Pub Date : 2016-07-30DOI: 10.4172/2167-0846.S4-004
I. Dones, A. Torre, A. Lavano
Chronic pain is the major cause of discomfort for any patient. Unfortunately there is still a present low efficacy of analgesic drugs to relief neuropathic pain [1]. The intrathecal drug delivery systems (IDDS) have been used for more than 30 years to deliver analgesic drugs into the cerebrospinal fluid and close to their site of action. These systems are being used in patients with both malignant and nonmalignant pain. Moreover much smaller doses of drugs are used when they are administered intrathecally and, sometimes, fewer products of the molecule degradation of the drug are obtained through that route thus decreasing their toxicity [2].
{"title":"Intrathecal Drug Delivery Therapy with Implantable Pump System in Refractory Cancer and Non-Cancer Pain","authors":"I. Dones, A. Torre, A. Lavano","doi":"10.4172/2167-0846.S4-004","DOIUrl":"https://doi.org/10.4172/2167-0846.S4-004","url":null,"abstract":"Chronic pain is the major cause of discomfort for any patient. Unfortunately there is still a present low efficacy of analgesic drugs to relief neuropathic pain [1]. The intrathecal drug delivery systems (IDDS) have been used for more than 30 years to deliver analgesic drugs into the cerebrospinal fluid and close to their site of action. These systems are being used in patients with both malignant and nonmalignant pain. Moreover much smaller doses of drugs are used when they are administered intrathecally and, sometimes, fewer products of the molecule degradation of the drug are obtained through that route thus decreasing their toxicity [2].","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"545 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86966721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-24DOI: 10.4172/2167-0846.1000253
Nthiga Pm, Kamau Jk, Safari Vz, M. Ngugi, Mburu Dn
Pain is an unpleasant sensation attributed to an interplay of sensory and cognitive mechanisms and thus a source of burden to the individual and society. Since pain acts as a source of discomfort, it requires medical suppression. There is a growing interest in the use of herbal remedies as an attractive healthcare alternative to synthetic drugs. This is due to conventional medications being expensive and arguably associated with various adverse effects, hence the necessity for herbal agents that are effective, safe and relatively cheap. Harrisonia abyssinica and Landolphia buchananii are herbs that have been utilized to manage various ailments afflicting people especially in tropical Africa. However, despite their wide folklore use, extensive literature research reveals limited evaluation on the pharmacological activities of their described effects on pain. Thus, the aim of the current study was to evaluate the antinociceptive effects of their methanolic extracts. Experimental mice were divided into a normal control group, a negative control group, a reference group and three dosage groups. The dosage groups were treated with stem bark extracts at concentration of 50 mg/kg, 100 mg/kg and 150 mg/kg. The formalin paw licking test was used to determine the antinociceptive potential. Evaluation of the antinociceptive activities was compared with diclofenac as the reference drug. The H. abyssinica extract reduced pain by 39.73%-81.13% (in the early phase) and 15.92%-69.84% (in the late phase) while L. buchananii extract reduced it by between 35.35%-47.72% (in the early phase) and 20.57-55.17% (in the late phase). In the early phase, reduction of pain by diclofenac was by 19.97%-46.50% and 76.77-74.80% (in the late phase). Several phytochemicals were observed to be present. The traditional medicinal use of the aforementioned plants in the suppression of pain has thus been confirmed by the study results.
{"title":"Antinociceptive Activity of Methanolic Stem Bark Extracts of Harrisonia Abyssinica Oliv and Landolphia Buchananii (Hallier F.) Stapf in Mice Model","authors":"Nthiga Pm, Kamau Jk, Safari Vz, M. Ngugi, Mburu Dn","doi":"10.4172/2167-0846.1000253","DOIUrl":"https://doi.org/10.4172/2167-0846.1000253","url":null,"abstract":"Pain is an unpleasant sensation attributed to an interplay of sensory and cognitive mechanisms and thus a source of burden to the individual and society. Since pain acts as a source of discomfort, it requires medical suppression. There is a growing interest in the use of herbal remedies as an attractive healthcare alternative to synthetic drugs. This is due to conventional medications being expensive and arguably associated with various adverse effects, hence the necessity for herbal agents that are effective, safe and relatively cheap. Harrisonia abyssinica and Landolphia buchananii are herbs that have been utilized to manage various ailments afflicting people especially in tropical Africa. However, despite their wide folklore use, extensive literature research reveals limited evaluation on the pharmacological activities of their described effects on pain. Thus, the aim of the current study was to evaluate the antinociceptive effects of their methanolic extracts. Experimental mice were divided into a normal control group, a negative control group, a reference group and three dosage groups. The dosage groups were treated with stem bark extracts at concentration of 50 mg/kg, 100 mg/kg and 150 mg/kg. The formalin paw licking test was used to determine the antinociceptive potential. Evaluation of the antinociceptive activities was compared with diclofenac as the reference drug. The H. abyssinica extract reduced pain by 39.73%-81.13% (in the early phase) and 15.92%-69.84% (in the late phase) while L. buchananii extract reduced it by between 35.35%-47.72% (in the early phase) and 20.57-55.17% (in the late phase). In the early phase, reduction of pain by diclofenac was by 19.97%-46.50% and 76.77-74.80% (in the late phase). Several phytochemicals were observed to be present. The traditional medicinal use of the aforementioned plants in the suppression of pain has thus been confirmed by the study results.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"2008 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82561782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-21DOI: 10.4172/2167-0846.S4-003
S. Raoul, E. Kuhn, S. Durand, J. Nguyen, J. Nizard
Introduction: Spinal cord stimulation is now a treatment of pain in refractory failed back surgery syndrome. The effect on radiculalgias is quite good but often unsatisfying to treat completely low back pain. Subcutaneous peripheral nerve stimulation is now one of the possibility to rescue chronic low back pain. The aim of this prospective study conducted in our center (Nantes, France) is to evaluate the benefit of the subcutaneous peripheral nerve stimulation on chronic low back pain. Method: 34 patients (aged 44-65, mean value 54.3) with chronic bilateral low back pain were evaluated with VAS Score, Medication quantification Scale (MQS), the patient satisfaction, and walking distance before and after stimulation. Stimulation was proposed after failure of multidisciplinary management of the patient with algologist, psychologist and rehabilitation. Electrode stimulation was implanted under local or general anesthesia and a test of 7 days was performed at home. The battery was implanted only if VAS score decreased than more 50%. Mean Follow up was 6 months (range 42 to 3 months). Result: All of 34 patients were implanted with good results: VAS score decreased from 7.5 in preoperative conditions to 2.3 in postop conditions (p ≤ 0.001). 63% of patients estimated than they were very satisfy of the surgery and they could propose that to patients. The MQS decreased from 34 in preoperative to 26 two months after the surgery and to 17 6 months after surgery. Walking distance increase after the surgery (800 meters before surgery and 1700 meters after surgery). We have 1 infection and one migration of electrodes Conclusion: this series shows that subcutaneous stimulation can be benefit to treat refractory low back pain. This surgery was well tolerated, safe.
{"title":"Peripheral Nerve Stimulation in Refractory Neuropathic Low Back Pain","authors":"S. Raoul, E. Kuhn, S. Durand, J. Nguyen, J. Nizard","doi":"10.4172/2167-0846.S4-003","DOIUrl":"https://doi.org/10.4172/2167-0846.S4-003","url":null,"abstract":"Introduction: Spinal cord stimulation is now a treatment of pain in refractory failed back surgery syndrome. The effect on radiculalgias is quite good but often unsatisfying to treat completely low back pain. Subcutaneous peripheral nerve stimulation is now one of the possibility to rescue chronic low back pain. The aim of this prospective study conducted in our center (Nantes, France) is to evaluate the benefit of the subcutaneous peripheral nerve stimulation on chronic low back pain. Method: 34 patients (aged 44-65, mean value 54.3) with chronic bilateral low back pain were evaluated with VAS Score, Medication quantification Scale (MQS), the patient satisfaction, and walking distance before and after stimulation. Stimulation was proposed after failure of multidisciplinary management of the patient with algologist, psychologist and rehabilitation. Electrode stimulation was implanted under local or general anesthesia and a test of 7 days was performed at home. The battery was implanted only if VAS score decreased than more 50%. Mean Follow up was 6 months (range 42 to 3 months). Result: All of 34 patients were implanted with good results: VAS score decreased from 7.5 in preoperative conditions to 2.3 in postop conditions (p ≤ 0.001). 63% of patients estimated than they were very satisfy of the surgery and they could propose that to patients. The MQS decreased from 34 in preoperative to 26 two months after the surgery and to 17 6 months after surgery. Walking distance increase after the surgery (800 meters before surgery and 1700 meters after surgery). We have 1 infection and one migration of electrodes Conclusion: this series shows that subcutaneous stimulation can be benefit to treat refractory low back pain. This surgery was well tolerated, safe.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"1518 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2016-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87818106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-08DOI: 10.4172/2167-0846.1000E121
A. Lavano
Chronic pain symbolizes a substantial health and societal concern. Chronic pain usually leads to deficit of effective productivity, financial gaining potential, and decreased and disturbed life quality. Pain causes hindrance in daily professional and personal work, physical and mind comfort. If the element of the pain gets clear it become easy to provide immediate treatment for its cure but in most of the cases doesn’t get clear. The major point of focus of the suffering individual or any health professional is to ease or to provide comfort by reducing pain, so that an individual could get back to their daily activities. Treatment plan or schedules can defer person to person and the intensity of the pain. There are few pain that are more adequate than others but it should be kept in mind that usually the chronic pain can’t be treated completely in shorter span of time but it can be managed effectively to provide relief to certain extend. In this review we focused on very specific point about the chronic pain like identification and difference among the acute and chronic pain, few known reason for chronic pain onset, impact of chronic pain on physical and psychological; its diagnosis methods, its treat and self-management techniques which can effectively able to ease the pain.
{"title":"Chronic Pain and its Management","authors":"A. Lavano","doi":"10.4172/2167-0846.1000E121","DOIUrl":"https://doi.org/10.4172/2167-0846.1000E121","url":null,"abstract":"Chronic pain symbolizes a substantial health and societal concern. Chronic pain usually leads to deficit of effective productivity, financial gaining potential, and decreased and disturbed life quality. Pain causes hindrance in daily professional and personal work, physical and mind comfort. If the element of the pain gets clear it become easy to provide immediate treatment for its cure but in most of the cases doesn’t get clear. The major point of focus of the suffering individual or any health professional is to ease or to provide comfort by reducing pain, so that an individual could get back to their daily activities. Treatment plan or schedules can defer person to person and the intensity of the pain. There are few pain that are more adequate than others but it should be kept in mind that usually the chronic pain can’t be treated completely in shorter span of time but it can be managed effectively to provide relief to certain extend. In this review we focused on very specific point about the chronic pain like identification and difference among the acute and chronic pain, few known reason for chronic pain onset, impact of chronic pain on physical and psychological; its diagnosis methods, its treat and self-management techniques which can effectively able to ease the pain.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"74 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2016-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86283035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-08DOI: 10.4172/2167-0846.C1.004
G. Nicolson
{"title":"Membrane lipid replacement with glycerolphospholipids to restore mitochondrial function and reduce fatigue and pain in CFS/ME and fibromyalgia patients","authors":"G. Nicolson","doi":"10.4172/2167-0846.C1.004","DOIUrl":"https://doi.org/10.4172/2167-0846.C1.004","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88665191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-08DOI: 10.4172/2167-0846.1000255
A. Aslam, Jaipaul Singh, S. Rajbhandari
Objective: This study assessed the efficacy of lignocaine infusion as a treatment for painful diabetic neuropathy (PDN) groups compared to chronic pain (non-PDN group) in challenging cases where conventional treatment is not helpful. Methods: A total 11 patients participated in the study with 7 patients referred from pain clinic (non-PDN group) and 4 for patients referred from diabetic foot clinic (PDN group) for lignocaine infusion as a treatment for chronic pain. Both groups of participants were on multiple combination of pain medication with minimal help. All the subjects gave consent for participation and filled out McGill short form (SF) questionnaire before and after the lignocaine infusion. Results: The results show 33% reduction of visual analogue pain score after lignocaine infusion in PDN group compared to 11% reduction of visual analogue pain score in non-PDN group. These data were statistically significant (p 0.05). All 11 patients had no reported adverse effects and their observations were in normal limits throughout the lignocaine infusion. Conclusion: Overall, the study showed that lignocaine infusion is both effective and safe in reducing chronic intractable pain when conventional treatments are intolerable or not helpful. It is more effective in painful diabetic neuropathy patients compared to other causes of chronic pain.
{"title":"An Observational Study on Lignocaine Infusion for Intractable Chronic Pain","authors":"A. Aslam, Jaipaul Singh, S. Rajbhandari","doi":"10.4172/2167-0846.1000255","DOIUrl":"https://doi.org/10.4172/2167-0846.1000255","url":null,"abstract":"Objective: This study assessed the efficacy of lignocaine infusion as a treatment for painful diabetic neuropathy (PDN) groups compared to chronic pain (non-PDN group) in challenging cases where conventional treatment is not helpful. Methods: A total 11 patients participated in the study with 7 patients referred from pain clinic (non-PDN group) and 4 for patients referred from diabetic foot clinic (PDN group) for lignocaine infusion as a treatment for chronic pain. Both groups of participants were on multiple combination of pain medication with minimal help. All the subjects gave consent for participation and filled out McGill short form (SF) questionnaire before and after the lignocaine infusion. Results: The results show 33% reduction of visual analogue pain score after lignocaine infusion in PDN group compared to 11% reduction of visual analogue pain score in non-PDN group. These data were statistically significant (p 0.05). All 11 patients had no reported adverse effects and their observations were in normal limits throughout the lignocaine infusion. Conclusion: Overall, the study showed that lignocaine infusion is both effective and safe in reducing chronic intractable pain when conventional treatments are intolerable or not helpful. It is more effective in painful diabetic neuropathy patients compared to other causes of chronic pain.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75675971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-08DOI: 10.4172/2167-0846.C1.006
K. F. T. F. S. Tominaga, T. Ishikawa
{"title":"Brain derived neurotrophic factor (BDNF) inducer ameliorates pain-emotion by preventing decreased CREB/BDNF mRNA: Similar to magnetic stimulation","authors":"K. F. T. F. S. Tominaga, T. Ishikawa","doi":"10.4172/2167-0846.C1.006","DOIUrl":"https://doi.org/10.4172/2167-0846.C1.006","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74511242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-24DOI: 10.4172/2167-0846.1000254
D. Vanni, R. Pappaccogli, A. Pantalone, D. D’Adamo, Salini
{"title":"Intraforaminal Ozone Therapy and Particular Side Effects: All that Glitters arent Gold","authors":"D. Vanni, R. Pappaccogli, A. Pantalone, D. D’Adamo, Salini","doi":"10.4172/2167-0846.1000254","DOIUrl":"https://doi.org/10.4172/2167-0846.1000254","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"151 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90865893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-20DOI: 10.4172/2167-0846.S4-002
W. Cheung, Yanli Huang, H. Tsang
This article argues that the sustainability of cognitive behavioral therapy (CBT) may be improved by the addition of complementary and alternative medicine (CAM) approach in helping teachers reduce their workplace stress. This is demonstrated by two clinical trials testing the effectiveness of a multi-component stress management program with the concurrent use of CBT and CAM approaches developed in Hong Kong. The multi-component stress management is shown to be effective in reducing and relieving stress-related emotional or psychosomatic symptoms. Meanwhile, the self-administered CAM techniques may serve to sustain the effects produced by CBT approach. This has the advantage of saving the additional resources needed from intervention by trained professionals such as occupational therapists and psychologists. Implications and future directions are discussed
{"title":"Improving Sustainability of Cognitive-Behavioral Therapy (CBT) by Complementary and Alternative Medicine Approaches (CAM) on Reducing Workplace Stress of Teachers","authors":"W. Cheung, Yanli Huang, H. Tsang","doi":"10.4172/2167-0846.S4-002","DOIUrl":"https://doi.org/10.4172/2167-0846.S4-002","url":null,"abstract":"This article argues that the sustainability of cognitive behavioral therapy (CBT) may be improved by the addition of complementary and alternative medicine (CAM) approach in helping teachers reduce their workplace stress. This is demonstrated by two clinical trials testing the effectiveness of a multi-component stress management program with the concurrent use of CBT and CAM approaches developed in Hong Kong. The multi-component stress management is shown to be effective in reducing and relieving stress-related emotional or psychosomatic symptoms. Meanwhile, the self-administered CAM techniques may serve to sustain the effects produced by CBT approach. This has the advantage of saving the additional resources needed from intervention by trained professionals such as occupational therapists and psychologists. Implications and future directions are discussed","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"22 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89059495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-03DOI: 10.4172/2167-0846.1000251
D. Kopsky
Neuropathic pain is defined as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system” [1]. Peripheral nerve damage causes the release of pro-inflammatory mediators (including interleukin-1β, tumor necrosis factor-α, bradykinin, substance P, calcitonin gene-related peptide, nerve growth factor, and prostaglandins) contributing to the ‘inflammatory soup’[2] The inflammatory response has adaptive functions enabling nerve repair [2]. On the other hand, these mediators have the undesired effect of sensitizing and stimulating nociceptors, leading to neuropathic pain [2]. The intensity of neuropathic pain progressively increases throughout the day [3]. This circadian cycle of neuropathic pain might be due to fluctuation of neurotransmitters and endocrine hormones, as well as repeated somatic stimulation and physical activity [3]. Allodynia (a potential characteristic of neuropathic pain) can exhibit temporal summation [3]. The fact that neuropathic pain often restricts walking and mobility, implies that physical activity evokes or exacerbates neuropathic pain [3]. Thus sensitization and stimulation of the peripheral nerve seem to play an important role in the aggravation throughout the day.
{"title":"Extending the Therapeutic Scope for the Treatment of Neuropathic Pain with Topical Analgesics","authors":"D. Kopsky","doi":"10.4172/2167-0846.1000251","DOIUrl":"https://doi.org/10.4172/2167-0846.1000251","url":null,"abstract":"Neuropathic pain is defined as \"pain arising as a direct consequence of a lesion or disease affecting the somatosensory system” [1]. Peripheral nerve damage causes the release of pro-inflammatory mediators (including interleukin-1β, tumor necrosis factor-α, bradykinin, substance P, calcitonin gene-related peptide, nerve growth factor, and prostaglandins) contributing to the ‘inflammatory soup’[2] The inflammatory response has adaptive functions enabling nerve repair [2]. On the other hand, these mediators have the undesired effect of sensitizing and stimulating nociceptors, leading to neuropathic pain [2]. The intensity of neuropathic pain progressively increases throughout the day [3]. This circadian cycle of neuropathic pain might be due to fluctuation of neurotransmitters and endocrine hormones, as well as repeated somatic stimulation and physical activity [3]. Allodynia (a potential characteristic of neuropathic pain) can exhibit temporal summation [3]. The fact that neuropathic pain often restricts walking and mobility, implies that physical activity evokes or exacerbates neuropathic pain [3]. Thus sensitization and stimulation of the peripheral nerve seem to play an important role in the aggravation throughout the day.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84256072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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