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Latest & greatest articles for pain
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Effectiveness of the Pilates Method in the Treatment of Chronic Mechanical Neck Pain: A Randomized Controlled Trial 29752907 2018 08 31 1532-821X 99 9 2018 Sep Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Effectiveness of the Pilates Method in the Treatment of Chronic Mechanical Neck Pain: A Randomized Controlled Trial. 1740-1746 S0003-9993(18)30291-0 10.1016/j.apmr.2018.04.018 To assess the effectiveness of the Pilates method on pain, function, quality (...) of life, and consumption of pain medication in patients with mechanical neck pain. The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis. The study took place in the outpatient clinic of the rheumatology department, referral center. Patients (N=64) with chronic mechanical neck pain were randomly allocated to 2 groups: the Pilates group (PG) and a control group (CG). The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises
Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial 29787734 2018 08 31 1532-821X 99 9 2018 Sep Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial. 1720-1729 S0003-9993(18)30295-8 10.1016/j.apmr.2018.04.022 (...) To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP). Parallel group randomized controlled trial. Private and institutional health centers. Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months. Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33
Effect of Mobile Device-Supported Single-Patient Multi-crossover Trials on Treatment of Chronic Musculoskeletal Pain: A Randomized Clinical Trial 30193253 2018 10 04 2168-6114 178 10 2018 Oct 01 JAMA internal medicine JAMA Intern Med Effect of Mobile Device-Supported Single-Patient Multi-crossover Trials on Treatment of Chronic Musculoskeletal Pain: A Randomized Clinical Trial. 1368-1377 10.1001/jamainternmed.2018.3981 Individually designed single-patient multi-crossover (n-of-1) trials can (...) facilitate tailoring of treatments directed at various conditions, including chronic musculoskeletal pain (CMSP) but are potentially burdensome, which may limit uptake in research and practice. To determine whether patients randomized to participate in an n-of-1 trial supported by a mobile health (mHealth) app would experience less pain and improved global health, adherence, satisfaction, and shared decision making compared with patients assigned to usual care. This randomized clinical trial compared
Does Dexamethasone Reduce Hospital Readiness for Discharge, Pain, Nausea, and Early Patient Satisfaction in Hip and Knee Arthroplasty? A Randomized, Controlled Trial 30078660 2018 08 06 1532-8406 2018 Jul 19 The Journal of arthroplasty J Arthroplasty Does Dexamethasone Reduce Hospital Readiness for Discharge, Pain, Nausea, and Early Patient Satisfaction in Hip and Knee Arthroplasty? A Randomized, Controlled Trial. S0883-5403(18)30637-5 10.1016/j.arth.2018.07.013 Reduction in postoperative pain (...) , nausea, and vomiting in patients undergoing total joint arthroplasty may facilitate earlier discharge from hospital and reduce healthcare costs. This study was performed to primarily assess whether perioperative dexamethasone reduced hospital length of stay and to assess the effect on pain, nausea and vomiting, and patient satisfaction. One hundred sixty-four patients undergoing total hip arthroplasty or total knee arthroplasty were randomized to receive either 8 mg intravenous dexamethasone (n = 86
Prophylactic Pregabalin to Decrease Pain During Medication Abortion: A Randomized Controlled Trial 30095762 2018 08 24 1873-233X 132 3 2018 Sep Obstetrics and gynecology Obstet Gynecol Prophylactic Pregabalin to Decrease Pain During Medication Abortion: A Randomized Controlled Trial. 612-618 10.1097/AOG.0000000000002787 To evaluate whether prophylactic pregabalin reduces pain experienced with medication abortion. We conducted a randomized, double-blind, placebo-controlled trial of women (...) initiating medication abortion with mifepristone and buccal misoprostol up to 70 days of gestation. Participants were randomized to 300 mg oral pregabalin or a placebo immediately before misoprostol. The primary outcome was maximum pain on an 11-point numerical rating scale, reported using real-time electronic surveys over 72 hours. Secondary outcomes included pain at each time point, ibuprofen and narcotic use, side effects, and satisfaction. We estimated that 110 women would be required to have 80
Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: A Randomized Clinical Trial 29777953 2018 09 29 1528-8447 19 10 2018 Oct The journal of pain : official journal of the American Pain Society J Pain Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: A Randomized Clinical Trial. 1201-1210 S1526-5900(18)30183-4 10.1016/j.jpain (...) .2018.04.017 This randomized clinical trial compared the effects of adding ultrasound (US)-guided percutaneouselectrolysis into a program consisting of manual therapy and exercise on pain, shoulder-related disability, function, and pressure sensitivity in subacromial pain syndrome. Fifty patients with subacromial pain syndrome were randomized into manual therapy and exercise or percutaneous electrolysis group. All patients received the same manual therapy and exercise program, 1 session per week for 5
Effectiveness and Downstream Healthcare Utilization for Patients That Received Early Physical Therapy Versus Usual Care for Low Back Pain: A Randomized Clinical Trial 29489568 2018 09 17 1528-1159 43 19 2018 Oct 01 Spine Spine Effectiveness and Downstream Healthcare Utilization for Patients That Received Early Physical Therapy Versus Usual Care for Low Back Pain: A Randomized Clinical Trial. 1313-1321 10.1097/BRS.0000000000002619 Randomized controlled trial. The aim of this study was to compare (...) early physical therapy versus usual care in patients with low back pain. Early physical therapy (PT) has been associated with reduced downstream healthcare utilization in retrospective studies, but not investigated prospectively in the military health system. Military service members seeking care from a general practitioner were recruited. Patients attended a 20-minute self-management class with focus on psychosocial resilience and then randomized to usual care only (UC) versus immediately starting
Pain after posterolateral versus nerve-sparing thoracotomy: A randomized trial 30195601 2018 09 09 1097-685X 2018 Jul 27 The Journal of thoracic and cardiovascular surgery J. Thorac. Cardiovasc. Surg. Pain after posterolateral versus nerve-sparing thoracotomy: A randomized trial. S0022-5223(18)32009-9 10.1016/j.jtcvs.2018.07.033 Post-thoracotomy pain leads to patient discomfort, pulmonary complications, and increased analgesic use. Intercostal nerve injury during thoracotomy or its entrapment (...) during closure can contribute to post-thoracotomy pain. We hypothesized that a modified technique of posterolateral thoracotomy and closure, preserving the intercostal neurovascular bundle, would reduce acute and chronic post-thoracotomy pain. We randomized 90 patients undergoing posterolateral thoracotomy for pulmonary resection at a tertiary level oncology center to standard posterolateral (control arm) or modified nerve-sparing thoracotomy. All patients received morphine via patient-controlled
Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies 29847469 2018 09 21 1872-6623 159 10 2018 Oct PainPain Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. 1932-1954 10.1097/j.pain.0000000000001293 This review examines evidence for the effectiveness (...) of cannabinoids in chronic noncancer pain (CNCP) and addresses gaps in the literature by: considering differences in outcomes based on cannabinoid type and specific CNCP condition; including all study designs; and following IMMPACT guidelines. MEDLINE, Embase, PsycINFO, CENTRAL, and clinicaltrials.gov were searched in July 2017. Analyses were conducted using Revman 5.3 and Stata 15.0. A total of 91 publications containing 104 studies were eligible (n = 9958 participants), including 47 randomised controlled
Effect of Methylprednisolone on Pain Management in Total Knee or Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 29595528 2018 08 27 1536-5409 34 10 2018 Oct The Clinical journal of pain Clin J Pain Effect of Methylprednisolone on Pain Management in Total Knee or Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 967-974 10.1097/AJP.0000000000000614 Total joint arthroplasty (TJA) has been reported to be a successful (...) strategy for patients with advanced osteoarthritis; however, early postoperative pain has become an unresolved issue. Perioperative methylprednisolone (MP) administration in TJA is an important and controversial topic. This study was conducted to assess the efficacy and safety of MP for pain management after total knee or hip arthroplasty (TKA/THA). PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials comparing MP versus placebo for patients undergoing TKA/THA
Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial 29777714 2018 08 31 1532-821X 99 9 2018 Sep Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial. 1730-1739 S0003-9993(18)30293-4 10.1016/j.apmr.2018.04.020 To compare the efficacy (...) of neuromuscular electrical stimulation (NMES) and transcutaneous nerve stimulation (TENS) on hemiplegic shoulder pain (HSP). This is a prospective randomized controlled trial. A rehabilitation hospital. Participants (N=90) were randomized into NMES (n=36), TENS (n=36), or control groups (n=18). NMES (15Hz, pulse width 200μs) was applied to supraspinatus and deltoids (medial and posterior parts), whereas TENS (100Hz, pulse width 100μs) was used on the same areas. The surface electrodes were placed near
Randomized Controlled Trial of Intravenous Acetaminophen Versus Intravenous Hydromorphone for the Treatment of Acute Pain in the Emergency Department 30119941 2018 08 18 1097-6760 2018 Aug 14 Annals of emergency medicine Ann Emerg Med Randomized Controlled Trial of Intravenous Acetaminophen Versus Intravenous Hydromorphone for the Treatment of Acute Pain in the Emergency Department. S0196-0644(18)30550-X 10.1016/j.annemergmed.2018.06.019 As clinicians look to nonnarcotic analgesics in (...) the emergency department (ED), it is essential to understand the effectiveness and adverse effects of nonopioid medications in comparison with existing opioid treatments. Studies of intravenous acetaminophen for acute pain in the ED demonstrate mixed results and suffer from small sample sizes and methodological limitations. This study compares intravenous hydromorphone with intravenous acetaminophen in adult ED patients presenting with acute pain. This was a prospective, randomized, clinical trial comparing
Effects of Combined Lower Thoracic Epidural/General Anesthesia on Pain Control in Patients Undergoing Elective Lumbar Spine Surgery: A Randomized Controlled Trial 29624542 2018 10 01 1528-1159 43 20 2018 Oct 15 Spine Spine Effects of Combined Lower Thoracic Epidural/General Anesthesia on Pain Control in Patients Undergoing Elective Lumbar Spine Surgery: A Randomized Controlled Trial. 1381-1385 10.1097/BRS.0000000000002662 Randomized controlled trial. Our objective was to compare postoperative (...) pain relief and operating field condition of single-shot, low-thoracic epidural anesthesia combined with general anesthesia versus general anesthesia alone. Prior studies have suggested that continuous epidural analgesia provides better postoperative pain relief and less intraoperative blood loss, but with the risk of the epidural catheter contaminating the surgical field. A total of 22 patients scheduled for elective lumbar spine surgery were enrolled and randomly allocated into two groups. Group
Are Invasive Procedures Effective for Chronic Pain? A Systematic Review 30204920 2018 09 11 1526-4637 2018 Sep 10 Pain medicine (Malden, Mass.) Pain Med Are Invasive Procedures Effective for Chronic Pain? A Systematic Review. 10.1093/pm/pny154 To assess the evidence for the safety and efficacy of invasive procedures for reducing chronic pain and improving function and health-related quality of life compared with sham (placebo) procedures. Systematic review with meta-analysis. Studies were (...) identified by searching multiple electronic databases, examining reference lists, and communicating with experts. Randomized controlled trials comparing invasive procedures with identical but otherwise sham procedures for chronic pain conditions were selected. Three authors independently extracted and described study characteristics and assessed Cochrane risk of bias. Two subsets of data on back and knee pain, respectively, were pooled using random-effects meta-analysis. Overall quality of the literature
Efficacy and Safety of Intravenous Meloxicam in Patients With Moderate-to-Severe Pain Following Bunionectomy: A Randomized, Double-Blind, Placebo-controlled Trial 29554032 2018 08 27 1536-5409 34 10 2018 Oct The Clinical journal of pain Clin J Pain Efficacy and Safety of Intravenous Meloxicam in Patients With Moderate-to-Severe Pain Following Bunionectomy: A Randomized, Double-Blind, Placebo-controlled Trial. 918-926 10.1097/AJP.0000000000000609 To evaluate the analgesic efficacy and safety (...) of a novel intravenous (IV) formulation of meloxicam (30 mg) in patients with moderate-to-severe pain following a standardized, unilateral bunionectomy with first metatarsal osteotomy and internal fixation. Patients who met the criteria for moderate-to-severe postoperative pain were randomized to receive bolus injections of meloxicam IV 30 mg (n=100) or placebo (n=101) administered once daily. The primary efficacy endpoint was the Summed Pain Intensity Difference over 48 hours (SPID48). Secondary
The Effects of a Life Stress Emotional Awareness and Expression Interview for Women with Chronic Urogenital Pain: A Randomized Controlled Trial 30252113 2018 09 25 1526-4637 2018 Sep 24 Pain medicine (Malden, Mass.) Pain Med The Effects of a Life Stress Emotional Awareness and Expression Interview for Women with Chronic Urogenital Pain: A Randomized Controlled Trial. 10.1093/pm/pny182 Women with chronic urogenital pain (CUP) conditions have elevated rates of lifetime trauma, relational stress (...) -minute life stress interview (N = 37) or no interview (treatment-as-usual control; N = 25). Self-report measures of pain severity (primary outcome), pain interference, pelvic floor symptoms, and psychological symptoms (anxiety and depression) were completed at baseline and six-week follow-up. Differences between the life stress interview and control conditions at follow-up were tested with analyses of covariance, controlling for baseline level of the outcome and baseline depression. Compared
A Randomized, Double-blind, Placebo-controlled Trial of Certolizumab Pegol in Women with Refractory Interstitial Cystitis/Bladder Pain Syndrome 30072210 2018 10 13 1873-7560 74 5 2018 Nov European urology Eur. Urol. A Randomized, Double-blind, Placebo-controlled Trial of Certolizumab Pegol in Women with Refractory Interstitial Cystitis/Bladder Pain Syndrome. 623-630 S0302-2838(18)30548-7 10.1016/j.eururo.2018.07.026 Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic, disabling (...) response assessment (GRA). Secondary endpoints included Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), and a numeric rating scale for pain and urgency. The primary endpoint of GRA improvement at week 2 was not met. However, by week 18, there was significant improvement in GRA for certolizumab pegol compared with placebo in pain (odds ratio [OR]=17.3, p=0.002), urgency (OR=9.92, p=0.02), and overall symptoms (OR=15.0, p=0.006). At week 18
Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial 29893977 2018 08 31 1538-6724 98 9 2018 Sep 01 Physical therapy Phys Ther Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial. 745-753 10.1093/ptj/pzy070 People with diabetes are at high risk for shoulder pain, limited joint mobility, and adhesive capsulitis. The objective (...) of this study was to evaluate the effects of a shoulder movement intervention (ShoMo) compared to a wellness intervention on the primary outcomes of active shoulder flexion and reported Shoulder Pain and Disability Index (SPADI) measured after intervention and 9 months later. The design was a prospective, randomized, controlled clinical trial. The setting was a research center at an academic medical center. Fifty-two participants with type 2 diabetes and shoulder pain or limited motion were randomized
Psychological therapies for the management of chronic and recurrent pain in children and adolescents. BACKGROUND: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. OBJECTIVES: The aim (...) of this review was to update the published evidence on the efficacy of psychological treatments for chronic and recurrent pain in children and adolescents.The primary objective of this updated review was to determine any effect of psychological therapy on the clinical outcomes of pain intensity and disability for chronic and recurrent pain in children and adolescents compared with active treatment, waiting-list, or treatment-as-usual care.The secondary objective was to examine the impact of psychological