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Chronic pain

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19 papers 1000+ followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
https://www.readbyqxmd.com/read/29178034/pharmacotherapy-for-neuropathic-pain-a-review
#1
REVIEW
Diego Fornasari
Neuropathic pain, comprising a range of heterogeneous conditions, is often severe and difficult to manage, and this may result in a chronic condition that negatively affects the overall functioning and quality of life in patients. The pharmacotherapy of neuropathic pain is challenging and for many patients effective treatment is lacking; therefore, evidence-based recommendations are essential. Currently, there is general agreement on which drugs are appropriate for the first-line treatment of neuropathic pain, whereas debate continues regarding second- and third-line treatments...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/26727925/management-of-lumbar-spinal-stenosis
#2
REVIEW
Jon Lurie, Christy Tomkins-Lane
Lumbar spinal stenosis (LSS) affects more than 200,000 adults in the United States, resulting in substantial pain and disability. It is the most common reason for spinal surgery in patients over 65 years. Lumbar spinal stenosis is a clinical syndrome of pain in the buttocks or lower extremities, with or without back pain. It is associated with reduced space available for the neural and vascular elements of the lumbar spine. The condition is often exacerbated by standing, walking, or lumbar extension and relieved by forward flexion, sitting, or recumbency...
January 4, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/16030082/a-multicentre-randomized-controlled-trial-of-epidural-corticosteroid-injections-for-sciatica-the-west-study
#3
RANDOMIZED CONTROLLED TRIAL
N K Arden, C Price, I Reading, J Stubbing, J Hazelgrove, C Dunne, M Michel, P Rogers, C Cooper
OBJECTIVE: To determine the effectiveness and predictors of response to lumbar epidural corticosteroid injections (ESI) in patients with sciatica. We performed a 12-month, multicentre, double-blind, randomized, placebo-controlled, parallel-group trial in four secondary pain-care clinics in the Wessex Region. METHODS: Two hundred and twenty-eight patients with a clinical diagnosis of unilateral sciatica of 1-18 months' duration were randomized to either three lumbar ESIs of triamcinolone acetonide or interligamentous saline injections at intervals of 3 weeks...
November 2005: Rheumatology
https://www.readbyqxmd.com/read/27105466/patient-priority-weighting-of-the-roland-morris-disability-questionnaire-does-not-change-results-of-the-lumbar-epidural-steroid-injections-for-spinal-stenosis-trial
#4
RANDOMIZED CONTROLLED TRIAL
Una E Makris, Todd C Edwards, Danielle C Lavallee, Zoya Bauer, Bryan A Comstock, Jeffrey G Jarvik, Donald L Patrick, Mahshid Lotfi, Janna L Friedly
STUDY DESIGN: Secondary analysis of lumbar epidural steroid injections for spinal stenosis randomized controlled trial data. OBJECTIVE: To reevaluate whether outcomes for older adults receiving epidural steroid injections with or without corticosteroid improve after using patient-prioritized Roland-Morris Disability Questionnaire (RDQ) items. SUMMARY OF BACKGROUND DATA: Epidural corticosteroid injections are commonly used to treat lumbar spinal stenosis symptoms, despite limited evidence for their effectiveness in clinical trials...
January 1, 2017: Spine
https://www.readbyqxmd.com/read/26610278/is-epidural-steroid-injection-effective-for-degenerative-lumbar-spinal-stenosis
#5
Sebastián Flores, Marcelo Molina
There are several nonsurgical alternatives to treat radicular pain in degenerative lumbar spinal stenosis. Epidural steroid injections have been used for several decades, but the different studies have shown variable effects. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified nine systematic reviews including seven pertinent randomized controlled trials. We concluded epidural steroid injection probably leads to little or no effect on reducing radicular pain of spinal stenosis...
November 16, 2015: Medwave
https://www.readbyqxmd.com/read/28363270/hip-pain-dry-needling-versus-cortisone-injections
#6
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Greater trochanteric pain syndrome (GTPS) is chronic, intermittent pain and tenderness on the outside of the hip. The medical community once thought that a swollen hip bursa was the source of such pain, which led to the use of corticosteroid injections to the bursa to help decrease swelling and pain. However, researchers now believe that injuries to the muscles and tendons around the hip are the actual cause of this pain, and that inflammation is often not involved. A study published in the April 2017 issue of JOSPT explores dry needling as an alternative to cortisone injections to reduce pain and improve function in patients with GTPS...
April 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/27408698/mechanisms-of-low-back-pain-a-guide-for-diagnosis-and-therapy
#7
REVIEW
Massimo Allegri, Silvana Montella, Fabiana Salici, Adriana Valente, Maurizio Marchesini, Christian Compagnone, Marco Baciarello, Maria Elena Manferdini, Guido Fanelli
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety...
2016: F1000Research
https://www.readbyqxmd.com/read/27028915/opioid-abuse-in-chronic-pain-misconceptions-and-mitigation-strategies
#8
REVIEW
Nora D Volkow, A Thomas McLellan
No abstract text is available yet for this article.
March 31, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26834359/the-effects-of-gluteus-muscle-strengthening-exercise-and-lumbar-stabilization-exercise-on-lumbar-muscle-strength-and-balance-in-chronic-low-back-pain-patients
#9
Ui-Cheol Jeong, Jae-Heon Sim, Cheol-Yong Kim, Gak Hwang-Bo, Chan-Woo Nam
[Purpose] The aim of this study was to examine the effects of exercise to strengthen the muscles of the hip together with lumbar segmental stabilization exercise on the lumbar disability index, lumbar muscle strength, and balance. [Subjects and Methods] This study randomly and equally assigned 40 participants who provided written consent to participate in this study to a lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilization exercise group...
December 2015: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/17342295/comparison-of-two-doses-of-corticosteroid-in-epidural-steroid-injection-for-lumbar-radicular-pain
#10
RANDOMIZED CONTROLLED TRIAL
M B Owlia, A Salimzadeh, Gh Alishiri, A Haghighi
INTRODUCTION: Low back pain and lumbar radicular pain are the leading causes of job loss worldwide. Therapeutic approaches to lumbar radicular pain, including sciatica and spinal canal stenosis, are diverse. Many clinicians use 80 mg long-acting glucocorticoids in epidural steroid injections (ESI). The aim of this study is to compare the clinical response of 80 mg versus 40 mg methylprednisolone in ESI. METHODS: 84 patients with newly exacerbated lumbar radicular pain were randomly al located into two groups...
March 2007: Singapore Medical Journal
https://www.readbyqxmd.com/read/26000680/low-back-pain-guidelines-for-the-clinical-classification-of-predominant-neuropathic-nociceptive-or-central-sensitization-pain
#11
REVIEW
Jo Nijs, Adri Apeldoorn, Hank Hallegraeff, Jacqui Clark, Rob Smeets, Annaleen Malfliet, Enrique L Girbes, Margot De Kooning, Kelly Ickmans
BACKGROUND: Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.g., lumbar radiculopathy), and central sensitization pain. In order to select an effective and preferably also efficient treatment in daily clinical practice, LBP patients should be classified clinically as either predominantly nociceptive, neuropathic, or central sensitization pain. OBJECTIVE: To explain how clinicians can differentiate between nociceptive, neuropathic, and central sensitization pain in patients with LBP...
May 2015: Pain Physician
https://www.readbyqxmd.com/read/25376753/effects-of-mindfulness-meditation-on-chronic-pain-a-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Peter la Cour, Marian Petersen
OBJECTIVE: This randomized controlled clinical trial investigated the effects of mindfulness meditation on chronic pain. DESIGN: A total of 109 patients with nonspecific chronic pain were randomized to either a standardized mindfulness meditation program (mindfulness-based stress reduction [MBSR]) or to a wait list control. METHODS: Pain, physical function, mental function, pain acceptance, and health-related quality of life were measured...
April 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/25351967/encouraging-couples-to-change-a-motivational-assessment-to-promote-well-being-in-people-with-chronic-pain-and-their-partners
#13
Lisa Renee Miller-Matero, Annmarie Cano
OBJECTIVE: Motivating people with chronic pain to engage in therapy can be difficult, especially when individuals have not experienced adequate pain management. Therefore, it may be useful for clinicians to use a motivational assessment as a part of treatment to help patients achieve immediate benefits. Additionally, because the social context impacts chronic illness, the significant other should be included in the assessment. This article describes a motivational assessment that was developed for people with chronic pain and their partners...
February 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/25218599/sympathetic-blockade-for-complex-regional-pain-syndrome
#14
EDITORIAL
Peter D Drummond, Philip M Finch
No abstract text is available yet for this article.
November 2014: Pain
https://www.readbyqxmd.com/read/25181605/further-development-in-the-assessment-of-psychological-flexibility-a-shortened-committed-action-questionnaire-caq-8
#15
L M McCracken, J Chilcot, S Norton
BACKGROUND: Committed action is a relatively understudied facet of the psychological flexibility model but a potentially important process of overt behaviour in relation to chronic pain. In this study, we take a previously developed measure of committed action, the Committed Action Questionnaire (CAQ), and validate a shorter version. METHODS: A total of 664 adults seeking treatment for chronic pain participated in this study. They provided responses to the CAQ and also completed measures of acceptance and health-related daily functioning...
May 2015: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/25159085/short-term-effects-of-bright-light-therapy-in-adults-with-chronic-nonspecific-back-pain-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Veronika Leichtfried, Raffaella Matteucci Gothe, Wilhelm Kantner-Rumplmair, Maria Mair-Raggautz, Christian Bartenbach, Helmut Guggenbichler, Dieter Gehmacher, Leonore Jonas, Martin Aigner, Dietmar Winkler, Wolfgang Schobersberger
OBJECTIVE: The present trial evaluated incorporation of bright light therapy in the treatment of chronic nonspecific back pain (CNBP). DESIGN: A prospective, randomized, controlled, multicenter, open design with three parallel trial arms was used. SETTING: Subjects received a novel therapeutic, an expected therapeutic ineffective low dose, or no light exposure at three different medical centers. PATIENTS: A total of 125 CNBP patients reporting pain intensity of ≥3 points on item 5 of the Brief Pain Inventory (BPI) were included...
December 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/25088289/a-systematic-review-of-therapeutic-interventions-to-reduce-acute-and-chronic-post-surgical-pain-after-amputation-thoracotomy-or-mastectomy
#17
REVIEW
S R Humble, A J Dalton, L Li
BACKGROUND: Perioperative neuropathic pain is under-recognized and often undertreated. Chronic pain may develop after any routine surgery, but it can have a far greater incidence after amputation, thoracotomy or mastectomy. The peak noxious barrage due to the neural trauma associated with these operations may be reduced in the perioperative period with the potential to reduce the risk of chronic pain. DATABASES AND DATA TREATMENT: A systematic review of the evidence for perioperative interventions reducing acute and chronic pain associated with amputation, mastectomy or thoracotomy...
April 2015: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/24217469/opioid-prescribing-a-systematic-review-and-critical-appraisal-of-guidelines-for-chronic-pain
#18
REVIEW
Teryl K Nuckols, Laura Anderson, Ioana Popescu, Allison L Diamant, Brian Doyle, Paul Di Capua, Roger Chou
BACKGROUND: Deaths due to prescription opioid overdoses have increased dramatically. High-quality guidelines could help clinicians mitigate risks associated with opioid therapy. PURPOSE: To evaluate the quality and content of guidelines on the use of opioids for chronic pain. DATA SOURCES: MEDLINE, National Guideline Clearinghouse, specialty society Web sites, and international guideline clearinghouses (searched in July 2013). STUDY SELECTION: Guidelines published between January 2007 and July 2013 addressing the use of opioids for chronic pain in adults were selected...
January 7, 2014: Annals of Internal Medicine
https://www.readbyqxmd.com/read/23756457/effectiveness-of-dry-needling-for-upper-quarter-myofascial-pain-a-systematic-review-and-meta-analysis
#19
REVIEW
David M Kietrys, Kerstin M Palombaro, Erica Azzaretto, Richard Hubler, Bret Schaller, J Mathew Schlussel, Mary Tucker
STUDY DESIGN: Systematic review and meta-analysis. BACKGROUND: Myofascial pain syndrome (MPS) is associated with hyperalgesic zones in muscle called myofascial trigger points. When palpated, active myofascial trigger points cause local or referred symptoms, including pain. Dry needling involves inserting an acupuncture-like needle into a myofascial trigger point, with the goal of reducing pain and restoring range of motion. OBJECTIVE: To explore the evidence regarding the effectiveness of dry needling to reduce pain in patients with MPS of the upper quarter...
September 2013: Journal of Orthopaedic and Sports Physical Therapy
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