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Latest & greatest articles for chronic pain
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Randomized Controlled Trial of Telephone-delivered Cognitive Behavioral Therapy Versus Supportive Care for Chronic Back Pain 28877139 2018 04 12 1536-5409 34 4 2018 Apr The Clinical journal of pain Clin J Pain Randomized Controlled Trial of Telephone-delivered Cognitive Behavioral Therapy Versus Supportive Care for Chronic Back Pain. 322-327 10.1097/AJP.0000000000000555 The objective of this study was to evaluate the efficacy of a telephone-delivered, home-based cognitive-behavioral (...) intervention for chronic low back pain in comparison to a matched supportive care (SC) treatment. Participants (N=66) were patients with chronic back pain that were randomized to either an 8-week Cognitive-Behavioral Therapy (CBT) or a SC condition matched for contact frequency, format, and time. Participants completed validated measures of improvement in back pain disability, pain severity, and overall improvement. Intent-to-treat analyses at posttreatment showed that the treatment groups not show
Non-invasive brain stimulation techniques for chronicpain. BACKGROUND: This is an updated version of the original Cochrane Review published in 2010, Issue 9, and last updated in 2014, Issue 4. Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronicpain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current (...) stimulation (tDCS), transcranial random noise stimulation (tRNS) and reduced impedance non-invasive cortical electrostimulation (RINCE). OBJECTIVES: To evaluate the efficacy of non-invasive cortical stimulation techniques in the treatment of chronicpain. SEARCH METHODS: For this update we searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, LILACS and clinical trials registers from July 2013 to October 2017. SELECTION CRITERIA: Randomised and quasi-randomised studies of rTMS, CES, tDCS, RINCE and tRNS
Cannabis-based medicines for chronic neuropathic pain in adults. BACKGROUND: This review is one of a series on drugs used to treat chronic neuropathic pain. Estimates of the population prevalence of chronicpain with neuropathic components range between 6% and 10%. Current pharmacological treatment options for neuropathic pain afford substantial benefit for only a few people, often with adverse effects that outweigh the benefits. There is a need to explore other treatment options (...) , with different mechanisms of action for treatment of conditions with chronic neuropathic pain. Cannabis has been used for millennia to reduce pain. Herbal cannabis is currently strongly promoted by some patients and their advocates to treat any type of chronicpain. OBJECTIVES: To assess the efficacy, tolerability, and safety of cannabis-based medicines (herbal, plant-derived, synthetic) compared to placebo or conventional drugs for conditions with chronic neuropathic pain in adults. SEARCH METHODS
Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. Importance: Limited evidence is available regarding long-term outcomes of opioids compared with nonopioid medications for chronicpain. Objective: To compare opioid vs nonopioid medications over 12 months on pain-related function, pain intensity, and adverse effects. Design, Setting, and Participants: Pragmatic, 12-month (...) , randomized trial with masked outcome assessment. Patients were recruited from Veterans Affairs primary care clinics from June 2013 through December 2015; follow-up was completed December 2016. Eligible patients had moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use. Of 265 patients enrolled, 25 withdrew prior to randomization and 240 were randomized. Interventions: Both interventions (opioid and nonopioid medication therapy) followed a treat-to-target strategy
Web-Based Cognitive Behavior Therapy for ChronicPain Patients with Aberrant Drug-Related Behavior: Outcomes from a Randomized Controlled Trial 29346579 2018 03 08 1526-4637 2018 Jan 13 Pain medicine (Malden, Mass.) Pain Med Web-Based Cognitive Behavior Therapy for ChronicPain Patients with Aberrant Drug-Related Behavior: Outcomes from a Randomized Controlled Trial. 10.1093/pm/pnx334 There is high unmet need for effective behavioral treatments for chronicpain patients at risk (...) for or with demonstrated histories of opioid misuse. Despite growing evidence supporting technology-based delivery of self-management interventions for chronicpain, very few such programs target co-occurring chronicpain and aberrant drug-related behavior. This randomized controlled trial evaluated the effectiveness of a novel, web-based self-management intervention, grounded in cognitive behavior therapy, for chronicpain patients with aberrant drug-related behavior. Opioid-treated chronicpain patients
Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis 29371112 2018 02 11 1878-1632 2018 Jan 31 The spine journal : official journal of the North American Spine Society Spine J Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. S1529-9430(18)30016-0 10.1016/j.spinee.2018.01.013 Mobilization and manipulation therapies are widely used to benefit patients with chronic low back pain. However (...) , questions remain about their efficacy, dosing, safety, and how these approaches compare with other therapies. The present study aims to determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic low back pain. This is a systematic literature review and meta-analysis. The present study measures self-reported pain, function, health-related quality of life, and adverse events. We identified studies by searching multiple electronic databases
Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial 29138049 2018 02 08 1532-821X 99 2 2018 Feb Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial. 338-347 S0003-9993(17)31343-6 10.1016/j.apmr.2017.10.016 To assess the effect of a pain neurophysiology (...) education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP). Single-blind randomized controlled trial. Private clinic and university. Patients with CLBP for ≥6 months (N=56). Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants. The primary outcome
Conventional Radiofrequency Thermocoagulation vs Pulsed Radiofrequency Neuromodulation of Ganglion Impar in Chronic Perineal Pain of Nononcological Origin 29329442 2018 03 08 1526-4637 2018 Jan 10 Pain medicine (Malden, Mass.) Pain Med Conventional Radiofrequency Thermocoagulation vs Pulsed Radiofrequency Neuromodulation of Ganglion Impar in Chronic Perineal Pain of Nononcological Origin. 10.1093/pm/pnx244 Chronic nononcological perineal pain has been effectively managed by ganglion Impar block (...) , as assessed by the subjective patient satisfaction questionnaire. There was no complication in any patient of either study group, except for short-lived infection at the site of skin puncture in a few. Ganglion Impar block by conventional radiofrequency provided a significantly better quality of pain relief with no major side effects in patients with chronic nononcological perineal pain as compared with pulsed radiofrequency. The short-term follow-up period of only six weeks was a major drawback
Literature Review and Meta-Analysis of Transcutaneous Electrical Nerve Stimulation in Treating Chronic Back Pain 29394211 2018 02 02 1532-8651 2018 Feb 01 Regional anesthesia and pain medicine Reg Anesth Pain Med Literature Review and Meta-Analysis of Transcutaneous Electrical Nerve Stimulation in Treating Chronic Back Pain. 10.1097/AAP.0000000000000740 This study is a meta-analysis of randomized controlled trials comparing the efficacy of transcutaneous electrical nerve stimulation (TENS (...) ) to a control and to other nerve stimulation therapies (NSTs) for the treatment of chronic back pain. Citations were identified in MEDLINE, the Cochrane Library, Google Scholar, and ClinicalTrials.gov through June 2014 using the following keywords: nerve stimulation therapy, transcutaneous electrical nerve stimulation, back pain, chronicpain. Control treatments included sham, placebo, or medication only. Other NSTs included electroacupuncture, percutaneous electrical nerve stimulation, and percutaneous
Gabapentin for Chronic Neuropathic Pain. Clinical Question: Is gabapentin associated with pain relief in people with chronic neuropathic pain? Bottom Line: Oral gabapentin (1200-3600 mg/d for 4-12 weeks) for patients with moderate or severe neuropathic pain from postherpetic neuralgia (PHN) or painful diabetic neuropathy (PDN) is associated with pain reduction of at least 50% in 14% to 17% more patients than placebo.
Literacy-Adapted Cognitive Behavioral Therapy Versus Education for ChronicPain at Low-Income Clinics: A Randomized Controlled Trial. Background: Chronicpain is common and challenging to treat. Although cognitive behavioral therapy (CBT) is efficacious, its benefit in disadvantaged populations is largely unknown. Objective: To evaluate the efficacy of literacy-adapted and simplified group CBT versus group pain education (EDU) versus usual care. Design: Randomized controlled trial (...) . (ClinicalTrials.gov: NCT01967342 ). Setting: Community health centers serving low-income patients in Alabama. Patients: Adults (aged 19 to 71 years) with mixed chronicpain. Interventions: CBT and EDU delivered in 10 weekly 90-minute group sessions. Measurements: Self-reported, postintervention pain intensity (primary outcome) and physical function and depression (secondary outcomes). Results: 290 participants were enrolled (70.7% of whom were women, 66.9% minority group members, 72.4% at or below the poverty
Comparative effectiveness review of paravertebral block for prevention of chronicpain after breast surgery Comparative effectiveness review of paravertebral block for prevention of chronicpain after breast surgery Comparative effectiveness review of paravertebral block for prevention of chronicpain after breast surgery HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment (...) has been made for the HTA database. Citation HAYES, Inc. Comparative effectiveness review of paravertebral block for prevention of chronicpain after breast surgery. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Patients undergoing breast surgery have a notable risk of developing persistent pain lasting for more than 3 months following the procedure. Paravertebral blocks (PVBs) may be used in breast surgery as part of anesthetic care, and have been linked to reduced acute
Brief Psychological Screening Questions Can be Useful for Ruling Out Psychological Conditions in Patients With ChronicPain 28542025 2018 01 04 1536-5409 34 2 2018 Feb The Clinical journal of pain Clin J Pain Brief Psychological Screening Questions Can be Useful for Ruling Out Psychological Conditions in Patients With ChronicPain. 113-121 10.1097/AJP.0000000000000514 Psychological symptoms are highly prevalent in chronicpain patients. Timely and accurate identification may enable (...) individualized treatment and improve outcomes. The aims of this study were to (1) investigate the concurrent validity of brief psychological screening questions assessing anxiety, fear of movement, stress, pain catastrophization, and depression in chronicpain patients, and (2) to determine screening question cut-points at which the likely probability of having these psychological states was <10%. Responses to 1-item or 2-item screening questions within each of these 5 psychological constructs were compared
Patient-reported rates of chronicpain and recurrence after groin hernia repair 29139566 2017 12 29 2017 12 29 1365-2168 105 1 2018 Jan The British journal of surgery Br J Surg Patient-reported rates of chronicpain and recurrence after groin hernia repair. 106-112 10.1002/bjs.10652 The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. This was prospective cohort study based (...) Journal Article Observational Study 2017 11 15 England Br J Surg 0372553 0007-1323 AIM IM Adult Aged Aged, 80 and over ChronicPain diagnosis epidemiology etiology Female Follow-Up Studies Hernia, Inguinal surgery Herniorrhaphy methods Humans Male Middle Aged Pain, Postoperative diagnosis epidemiology etiology Patient Reported Outcome Measures Prospective Studies Recurrence Registries Reoperation statistics & numerical data Risk Assessment Risk Factors Sweden 2017 02 28 2017 04 21 2017 06 23 2017 11
The Effect of Intraoperative Nefopam Administration on Acute Postoperative Pain and Chronic Discomfort After Robotic or Endoscopic Assisted Thyroidectomy: A Randomized Clinical Trial 29288309 2017 12 30 1432-2323 2017 Dec 29 World journal of surgery World J Surg The Effect of Intraoperative Nefopam Administration on Acute Postoperative Pain and Chronic Discomfort After Robotic or Endoscopic Assisted Thyroidectomy: A Randomized Clinical Trial. 10.1007/s00268-017-4421-9 Acute postoperative pain (...) and chronic discomfort are reported after robotic or endoscopic thyroidectomy. The purpose of this prospective, randomized, and double-blinded clinical trial was to investigate whether intraoperative infusion of nefopam decreases acute postoperative pain and chronic discomfort following either a robotic or endoscopic thyroidectomy via the bilateral axillo-breast approach (BABA). Patients were randomized into two groups: The control group (n = 29) or the nefopam group (n = 29). Patients in each group were
Movement System Impairment-Based Classification Treatment Versus General Exercises for Chronic Low Back Pain: Randomized Controlled Trial 29077963 2017 12 22 1538-6724 98 1 2018 Jan 01 Physical therapy Phys Ther Movement System Impairment-Based Classification Treatment Versus General Exercises for Chronic Low Back Pain: Randomized Controlled Trial. 28-39 10.1093/ptj/pzx094 Treatment for chronic low back pain (LBP) includes different forms of exercises, that to date have resulted in only small (...) to moderate treatment effects. To enhance the treatment effects, different classification systems have been developed to classify people with LBP into more homogeneous subgroups leading to specific treatments for each subgroup. The purpose of this study was to compare the efficacy of a treatment based on the Movement System Impairment (MSI) model with a treatment consisting of symptom-guided stretching and strengthening exercises in people with chronic LBP. The study was a 2-arm, prospectively registered
Assessment of chronic abdominal pain Assessment of chronic abdominal pain - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Assessment of chronic abdominal pain Last reviewed: August 2018 Last updated: June 2018 Summary Chronic abdominal pain is defined as continuous or intermittent abdominal discomfort lasting for at least 6 months. Pain may arise from any system, including the genitourinary, gastrointestinal (...) , and gynaecological tracts. The aetiology of chronic abdominal pain is so wide that only the more common causes can be covered here. A clear relationship with an anatomical structure or underlying process may not always be present. Classification Chronic abdominal pain is divided into organic and functional aetiologies. Organic aetiologies have a clear anatomical, physiological, or metabolic cause. Chronic abdominal pain without clear source, in spite of a thorough diagnostic evaluation, is usually termed
Chronic pelvic pain in women Chronic pelvic pain in women - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Chronic pelvic pain in women Last reviewed: August 2018 Last updated: March 2018 Summary Chronic pelvic pain is a syndrome of pain arising from one or more pelvic organs, and can include any one or all pelvic viscera or muscles. A methodical, complete, criteria-based history is required to determine how many (...) ultrasound, cystoscopy with hydrodistension, and diagnostic laparoscopy. Because chronicpain is sometimes a disorder of pain perception, minimal if any pathological change may be found. Treatment is targeted at each organ system involved in pain production. Global pain in all organs or refusal of non-narcotic management may represent drug-seeking behaviour. Complications are inherent to all treatments, which frequently include surgery. Definition Chronic pelvic pain is inconsistently defined
Chronicpain syndromes Chronicpain syndromes - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Chronicpain syndromes Last reviewed: August 2018 Last updated: July 2018 Summary Chronicpain is one of the most common reasons for seeing a primary care physician. Classification of chronicpain may be based on major pain features or by body region: myofascial, musculoskeletal (mechanical), neuropathic, fibromyalgia (...) , and chronic headache syndromes. One in 3 patients over the age of 65 years is affected by chronicpain, often due to arthritis, osteoporosis with fractures and/or lumbar spinal stenosis. These conditions are treatable and should not be considered part of the normal ageing process. Untreated chronicpain in geriatric patients can result in depression, poor quality of life, and loss of independence. Some treatments, such as stretching exercises, relaxation techniques, antidepressants, and antiepileptic
Access to and Availability of the Non-Pharmacological Treatment of Chronic Non-Cancer Pain in Canada Access to and Availability of the Non-Pharmacological Treatment of Chronic Non-Cancer Pain in Canada | CADTH.ca Find the information you need Access to and Availability of the Non-Pharmacological Treatment of Chronic Non-Cancer Pain in Canada Access to and Availability of the Non-Pharmacological Treatment of Chronic Non-Cancer Pain in Canada Published on: December 13, 2017 Project Number: ES0313 (...) -000 Product Line: Result type: Report CADTH is undertaking an Environmental Scan to understand the current context around access to and the availability of non-pharmacological treatment for patients with chronic non-cancer pain across Canada. The opioid crisis has resulted in a pressing need for alternative therapies and complementary multi-modal care. Current guidelines recommend the use of non-opioid treatments, including non-pharmacological strategies (both physical and psychological), but many