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Pain Management

Thomas Richard Dawes, Ben Eden-Green, Claire Rosten, Julian Giles, Ricardo Governo, Francesca Marcelline, Charles Nduka
Currently, clinicians observe pain-related behaviors and use patient self-report measures in order to determine pain severity. This paper reviews the evidence when facial expression is used as a measure of pain. We review the literature reporting the relevance of facial expression as a diagnostic measure, which facial movements are indicative of pain, and whether such movements can be reliably used to measure pain. We conclude that although the technology for objective pain measurement is not yet ready for use in clinical settings, the potential benefits to patients in improved pain management, combined with the advances being made in sensor technology and artificial intelligence, provide opportunities for research and innovation...
February 22, 2018: Pain Management
Kailyn Jones, David Nordstokke, Gabrielle Wilcox, Meadow Schroeder, Melanie Noel
School is often cited as the 'work of childhood' and serves as an important site for child and adolescent development. Frequent school absences in children and adolescents with chronic pain are well documented; however, variables that may explain school impairment are not understood. The potential consequences of school impairment are extensive, as these children and adolescents are at great risk for achieving poor grades and sometimes require full-time homebound instruction. This, in turn, can have adverse effects on occupational and social functioning well into adulthood...
February 22, 2018: Pain Management
Érika Patrícia Rampazo da Silva, Viviane Ribeiro da Silva, Anabelly Sato Bernardes, Fabio Massao Matuzawa, Richard Eloin Liebano
The aim of the study will be to compare different types of analgesic electrical currents in relation to the pressure pain threshold and sensory comfort in healthy individuals. A total of 100 individuals will be randomly assigned to four groups: transcutaneous electrical nerve stimulation, interferential current, Aussie current or placebo. The electrical stimulation will be administered with a strong level for 30 min and to the placebo group, the electrodes will be positioned while the equipment will remain switched off...
February 16, 2018: Pain Management
Daniel A Bissell, Maisa S Ziadni, John A Sturgeon
Chronic pain conditions have been shown to be exacerbated by psychological factors, and a better understanding of these factors can inform clinical practice and improve the efficacy of interventions. The current paper investigates perceived injustice, a novel psychosocial construct, within a framework influenced by the tenets of predictive processing. The proposed conceptual model derived from tenets of predictive processing yields a single hierarchical self-reconfiguring system driven by prediction, which accounts for a wide range of human experiences such as perception, behavior, learning and emotion...
February 16, 2018: Pain Management
Rachel L Graves, Jesse Goldshear, Jeanmarie Perrone, Lyle Ungar, Elissa Klinger, Zachary F Meisel, Raina M Merchant
AIM: To characterize Yelp reviews about pain management and opioids. METHODS: We manually coded and applied natural language processing to 836 Yelp reviews of US hospitals mentioning an opioid medication. RESULTS: Yelp reviews by patients and caregivers describing experiences with pain management and opioids had lower ratings compared with other reviews. Negative descriptions of pain management and opioid-related experiences were more commonly described than positive experiences, and the number of themes they reflected was more diverse...
February 16, 2018: Pain Management
Bernard Schachtel, Adrian Shephard, Emily Schachtel, Mary Beth Lorton, Tim Shea, Sue Aspley
AIM: Patients with pharyngitis often describe various sensory, affective and evaluative pain qualities. Using an 11-word/phrase index, the Qualities of Sore Throat Index (QuaSTI), we characterized throat symptoms and evaluated changes in a randomized controlled trial (NCT01986361). MATERIALS & METHODS: Patients received a single flurbiprofen 8.75 mg (n = 101) or placebo (n = 21) lozenge and rated throat soreness at baseline and regular intervals over 3 h, and the QuaSTI at baseline, 1, 2 and 3 h post-treatment...
January 30, 2018: Pain Management
Ferdinandus de Looze, Marc Russo, Mark Bloch, Barney Montgomery, Adrian Shephard, Robert DeVito
AIM: Evaluate the efficacy of flurbiprofen 8.75 mg spray for sore throat relief. PATIENTS & METHODS: Randomized, double-blind study in adults with sore throat due to upper respiratory tract infection who took flurbiprofen (n = 249) or placebo spray (n = 256). Pain relief was assessed using the Sore Throat Relief Rating Scale. RESULTS: Flurbiprofen spray provided significantly greater relief versus placebo from 20 min to 6 h (p < 0...
January 29, 2018: Pain Management
Sarah R Martin, Lonnie K Zeltzer
No abstract text is available yet for this article.
March 2018: Pain Management
Sandra K Kabagambe, Laura F Goodman, Y Julia Chen, Benjamin A Keller, James C Becker, Gary W Raff, Rebecca A Stark, Jacob T Stephenson, Amy Rahm, Diana L Farmer, Shinjiro Hirose
AIM: To compare outcomes of continuous subcutaneous infusion of local anesthetic and epidural analgesia following the Nuss procedure. PATIENTS & METHODS: A retrospective chart review compared patients managed with subcutaneous local anesthetic infusion (n = 12) versus thoracic epidural (n = 19) following the Nuss procedure from March 2013 to June 2015. RESULTS: There was no difference in hospital length of stay or days on intravenous narcotics...
January 2018: Pain Management
Jessica W Guite, David D Sherry, Esther W Jarvis, Margaret O Lewen, Sarosh Khan, Francis Wickham Kraemer
AIM: To characterize medication use by adolescents with chronic musculoskeletal pain syndromes before an initial multidisciplinary clinic visit. PATIENTS & METHODS: A cross-sectional sample of 120 adolescents and parents reported on standardized assessment measures, with medication use data extracted from the medical chart and categorized. RESULTS: On average, 3.2 medications were reported; 70% used more than one pain-specific medication including opioids (17%), nonopioids (31%), psychotropics/neuropathics (45%) and other medications (13%)...
January 2018: Pain Management
Lauren Shaw, Maria Morozova, Ishaq Abu-Arafeh
The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents. Literature search of PubMed, Embase, Cochrane databases and Google Scholar was carried out for all studies reporting on CPTH in children and young people under the age of 18 years between January 1980 and November 2016. Search command included post-traumatic headache, postconcussion syndrome, child and adolescent. Demographic data, diagnostic criteria of headache disorders, occurrence of headache after head injury and headache phenotypes were collected...
January 2018: Pain Management
Tanja Bossmann, Torsten Brauner, Thomas Horstmann
AIM: Facilitated temporal summation is one component of central sensitization. The aim of this exploratory study was to classify pro-, eu- and antinociceptive subgroups based on wind-up ratio cut-off scores in patients with knee osteoarthritis (OA). PATIENTS & METHODS:  A total of 56 patients with knee OA met the inclusion criteria. Temporal summation was measured and wind-up ratio was calculated. Reference values of 180 healthy subjects were used to define wind-up ratio cut-off scores...
January 2018: Pain Management
Stefania Ceruti
Clinical data outline the high incidence of pain syndromes in patients with multiple sclerosis, with a significant prevalence of craniofacial manifestations, including trigeminal neuralgia and migraine, which are very difficult to be managed pharmacologically. The common explanation of a localization of demyelinating plaques in areas devoted to pain modulation and integration as a trigger for pain development seems now partially unsatisfactory, since pain is often manifested well before the clinical signs of the pathology and its severity does not correlate with disease progression...
January 2018: Pain Management
Ana Torres, Mariano Fernández-Fairen, José Sueiro-Fernández
Greater trochanteric pain syndrome (GTPS) affects 10-25% of people in developed countries. The underlying etiology for GTPS is most commonly the tendinosis or a tendon tear of the gluteus medius, minimus or both at the greater trochanter; the inflammation of the tendon is not a major feature. We critically evaluated conservative treatment, for which we reviewed 76 publications, grading them according to four levels of evidence. We identified a wide variety of conservative treatment options: home therapy (insoles, walking sticks/crutches, orthotic devices, stretching exercises and preventive measures); physiotherapy (massage and stretching exercises); infiltrations (corticosteroids and local anesthetics); image-guided infiltrations (fluoroscopy and ultrasound); shockwave therapy; platelet-rich plasma injection; and drug therapy...
January 2018: Pain Management
George Ikkos, Angela Gall, Carol Smyth
Spinal cord injury is an uncommon condition, potentially causing a wide range of consequences and requiring specialist rehabilitation to optimize health, activity and participation. Early psychological response to injury and relations with staff, as well as family, may set the foundations for long-term emotional adjustment, healthcare utilization and quality of life. The Stanmore Nursing Assessment of Psychological Status has been developed at the London Spinal Cord Injury Centre to empower nurses to adopt a consistently empathic approach to patient care, as part of a comprehensive range of rehabilitation team skills...
January 2018: Pain Management
Bonifacio S Rafanan, Benedict F Valdecañas, Boon Ping Lim, Anan Malairungsakul, Warat Tassanawipas, Chen Shiyi, Lung Fung Tse, Tuan Khanh Luong
Osteoarthritis prevalence is expected to increase markedly in the Asia-Pacific region due to rapid population aging. Identifying effective and safe therapeutic options to manage osteoarthritic pain is viewed as a priority. The Asia-Pacific Experts on Topical Analgesics Advisory Board developed consensus statements for use of topical NSAIDs in musculoskeletal pain. Evidence supporting these statements in osteoarthritic pain was reviewed. Best available evidence indicates that topical NSAIDs have a moderate effect on relief of osteoarthritic pain, comparable to that of oral NSAIDs but with a better risk-to-benefit ratio...
December 18, 2017: Pain Management
Michael J Brennan, Ernest A Kopecky, Ann Marseilles, Melinda O'Connor, Alison B Fleming
AIM: To further characterize the pharmacokinetics of Xtampza® ER. SUBJECTS & METHODS: This was an open-label, randomized, active-controlled, five-treatment, five-period, naltrexone-blocked, cross-over study. Healthy subjects received five equivalent oxycodone doses: Xtampza ER (intact or crushed), OxyContin® (intact or crushed) or immediate-release (IR) oxycodone (crushed). Blood samples were collected to assess oxycodone concentrations. RESULTS: Crushed and intact Xtampza ER resulted in lower peak plasma concentrations compared with crushed oxycodone IR; crushed and intact Xtampza ER were bioequivalent...
November 2017: Pain Management
Nebojsa Nick Knezevic, Tatiana Tverdohleb, Farid Nikibin, Ivana Knezevic, Kenneth D Candido
The goal of our review was to emphasize important aspects that physicians should take into consideration when prescribing topical analgesics as part of chronic neuropathic pain treatment. We discuss the dermatopharmacokinetics and microstructural components of the skin, differences between topical and transdermal drug delivery, and topical medication effects on peripheral neuropathy and central sensitization. Even though the US FDA approved topical analgesics are 8%-capsaicin and 5%-lidocaine patches for treating postherpetic neuralgia, there are many other studies conducted on the efficacy of topical ketamine cream, clonidine gel, topical gabapentin, topical baclofen and topical phenytoin for peripheral neuropathic pain, either alone or in combination with other formulations...
November 2017: Pain Management
Jeremy N Cashman, Lenny Ng
Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Nevertheless, a variety of more or less complex protocols exist for intraprocedural sedation and for peri- and postprocedural analgesia...
November 2017: Pain Management
Nicole E Burma, Charlie Ht Kwok, Tuan Trang
No abstract text is available yet for this article.
November 2017: Pain Management
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