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Treatment of chronic pain

Wen-Qiang Cui, Wen-Shan Sun, Fei Xu, Xue-Ming Hu, Wei Yang, Yang Zhou, Li-Xia Du, Wen-Wen Zhang, Qi-Liang Mao-Ying, Wen-Li Mi, Yu-Xia Chu, Yan-Qing Wang
Acupoint catgut embedding (ACE) is a widely used traditional Chinese medicine method to manage various diseases, including chronic inflammatory pain. We sought to assess the possible analgesic effects of ACE in comparison to electroacupuncture (EA) and to study the analgesic mechanisms of ACE in a rat model of inflammatory pain induced by injection of complete Freund's adjuvant (CFA) into the hind paw of rats. The von Frey, radiant heat, and gait analysis tests were performed to evaluate the analgesic effects of ACE and EA, and western blot and immunohistochemistry assays were carried out to determine the molecular mechanisms of ACE...
August 10, 2018: Journal of Pain: Official Journal of the American Pain Society
Emilia Waraksa, Mateusz Kacper Woźniak, Ewa Kłodzińska, Robert Wrzesień, Barbara Bobrowska-Korczak, Jacek Namieśnik
Ibuprofen is widely used in human and veterinary medicine for the treatment of chronic pain as well as rheumatic and musculoskeletal disorders. However, the analgesic and anti-inflammatory properties of Ibuprofen have contributed to frequent drug abuse in equestrian sports. A sensitive and rapid GC-MS/MS-based method with a simple liquid-liquid extraction and derivatization requiring 200 μL volume of sample and 2 mL of extraction solvent for the simultaneous determination of ibuprofen and its metabolites was developed...
August 12, 2018: Journal of Separation Science
Michael Mousseau, Nicole E Burma, Kwan Yeop Lee, Heather Leduc-Pessah, Charlie H T Kwok, Allison R Reid, Melissa O'Brien, Boriss Sagalajev, Jo Anne Stratton, Natalya Patrick, Patrick L Stemkowski, Jeff Biernaskie, Gerald W Zamponi, Paul Salo, Jason J McDougall, Steven A Prescott, John R Matyas, Tuan Trang
Chronic joint pain such as mechanical allodynia is the most debilitating symptom of arthritis, yet effective therapies are lacking. We identify the pannexin-1 (Panx1) channel as a therapeutic target for alleviating mechanical allodynia, a cardinal sign of arthritis. In rats, joint pain caused by intra-articular injection of monosodium iodoacetate (MIA) was associated with spinal adenosine 5'-triphosphate (ATP) release and a microglia-specific up-regulation of P2X7 receptors (P2X7Rs). Blockade of P2X7R or ablation of spinal microglia prevented and reversed mechanical allodynia...
August 2018: Science Advances
Sameeh Al-Maharbi, Abdullah Bakr Abolkhair, Hani Al Ghamdi, Mamdouh Haddara, Yasser Tolba, Ahmed El Kabbani, Adwa Al Sadoun, Evelyn Pangilinan, Jaya Joy, Shadi Abu Khait, May Wathiq Al-Khudhairy
Introduction: Mental health issues, especially depression, are common in chronic pain patients. Depression affects these patients negatively and could lead to poor control of their pain. Some risk factors for both chronic pain and depression are known and need to be targeted as part of the management in a multidisciplinary approach. This study was conducted to estimate the prevalence of depression among chronic pain patients attending a pain clinic and to explore the association between depression in chronic pain patients and other factors such as sociodemographic features, number of pain sites, severity of pain, and types of pain...
July 2018: Saudi Journal of Anaesthesia
Safoora Ebadi, Noureddin Nakhostin Ansari, Tannaz Ahadi, Ehsan Fallah, Bijan Forogh
BACKGROUND AND DESIGN: Chronic nonspecific low back pain (CNSLBP) has major socioeconomic as well as personal impact in many industrialized and developing countries. Physiotherapy is a common intervention for this group of patients and using anti-pain physical modalities is a common part of the physical therapy. In a randomized controlled trial we investigated the immediate effect of the Diadynamic current in comparison to TENS on reducing the pain in patients suffering from non specific chronic low back pain...
July 2018: Journal of Bodywork and Movement Therapies
Peter Przekop, Allison Przekop, Mark G Haviland, Keiji Oda
Patients with chronic pain (CP) and substance use disorder (SUD) are complex, not yet adequately described, and in need of comprehensive treatments that address both diseases concurrently. Our objectives were to (a) describe a cohort of CP patients who failed traditional treatment (mainly opioids) - then developed opioid use disorder (OUD) and other SUDs and (b) evaluate a comprehensive inpatient treatment program for these patients. Patients were enrolled in an inpatient CP program. Treatment consisted of medical detoxification, group process/education, external and internal qigong, osteopathic manual medicine, and qigong-based mindfulness...
July 2018: Journal of Bodywork and Movement Therapies
Brett Morgan, Steve Wooden
Management of chronic pain has become a significant challenge for primary care providers, and the population of patients with chronic pain is expected to increase. Common syndromes seen in the primary care setting include myofascial pain syndrome, fibromyalgia, chronic postsurgical pain, complex regional pain syndrome, and painful diabetic neuropathy. This article describes these syndromes and presents current treatment options.
September 2018: Nursing Clinics of North America
Wenjing Zhang, Weiguo Xu, Cong Ning, Mingqiang Li, Guoqing Zhao, Weiqian Jiang, Jianxun Ding, Xuesi Chen
Local anesthetics are a class of drugs, which have wide applications in the treatment of acute and chronic pain. However, their analgesic effects only last for a few hours because of their short half-life, which is insufficient for clinical application, especially for long-term surgery or postoperative analgesia. Herein, an injectable hydrogel/microsphere (GEL/MS) composite co-encapsulating bupivacaine (BUP) and dexmedetomidine (DEX) was developed for effective sustained analgesia. The GEL/MS composite appeared as a three-dimensional porous network microstructure and displayed sustained sequential release of DEX and BUP over several days in vitro, without obvious burst release...
July 27, 2018: Biomaterials
Blake F Dear, Milena Gandy, Eyal Karin, Rhiannon Fogliati, Vincent J Fogliati, Lauren G Staples, Bethany M Wootton, Louise Sharpe, Nickolai Titov
Little is known about the long-term outcomes of emerging internet-delivered pain management programs. The current study reports the 12-month and 24-month follow-up data from a randomised controlled trial (n = 490) of an internet-delivered pain management program, the Pain Course. The initial results of the trial to 3-month follow-up have already been reported elsewhere. Significant improvements in disability, depression, anxiety and pain levels across three treatment groups receiving different levels of clinician support, compared with a treatment-as-usual control...
August 9, 2018: Journal of Pain: Official Journal of the American Pain Society
Jean-Frederic Colombel, Andrea Shin, Peter R Gibson
DESCRIPTION: The purpose of this clinical practice update review is to describe key principles in the diagnosis and management of functional gastrointestinal (GI) symptoms in patients with inflammatory bowel disease (IBD). METHODS: The evidence and best practices summarized in this manuscript are based on relevant scientific publications, systematic reviews, and expert opinion where applicable. BEST PRACTICE ADVICE 1: A stepwise approach to rule-out ongoing inflammatory activity should be followed in IBD patients with persistent GI symptoms (measurement of fecal calprotectin, endoscopy with biopsy, cross-sectional imaging)...
August 9, 2018: Clinical Gastroenterology and Hepatology
Joseph T Giacino, Douglas I Katz, Nicholas D Schiff, John Whyte, Eric J Ashman, Stephen Ashwal, Richard Barbano, Flora M Hammond, Steven Laureys, Geoffrey S F Ling, Risa Nakase-Richardson, Ronald T Seel, Stuart Yablon, Thomas S D Getchius, Gary S Gronseth, Melissa J Armstrong
OBJECTIVE: To update the 1995 American Academy of Neurology (AAN) practice parameter on persistent vegetative state and the 2002 case definition on minimally conscious state (MCS) and provide care recommendations for patients with prolonged disorders of consciousness (DoC). METHODS: Recommendations were based on systematic review evidence, related evidence, care principles, and inferences using a modified Delphi consensus process according to the AAN 2011 process manual, as amended...
August 7, 2018: Archives of Physical Medicine and Rehabilitation
John D Breckenridge, Karen A Ginn, Sarah B Wallwork, James H McAuley
The left/right judgement task (LRJT) is the most commonly used method of assessing motor imagery performance. Abnormally long response times are thought to reflect delayed processing of body/spatial representations and poor accuracy is thought to reflect disrupted cortical proprioceptive representations or body schema. Slower and less accurate responses on the LRJT have been reported in a variety of chronic musculoskeletal pain conditions. To date no systematic review of the literature has been conducted to assess if altered motor imagery performance as measured by the LRJT is characteristic of all chronic musculoskeletal pain conditions...
August 8, 2018: Journal of Pain: Official Journal of the American Pain Society
A Coloma-Carmona, J L Carballo, J Rodríguez-Marín, C J van-der Hofstadt
BACKGROUND: Withdrawal symptoms have been widely shown to be a useful indicator of the severity of opioid dependence. One of the most used instruments to assess them is the Adjective Rating Scale for Withdrawal (ARSW). However, there is a lack of adaptations and validations for its use with prescription opioids, even less for chronic pain patients under treatment with these analgesics. Thus, the aims of this study were to analyze the psychometric properties and invariance across gender of the ARSW in a sample of chronic non-cancer pain patients...
August 10, 2018: European Journal of Pain: EJP
Christoph Dybowski, Bernd Löwe, Christian Brünahl
OBJECTIVE: Chronic pelvic pain syndrome (CPPS) can affect both men and women and often causes substantial impairment to quality of life. Although cross-sectional studies have suggested that psychosocial aspects may constitute important factors in the etiology and maintenance of CPPS, longitudinal studies are rare. Therefore, the present study examines psychosocial factors as prospective predictors of pain intensity, urinary symptoms and impediments to quality of life in men and women with CPPS...
September 2018: Journal of Psychosomatic Research
Mark H Pitcher, Michael Von Korff, M Catherine Bushnell, Linda Porter
The multidimensional nature of chronic pain is not reflected by definitions based solely on pain duration, resulting in high prevalence estimates limiting effective policy development. The newly proposed concept of High Impact Chronic Pain (HICP) incorporates both disability and pain duration to identify a more severely impacted portion of the chronic pain population, yet remains uncharacterized at the population level. As such, we used the 2011 National Health Interview Survey (NHIS; n=15,670) to (i) assess the likelihood of disability in the overall chronic pain population, (ii) to estimate the prevalence of HICP, and (iii) to characterize the disability, health status and health care use profile of this population in the United States...
August 7, 2018: Journal of Pain: Official Journal of the American Pain Society
Anyela Marcela Castañeda Anaya, Jae-Kyu Choi, Chang-Soon Lee, Euna Oh, Youngwon Kim, Jee Youn Moon, Pyung Bok Lee, Yong-Chul Kim
Although ketamine infusion therapy (KIT) has been used extensively for the treatment of chronic persistent pain, there remains high heterogeneity in the administration protocols. The aim of this study was to assess the current clinical use and the infusion protocols of KIT in South Korea and to compare the protocol details with previous relevant studies.In the first phase, an online survey about KIT, including protocol information, was distributed to pain physicians managing chronic pain patients at 47 teaching hospitals registered in the Korean Pain Society...
August 2018: Medicine (Baltimore)
M Bewarder, A Klostermann, M Ahlgrimm, J T Bittenbring, M Pfreundschuh, S Wagenpfeil, D Kaddu-Mulindwa
Intensive chemotherapy, with or without following autologous or allogeneic stem cell transplantation (HSCT), is often the only curative treatment option for patients with hematological malignancies and leave many survivors physically and psychologically impaired. Electrical muscle stimulation (EMS) is a proven tool to improve physical performance in seniors and patients with chronic diseases. We therefore investigated the safety and feasibility of EMS in 45 patients undergoing autologous HSCT (n = 13), allogeneic HSCT (n = 11) and intensive chemotherapy (n = 21)...
August 9, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Leidiane Mazzardo-Martins, Daiana Cristina Salm, Elisa C Winkelmann-Duarte, Júlia Koerich Ferreira, Daniela Dero Lüdtke, Kamilla Pamplona Frech, Luiz Augusto Oliveira Belmonte, Verônica Vargas Horewicz, Anna Paula Piovezan, Francisco José Cidra-Filho, Ari Ojeda Ocampo Moré, Daniel Fernandes Martins
Complex regional pain syndrome (CRPS) is a disorder that involves abnormal inflammation and nerve dysfunction frequently resistant to a broad range of treatments. Peripheral nerve stimulation with electroacupuncture (EA) has been widely used in different clinical conditions to control pain and inflammation; however, the use of EA in the treatment of CRPS is under investigation. In this study, we explore the effects of EA on hyperalgesia and edema induced in an animal model of chronic post-ischemia pain (CPIP model) and the possible involvement of endothelin receptor type B (ETB ) in this effect...
August 10, 2018: Pflügers Archiv: European Journal of Physiology
Paulina C Altshuler, Brandon T Garland, Michael E Jorgensen, Nel E Gerig
Background: Pelvic venous disorders are often undiagnosed due to the symptom variability and similarity to other disease presentations. 'Pelvic congestion syndrome' is a term often used as a diagnosis of exclusion, since there is currently no standardized diagnostic approach for pelvic venous disorders, which further delays treatment. Case: A 25-year-old woman with treatment-refractory vulvodynia presented with symptoms that included left-sided vaginal wall pain, pruritis, dysmenorrhea, dyspareunia, muscle tension, and a chronic vaginal ulceration...
July 2018: Case Reports in Women's Health
Rodney A Gabriel, Brian M Ilfeld
Maximizing analgesia is critical following joint arthroplasty because postoperative pain is a major barrier to adequate physical therapy. Continuous peripheral nerve blocks have been the mainstay for acute pain management in this population; however, this and similar techniques are limited by their duration of action. Cryoneurolysis and peripheral nerve stimulation are two methodologies used for decades to treat chronic pain. With the advent of portable ultrasound devices and percutaneous administration equipment, both procedures may now be suitable for treatment of acute pain...
September 2018: Anesthesiology Clinics
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