Painful sequelae of nerve injury

Campbell, J. N.; Raja, Srinivasa N.; Meyer, Richard A.

doi:10.1016/0304-3959(87)91728-3

Cited by 23 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The nervi nervorum of peripheral nerve trunks may also contribute to the nociceptive input to the dorsal horn following irritation of nerve trunks [12,23]. Such aberrant aerent input can lead to changes in dorsal horn sensory processing [6,19], changes that may contribute to the hyperalgesic and allodynic pains observed with neuropathic disorders [4,8,18]. A possible cause of RSI may be minor nerve entrapment or irritation, and the particular involvement of the median nerve indicates that potential sites may be at the carpal tunnel or more proximal, where the nerve passes under the ®brous arch of the¯exor digitorum super®cialis at the elbow.…”

Section: Discussionmentioning

confidence: 99%

Vibration sense in the upper limb in patients with repetitive strain injury and a group of at-risk office workers

Greening¹,

Lynn²

1998

International Archives of Occupational and Environmental Health

102

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Vibration sense in the upper limb in patients with repetitive strain injury and a group of at-risk office workers

Greening¹,

Lynn²

1998

International Archives of Occupational and Environmental Health

102

View full text Add to dashboard Cite

show abstract

“…Die Arbeitsgruppe von Campbell definierten den Begriff des SMP nur noch über die Wirksamkeit von Sympathikusblockaden [22]. Allerdings verwirrten sie die Diskussion erneut, da sie den SMP nur für ein Krankheitsbild und einen einzigen Pathomechanismus zu rekrutieren versuchten: brennende und/oder mit einer Allodynie verbundene Schmerzen im Versorgungsgebiet eines betroffenen Nerven, ausgelöst durch eine von ihnen postulierte α-adrenerge Stimulation peripherer Nozizeptoren ( [22,119], zur Kritik vergl.…”

Section: Diagnostik Und Therapie Des Sympathisch Unterhaltenen Schmerzesunclassified

Diagnostik und Therapie des sympathisch unterhaltenen Schmerzes

Maier

Gleim

1998

Der Schmerz

View full text Add to dashboard Cite

The term "sympathetically maintained pain" (SMP) describes a symptom that might accompany a variety of diseases (CRPS, (post-) herpetic and post-injury neuralgia), which might transform into sympathetically independent pain (SIP) after some time. Patients with SMP present a bunch of disorders of the autonomic and sensory system, but the only reliable way to diagnose a pain as SMP is a positive response to an intervention at the sympathetic nervous system. Three ways of influencing the sympathetic system are commonly used: (a) local anesthetic sympathetic blockade (SB), (b) intravenous regional sympathectomy (IVRS) and (c) ganglionic local opioid application (GLOA). A review of current literature shows that SB has certain advantages in diagnostic sensitivity, whereas GLOA might be slightly superior in therapy of some diseases with longstanding pain history. Obviously, the therapeutic benefit of all interventions is complete independent of the accompanying autonomic disorder and of a blockade of efferent fibers. A new heuristic model of the SMP mechanism is presented, including both experimental and clinical data. For reducing the risks of false positive or negative diagnosis of SMP and SIP, a diagnostic algorithm is proposed. This includes optimizing the technique, changes of interventional measures, and adequate monitoring both of analgesia and as well of the extend of efferent sympathetic blockade (e.g. measurement of sympathetic reflexes). The treatment recommendations in patients with SMP vary in dependence of the kind of disease. In SMP, invasive measures play an important, but only limited role within the comprehensive treatment concept. As an example a three-stage, symptom-adapted treatment algorithm is demonstrated for CRPS, including also drug therapy, psychologic and physiotherapeutic approaches.

show abstract

“…It has been hypothesized that sympathetically maintained pain results from a cycle of sympathetic-efferent somatic-afferent activity involving neural (52,53) and vascular (54) changes. Pain has been attributed to sympathetically triggered ephaptic transmission (55), sympathetic activation of sensitized nociceptors (56) or low threshold mechanoreceptors that terminate on sensitized spinal cord cells (52,53), and injury-induced alteration in the pattern of post-ganglionic cutaneous vasoconstrictor neurons, which lose their normal thermoregulatory function, leading to trophic changes and ischemia (54,55).…”

Section: Phantom Limb Painmentioning

confidence: 99%