharmacologic (eg, weight loss, resistive and aerobic exercise, patient education, cognitive behavioral therapy and pharmacologic approaches. Older adults with severe osteoarthritis pain are more likely to take analgesics than those with less severe pain. The pharmacologic approaches to painful osteoarthritis remain controversial, but may include topical as well as oral nonsteroidal antiinflammatory drugs, acetaminophen, duloxetine, and opioids. The role of duloxetine for musculoskeletal conditions is still evolving.Keywords: pain, musculoskeletal, duloxetine, osteoarthritis, low back, serotonin-norepinephrine reuptake inhibitor

  13. Estimating the prevalence of chronic pain: validation of recall against longitudinal reporting (the HUNT pain study).

    Science.gov (United States)

    Landmark, Tormod; Romundstad, Pål; Dale, Ola; Borchgrevink, Petter C; Kaasa, Stein

    2012-07-01

    Methods for classifying chronic pain in population studies are highly variable, and prevalence estimates ranges from 11% to 64%. Limited knowledge about the persistence of pain and the validity of recall questions defining chronic pain make findings difficult to interpret and compare. The primary aim of the current study was to characterize the persistence of pain in the general population and to validate recall measures against longitudinal reporting of pain. A random sample of 6419 participants from a population study (the HUNT 3 study in Norway) was invited to report pain on the SF-8 verbal pain rating scale every 3 months over a 12-month period and to report pain lasting more than 6 months at 12-month follow-up. Complete data were obtained from 3364 participants. Pain reporting was highly stable (intraclass correlation 0.66, 95% confidence interval 0.65 to 0.67), and the prevalence of chronic pain varied considerably according to level of severity and persistence: 31% reported mild pain or more, whereas 2% reported severe pain on 4 of 4 consecutive measurements. When defined as moderate pain or more on at least 3 of 4 consecutive measurements, the prevalence was 26%. Compared with the longitudinal classification, a cross-sectional measure of moderate pain or more during the last week on the SF-8 scale presented a sensitivity of 82% and a specificity of 84%, and a sensitivity of 80% and a specificity of 90% when combined with a 6-month recall question. Thus pain reporting in the general population is stable and cross-sectional measures may give valid prevalence estimates of chronic pain.

  14. Neuropathic pain as part of chronic widespread pain: environmental and genetic influences

    OpenAIRE

    Momi, Sukhleen K.; Fabiane, Stella Maris; Lachance, Genevieve; Livshits, Gregory; Williams, Frances M. K.

    2015-01-01

    Abstract Chronic widespread pain (CWP) has complex aetiology and forms part of the fibromyalgia syndrome. Recent evidence suggests a higher frequency of neuropathic pain features in those with CWP than previously thought. The aim of this study was to determine the prevalence of neuropathic pain features in individuals with CWP and to estimate the influence of genetic and environmental factors on neuropathic pain in CWP. Validated questionnaires (the London Fibromyalgia Screening Study questio...

  15. Effects of coping statements on experimental pain in chronic pain patients

    OpenAIRE

    Daniela Roditi; Robinson, Michael E.; Nola Litwins

    2009-01-01

    Daniela Roditi, Michael E Robinson, Nola LitwinsDepartment of Clinical and Health Psychology, University of Florida, Gainesville, FL, USAAbstract: The present study measured the effects of catastrophizing self-statements and positive coping self-statements on cold pressor-induced pain. Participants were 58 adult chronic pain patients with current facial pain. It was hypothesized that catastrophizing would lead to a decrease in pain endurance whereas positive coping would lead to an increase i...

  16. Chronic pain and quality of life in schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Jouce Gabriela de Almeida

    2013-03-01

    Full Text Available OBJECTIVE: To identify the prevalence and characteristics of chronic pain in schizophrenic patients and to compare the quality of life in patients with and without chronic pain. METHODS: Crossover design with a probablistic sample of 205 adult schizophrenic outpatients (80% paranoid schizophrenia. Socio-demographic, psychiatric disorder, pain and quality of life (WHOQOL- brief data were collected between June and September 2008. RESULTS: Mean age was 37 years, 65% were men, and the mean time spent in school was 9 years; 87% were single, 65% lived with parents and 25% had a job. Among patients with chronic pain, 70% did not receive treatment for pain. Regarding quality of life, patients with pain had more physical disabilities compared to those without pain (p < .001. There were no differences in other domains. Comparisons between patients with and without pain did not show any differences in how much they felt their mental health problems disabled them. Conclusion: Chronic pain was common in schizophrenic patients (similar to the general population of a similar age and decreased their quality of life. It is necessary to pay more attention to this co-morbidity.

  17. Psychological therapies for the management of chronic pain

    Directory of Open Access Journals (Sweden)

    Sturgeon JA

    2014-04-01

    Full Text Available John A Sturgeon Department of Anesthesiology, Stanford University, Palo Alto, CA, USA Abstract: Pain is a complex stressor that presents a significant challenge to most aspects of functioning and contributes to substantial physical, psychological, occupational, and financial cost, particularly in its chronic form. As medical intervention frequently cannot resolve pain completely, there is a need for management approaches to chronic pain, including psychological intervention. Psychotherapy for chronic pain primarily targets improvements in physical, emotional, social, and occupational functioning rather than focusing on resolution of pain itself. However, psychological therapies for chronic pain differ in their scope, duration, and goals, and thus show distinct patterns of treatment efficacy. These therapies fall into four categories: operant-behavioral therapy, cognitive-behavioral therapy, mindfulness-based therapy, and acceptance and commitment therapy. The current article explores the theoretical distinctiveness, therapeutic targets, and effectiveness of these approaches as well as mechanisms and individual differences that factor into treatment response and pain-related dysfunction and distress. Implications for future research, dissemination of treatment, and the integration of psychological principles with other treatment modalities are also discussed. Keywords: pain management, multidisciplinary pain treatment, psychological therapy

  18. Chronic Pain, Psychopathology, and DSM-5 Somatic Symptom Disorder.

    Science.gov (United States)

    Katz, Joel; Rosenbloom, Brittany N; Fashler, Samantha

    2015-04-01

    Unlike acute pain that warns us of injury or disease, chronic or persistent pain serves no adaptive purpose. Though there is no agreed on definition of chronic pain, it is commonly referred to as pain that is without biological value, lasting longer than the typical healing time, not responsive to treatments based on specific remedies, and of a duration greater than 6 months. Chronic pain that is severe and intractable has detrimental consequences, including psychological distress, job loss, social isolation, and, not surprisingly, it is highly comorbid with depression and anxiety. Historically, pain without an apparent anatomical or neurophysiological origin was labelled as psychopathological. This approach is damaging to the patient and provider alike. It pollutes the therapeutic relationship by introducing an element of mutual distrust as well as implicit, if not explicit, blame. It is demoralizing to the patient who feels at fault, disbelieved, and alone. Moreover, many medically unexplained pains are now understood to involve an interplay between peripheral and central neurophysiological mechanisms that have gone awry. The new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, somatic symptom disorder overpsychologizes people with chronic pain; it has low sensitivity and specificity, and it contributes to misdiagnosis, as well as unnecessary stigma. Adjustment disorder remains the most appropriate, accurate, and acceptable diagnosis for people who are overly concerned about their pain.

  19. Clinical study of acute and chronic pain after temporal craniotomy

    Directory of Open Access Journals (Sweden)

    WANG Cheng-wei

    2013-10-01

    Full Text Available Objective To investigate the correlation of chronic pain after surgery and acute pain within 48 h after temporal craniotomy. Methods One hundred and seventy-six patients who underwent surgery through temporal approach were divided into 3 groups and treated with morphine 30 mg (Group M, N = 57, tramadol 1000 mg (Group T, N = 60 and morphine 20 mg + flurbiprofen 200 mg (Group F, N = 59 by patient-controlled intravenous analgesia (PCIA. Postoperative acute pain (resting and movement was evaluated by Visual Analogue Scale (VAS at 4, 16, 24 and 48 h respectively. Chronic pain was measured by Short-Form McGill Pain Questionnaire (SF-MPQ 3 months after surgery. The characteristics of acute and chronic pain, the relationship between them and analgesic effect of 3 kinds of analgesic drugs were analyzed. Results The differences of observed indicators including gender, age, weight and operating time, which might affect the degree of postoperative pain between before and after surgery were not statistically significant (P > 0.05. VAS scores at different time points within 48 h after surgery in each group decreased gradually. The VAS scores in group T (2.91 ± 1.64 was significantly higher than group M (2.19 ± 1.68 and group F (1.71 ± 1.17, P 0.05. The overall incidence rate of chronic pain was 71.02% (125/176, with moderate and severe pain in 15.91% (28/176. Chronic pain and acute postoperative pain severity were positively correlated (resting: rs = 0.171, P = 0.012; movement: rs = 0.190, P = 0.006. The difference of the acute pain (VAS corresponding to SF-MPQ Ⅱ score > 0 and SF-MPQ Ⅱ score = 0 was statistically significant (P < 0.05. Conclusion The postoperative chronic pain following temporal craniotomy is related to acute pain within 48 h after operation. Effective treatment of early postoperative acute pain may reduce the incidence of chronic pain.

  20. Hypoalgesia after exercise and the cold pressor test is reduced in chronic musculuskeletal pain patients with high pain sensitivity

    DEFF Research Database (Denmark)

    Vægter, Henrik Bjarke; Handberg, Gitte; Graven-Nielsen, Thomas

    2016-01-01

    OBJECTIVES: In chronic pain patients, impaired conditioned pain modulation (CPM) and exercise-induced hypoalgesia (EIH) have been reported. No studies have compared CPM and EIH in chronic musculoskeletal pain patients with high pain sensitivity (HPS) and low pain sensitivity (LPS). MATERIALS.......005). Pain tolerance increased after the cold pressor test and exercise in both groups (PCPM and EIH were partly impaired in chronic pain patients with high versus less pain sensitivity, suggesting that the CPM and EIH responses depend on the degree of pain sensitivity. This has clinical...

  1. Depressive symptoms and pain evaluations among persons with chronic pain: catastrophizing, but not pain acceptance, shows significant effects.

    Science.gov (United States)

    Richardson, Elizabeth J; Ness, Timothy J; Doleys, Daniel M; Baños, James H; Cianfrini, Leanne; Richards, J Scott

    2009-12-15

    Cognitive factors such as catastrophic thoughts regarding pain, and conversely, one's acceptance of that pain, may affect emotional functioning among persons with chronic pain conditions. The aims of the present study were to examine the effects of both catastrophizing and acceptance on affective ratings of experimentally induced ischemic pain and also self-reports of depressive symptoms. Sixty-seven individuals with chronic back pain completed self-report measures of catastrophizing, acceptance, and depressive symptoms. In addition, participants underwent an ischemic pain induction procedure and were asked to rate the induced pain. Catastrophizing showed significant effects on sensory and intensity but not affective ratings of the induced pain. Acceptance did not show any significant associations, when catastrophizing was also in the model, with any form of ratings of the induced pain. Catastrophizing, but not acceptance, was also significantly associated with self-reported depressive symptoms when these two variables were both included in a regression model. Overall, results indicate negative thought patterns such as catastrophizing appear to be more closely related to outcomes of perceived pain severity and affect in persons with chronic pain exposed to an experimental laboratory pain stimulus than does more positive patterns as reflected in measures of acceptance.

  2. Reduced acute nociception and chronic pain in Shank2-/- mice.

    Science.gov (United States)

    Ko, Hyoung-Gon; Oh, Seog-Bae; Zhuo, Min; Kaang, Bong-Kiun

    2016-01-01

    Autism spectrum disorder is a debilitating mental illness and social issue. Autism spectrum disorder patients suffer from social isolation, cognitive deficits, compulsive behavior, and sensory deficits, including hyposensitivity to pain. However, recent studies argued that autism spectrum disorder patients show physiological pain response and, in some cases, even extremely intense pain response to harmless stimulation. Recently, Shank gene family was reported as one of the genetic risk factors of autism spectrum disorder. Thus, in this study, we used Shank2(-) (/) (-) (Shank2 knock-out, KO) mice to investigate the controversial pain sensitivity issue and found that Shank2 KO mice showed reduced tactile perception and analgesia to chronic pain.

  3. [Drug therapy of acute and chronic abdominal pain].

    Science.gov (United States)

    Streitberger, Konrad; Stüber, Frank; Kipfer Buchli, Irène; Stamer, Ulrike M

    2011-08-01

    For drug therapy a differentiation of acute and chronic pain is essential. In emergency situations of acute abdominal pain a fast diagnosis is mandatory. Analgesia should be provided as soon as possible. The different groups of analgesics should be used according to their known effects, side effects and contraindications. Postoperative pain after abdominal surgery has to be considered as a special condition of acute abdominal pain. Main treatment options are non opioid analgesics and opioids. Opioids can be administered intravenously via patient controlled analgesia (PCA) devices. In major abdominal surgery neuroaxial analgesia, preferentially administered via an epidural catheter provides excellent pain relief with positive impact on gastrointestinal motility and patients' recovery. Because of difficulties to allocate chronic abdominal pain to a specific organ, causal treatment often turns out to be difficult. Peripheral and central sensitization, as well as an alteration of the endogenous pain modulation comes to the fore in these chronic pain conditions. Co-analgesics like anticonvulsants and antidepressants are utilized to reduce sensitization and improve the endogenous pain modulating system. Non drug approaches and alternative treatment options might be useful. In contrast, orally or transcutaneously administered opioids are the principal corner stone for the treatment of cancer pain.

  4. Increased proportion of megafibers in chronically painful muscles

    DEFF Research Database (Denmark)

    Andersen, Lars L; Suetta, Charlotte; Andersen, Jesper Løvind

    2008-01-01

    Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employees in monotonous stressful jobs, potentially due to chronic overload of type I muscle fibers. In this study, we investigated the intra-individual distribution of trapezius muscle fiber size, and hypoth......Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employees in monotonous stressful jobs, potentially due to chronic overload of type I muscle fibers. In this study, we investigated the intra-individual distribution of trapezius muscle fiber size...

  5. Managing chronic pain in older people.

    Science.gov (United States)

    Schofield, Patricia

    This article presents the results of a collaborative project between the British Pain Society and British Geriatric Society to produce guidelines on the management of pain in older adults. The guidelines are the first of their kind in the UK and aim to provide best practice for the management of pain to all health professionals working with older adults in any care setting.

  6. Pelvic actinomycosis: urologic perspective

    Directory of Open Access Journals (Sweden)

    Venkata K. Marella

    2004-10-01

    Full Text Available PURPOSE: Actinomycosis is a chronic granulomatous infection caused by the gram-positive anaerobic bacteria, Actinomyces israelli. This paper reviews the etiology and clinical presentation associated with Actinomycosis that often presents as a pelvic mass that mimics a pelvic malignancy. MATERIALS AND METHODS: A combination of patients treated by the authors in the recent past and a literature review of patients with pelvic Actinomycosis were assessed for diographic, clinical and predisposing co-factors. An analysis is made of age distribution, gender, diagnostic methods and treatment concepts. RESULTS: Thirty-three patients were included in the study that included 2 current patients and 31 obtained from literature review. There were 27 fiales (age range 16 - 69 years, mean 38 years and 6 males (16 - 55 years, mean 36 years. Presenting signs and symptoms were lower abdominal mass in 28 (85%; lower abdominal pain in 21 (63%; vaginal discharge or hiaturia in 7 (22%. Two patients developed fistulae (entero-vesico 1; vesico-cutaneous 1. Nineteen (70% of the 27 fiale patients had intra-uterine contraceptive devices (IUD. Four patients (12.5% (3 males and 1 fiale had urachus or urachal rinants. Cystoscopy in 12 patients noted an extrinsic mass effect, bullous edia and in one patient vegetative proliferation proven to be a chronic inflammatory change. Exploratory laparotomy was performed in 32 of the 33 patients who had excision of mass and involved orga