Assessment of Neuropathic Pain

Clavitherapy is a new diagnostic and therapeutic direction
in Reflexology. The method was discovered in the sixties of XX
century. Polish psychologist doctor Ferdynand Barbasiewicz is
the father of this pioneer methods. Mechanisms of Clavitherapy
have scientific basis. To use this method in diagnosis and therapy,
detail knowledge of anatomy of human nervous system, circulatory
system and neurology is mandatory. Scientific basis of this
method differs it from acupunctures or acupressure.

As we know that pain is the most common reason for which the patient takes medicine. Pain is not a single entity but
may be classified as nociceptive pain, inflammatory pain, and neuropathic pain. nociceptive pain such pain can be healed or
cured by using NSAIDs and other analgesics. Neuropathic pain is caused by the direct lesion on the neuron or damage or
dysfunction of peripheral or central neurons. Minor neuropathic can be healed automatically because peripheral nervous
systems neuron surrounded by Schwann cell which promotes the healing of neurons but CNS neurons don't have Schwann cell
they are covered with oligodendrocytes which don't have healing property so pain mediated through CNS are generally chronic
in nature. Even the smallest stimulation results in spontaneous intense pain after than it gets transformed into chronic pain
syndrome which is difficult to treat.

The 27h of May 2016, we observed for the 1000th times the same phenomenon (Table I): When the hyper-sensitivity to touch – allodynia – disappears, an underlying tactile hypo-aesthesia is revealed.

We conclude that one of the aetiologies of tactile allodynia is Aβ neurofibers lesion of a cutaneous branch.

Context: Pain processing implicates multiple concurrent mechanisms of nociceptive transmission and modulation. Electroacupuncture (EA) analgesia involves mainly the activation of the endogenous anti-nociceptive systems that modulate pain transmission in addition to the regulation of glial activity and inhibition of pro-inflammatory cytokines in the spinal cord. Aims: To examine the potential anti-hyperalgesic effects the EA and the combination EA-ketamine in patients with post-herpetic neuralgia (PHN). Methods: Sixty-eight patients with PHN irritable nociceptor type were randomly allocated to 3 groups: group I (n=26), that received treatment with EA (10 Hz, 2-3 mA, 0.5 ms, 20 min/15 sessions) alone, group II (n=21) with a combination EA-ketamine (0.25-0.5 mg/kg, i.m.) or group III (n=21) with sham EA-ketamine for 15 days. The average daily pain score (ADPS) using the Likert scale, area and rate of dynamic allodynia, the rate of thermal allodynia, and frequency of intermittent lancinating pain were evaluated during five visits – before treatment and at 15, 30, 60, 90 days. Results: ADPS and sensory abnormalities decreased significantly concerning baseline data at 90 days in the three groups, but patients treated with the combination EA-ketamine significantly improved compared with the other groups. Conclusions: These results suggest that the combination EA-ketamine shows an early and long-term anti-hyperalgesic effect in PHN patients. However, a controlled clinical trial is necessary to confirm this hypothesis.

Une des étiologies de ces situations de handicap était des troubles somesthésiques. La rééducation sensitive des douleurs neuropathiques leur a permis de retrouver des habitudes de vie, de redonner quelques couleurs à leur survie, de redevenir sujet de leur existence

ObjectiveTo evaluate smartphone apps intended for self-management of pain using quality assessment criteria and usability testing with prospective users.To evaluate smartphone apps intended for self-management of pain using quality assessment criteria and usability testing with prospective users.Design1) Survey and content analysis of available apps; and 2) individual usability study of two apps.1) Survey and content analysis of available apps; and 2) individual usability study of two apps.SettingUniversity of Leeds, United Kingdom.University of Leeds, United Kingdom.ParticipantsForty-one participants (aged 19–59 years) with experience of chronic or recurrent pain episodes.Forty-one participants (aged 19–59 years) with experience of chronic or recurrent pain episodes.MethodsWe undertook a survey, content analysis, and quality appraisal of all currently available mobile phone apps for self-management of pain. Two apps were then selected and assessed with usability testing.We undertook a survey, content analysis, and quality appraisal of all currently available mobile phone apps for self-management of pain. Two apps were then selected and assessed with usability testing.ResultsTwelve apps met the inclusion criteria. The quality assessment revealed wide variation in their clinical content, interface design, and usability to support self-management of pain. Very little user or clinician involvement was identified in the development of the apps. From the usability testing, participants stated a preference for an interface design employing a lighter color scheme and particular text font. Although very few participants were aware of pain-reporting apps prior to participation, many would consider use in the future.Twelve apps met the inclusion criteria. The quality assessment revealed wide variation in their clinical content, interface design, and usability to support self-management of pain. Very little user or clinician involvement was identified in the development of the apps. From the usability testing, participants stated a preference for an interface design employing a lighter color scheme and particular text font. Although very few participants were aware of pain-reporting apps prior to participation, many would consider use in the future.ConclusionsVariation in app quality and a lack of user and clinician engagement in development were found across the pain apps in this research. Usability testing identified a range of user preferences. Although useful information was obtained, it would be beneficial to involve users earlier in the process of development, as well as establishing ways to merge end user requirements with evidence-based content, to provide high-quality and usable apps for self-management of pain.Variation in app quality and a lack of user and clinician engagement in development were found across the pain apps in this research. Usability testing identified a range of user preferences. Although useful information was obtained, it would be beneficial to involve users earlier in the process of development, as well as establishing ways to merge end user requirements with evidence-based content, to provide high-quality and usable apps for self-management of pain.

Context: JM-20 is a hybrid synthetic molecule, which is based on a multimodal drug design paradigm for cerebrovascular disease. In addition to its neuroprotective effects, JM-20 also decreased sciatic nerve chronic constriction injury (CCI)-induced mechanical hypersensitivity in rats. JM-20 has a strong mitoprotective ability, and its effects could be in correspondence with the mitotoxicity hypothesis for paclitaxel-induced painful peripheral neuropathy. Aims: To evaluate the efficacy of the JM-20 to reduce neuropathic pain manifestations induced by the administration of paclitaxel in rats. Methods: In this study was implemented a rat model of painful peripheral neuropathy, produced by the chemotherapeutic agent paclitaxel, to determine whether JM-20 (10 mg/kg, p.o) could prevent the development of neuropathic pain during the exposure to paclitaxel. As well as to determine whether JM-20 (20 mg/kg, p.o) could reverse the established neuropathic pain. Mechanical behavioral assessment using von Frey filaments applied to the hind paws was applied before, during, and after treatments for 35 days. Results: Giving JM-20 during the exposure to paclitaxel significantly reduced the severity of mechanical allodynia and mechanical hyperalgesia. Moreover, JM-20 significantly reduced both established neuropathic pain manifestations. There was no evidence of tolerance to the effect during three days of dosing, and a long-term effect was observed after JM-20 discontinuation. Conclusions: JM-20 may be clinically relevant for both the prevention and treatment of paclitaxel-induced painful peripheral neuropathy.

Diabetic peripheral neuropathy (DPN) is the most incapacitating complication of diabetes mellitus. Up to 50% of patients with DPN develop peripheral neuropathic pain (PNP). The underlying ionic and molecular mechanisms of diabetic PNP (DPNP) are poorly understood. However, voltage gated potassium (Kv7) channels which have been implicated in the pathogenesis of other types of PNP are likely to be involved. Here we examined, in the streptozotocin (STZ) rat model of DPNP, whether activating the Kv7 channels with a potent activator retigabine (ezogabine) would reverse/attenuate behavioural signs of DPNP. STZ rats exhibited behavioural indices of mechanical and heat hypersensitivity, but not cold hypersensitivity or spontaneous pain, 35 days after STZ injection. Retigabine given at a dose of 15 mg/kg (but not at 7.5 mg/kg, i.p.) significantly attenuated mechanical, but not heat hypersensitivity in DPNP rats, and was as effective as the positive control gabapentin. This analgesic effect of retigabine was completely reversed by the Kv7/M channel blocker XE991 (3 mg/kg, i.p.) indicating that the anti-allodynic effects of retigabine were mediated by Kv7 channels. In conclusion, the findings suggest that Kv7 channels are involved in DPNP pathogenesis, and that strategies that target their activation may prove to be effective in treating DPNP.