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Clinical Journal of Pain

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https://www.readbyqxmd.com/read/28060194/chronic-lateral-epicondylalgia-does-not-exhibit-mechanical-pain-modulation-in-response-to-noxious-conditioning-heat-stimulus
#1
Edwin Choon Wyn Lim, Michele Sterling, Bill Vicenzino
The impaired attenuation of pain by the application of a noxious conditioning stimulus at a segmentally distinct site, known as conditioned pain modulation, has been implicated in clinical pain states. Chronic lateral epicondylalgia (LE), which is characterized by lower pressure pain thresholds at sites remote to the affected elbow and spinal cord hyperexcitability, is a clinical pain state that might plausibly involve less efficacious conditioned pain modulation. This study aimed to determine if LE exhibits a less efficacious conditioned pain modulation compared to healthy controls...
January 3, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28033158/a-review-of-adult-and-pediatric-neuropathic-pain-assessment-tools
#2
Kyle Joseph Morgan, Doralina L Anghelescu
An early and thorough assessment of pain is essential to its proper diagnosis and treatment. This assessment is especially important when NP is suspected, given the different treatment modalities available and the serious impact of NP on patients' quality of life. This article summarizes the various screening and assessment tools available to clinicians for evaluating NP. Despite the availability of the 15 tools discussed, a deficiency remains, particularly in the pediatric realm. To date, there is no well-validated NP assessment tool for children younger than 5 years, no pediatric NP screening tool that has been validated outside the domain of chemotherapy-induced peripheral neuropathy, and no consistent recommendation regarding the optimal tool to use with pediatric patients who have chronic pain...
December 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28033157/measuring-glutamate-levels-in-the-brains-of-fibromyalgia-patients-and-a-potential-role-for-glutamate-in-the-pathophysiology-of-fibromyalgia-symptoms-a-systematic-review
#3
Tahni Pyke, Peter G Osmotherly, Surinder Baines
OBJECTIVES: The aim of this study is to systematically review the literature concerning proton magnetic resonance spectroscopy (H-MRS) measured glutamate levels in specific brain regions of fibromyalgia (FM) patients to determine if there is a correlation between raised glutamate levels and the presentation of FM. METHODS: The electronic databases - MEDLINE, EMBASE Classic+Embase, PsychINFO, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effect, Cochrane Central Register of Controlled Trials - were searched to find original studies that used H-MRS to measure glutamate concentrations in the brains of FM patients...
December 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28005560/capsaicin-8-patch-repeat-treatment-in-non-diabetic-peripheral-neuropathic-pain-a-52-week-open-label-single-arm-safety-study
#4
Rafael Gálvez, Marie-Louise Navez, Graeme Moyle, Christian Maihöfner, Malcolm Stoker, Etienne Ernault, Turo J Nurmikko, Nadine Attal
OBJECTIVES: To investigate long-term safety and tolerability of capsaicin 8% patch repeat treatment in non-diabetic patients with peripheral neuropathic pain (NP). METHODS: Prospective, open-label, observational study in patients with post-herpetic neuralgia, post-traumatic or post-surgical nerve injury, HIV-associated distal sensory polyneuropathy, or other peripheral NP, and average daily pain score ≥4, received ≤6 capsaicin 8% patch treatments over 52 weeks according to clinical need (retreatment at 9-12 wk intervals)...
December 21, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28002096/duloxetine-as-an-analgesic-reduces-opioid-consumption-after-spine-surgery-a-randomized-double-blind-controlled-study
#5
Antonio Bedin, Rafael Antonio Caldart Bedin, Joaquim Edson Vieira, Hazem Adel Ashmawi
OBJECTIVES: Multimodal analgesia is widely advocated for the control of perioperative pain in an effort to reduce the use of opioid. Duloxetine is a selective inhibitor of serotonin and norepinephrine reuptake with efficacy for chronic pain conditions. The primary objective of this study was to evaluate the efficacy of two 60 mg oral doses of duloxetine in terms of fentanyl consumption during the postoperative period in patients undergoing elective spine surgery. METHODS: This study was prospective, double blind, randomized, and placebo controlled...
December 19, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28002095/assessing-prescribing-trends-of-adjuvant-medication-therapy-in-outpatients-with-a-diagnosis-of-non-malignant-chronic-pain
#6
Rafia S Rasu, Rachel K Vossen, Maureen Knell
BACKGROUND: Chronic pain affects over 100 million people in the United States, yet continues to be difficult to treat. Concerns continue to mount over the use of opioids to treat nonmalignant chronic pain (NMCP). Guidelines support the use of adjuvant medications as one of the preferred options for treating chronic pain over opioids. OBJECTIVES: To examine reported usage of adjuvants in the treatment of chronic pain via the National Ambulatory Medical Care Survey (NAMCS)...
December 19, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28002094/the-association-between-headaches-and-temporomandibular-disorders-is-confounded-by-bruxism-and-somatic-complaints
#7
Hedwig A van der Meer, Caroline M Speksnijder, Raoul Engelbert, Frank Lobbezoo, Maria W G Nijhuis-van der Sanden, Corine M Visscher
OBJECTIVES: The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. METHODS: Several subtypes of headaches were diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache (TTH), and secondary headache attributed to TMD. The presence of TMD was subdivided into two subtypes: painful TMD and function-related TMD...
December 19, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28002093/postoperative-analgesia-via-a-transversus-abdominis-plane-block-using-different-concentrations-of-ropivacaine-for-abdominal-surgery-a-meta-analysis
#8
Ni Sun, Shouyong Wang, Pengpeng Ma, Shuting Liu, Aijie Shao, Ling Xiong
BACKGROUND: The transversus abdominis plane block (TAPB) has been proven to be an effective means of postoperative anesthesia, but the optimum effective concentration of ropivacaine warrants further research. OBJECTIVE: This study aimed to identify the optimal ropivacaine concentration of TAPB using a meta-analysis. METHODS: This study consisted of a meta-analysis of randomized controlled trials (RCTs). We searched online databases, including PubMed, Embase, the Cochrane Database of Systematic Reviews, and Web of Science...
December 19, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27984242/impact-of-abuse-on-adjustment-and-chronic-pain-disability-a-structural-equation-model
#9
Swati Mehta, Danielle Rice, Alan Chan, Allan P Shapiro, Keith Sequeira, Robert W Teasell
INTRODUCTION/AIM: Sexual abuse, "state" and "trait" psychosocial factors, pain intensity, and pain related disability have been shown to be correlated among individuals with chronic pain. However, the interacting relationships between these factors is poorly understood. The current study aims to test model which examines the effect of abuse, "state" and "trait" psychosocial factors, and pain intensity on pain related disability among individuals with chronic pain. METHODS: 229 participants diagnosed with chronic pain were recruited from a specialist chronic pain hospital in London, Ontario...
December 15, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27977426/symptoms-of-depression-and-risk-of-low-back-pain-a-prospective-co-twin-study
#10
Marina B Pinheiro, Manuela L Ferreira, Kathryn Refshauge, Lucia Colodro-Conde, Francisca González-Javier, John L Hopper, Juan R Ordoñana, Paulo H Ferreira
OBJECTIVES: To investigate whether symptoms of depression increase the risk of low back pain (LBP), after adjusting for genetic and environmental influences. METHODS: Baseline data of 1607 twins from the Murcia Twin Registry (Spain) were collected in 2009-2011 and follow-up data in 2013. Twins answered questions on depression-related symptomatology and LBP. Only participants not reporting chronic LBP (pain>6 mo) at baseline were included. The association between symptoms of depression and LBP was investigated using logistic regression analysis including the complete sample...
December 13, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27977425/sensory-symptom-profiles-of-patients-with-neuropathic-pain-after-spinal-cord-injury
#11
M Dolors Soler, David Moriña, Neus Rodríguez, Joan Saurí, Joan Vidal, Albert Navarro, Xavier Navarro
Patients suffering from neuropathic pain (NP) after spinal cord injury (SCI) present with a variety of pain descriptors in different combinations and at different intensities. These sensory features form distinct patterns, known as sensory symptom profiles. In the present cross-sectional study, we have used a multivariate statistical method (multiple correspondence analysis) to categorize the sensory symptom profiles of a cohort of 338 patients with at-level or below-level NP after SCI. We also investigated possible associations between positive neuropathic symptoms and features of the neurological lesion...
December 13, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27930393/mediators-of-treatment-effect-in-the-back-in-action-trial-using-latent-growth-modelling-to-take-change-over-time-into-account
#12
Gemma Mansell, Jonathan C Hill, Chris Main, Michael Von Korff, Daniëlle van der Windt
OBJECTIVES: To test whether change in fear-avoidance beliefs was a mediator of the effect of treatment on disability outcome; To test an analytical approach, latent growth modelling, not often applied to mediation analysis. METHODS: Secondary analysis was carried out on a randomised controlled trial designed to compare an intervention addressing fear-avoidance beliefs (n=119) with treatment as usual (n=121) for patients with low back pain, which found the intervention to be effective...
December 7, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27930392/pain-catastrophizing-is-not-associated-with-spinal-nociceptive-processing-in-people-with-chronic-widespread-pain
#13
David A Rice, Rosalind S Parker, Gwyn N Lewis, Michal T Kluger, Peter J McNair
OBJECTIVES: Pain catastrophizing has been associated with higher pain intensity, increased risk of developing chronic pain and poorer outcomes after pain treatments. Despite this, the mechanisms by which pain catastrophizing influences pain remain poorly understood. It has been hypothesised that pain catastrophizing may impair descending inhibition of spinal level nociception. The aims of this study were to compare spinal nociceptive processing in people with chronic widespread pain and pain free controls and examine potential relationships between measures of pain catastrophizing and spinal nociception...
December 7, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27922842/what-s-in-a-name-healthcare-providers-perceptions-of-pediatric-pain-patients-based-on-diagnostic-labels
#14
Taylor A Betsch, Ayala Y Gorodzinsky, G Allen Finley, Michael Sangster, Jill Chorney
OBJECTIVES: Diagnostic labels can help patients better understand their symptoms and can influence providers' treatment planning and patient interactions. Recurrent pain is common in childhood; however, there are various diagnostic labels used. The objective of this study was to evaluate the influence of diagnostic labels on pediatric healthcare providers' perceptions of pediatric chronic pain patients. METHODS: Using an online survey, providers were randomly assigned to one of two vignette conditions (differing only in diagnostic label provided) and completed questionnaires about their perceptions of the vignette patient...
December 5, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27898458/smoking-status-and-opioid-related-problems-and-concerns-among-men-and-women-on-chronic-opioid-therapy
#15
Kelly C Young-Wolff, Daniella Klebaner, Constance Weisner, Michael Von Korff, Cynthia I Campbell
OBJECTIVES: Smokers on chronic opioid therapy for non-cancer pain use prescription opioids at higher dosages and are at increased risk for opioid misuse and dependence relative to non-smokers. The current study aims to assess whether smoking is associated with problems and concerns with chronic opioid therapy from the perspective of the patient. METHODS: In a large sample (N=972) of adult patients prescribed opioids for chronic noncancer pain, we examined sex-specific associations between smoking status and patient perceptions of problems and concerns with chronic opioid therapy using regression analyses, adjusting for covariates...
November 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27898457/ethnicity-cortisol-and-experimental-pain-responses-among-persons-with-symptomatic-knee-osteoarthritis
#16
Matthew S Herbert, Burel R Goodin, Hailey W Bulls, Adriana Sotolongo, Megan E Petrov, Jeffrey C Edberg, Laurence A Bradley, Roger B Fillingim
OBJECTIVES: While several factors are known to contribute to ethnic differences in pain, relatively little attention has been devoted to physiological factors. Our first aim was to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Our second aim was to assess the relationship between perceived racial discrimination and cortisol among AA participants...
November 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27898461/cold-pain-threshold-identifies-a-subgroup-of-patients-with-knee-osteoarthritis-that-present-with-multimodality-hyperalgesia-and-elevated-pain-levels
#17
Anthony Wright, Heather A E Benson, Rob Will, Penny Moss
OBJECTIVES: Cold hyperalgesia has been established as an important marker of pain severity in a number of conditions. This study aimed to establish the extent to which patients with knee osteoarthritis (OA) demonstrate widespread cold, heat, and pressure hyperalgesia. OA participants with widespread cold hyperalgesia were compared with the remaining OA cohort to determine whether they could be distinguished in terms of hyperalgesia, pain report, pain quality, and physical function. METHODS: A total of 80 participants with knee OA and 40 matched healthy controls participated...
November 24, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27898460/a-pilot-comparison-of-a-smartphone-app-with-or-without-2-way-messaging-among-chronic-pain-patients-who-benefits-from-a-pain-app
#18
Robert N Jamison, Dylan C Jurcik, Robert R Edwards, Chuan-Chin Huang, Edgar L Ross
OBJECTIVES: The overall aim of this study was to determine the effect of introducing a smartphone pain app, for both Android and iPhone devices that enables chronic pain patients to assess, monitor, and communicate their status to their providers. METHODS: This study recruited 105 chronic pain patients to use a smartphone pain app and half of the subjects (N=52) had 2-way messaging available through the app. All subjects completed baseline measures and were asked to record their progress every day for 3 months, with the opportunity to continue for 6 months...
November 24, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27898459/characterization-of-the-adverse-effects-induced-by-acetaminophen-and-non-steroidal-anti-inflammatory-drugs-based-on-the-analysis-of-the-japanese-adverse-drug-event-report-database
#19
Junko Nagai, Yoshihiro Uesawa, Ryotaro Shimamura, Hajime Kagaya
OBJECTIVES: Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) are antipyretic analgesics with established adverse effects; however, only a few studies have compared their adverse effects simultaneously. We aimed to compare the adverse effects of these medications to confirm the respective frequencies of both rare and major adverse effects. METHODS: We used a high-quality database for spontaneous adverse drug event reporting in Japan. Data were extracted regarding the adverse effects of acetaminophen and NSAIDs to compare the tendency of the appearance of those adverse effects between the drugs...
November 24, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27875377/spinal-cord-stimulation-for-refractory-angina-pectoris-a-systematic-review-and-meta-analysis
#20
Xiaoxiao Pan, Hongguang Bao, Yanna Si, Chenjie Xu, Hao Chen, Xianzhong Gao, Xinyi Xie, Yajie Xu, Fan Sun, Lingqing Zeng
OBJECTIVES: Parasthesia free stimulation, such as high frequency and burst have been demonstrated as effective therapies for neuropathic pain. The aim of this meta-analysis was to evaluate the efficacy and safety of conventional spinal cord stimulation (SCS) in the treatment of refractory angina pectoris (RAP). METHODS: Relevant randomized controlled trial (RCT) studies that investigated SCS for patients with RAP were comprehensively searched in Medline, Pubmed, Embase, and Cochrane Library...
November 21, 2016: Clinical Journal of Pain
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