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Clinical Journal of Pain

Dmitry Tumin, Rebecca Miller, Mohammed Hakim, Shabana Z Shafy, David Drees, Sharon Wrona, Timothy P Smith, Joseph D Tobias, Tarun Bhalla
OBJECTIVES: To retrospectively characterize the rate of referrals to an outpatient chronic pain clinic among adolescents with chronic pain, and to identify factors associated with referral. METHODS: Adolescents 13-18 years of age seen in 2010-2015 at outpatient clinics associated with Nationwide Children's Hospital (NCH) and diagnosed with chronic pain were included if they lived near NCH and had not been previously referred to the NCH outpatient chronic pain clinic...
October 9, 2018: Clinical Journal of Pain
Eugene R Viscusi
OBJECTIVES: Opioid analgesics may be associated with chronic adverse effects, such as opioid-induced constipation (OIC). Available and emerging prescription medications for OIC in patients with chronic noncancer pain are described, including concerns and challenges associated with OIC management. METHODS: Narrative review. RESULTS: Opioid-induced constipation is characterized by a change in bowel habits and defecation patterns that occurs when initiating opioid therapy and is associated with reduced bowel frequency, straining, sensation of incomplete evacuation, and/or patient distress related to bowel habits...
October 4, 2018: Clinical Journal of Pain
Cate Sinclair, Pamela Meredith, Jenny Strong, George A Chalkiadis
OBJECTIVES: Sensory modulation patterns contribute to altered pain perception and disengagement in activities; atypical sensory modulation patterns have been associated with higher pain sensitivity, catastrophizing, and reduced function. Objectives of this study were to ascertain whether: adolescents with persistent pain had atypical sensory modulation patterns, atypical sensory modulation was associated with reduced functioning and higher pain, and pain catastrophizing mediated the relationship between sensory modulation and functional disability...
October 3, 2018: Clinical Journal of Pain
Christine H Meyer-Frießem, Theresa Wiegand, Lynn Eitner, Christoph Maier, Tina Mainka, Jan Vollert, Elena K Enax-Krumova
OBJECTIVES: Spinal cord and peripheral nerve stimulation (SCS/PNS) alleviate chronic pain; however, the underlying mechanisms remain controversial. Aim of this observational study was to assess sensory changes in the ON- and OFF-conditions to obtain insights into mechanism of analgesic effects of SCS/PNS. METHODS: We contacted 85 patients and selected 28 patients with sufficient pain relief by SCS (n=15) or PNS (n=13) to assess their ongoing pain intensity (Numerical Rating Scale, NRS 0-10), pain thresholds using Quantitative Sensory Testing (DFNS-protocol) and conditioned pain modulation (CPM, conditioning stimulus: heat, test stimulus: cold water) in a non-randomized manner 2-4 hours after SCS/PNS deactivation (OFFcondition) and during stimulation (ON-condition)...
September 26, 2018: Clinical Journal of Pain
Brett Vaughan, Jane Mulcahy, Kylie Fitzgerald, Philip Austin
OBJECTIVE: Educating patients about the neurobiological basis of their pain experience is now an important part of managing patients with pain disorders. The aim of this study was to evaluate the measurement properties of the Neurophysiology of Pain Questionnaire (NPQ) in a population seeking osteopathy treatment for both acute and chronic musculoskeletal pain complaints. METHODS: Patients attending the Victoria University Osteopathy Clinic for their initial osteopathy consultation were recruited consecutively...
September 26, 2018: Clinical Journal of Pain
Robert Waller, Anne Julia Smith, Peter Bruce O'Sullivan, Helen Slater, Michele Sterling, Leon Melville Straker
OBJECTIVES: To investigate the cross-sectional associations between musculoskeletal pain experience and measures of pressure and cold pain sensitivity in young adults from the Western Australian Pregnancy Cohort (Raine) Study. METHODS: PARTICIPANTS: (n=917) were eligible for analysis if they provided data pertaining to musculoskeletal pain status at the 22-year follow up and had data for at least one valid pain sensitivity test. Standardised protocols were used to assess pressure pain threshold (4 sites: lumbar spine, tibialis anterior, upper trapezius and wrist) and cold pain threshold (wrist)...
September 26, 2018: Clinical Journal of Pain
Christine Miaskowski, Steven M Paul, Judy Mastick, Gary Abrams, Kimberly Topp, Betty Smoot, Kord M Kober, Margaret Chesney, Mark Schumacher, Yvette P Conley, Marilyn Hammer, Steven Cheung, David Borsook, Jon D Levine
Numbness associated with neuropathic pain suggests the loss of function in myelinated, large diameter sensory neurons. The purpose of this study was to examine the relationships between pain severity and subjective (i.e., severity of numbness) and objective (i.e., loss of light touch sensations, vibration thresholds) measures of loss of large fiber function in adult survivors with chemotherapy-induced peripheral neuropathy (CIN, n=426) and breast cancer patients with persistent post-surgical pain (n=80). For both samples, average pain and numbness were evaluated using a 0 to 10 numeric rating scale (NRS)...
September 21, 2018: Clinical Journal of Pain
Teeranai Sakulchit, Boris Kuzeljevic, Ran D Goldman
OBJECTIVES: Accurate assessment of pain in young children is challenging. An Emotion Application Programing Interface (API) can analyze and report eight emotions from facial images. Each emotion ranges between 0 (no correlation) to 1 (greatest correlation). We evaluated correlation between the Emotion API with the FLACC scale among children less than six years old during blood sampling. METHODS: Prospective pilot exploratory study in children during blood sampling...
September 21, 2018: Clinical Journal of Pain
Tibor M Szikszay, Waclaw M Adamczyk, Kerstin Luedtke
OBJECTIVE: Offset analgesia (OA) is a test paradigm increasingly used to estimate endogenous pain modulation characterized by a disproportionally profound analgesia after a small decrease of a heat stimulus. This systematic review and meta-analysis examined the magnitude and difference of OA in healthy subjects and chronic pain patients. METHODS: Controlled trials, case-control studies, cross-sectional studies, case-series or other observational studies evaluating the effect of a ±1°C offset trial in healthy controls and patients with chronic pain were searched in PubMed, Web of Science, CINAHL, PEDro, PsycINFO and Cochrane CENTRAL...
September 21, 2018: Clinical Journal of Pain
Judith Kappesser, Elisa Kamper, Jan de Laffolie, Dirk Faas, Harald Ehrhardt, Linda S Franck, Christiane Hermann
OBJECTIVES: There are many neonatal pain assessment tools available nowadays. However, systematic psychometric comparisons between tools are still lacking, particularly those comparing tools regarding their ability to differentiate between pain and stressful procedures. The aim of the present study was to psychometrically compare five widely used neonatal pain assessment tools: Neonatal Facial Coding System-Revised (NFCS-R), Premature Infant Pain Profile-Revised (PIPP-R), Neonatal Pain, Agitation and Sedation Scale (N-PASS) Neonatal Infant Pain Scale (NIPS) and Bernese Pain Scale Neonates (BPSN)...
September 21, 2018: Clinical Journal of Pain
Lizhong Wang, Changna Wei, Fe Xiao, Xiangyang Chang, Yinfa Zhang
OBJECTIVES: To assess the effects of cathechol-O-methyl-transferase (COMT) rs4680 and μ-opioid receptor (OPRM1) rs1799971 polymorphisms alone or genotype combinations on chronic postsurgical pain (CPSP), acute pain and analgesic consumption after elective caesarean delivery in a Chinese cohort. METHODS: Two hundred and sixty-six patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anesthesia were enrolled in this prospective, observational study...
September 18, 2018: Clinical Journal of Pain
Ségolène Lithfous, Olivier Després, Thierry Pebayle, André Dufour
OBJECTIVE: Aging has been associated with increases in pain threshold and reductions in tolerance threshold, as well as a deficiency in endogenous pain inhibition. Top-down pain modulation mainly involves the frontal cortex network, which is also one of the most vulnerable brain regions in aging. Because the frontal cortex also sustains executive functions, we aimed to determine if reductions in executive functions subtended by the frontal network are associated with the lack of descending inhibitor control in healthy elderly subjects...
September 15, 2018: Clinical Journal of Pain
Alberto Marcos Heredia-Rizo, Kristian Kjær Petersen, Pascal Madeleine, Lars Arendt-Nielsen
OBJECTIVES: The effects of eccentric exercises on clinical outcomes and central pain mechanisms are unclear in neck/shoulder pain (NSP). The aims were to (1) evaluate the clinical impact of unilateral eccentric training in female computer users with chronic NSP, (2) compare pressure pain sensitivity, temporal summation of pain (TSP), and conditioned pain modulation (CPM) in female office workers with and without NSP, and (3) assess sensitization and central pain responses after training...
September 15, 2018: Clinical Journal of Pain
Roi Treister, Erica Suzan, Oluwadolapo D Lawal, Nathaniel P Katz
OBJECTIVES: Analgesic trials often fail to show a significant effect even when medications with known efficacy are tested. This could be attributed to insufficient assay sensitivity of analgesic trials, which may be due, in part, to the insensitivity of pain-related outcome measures. The aim of this methodological study was to assess the responsiveness of evoked pain generated by the staircase procedure compared to other commonly used pain outcomes in knee osteoarthritis. METHODS: This was a randomized, double-blind, placebo-controlled, cross-over trial of 1-week treatment of naproxen versus placebo...
September 15, 2018: Clinical Journal of Pain
Benjamin Wei Da Yap, Edwin Choon Wyn Lim
INTRODUCTION: In recent years, there has been an increase in the use of motor imagery in the rehabilitation of musculoskeletal pain conditions. Across the literature, most reviews have yet to consider Laterality Judgement Task training as a form of motor imagery method. This review aimed to evaluate the effectiveness when using MI as an adjunct to standard rehabilitation on the improvement of pain and range of motion parameters when managing patients with musculoskeletal pain conditions...
September 15, 2018: Clinical Journal of Pain
Benjamin J Morasco, Erin E Krebs, Melissa H Adams, Stephanie Hyde, Janet Zamudio, Steven K Dobscha
OBJECTIVE: Urine drug testing (UDT) is recommended for patients who are prescribed opioid medications, but little is known about the various strategies clinicians use to respond to aberrant UDT results. We sought to examine changes in opioid prescribing and implementation of other risk reduction activities following an aberrant UDT. METHODS: In a national cohort of VA patients with new initiations of opioid therapy through 2013, we identified a random sample of 100 patients who had aberrant positive UDTs (results positive for non-prescribed/illicit substance), 100 who had aberrant negative UDTs (results negative for prescribed opioid), and 100 who had expected UDT results...
September 15, 2018: Clinical Journal of Pain
Tereza Andrasinova, Eva Kalikova, Roman Kopacik, Iva Srotova, Eva Vlckova, Ladislav Dusek, Josef Bednarik, Blanka Adamova
OBJECTIVES: Assessment of neuropathic pain in chronic low back syndromes is important. However, there is currently no gold standard for its diagnosis. The aim of this observational cross-sectional study was to assess the neuropathic component of pain in various chronic low back pain syndromes using a range of diagnostic tests. METHODS: Included in this study were 63 patients with chronic axial low back pain (ALBP), 48 patients with chronic radicular syndromes (CRS) comprising 23 with discogenic compression (CDRS) and 25 with lumbar spinal stenosis (LSS), and 74 controls...
September 15, 2018: Clinical Journal of Pain
Shih-Pin Lin, Kuang-Yi Chang, Hsiu-Hsi Chen, Mei-Yung Tsou
INTRODUCTION: Surgical procedure is an important predictor for analgesic consumptions of intravenous patient-controlled analgesia (IV-PCA) for acute pain. OBJECTIVES: To better fit the analgesic consumptions of IV-PCA regarding to the different surgical procedures. METHODS: A statistical model (random effect model) was proposed to develop procedure-specific morphine consumptions for various surgical procedures of IV-PCA. After model was developed, an independent dataset was used for external validation...
August 24, 2018: Clinical Journal of Pain
Zongming Jiang, Guozhong Zhou, Qiliang Song, Chenying Bao, Hua Wang, Zhonghua Chen
OBJECTIVE: Oxycodone or dexmedetomidine (DEX) alone are widely used in clinical practice. The aim of this study was to observe the effect of two oxycodone and DEX combinations on postoperative sleep quality. METHODS: This was a prospective and randomized clinical study. 99 patients underwent laparoscopic assisted operations on stomach and intestines with general anesthesia were enrolled and randomly divided into three groups according to postoperative analgesic protocol (n=33 each)...
August 21, 2018: Clinical Journal of Pain
Lorin Stahlschmidt, Yvonne Friedrich, Boris Zernikow, Julia Wager
OBJECTIVES: The assessment of pain-related disability in pediatric chronic pain patients plays an important role in research on the effectiveness of pain treatment. The present study aimed to compare the two available measures of pain-related disability in German language, the Functional Disability Inventory (FDI) and Paediatric Pain Disability Index (PPDI), in terms of psychometric properties and convergent validity. Additionally, associations between FDI/PPDI scores and sex, age and pain locations were investigated...
August 21, 2018: Clinical Journal of Pain
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