Normalization of serum cortisol concentration with opioid treatment of severe chronic pain.
Serum cortisol concentrations may be altered in severe, chronic pain due to excess stimulation of the hypothalamic-pituitary-adrenal axis. Among 40 consecutive patients with severe, chronic pain 26 (65.0%) demonstrated abnormal serum cortisol concentration. After 90 days of treatment, only 7 (17.5%; p<0.01) continued to show abnormal serum cortisol concentration indicating that serum cortisol and other serologic abnormalities may serve as biologic markers of severe, chronic pain.
Tennant
Forest
F
Veract Intractable Pain Centers, West Covina, California 91790, USA.
Hermann
Laura
L