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Latest & greatest articles for pain
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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
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
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
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
Listening to music reduces pain and anxiety for patients having surgery Signal - Listening to music reduces pain and anxiety for patients having surgery Dissemination Centre Discover Portal NIHR DC Discover Listening to music reduces pain and anxiety for patients having surgery Published on 28 October 2015 This systematic review found that music can moderately reduce pain and anxiety when played before, during or after surgery. It also strongly increased patient satisfaction. Music was equally (...) on the research. Why was this study needed? Music is a non-invasive and inexpensive intervention that offers the chance of improved patient outcomes. Music is not routinely played before, during or after surgery, though there is a growing interest in its use. It is thought that listening to music can reduce pain and anxiety. Listening to music has been studied in a large number of mostly small trials. Previous systematic reviews have investigated the effect of patients listening to music when undergoing
Assessment of back pain Assessment of back pain - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Assessment of back pain Last reviewed: August 2018 Last updated: September 2018 Summary Back pain is the primary cause of disability in people <50 years of age. The annual incidence in the adult population is 10% to 15% with a point prevalence of approximately 30% in developed countries. Low-back pain (LBP) is second only (...) to upper respiratory problems for physician visits each year, with a lifetime prevalence of 70% to 85%. Despite its widespread prevalence, the general prognosis of acute LBP is favourable, as 90% of patients recover without sequelae. Spitzer WO, LeBlanc FE, Dupuis M, et al. Scientific approach to the assessment and management of activity-related spinal disorders: a monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Spine. 1987 Sep;12(7 Suppl):S1-59. http
Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a narrative review 30214945 2018 11 14 2397-1789 13 2018 Scoliosis and spinal disorders Scoliosis Spinal Disord Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a narrative review. 17 10.1186/s13013-018-0165-z Posterior spinal fusion for adolescent idiopathic scoliosis is one of the most invasive surgical procedures (...) performed in children and adolescents. Because of the extensive surgical incision and massive tissue trauma, posterior spinal fusion causes severe postoperative pain. Intravenous patient-controlled analgesia with opioids has been the mainstay of postoperative pain management in these patients. However, the use of systemic opioids is sometimes limited by opioid-related side effects, resulting in poor analgesia. To improve pain management while reducing opioid consumption and opioid-related complications
Chronic Pain Among Suicide Decedents, 2003 to 2014: Findings From the National Violent Death Reporting System. Background: More than 25 million adults in the United States have chronic pain. Chronic pain has been associated with suicidality, but previous studies primarily examined nonfatal suicidal behaviors rather than suicide deaths associated with chronic pain or the characteristics of such deaths. Objective: To estimate the prevalence of chronic pain among suicide decedents in a large (...) multistate sample and to characterize suicide decedents with and without chronic pain. Design: Retrospective analysis of National Violent Death Reporting System (NVDRS) data. The NVDRS links death certificate, coroner or medical examiner, and law enforcement data collected by investigators, who often interview informants who knew the decedent to gather information on precipitating circumstances surrounding the suicide. Information is abstracted by using standard coding guidance developed by the Centers
Cognitive behavioural therapy may help people with persistent low back pain Signal - Cognitive behavioural therapy may help people with persistent low back pain Dissemination Centre Discover Portal NIHR DC Discover Cognitive behavioural therapy may help people with persistent low back pain Published on 14 October 2015 This NIHR-funded systematic review aimed to assess the effectiveness of talking therapies in improving outcomes for people with non-specific low back pain. It found that cognitive (...) behavioural therapies were more effective than no treatment and provided some benefit compared with other active treatments like physiotherapy with education, home and clinic based exercise, or to less active treatments like manual therapy or pain reliving drugs. It adds to other reviews by including older patients, who tend to experience back pain more often, and by including people with recent persistent symptoms (for under three months). This makes it particularly useful for decision makers, given
Supplementary addendum to â€œNon-radiographic methods of measuring global sagittal balance: a systematic reviewâ€; Reliability of the Spinal Mouse in adult back pain sufferers 30202788 2018 11 14 2397-1789 13 2018 Scoliosis and spinal disorders Scoliosis Spinal Disord Supplementary addendum to "Non-radiographic methods of measuring global sagittal balance: a systematic review"; Reliability of the Spinal Mouse in adult back pain sufferers. 20 10.1186/s13013-018-0167-x Cohen Larry L 0000-0003
National clinical guideline for the assessment, treatment and rehabilitation of patients with chronic widespread pain National clinical guideline for the assessment, treatment and rehabilitation of patients with chronic widespread pain Published by the Danish Health Authority, June 2018 NATIONAL CLINICAL GUIDELINE FOR THE ASSESSMENT, TREATMENT AND REHABILITATION OF PATIENTS WITH CHRONIC WIDESPREAD PAIN Quick guide It is good practice to consider a patient with chronic widespread pain fully (...) diagnosed when relevant differential diagnoses have been excluded. The patient can be fully diagnosed based on the medical history, the symptoms, the duration and a physical examination. Chronic wide- spread pain is considered a condition with a wide variety of potential diagnosis designations. It is good practice to assess the overall functioning of the patient based on a bio-psycho- social conceptual framework. Good practice (consensus) It was not considered necessary to update the recommendation
A modified developmental care bundle reduces pain and stress in preterm infants undergoing examinations for retinopathy of prematurity: A randomised controlled trial 30091495 2018 09 04 1365-2702 2018 Aug 09 Journal of clinical nursing J Clin Nurs A modified developmental care bundle reduces pain and stress in preterm infants undergoing examinations for retinopathy of prematurity: A randomised controlled trial. 10.1111/jocn.14645 To determine the comparative efficacy of developmental care (...) versus standard care for reducing pain and stress in preterm infants during examinations for retinopathy of prematurity (ROP). ROP examinations are routinely performed in neonatal intensive care units to detect these lesions. Pain scores recorded during and after eye examinations have revealed physiological and behavioural manifestations of pain and stress. A randomised crossover trial was conducted. Fourteen preterm infants were evaluated. The modified developmental care bundle included
A Comparison of the Effect of One, Three, or Six Weeks of Immobilization on Function and Pain After Open Reduction and Internal Fixation of Distal Radial Fractures in Adults: A Randomized Controlled Trial 29975268 2018 07 05 1535-1386 100 13 2018 Jul 05 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am A Comparison of the Effect of One, Three, or Six Weeks of Immobilization on Function and Pain After Open Reduction and Internal Fixation of Distal Radial Fractures (...) trial (RCT). After cast removal, a standardized education and exercise program was followed for 6 weeks. Primary outcomes were function (according to the Patient-Rated Wrist Evaluation [PRWE]), worst (visual analog scale [VAS]-W) and usual (VAS-U) pain in the past week, and active wrist extension and forearm supination range of motion. All measures were recorded at 6, 12, and 26 weeks following surgery. Secondary outcomes were wrist flexion, radial deviation, ulnar deviation, and forearm pronation