Pain Threshold and Arthritis

Huskisson, E.C.; Fd, Hart

doi:10.1136/bmj.4.5834.193

Cited by 59 publications

(22 citation statements)

References 10 publications

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“…Measurement of pain threshold, defined as 'the first barely perceptible pain to appear in an instructed subject under given conditions of noxious stimulation' (1), has been considered an important variable, and elicited by a variety of mechanical (2,3), thermal (4,5,6), vascular (7), chemical (8), and electrical methods (for reviews see 9,10). Pain threshold studies have been performed in normal subjects (9,10,11), and in patients with osteoarthritis of the hip (12), rheumatoid arthritis and ankylosing spondylitis (13), and fibrositis (14,15). To our knowledge only one major study has been reported on the reliability of the pressure algometer as a measure of 'trigger-point' sensitivity in fibrositis (15).…”

Section: Introductionmentioning

confidence: 97%

Evaluation of pain threshold using a simple pressure algometer

Buchanan

Midgley

1987

Clin Rheumatol

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Pain threshold was measured using a simple pressure algometer in 190 subjects. The measurement had a highly acceptable intra-observer error. Significantly lower pain thresholds were observed in all of the five areas of the body studied in females. The most sensitive area was the forehead. There was a higher pain threshold in the dominant hand. Anxiety and fear of pain significantly reduced the threshold.

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Section: Introductionmentioning

confidence: 97%

Evaluation of pain threshold using a simple pressure algometer

Buchanan

Midgley

1987

Clin Rheumatol

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“…Beecher (1959) described different techniques used in order to measure the pain threshold. The technique using the pressure algometer is simple and reproducible (Keele, 1954;Merskey and Spear, 1964), and its value has been shown in cardiac pain (Keele, 1968) and in rheumatoid arthritis and ankylosing spondylitis (Huskisson and Hart, 1972). Though formal psychological testing was not undertaken there did not appear Eo be any undue anxiety in any of the subjects tested, nor have we noted any change in the pain threshold associated with anxiety.…”

Section: Discussionmentioning

confidence: 66%

“…The test was performed in a standardized fashion. Preliminary studies by ourselves, by Keele (1954), and by Huskisson and Hart (1972) have shown that pain threshold measurements obtained by this method are reproducible.…”

Section: Methodsmentioning

confidence: 99%

Pain threshold analysis in patients with osteoarthrosis of hip

O'Driscoll¹,

Jayson²

1976

Pain

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714BRITISH MEDICAL JOURNAL 21 SEPTEMBER 1974 g/day when their patients were on Nutrizym (mean fat excretion 42-5 g) compared with when they were on Pancrex V forte (mean fat excretion 57-3 g). Our patients' fat excretion was closely similar with both products (25 3 g on Nutrizym and 24-3 g on Pancrex V forte). Before the start of our trial patients had been taking Pancrex V forte in a dosage which had been established by the parents as being the most effective one for reducing stool frequency and improving stool character. All patients continued with this regimen for the first two weeks of the trial so that dosage and relevant details could be recorded, and the number of tablets was halved (though the enzyme dose for trypsin and lipase remained the same) during the two weeks when Nutrizym was given. Knill-Jones et al. (1970) chose to use suboptimal doses of pancreatic replacement therapy to facilitate the detection of improved digestion with either of the two preparations. Our doses resulted in smaller faecal fat excretions, but these were still sufficiently abnormal, we believe, for any differences in the effectiveness of the tablets to be apparent.In addition we did not find a significant difference in stool volume (mean volume 294 ml/day on Nutrizym and 259 ml/day on Pancrex V forte). Knill-Jones et al. (1970) Though the laboratory investigations did not provide any evidence in favour of either product the final questionnaire completed by the parents showed some patient preference for Nutrizym. There was some discrepancy (unexplained) between the information on stool frequency and character and the occurrence of abdominal pain obtained during the course of the trial, when there was no patient preference, and the information obtained at the end, when some of the parents modified their views in favour of Nutrizym. Clearly it is more convenient, especially for those patients who take a high dose of pancreatic preparation, to be able to reduce the number of tablets.With the exception of the two children whose coefficients of fat absorption were nil (table III) values obtained for the children while on pancreatic replacement therapy were comparable with those in previous reports (Harris et al., 1955;Ross, 1955; Matthew and Spector, 1961), and the mean value (70%) was some 28% less than normal (96% i 40) (Matthews and Spector, 1961).The apparent absence of fat absorption in cases 2 and 5 is difficult to explain. Both children were taking high doses of pancreatic therapy (mean numbers of Pancrex V forte and Nutrizym tablets per week were 133 and 63 respectively for case 2, and 378 and 214 respectively for case 5). One patient (case 2), aged 6-6 years, was on the 75th centile for weight, and the other (case 5), aged 8-7 years, was on the 10th centile.Pancreatic enzyme preparations, even in high dosage, do not eliminate the steatorrhoea of cystic fibrosis and it seems expedient to investigate other mechanisms which may influence fat absorption in this disease.

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“…One author argues that the response of AS patients to pain is'. .. more factual and less emotional than in patients with other forms of arthritis' (Hart, 1980:55), and another report states that AS patients have been found to have a high pain threshold, which may be related to the attitude expressed by the physician to the patient (Huskisson and Hart, 1972), presumably by some sort of placebo effect. While the matter of pain has some basis in evidence, other characteristics seem to have been derived from 'clinical experience': they are 'conscientious people' (Wynn Parry and Deary 1980:215), less depressed and anxious, less prone to illness behaviour and absence from work (Hart 1980), and 'often highly intelligent' (Chamberlain 1980:230).…”

Section: Ankyiosing Spondylitis: Professimial and Lay Perspectivesmentioning

confidence: 99%

Hope for the humblest? The role of self‐help in chronic illness: the case of ankylosing spondylitis

Williams¹

1989

Sociology Health & Illness

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This paper puts forward the proposition that modern self‐help organizations are the progeny of an uneasy relationship between two ideologies: individualism and collectivism. Within this relationship individualism is the dominant partner. Using a case‐study I examine the way in which these ideological influences can be seen to take concrete form in the history and activities of the National Ankylosing Spondylitis Society. I argue that certain characteristics of ankylosing spondylitis itself make it particularly amenable to self‐help, but that under pressure from various social and cultural forces this tends to take the form of an emphasis on individual self‐reliance rather than mutual aid. This tendency makes it difficult for the Society to respond in a meaningful way to social aspects of disablement. Although these interpretations are necessarily provisional, the paper concludes by suggesting that the tensions and equivocations revealed by the analysis have more general relevance to self‐help groups, particularly those which are condition‐specific and rely, to some extent, on the patronage of doctors and other health professionals.

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Pain Threshold and Arthritis

Cited by 59 publications

References 10 publications

Evaluation of pain threshold using a simple pressure algometer

Evaluation of pain threshold using a simple pressure algometer

Pain threshold analysis in patients with osteoarthrosis of hip

Hope for the humblest? The role of self‐help in chronic illness: the case of ankylosing spondylitis

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