beta-endorphin and Shoulder-Pain

The purpose of this study was to evaluate the effect of saline washout under the diaphragm on postoperative shoulder tip pain (STP) and β-endorphin (βE) levels in patients who had undergone laparoscopic cholecystectomy (LC).. Between December 2010 and March 2011, 50 patients requiring cholecystectomy for benign gallbladder disease were enrolled in this study. Twenty-five patients (Group 1) underwent LC without saline irrigation, whereas the other 25 were operated on with saline irrigation (30 mL/kg) under the diaphragm (Group 2). Plasma levels of βE were measured before and after the operation. The degree of STP following LC was assessed using a visual analog pain scale (VAS) at 6, 12, and 24 hours postoperatively.. Eight patients in Group 1 (32.0%) and seven patients in Group 2 (28.0%) complained of STP. There was no significant difference between the two groups in operation time, postoperative hospital length, postoperative βE, dose of analgesics, or VAS at 6, 12, and 24 hours after surgery. The intensity of abdominal pain (AP) was significantly higher than that of STP. Significantly elevated levels (11.3±5.1 pg/mL) of βE were observed postoperatively when compared with preoperative levels (9.7±5.2 pg/mL) (P=.02).. Normal saline irrigation under the diaphragm does not reduce postoperative STP after LC. Ancillary techniques to reduce AP and STP should be considered.

Topics: Adult; beta-Endorphin; Cholecystectomy, Laparoscopic; Cholecystitis; Cholelithiasis; Female; Humans; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Pneumoperitoneum, Artificial; Shoulder Pain; Sodium Chloride; Therapeutic Irrigation

In peripheral tissue, several substances influence pain and pain modulation. Exercise has been found to decrease pain and improve function for chronic pain conditions, but how and why exercise produces beneficial effects remains unclear. This study investigates whether aspects of pain and concentrations of substances with algesic, analgesic and metabolic functions differ between women with chronic neck shoulder pain (CNSP) and healthy women (CON) and whether changes are found after an exercise intervention for CNSP.. Forty-one women with CNSP and 24 CON subjects were included. The participants attended two microdialysis sessions with 4-6 months between the experiments. During this period, the CNSP subjects underwent an exercise intervention. Expression levels of substance P, beta-endorphin, cortisol, glutamate, lactate and pyruvate as well as pain intensity and pressure pain thresholds were analysed.. At baseline, higher concentrations of glutamate and beta-endorphin and lower concentrations of cortisol in CNSP than CON were found. After exercise, decreased levels of substance P and possibly of glutamate, increased levels of beta-endorphin and cortisol as well as decreased pain intensity and increased pain pressure thresholds were found for CNSP.. The findings at baseline indicated algesic and analgesic alterations in the painful trapezius muscles. The findings for CNSP after the exercise intervention, with changes in peripheral substances and decreased pain intensity and sensitivity, could reflect a long-term physiological effect of the exercise.

Topics: Adult; beta-Endorphin; Chronic Disease; Exercise Therapy; Female; Glutamic Acid; Humans; Hydrocortisone; Lactic Acid; Microdialysis; Middle Aged; Neck Pain; Pain Measurement; Pain Threshold; Pyruvic Acid; Shoulder Pain; Substance P; Superficial Back Muscles; Young Adult

Prospective study.. To evaluate the prognosis of spine disease by investigating biologic parameters reflecting different physiologic or psychophysiological systems in men and women with acute onset of low back or neck/shoulder complaints.. Psychosocial factors may be of importance to the etiology and prognosis of musculoskeletal disorders. The possible mechanisms, however, remain unclear. Stress-induced long-lasting energy mobilization resulting in inhibited anabolism has been discussed. Using a theoretical framework within stress physiology, such psychophysiological processes were recorded by measures of substances representing the anabolic, catabolic, immunologic, and opioid systems.. The study comprised 67 working men and women 21 to 59 years of age seeking care by any caregiver for acute low back and/or neck/shoulder pain. Blood samples were taken and analyzed for 3 methyl 5hydroxy phenylethylene glycol (MHPG, reflecting sympathoadrenomedullary activity), DHEA-s (anabolism), immunoglobulin E, interleukin 6 (immune activity), and beta-endorphin (pain regulation). The participants were followed up for 6 months after the blood samples had been drawn.. In women, low MHPG, low DHEA-s, and low beta-endorphin predicted persistent disability due to low back complaints. Few significant findings were made for self-reported pain, for neck/shoulder complaints, and for men.. Disturbances of the regulation of certain biologic parameters might be indicators of a prolonged course of low back disease in women. Prospective studies are necessary to enable causal conclusions.

Topics: Adult; beta-Endorphin; Dehydroepiandrosterone Sulfate; Endocrine System; Female; Humans; Immunoglobulin E; Interleukin-6; Low Back Pain; Male; Methoxyhydroxyphenylglycol; Middle Aged; Musculoskeletal Diseases; Neck Pain; Pain Measurement; Predictive Value of Tests; Prognosis; Shoulder Pain; Time Factors