MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Pain Practice' source. Wed, 08 Feb 2012 07:39:23 +0100 http://www.medworm.com/index.php?rid=5666597&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00529.x Conclusion:  Based on this study, a MC containing OGTs is safe, effective, and provided significantly better pain relief than MC alone. The combination of oxygenated glycerol trimesters and MC provided significant pain relief and offered continued improvement in pain relief over time. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5666597 Sun, 05 Feb 2012 05:00:00 +0100 5666597 http://www.medworm.com/index.php?rid=5666596&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00531.x Conclusion: SCS significantly modulated the somatosensory profile in a patient with primary Raynaud′s syndrome. These effects were pronounced in qualities involving Aβ, C, and A∂ nerve fibers. Further investigations may help to understand the mechanisms of action of SCS. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5666596 Sun, 05 Feb 2012 05:00:00 +0100 5666596 http://www.medworm.com/index.php?rid=5666595&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00532.x Conclusions:  Patients with OA and CLBP used a variety of pain‐related and adjunctive medications. Although, alternative treatments are widely recommended, we found limited use of several of these in clinical practice, potentially due to the source of our data (commercial claims). Further research is needed to ascertain the extent to which such therapies contribute to the total costs of OA and CLBP management. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5666595 Sun, 05 Feb 2012 05:00:00 +0100 5666595 http://www.medworm.com/index.php?rid=5666594&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00533.x Conclusions:  Transcutaneous electrical nerve stimulation and sham TENS show similar effects in patients with chronic pain over a period of 1 year. We found support for a long sustained placebo effect. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5666594 Sun, 05 Feb 2012 05:00:00 +0100 5666594 http://www.medworm.com/index.php?rid=5666593&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00534.x AbstractPain is generally undertreated in the United States, owing to a number of barriers including geographic distance from specialty treatment providers; functional disability that limits mobility; treatment‐related stigma; economic limitations; and educational barriers. Pain undertreatment exacerbates pain chronicity and emotional disruption that can significantly erode a pain patient’s quality of life, and there is widespread agreement that pain care must evolve to address this significant problem. The growing field of telehealth (defined for the purposes of this paper as technology that allows for distance interaction between providers and/or patients) offers a novel opportunity to expand pain assessment, consultation, and treatment services beyond the walls of the specialty pain... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5666593 Sun, 05 Feb 2012 05:00:00 +0100 5666593 http://www.medworm.com/index.php?rid=5666592&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00535.x Conclusion:  Newly diagnosed osteoarthritis patients incurred higher annual costs, but lower pain‐related prescription drug costs in the year following diagnosis than patients with existing osteoarthritis. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5666592 Wed, 01 Feb 2012 05:00:00 +0100 5666592 http://www.medworm.com/index.php?rid=5659295&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00492.x Abstract:  Pelvic pain is a common condition. Treatment interventions have traditionally targeted biomedical conditions with variable success. Utilizing a systematic approach to examination of the pelvic girdle and related organ systems contained within the pelvis will aid the clinician in identifying the painful structure(s) as well as the associated impairments limiting functional recovery. From this, a complete management program can be instituted. The following description of gynecologic, urologic, gastrointestinal, musculoskeletal, and neurologic conditions that can cause or are associated with chronic pelvic pain leads to conservative management proposals based on the available evidence. Finally, nonoperative interventional strategies are described, which target the pain system fro... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5659295 Wed, 01 Feb 2012 05:00:00 +0100 5659295 http://www.medworm.com/index.php?rid=5659294&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00523.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5659294 Wed, 01 Feb 2012 05:00:00 +0100 5659294 http://www.medworm.com/index.php?rid=5659293&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2012.00530.x Conclusion:  Our findings suggest that many patients who begin migraine prophylaxis with antidepressants, antiepileptics, or beta blockers are no longer taking these medications at 6 months. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5659293 Wed, 01 Feb 2012 05:00:00 +0100 5659293 http://www.medworm.com/index.php?rid=5627927&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00518.x Conclusions:  This study demonstrated that in LSS patients suffering with neurogenic claudication, mild provides statistically significantly better pain reduction and improved functional mobility vs. treatment with ESI. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5627927 Thu, 26 Jan 2012 12:10:25 +0100 5627927 http://www.medworm.com/index.php?rid=5607851&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00528.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5607851 Fri, 20 Jan 2012 12:11:22 +0100 5607851 http://www.medworm.com/index.php?rid=5580785&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00525.x Conclusion:  Despite stringent criteria, 64.4% of patients achieved an effective dose of fentanyl sublingual tablet within the dose range of 100 to 800 μg. Baseline characteristics were not identified to be associated with the likelihood of successful titration or with the actual effective dose of fentanyl sublingual tablet. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5580785 Mon, 09 Jan 2012 05:00:00 +0100 5580785 http://www.medworm.com/index.php?rid=5580784&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00526.x Discussion:  Research covering 1999 to 2005 using the same methods found that 15.9% of patients with FM used TCAs during the year before FM diagnosis and 20.7% used TCAs during the year after. These findings suggest that TCA use among the patients with FM is uncommon and may be declining in real‐world practice. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5580784 Mon, 09 Jan 2012 05:00:00 +0100 5580784 http://www.medworm.com/index.php?rid=5580788&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00504.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5580788 Sun, 01 Jan 2012 05:00:00 +0100 5580788 http://www.medworm.com/index.php?rid=5580787&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00506.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5580787 Sun, 01 Jan 2012 05:00:00 +0100 5580787 http://www.medworm.com/index.php?rid=5580786&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00505.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5580786 Sun, 01 Jan 2012 05:00:00 +0100 5580786 http://www.medworm.com/index.php?rid=5580783&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00524.x Conclusions:  This study demonstrates that therapy switching and discontinuation of select pain medications were common among OA and CLBP patients in the U.K. and may result from inadequate pain relief or undesirable side effects. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5580783 Sun, 01 Jan 2012 05:00:00 +0100 5580783 http://www.medworm.com/index.php?rid=5486266&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00517.x AbstractNonsteroidal anti‐inflammatory drugs (NSAIDs), including aspirin, have been associated with the damage to the gastrointestinal tract. One proposed mechanism of injury to the gastrointestinal mucosa by NSAIDs is oxygen radical‐dependent microvascular injury. There is reasonable evidence to support the benefit of the addition of ascorbic acid, an ingredient with antioxidant properties, to moderate the adverse gastrointestinal (GI) effects of aspirin. Pharmacokinetic data have demonstrated that aspirin and ascorbic acid combination therapy can assist in mitigating the decrease in levels of ascorbic acid secondary to aspirin monotherapy. Endoscopic evaluation has demonstrated that the addition of ascorbic acid to aspirin significantly improves Lanza scores and rates of blood loss w... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5486266 Wed, 07 Dec 2011 05:00:00 +0100 5486266 http://www.medworm.com/index.php?rid=5440227&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00519.x Conclusion:  Nonmechanical findings during a traditional movement screen are not specific to sinister conditions such as metastatic spinal cancer. Clinicians should expect concomitant conditions to exhibit painful or limited findings in patients with and without cancer. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5440227 Tue, 22 Nov 2011 05:00:00 +0100 5440227 http://www.medworm.com/index.php?rid=5537347&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00521.x Abstract:  In the recent years new technology has led to the development of a bewildering array of imaging procedures. Yet, conventional radiography remains one of the most used tools to diagnose and to aid procedural interventions. Fluoroscopy guidance facilitates targeted drug delivery or radiofrequency directly to the area of pathology, a benefit that has to be balanced against the risks of radiation exposure. In this prospective observational survey of routine practice, dose area product (DAP) and screening time (ST) were recorded in 127 consecutive patients undergoing fluoroscopically guided spinal procedures along with other probable measures of potentially greater radiation exposure such as weight, type of spinal pathology, the ease of recognition of the anatomical landmarks, and ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5537347 Tue, 01 Nov 2011 04:00:00 +0100 5537347 http://www.medworm.com/index.php?rid=5486265&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00522.x Abstract:  A 23‐year‐old female with an 18‐month history of left anterolateral thigh paresthesias and burning pain consistent with meralgia paresthetica was referred to our clinic after failing trials of physical therapy, nonsteroidal anti‐inflammatories, gabapentin, and amitriptyline. We performed 3 lateral femoral cutaneous nerve blocks with corticosteroid over a 4‐month period; however, each block provided only temporary relief. As this pain was limiting the patient’s ability to perform her functions as an active duty service member, we elected to perform a pulsed radiofrequency treatment of the lateral femoral cutaneous nerve with ultrasound guidance and nerve stimulation. After locating the lateral femoral cutaneous nerve with ultrasound and reproducing the patient’s d... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5486265 Tue, 01 Nov 2011 04:00:00 +0100 5486265 http://www.medworm.com/index.php?rid=5440226&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00520.x Conclusions:  Advanced HIV disease and greater medical and neuropsychiatric comorbidity predict repeat opioid prescribing, and these findings reflect the underlying complexities in managing pain symptoms in this population. We also highlight multiple deficiencies in opioid prescribing practices and nonadherence to guidelines, which are of concern as effective and safe pain management for our HIV‐infected population is an optimal goal. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5440226 Tue, 01 Nov 2011 04:00:00 +0100 5440226 http://www.medworm.com/index.php?rid=5384191&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00516.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5384191 Tue, 01 Nov 2011 04:00:00 +0100 5384191 http://www.medworm.com/index.php?rid=5384190&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00500.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5384190 Tue, 01 Nov 2011 04:00:00 +0100 5384190 http://www.medworm.com/index.php?rid=5384189&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00501.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5384189 Tue, 01 Nov 2011 04:00:00 +0100 5384189 http://www.medworm.com/index.php?rid=5384188&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00502.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5384188 Tue, 01 Nov 2011 04:00:00 +0100 5384188 http://www.medworm.com/index.php?rid=5334872&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00511.x Conclusion:  The PII showed satisfactory psychometric properties in terms of construct validity and reliability with regard to gender, age‐groups, and primary pain location. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5334872 Wed, 19 Oct 2011 04:00:00 +0100 5334872 http://www.medworm.com/index.php?rid=5334871&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00513.x Abstract:  Pain relief after laparoscopic cholecystectomy (LC) is an issue of great practical importance. Pain after LC has several origins: incisional, local visceral, peritoneal, and referred. Several modalities have been employed for achieving effective and safe analgesia: nonsteroidal anti‐inflammatory drugs (NSAIDs) and cyclooxygenase‐2 (COX‐2) inhibitors, gabapentinoids, local anesthetics, and transversus abdominis plane (TAP) block. They have their advantages and disadvantages, and multimodal approaches are often followed because of the multiple sources of pain. Among COX‐2 inhibitors, parecoxib and valdecoxib are useful, and fears regarding their cardiovascular adverse effects in noncardiac surgery (such as LC) have not been substantiated when used in short term. Gabapent... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5334871 Wed, 19 Oct 2011 04:00:00 +0100 5334871 http://www.medworm.com/index.php?rid=5334870&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00512.x Abstract:  The development of diagnostic criteria and the use of provocative discography allow identifying the degenerative disc as causative structure for chronic low‐back pain. Unfortunately, none of the available interventional treatment options have been demonstrated to be effective over a prolonged period of time for a considerable number of patients.Pathophysiological studies indicate sprouting of sensory nerves and inflammatory processes as underlying pain mechanisms.Pulsed radiofrequency (PRF) treatment in small and larger joints was described to reduce pain and improve healing by stimulating the immunology. Earlier findings of PRF applied in the disc annulus were promising. It is assumed that PRF applied in the nucleus would change the conductivity of nerve endings and provide... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5334870 Wed, 19 Oct 2011 04:00:00 +0100 5334870 http://www.medworm.com/index.php?rid=5334873&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00515.x Conclusions:  The cost of care in patients with gabapentin‐refractory peripheral neuropathic pain appeared to be significantly reduced after switching to pregabalin treatment, alone or in combination with other analgesic drugs, in a real‐life setting. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5334873 Mon, 17 Oct 2011 04:00:00 +0100 5334873 http://www.medworm.com/index.php?rid=5259917&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00493.x Abstract:Central sensitization (CS) has been proposed as a common pathophysiological mechanism to explain related syndromes for which no specific organic cause can be found. The term “central sensitivity syndrome (CSS)” has been proposed to describe these poorly understood disorders related to CS. The goal of this investigation was to develop the Central Sensitization Inventory (CSI), which identifies key symptoms associated with CSSs and quantifies the degree of these symptoms. The utility of the CSI, to differentiate among different types of chronic pain patients who presumably have different levels of CS impairment, was then evaluated. Study 1 demonstrated strong psychometric properties (test–retest reliability = 0.817; Cronbach’s alpha = 0.879) of the CSI in a cohort of... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5259917 Mon, 26 Sep 2011 04:00:00 +0100 5259917 http://www.medworm.com/index.php?rid=5259916&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00494.x Conclusion:  DPNP patients in the VA healthcare system with prior other treatment use, select comorbid conditions, prior substance abuse, prior opioid use, and higher pain level were more likely to receive duloxetine. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5259916 Mon, 26 Sep 2011 04:00:00 +0100 5259916 http://www.medworm.com/index.php?rid=5259915&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00495.x Conclusion:  Controlling for cross‐cohort differences, veterans with MDD treated with duloxetine were associated with lower risks of opioid use and substance abuse and lower health care utilization than those treated with other antidepressants. ▪ (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5259915 Mon, 26 Sep 2011 04:00:00 +0100 5259915 http://www.medworm.com/index.php?rid=5224517&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00496.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5224517 Fri, 16 Sep 2011 04:00:00 +0100 5224517 http://www.medworm.com/index.php?rid=5346700&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00510.x Abstract:  There exists substantial evidence that a peridural membrane (PM) is present in the spinal canal of humans and, like the pleura and peritoneum, has one or more physiologic functions. Innervation of the PM suggests that it may become a source of pain if injured. Although debated, the physiology of this structure has important implications with respect to neuraxial distribution of drugs and for back and radiating pain. This review, separated into embryological, anatomic, and physiologic discussions, provides an in‐depth summary of the observations of this connective tissue. The discrepancies between accounts are highlighted within each section. Focused research to clearly elucidate the true nature of the PM, especially as related to neuraxial distribution of drugs and back and ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5346700 Thu, 01 Sep 2011 04:00:00 +0100 5346700 http://www.medworm.com/index.php?rid=5334869&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00514.x Conclusion:  Repeated‐dose 24‐hours end points were found to be as robust as previously published results. IV acetaminophen efficacy and safety appeared to be unaffected by specific subset variables.▪ (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5334869 Thu, 01 Sep 2011 04:00:00 +0100 5334869 http://www.medworm.com/index.php?rid=5273044&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00507.x Abstract  The postsynaptic fibers of the pterygopalatine or sphenopalatine ganglion (PPG or SPG) supply the lacrimal and nasal glands. The PPG appears to play an important role in various pain syndromes including headaches, trigeminal and sphenopalatine neuralgia, atypical facial pain, muscle pain, vasomotor rhinitis, eye disorders, and herpes infection. Clinical trials have shown that these pain disorders can be managed effectively with sphenopalatine ganglion blockade (SPGB). In addition, regional anesthesia of the distribution area of the SPG sensory fibers for nasal and dental surgery can be provided by SPGB via a transnasal, transoral, or lateral infratemporal approach. To arouse the interest of the modern‐day clinicians in the use of the SPGB, the advantages, disadvantages, and m... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5273044 Thu, 01 Sep 2011 04:00:00 +0100 5273044 http://www.medworm.com/index.php?rid=5259914&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00498.x This study compared patients with and without such an incident DDE to determine healthcare utilization and associated payments. Using a retrospective database analysis, the impact of DDEs was evaluated in terms of associated clinical events, healthcare services utilization (office visits, outpatient visits, ED visits, hospitalization), and payments in patient populations based on age (those under age 65 and those 65 years of age and older), during the 6 months after exposure. DDE patients had significantly more inpatient hospitalizations than no‐DDE patients. Mean total payments at 6 months were significantly higher for both younger and older patients with DDE compared to similar patients without DDE ($9,469, SD = $12,192 vs. $8,382, SD = $14,078, respectively, for younger ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5259914 Thu, 01 Sep 2011 04:00:00 +0100 5259914 http://www.medworm.com/index.php?rid=5224521&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00486.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5224521 Thu, 01 Sep 2011 04:00:00 +0100 5224521 http://www.medworm.com/index.php?rid=5224520&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00483.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5224520 Thu, 01 Sep 2011 04:00:00 +0100 5224520 http://www.medworm.com/index.php?rid=5224519&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00482.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5224519 Thu, 01 Sep 2011 04:00:00 +0100 5224519 http://www.medworm.com/index.php?rid=5224518&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00490.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5224518 Thu, 01 Sep 2011 04:00:00 +0100 5224518 http://www.medworm.com/index.php?rid=5224516&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00503.x This study compared utilization of healthcare resources and associated payments in cLBP patients with and without incident DDEs with the potential to cause PK DDIs. A retrospective database analysis examined the associated clinical events, healthcare utilization (measured in terms of claims for office visits, outpatient visits, emergency department visits, and hospitalization), and cost to the health plan, as defined as the sum of health plan payments for resources used. Patients were grouped into 2 cohorts by age (those under 65 and those 65 years and over). In the 6 months after exposure, total healthcare payments were significantly higher for DDE patients than those without DDEs (no‐DDE), in both in the younger ($7,086, SD = $8,370) and $6,353, SD = $8,352, respectively, P... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5224516 Thu, 01 Sep 2011 04:00:00 +0100 5224516 http://www.medworm.com/index.php?rid=5078380&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00485.x Abstract:Neuropathic cancer pain (NCP), commonly encountered in clinical practice, may be cancer‐related, namely resulting from nervous system tumor invasion, surgical nerve damage during tumor removal, radiation‐induced nerve damage and chemotherapy‐related neuropathy, or may be of benign origin, unrelated to cancer. A neuropathic component is evident in about 1/3 of cancer pain cases. Although from a pathophysiological perspective NCP may differ from chronic neuropathic pain (NP), such as noncancer‐related pain, clinical practice, and limited publications have shown that these two pain entities may share some treatment modalities. For example, co‐analgesics have been well integrated into cancer pain‐management strategies and are often used as First‐Line options for the trea... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5078380 Thu, 28 Jul 2011 23:00:00 +0100 5078380 http://www.medworm.com/index.php?rid=5078379&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00487.x Abstract  Studies suggest that around 20% of adults in Europe experience chronic pain, which not only has a considerable impact on their quality of life but also imposes a substantial economic burden on society. More than one‐third of these people feel that their pain is inadequately managed. A range of analgesic drugs is currently available, but recent guidelines recommend that NSAIDs and COX‐2 inhibitors should be prescribed cautiously. Although the short‐term efficacy of opioids is good, adverse events are common and doses are frequently limited by tolerability problems. There is a perceived need for improved pharmacological treatment options.Currently, many treatment decisions are based solely on pain intensity. However, chronic pain is multifactorial and this apaproach ignores... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5078379 Thu, 28 Jul 2011 23:00:00 +0100 5078379 http://www.medworm.com/index.php?rid=5078378&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00488.x Conclusions:  This study illustrates that it is possible to measure functioning as a unidimensional construct based on selected ICF categories from the components body functions, as well as activities and participation of the Brief ICF‐Core‐Set for CWP in patients with FM. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5078378 Thu, 28 Jul 2011 23:00:00 +0100 5078378 http://www.medworm.com/index.php?rid=5207595&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00497.x Conclusions:  The presence of select comorbidities and prior use of certain medications were associated with the duloxetine initiation among working‐age, commercially insured patients with fibromyalgia. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5207595 Fri, 01 Jul 2011 04:00:00 +0100 5207595 http://www.medworm.com/index.php?rid=5183080&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00499.x Abstract:  Among adrenal incidentalomas, pheochromocytomas are rare. Malignant pheochromocytoma is even less common, and it typically presents with classic hormonal symptoms, such as palpitations, labile blood pressures, and headaches. Bony metastasis usually occurs late in disease, but we report an unusual case of incapacitating bony pain as the initial presentation of malignant pheochromocytoma. Our patient is a 70‐year‐old woman with neurofibromatosis type 1 and a history of primary hyperparathyroidism, who tested negative for the ret mutation. She came to medical attention with chest pain and palpitations and was incidentally found to have an adrenal mass. Serum and urine testing was consistent with pheochromocytoma. Her blood pressure was easily controlled as she awaited electiv... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5183080 Thu, 30 Jun 2011 23:00:00 +0100 5183080 http://www.medworm.com/index.php?rid=5108812&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00491.x AbstractFentanyl buccal tablet (FBT) is indicated for the treatment of breakthrough pain in patients who are already receiving and are tolerant to opioid therapy for underlying, persistent cancer pain. FBT is designed to enhance the rate and efficiency of absorption of fentanyl through the buccal mucosa. FBT was shown to be dose proportional from 100 to 1,300 μg. This analysis provides an overview of the pharmacokinetic profile of FBT based on pooled data from nine pharmacokinetic studies. In all, 365 healthy non‐opioid‐tolerant adults receiving naltrexone were included in the analysis. Single‐dose (100 to 1,300 μg) pharmacokinetic parameters were dose normalized to 100 μg. Pharmacokinetic measures included maximum observed plasma drug concentration (Cmax), plasma drug conce... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5108812 Thu, 30 Jun 2011 23:00:00 +0100 5108812 http://www.medworm.com/index.php?rid=5087114&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00492.x Abstract:Pelvic pain is a common condition. Treatment interventions have traditionally targeted biomedical conditions with variable success. Utilizing a systematic approach to examination of the pelvic girdle and related organ systems contained within the pelvis will aid the clinician in identifying the painful structure(s) as well as the associated impairments limiting functional recovery. From this, a complete management program can be instituted. The following description of gynecologic, urologic, gastrointestinal, musculoskeletal, and neurologic conditions that can cause or are associated with chronic pelvic pain leads to conservative management proposals based on the available evidence. Finally, nonoperative interventional strategies are described, which target the pain system from a ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=5087114 Thu, 30 Jun 2011 23:00:00 +0100 5087114 http://www.medworm.com/index.php?rid=5078377&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00489.x Conclusions:  The current study indicates that SCS may provide effective pain relief, improve disability, and reduce opioid usage in patients with discogenic pain. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5078377 Thu, 30 Jun 2011 23:00:00 +0100 5078377 http://www.medworm.com/index.php?rid=5009375&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00471.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5009375 Thu, 30 Jun 2011 23:00:00 +0100 5009375 http://www.medworm.com/index.php?rid=5009374&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00484.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=5009374 Thu, 30 Jun 2011 23:00:00 +0100 5009374 http://www.medworm.com/index.php?rid=4936029&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00474.x Abstract:  Chronic pancreatitis is defined as a progressive inflammatory response of the pancreas that has lead to irreversible morphological changes of the parenchyma (fibrosis, loss of acini and islets of Langerhans, and formation of pancreatic stones) as well as of the pancreatic duct (stenosis and pancreatic stones). Pain is one of the most important symptoms of chronic pancreatitis. The pathogenesis of this pain can only partly be explained and it is therefore often difficult to treat this symptom.The management of pain induced by chronic pancreatitis starts with lifestyle changes and analgesics.For the pharmacological management, the three‐step ladder of the World Health Organization extended with the use of co‐analgesics is followed.Interventional pain management may consist o... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936029 Wed, 15 Jun 2011 23:00:00 +0100 4936029 http://www.medworm.com/index.php?rid=4936028&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00475.x We report the successful use of low‐dose ketamine infusion for treating a severe episode of painful myoclonus in the lower extremities, associated with opioid‐induced hyperalgesia (OIH), in a patient who was receiving long‐term, high dose intrathecal hydromorphone therapy. A low‐dose ketamine infusion immediately relieved the painful myoclonus. It also enabled a reduction in the intrathecal opioid dosage leading to a resolution of the acute symptoms attributed to OIH. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936028 Wed, 15 Jun 2011 23:00:00 +0100 4936028 http://www.medworm.com/index.php?rid=4936027&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00476.x Abstract:  Good surgical outcomes depend in part on good pain relief, allowing for early mobilization, optimal recovery, and patient satisfaction. Postsurgical pain has multiple mechanisms, and multimechanistic approaches to postoperative analgesia are recommended and may be associated with improved pain relief, lowered opioid doses, and sometimes a lower rate of opioid‐associated side effects. Acetaminophen (paracetamol) is a familiar agent for treating many types of pain, including postsurgical pain. Oral acetaminophen has been shown to be safe and effective in a variety of acute pain models. Combination products using a fixed‐dose of acetaminophen and an opioid have also been effective in treating postsurgical pain. Combination products with acetaminophen have demonstrated an opio... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936027 Wed, 15 Jun 2011 23:00:00 +0100 4936027 http://www.medworm.com/index.php?rid=4936026&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00477.x Abstract:  Severe chronic neuropathic pain is a challenge to treat, and due to adverse effects of classical oral medication, optimal and effective dose levels are difficult to reach. Therefore, administration of topical analgesics might be an option, due to reduced adverse effects, and increased patient compliance.The aim of this article is to describe two cases treated effectively with topical amitriptyline 5% and 10%, the highest dosage described to date. The first patient was a 39‐year‐old man, suffering from severe intractable neuropathic pain in feet and hands, due to diabetes mellitus type II (DM‐II). After application of amitriptyline 5% the patient experienced a complete relieve only in the hands, whereas after application of amitriptyline 10%, a total reduction of pain occ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936026 Wed, 15 Jun 2011 23:00:00 +0100 4936026 http://www.medworm.com/index.php?rid=4936025&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00478.x Conclusion:  No differences were noted in all‐cause costs attributable to pregabalin or duloxetine. Although patients receiving pregabalin had a significantly greater pre‐ to post‐index increase in pDPN‐related health care costs compared with patients receiving duloxetine, this may have been due to an imbalance in patient exclusion criteria between cohorts. ▪ (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936025 Wed, 15 Jun 2011 23:00:00 +0100 4936025 http://www.medworm.com/index.php?rid=4936024&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00479.x Conclusions: HLA‐B*1502 is a strong genetic marker for CBZ‐induced SJS/TEN in Thai patients with neuropathic pain. The screening for this marker should be performed prior to initiation of CBZ treatment to assess the risk of this serious side effect. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936024 Wed, 15 Jun 2011 23:00:00 +0100 4936024 http://www.medworm.com/index.php?rid=4936023&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00480.x Conclusions:  A single preoperative oral dose of gabapentin (600 mg) did not reduce pain scores or opioid consumption following elective thoracotomy, and did not confer any analgesic benefit in the setting of effective multimodal analgesia that included thoracic epidural infusion. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936023 Wed, 15 Jun 2011 23:00:00 +0100 4936023 http://www.medworm.com/index.php?rid=4936022&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00481.x Conclusions:  At 1 year this 58‐patient cohort demonstrated continued excellent safety profile of the mild® procedure and equally important, showed long‐term pain relief and improved functionality. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936022 Wed, 15 Jun 2011 23:00:00 +0100 4936022 http://www.medworm.com/index.php?rid=4872891&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00469.x Discussion:  Our preliminary data suggest possible efficacy of thoracic epidural steroid and clonidine mixture in the treatment of chronic post‐thoracotomy pain. No serious adverse effects were noted in this pilot study. ▪ (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4872891 Wed, 25 May 2011 23:00:00 +0100 4872891 http://www.medworm.com/index.php?rid=4872890&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00467.x This article presents our hospital‐based in‐patient palliative care unit experience with early ultrasonography‐guided neurolysis of celiac plexus, superior hypogastric plexus and ganglion impar. Of the 44 patients we studied, 20 underwent celiac plexus neurolysis, 18 superior hypogastric plexus neurolysis, and 6 ganglion impar neurolysis. Their pain was being managed with oral morphine before neurolysis, but only 11.4% patients required oral morphine for satisfactory pain control, 2 months after neurolysis. The mean Visual Analog Scale score before block placement was 5.64 ± 0.69 and fell to 2.25 ± 1.33 at 2 months post neurolysis (P < 0.001). We suggest that bedside ultrasonography‐guided sympathetic axis neurolysis may be employed early in patients with incur... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4872890 Wed, 25 May 2011 23:00:00 +0100 4872890 http://www.medworm.com/index.php?rid=4872889&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00470.x Conclusion:  No significant differences were found between pregabalin and duloxetine in the pre‐ to postindex change in mean all‐cause or fibromyalgia‐related total health care costs. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4872889 Wed, 25 May 2011 23:00:00 +0100 4872889 http://www.medworm.com/index.php?rid=4936021&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00473.x Abstract:  Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients’ quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate application of these interventional techniques provides better pain control, allows the reduction of analgesics and hence improves quality of life. Until recently, the majority of these techniques are considered to be a fourth consecutive step following the World Health Organization’s pain treatment ladder. However, in cancer patients, earlier application of interventional pain management techniques can be recommended even before considering the use of strong opioids.Epidural a... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4936021 Sat, 30 Apr 2011 23:00:00 +0100 4936021 http://www.medworm.com/index.php?rid=4894558&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00468.x Conclusions:  The relief from scalene muscle injections in patients with neurogenic thoracic outlet syndrome is not related to blockade of the brachial plexus. ▪ (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4894558 Sat, 30 Apr 2011 23:00:00 +0100 4894558 http://www.medworm.com/index.php?rid=4872888&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00472.x This report is the history of Texas Pain Society as the activities unfolded from 1989 to 2011.The reader may question why there is a need to tell such a story. We believe strongly that, with disparities of standards of practice in pain medicine and poor recognition of advances in pain management, this scenario is quite common in many states and countries. The practitioners of pain management in these regions certainly must have considered getting together and forming a consensus on the standards of practice in their communities. This historical report of the Texas Pain Society provides the relevant information necessary and the efforts to be made for a society’s mission to achieve its goals and have an ongoing impact in its own region. We hope that we have shed some light on a process fo... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4872888 Sat, 30 Apr 2011 23:00:00 +0100 4872888 http://www.medworm.com/index.php?rid=4863558&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00465.x Abstract:  Chronic pelvic pain is defined as the presence of pain in the pelvic girdle region for over a 6‐month period and can arise from the gynecologic, urologic, gastrointestinal, and musculoskeletal systems. As 15% of women experience pelvic pain at some time in their lives with yearly direct medical costs estimated at $2.8 billion, effective evaluation and management strategies of this condition are necessary. This merits a thorough discussion of a systematic approach to the evaluation of chronic pelvic pain conditions, including a careful history‐taking and clinical examination. The challenge of accurately diagnosing chronic pelvic pain resides in the degree of peripheral and central sensitization of the nervous system associated with the chronicity of the symptoms, as well ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4863558 Sat, 30 Apr 2011 23:00:00 +0100 4863558 http://www.medworm.com/index.php?rid=4790035&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00456_2.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4790035 Sat, 30 Apr 2011 23:00:00 +0100 4790035 http://www.medworm.com/index.php?rid=4790034&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00456_1.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4790034 Sat, 30 Apr 2011 23:00:00 +0100 4790034 http://www.medworm.com/index.php?rid=4735484&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00463.x Conclusion:  This trial shows a dose–response effect of 40 mg/kg over 15 mg/kg of intravenous dipyrone based on better movement‐induced pain control, lower morphine consumption and fewer opioid‐related side effects. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4735484 Tue, 19 Apr 2011 23:00:00 +0100 4735484 http://www.medworm.com/index.php?rid=4654023&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00447.x Conclusion:  Bilateral paravertebral blockade performed prior to general anesthesia for laparoscopic cholecystectomy can provide early discharge and better postoperative pain management. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4654023 Tue, 29 Mar 2011 23:00:00 +0100 4654023 http://www.medworm.com/index.php?rid=4654022&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00451.x Abstract:  Pain, motor, and sensory deficits characterize patients with a traumatic lesion of the brachial plexus. Frequently, more severe injuries co‐exist that require immediate surgical attention.Early rehabilitation and physical therapy are the cornerstones of treatment. Pharmacological management can be difficult. Surgical reconstruction is frequently advised when nerves are disrupted. The results, mostly from small historical reports, vary greatly. Neurostimulation may have an additional beneficial effect, especially if the pathophysiology of nociception and neuropathic pain becomes evident in these complex patients. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4654022 Tue, 29 Mar 2011 23:00:00 +0100 4654022 http://www.medworm.com/index.php?rid=4654021&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00454.x Abstract:  Phantom pain is pain caused by elimination or interruption of sensory nerve impulses by destroying or injuring the sensory nerve fibers after amputation or deafferentation. The reported incidence of phantom limb pain after trauma, injury or peripheral vascular diseases is 60% to 80%. Over half the patients with phantom pain have stump pain as well. Phantom pain can also occur in other parts of the body; it has been described after mastectomies and enucleation of the eye.Most patients with phantom pain have intermittent pain, with intervals that range from 1 day to several weeks. Even intervals of over a year have been reported. The pain often presents itself in the form of attacks that vary in duration from a few seconds to minutes or hours. In most cases, the pain is experi... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4654021 Tue, 29 Mar 2011 23:00:00 +0100 4654021 http://www.medworm.com/index.php?rid=4654020&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00455.x We present the use of an alternative approach to neuromodulation of anginal pain using subcutaneous leads placed at the site of pain. In this case series, five patients with refractory angina received successful treatment with subcutaneous target stimulation–peripheral subcutaneous field stimulation. This technique was able to provide good analgesia in two patients that had had poor pain relief from existing spinal cord stimulators. All five patients achieved significant pain relief with a reduction in symptoms and a decrease in the use of pain medication. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4654020 Tue, 29 Mar 2011 23:00:00 +0100 4654020 http://www.medworm.com/index.php?rid=4632160&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00446.x Abstract:  An 80‐year‐old female with a history of osteoporosis was evaluated for sudden onset axial low back pain with bilateral lower extremity weakness, hyperreflexia, pain, urinary retention, and decreased rectal tone. Computed tomography of the lumbar spine revealed L1 compression fracture, retropulsion of bone causing spinal canal compromise with associated severe central canal stenosis. Following cement kyphoplasty of L1 with polymethyl methacrylate, the patient developed tachycardia and dyspnea. Chest radiograph and computed tomographic pulmonary angiogram revealed a large collection of hyperdense material within the right lower lobe pulmonary artery, consistent with pulmonary cement emboli. Management and imaging are discussed. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4632160 Fri, 25 Mar 2011 00:00:00 +0100 4632160 http://www.medworm.com/index.php?rid=4632159&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00448.x Conclusions:  The PASS is elevated when other measures of psychosocial distress are also elevated. However, the PASS fails to discriminate between different indices of depression and anxiety and it is not highly related to 1‐year outcomes in a CDOMD cohort. If time and resources are limited, a different measure of psychosocial distress that does relate to socioeconomic outcomes might be a better option in a CDOMD evaluation process. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4632159 Fri, 25 Mar 2011 00:00:00 +0100 4632159 http://www.medworm.com/index.php?rid=4632158&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00457.x Abstract:  Carpal tunnel syndrome (CTS) is a common disorder. In the majority of cases, patients with CTS can be diagnosed by means of appropriate history taking. Nerve conduction examination of the nervus medianus is the most important additional diagnostic test and is the best predictor of symptom severity and functional status in idiopathic CTS. Treatment option depends on the severity of the symptoms and the degree of functional daily limitations. If few limitations are present, splinting or corticosteroid injections are preferred. Surgical interventions are reserved for the more severe conditions resulting in significant disability.Interventional pain treatment such as pulsed radiofrequency could be an addition to the future treatment options for CTS. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4632158 Fri, 25 Mar 2011 00:00:00 +0100 4632158 http://www.medworm.com/index.php?rid=4632157&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00458.x AbstractMeralgia paresthetica (MP) is a neurological disorder of the nervus cutaneous femoris lateralis (lateral femoral cutaneous nerve) (LFCN) characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. Medical history and neurological examination are essential in making the diagnosis. However, red flags such as tumor and lumbar disc herniations must be ruled out. While the diagnosis of MP is essentially a clinical diagnosis, sensory nerve conduction velocity studies are a useful additional diagnostic tool.The first choice in management of MP is, besides treating the underlying cause, always a conservative approach. Simple measures such as losing weight and not wearing tight belts and/or trousers can be advised. Pharmacological therapy consists... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4632157 Fri, 25 Mar 2011 00:00:00 +0100 4632157 http://www.medworm.com/index.php?rid=4593555&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00444.x AbstractAngina pectoris, cardiac pain associated with ischemia, is considered refractory when optimal anti‐anginal therapy fails to resolve symptoms. It is associated with a decreased life expectancy and diminishes the quality of life. Spinal cord stimulation (SCS) may be considered for patients who have also undergone comprehensive interventions, such as coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA) procedures.The mechanism of action of SCS is not entirely clear. Pain reduction is related to the increased release of inhibitory neuropeptides as well as normalization of the intrinsic nerve system of the heart muscle, and may have a protective myocardial effect.SCS in patients with refractory angina pectoris results in reduced anginal attacks... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4593555 Tue, 15 Mar 2011 00:00:00 +0100 4593555 http://www.medworm.com/index.php?rid=4593554&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00449.x Abstract:  Chronic pain has been recognized as a major worldwide health care problem. Today, medical experts and health agencies agree that chronic pain should be treated with the same priority as the disease that caused it, and patients should receive adequate pain relief. To achieve good analgesia, patient adherence to a prescribed pain treatment is of high importance. Patients with chronic pain often do not use their medication as prescribed, but change the frequency of intake. This can result in poor treatment outcomes and may necessitate additional emergency treatment, which increases the overall costs.Factors that influence adherence include knowledge of the disease, realistic treatment expectations, perceived benefit from treatment, side effects, depression, dosing frequency, and ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4593554 Tue, 15 Mar 2011 00:00:00 +0100 4593554 http://www.medworm.com/index.php?rid=4593553&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00450.x Conclusions:  Patients with pDPN prescribed pregabalin and gabapentin had a substantial comorbidity and pain medication burden. Although healthcare costs increased in both groups, the increase in pain medication burden was higher in the gabapentin group. Direct medical costs were similar for both groups. Given the human and economic burden of pDPN, future research may benefit from a focus on efficacy parameters to further differentiate treatment options. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4593553 Tue, 15 Mar 2011 00:00:00 +0100 4593553 http://www.medworm.com/index.php?rid=4754592&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00462.x Abstract:Although previous studies suggest that the clinical setting of an interdisciplinary pain treatment program may provide an optimal environment to promote smoking cessation, currently available smoking cessation interventions may be less effective for adults with chronic pain due, in part, to unrecognized clinical factors related to chronic pain. The specific aim of this qualitative study was to solicit information from adult smokers with chronic pain participating in an interdisciplinary pain treatment program regarding their perceptions of how smoking affects pain symptoms, and how these beliefs, cognitions, and emotions may either impede or facilitate smoking cessation. Similar information was solicited from a group of pain specialty physicians. The study involved 18 smokers with... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4754592 Tue, 01 Mar 2011 00:00:00 +0100 4754592 http://www.medworm.com/index.php?rid=4735483&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00466.x This study has an original design using data from family practices: the incidence of the most frequent diseases was compared in patients with and without LBP in 2004. The database includes data from 67 family physicians in 52 family practices in Flanders, Belgium. It contains data from 160,000 different patients with 1,500,000 diagnoses during the period 1994 to 2004. The incidence of the most frequent diagnoses is presented in patients with and without LBP in 2004. The diagnoses were coded according to the ICPC‐2‐classification.In 2004, the incidence of LBP was 51.4‰ (95% CI: 49.8 to 53.1) in patients aged 18 or older. The incidence was slightly higher in women than in men: 53.0‰ (95% CI: 50.7 to 55.4) vs. 49.9‰ (95% CI: 47.7 to 52.3). The highest incidence was recorded in the a... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4735483 Tue, 01 Mar 2011 00:00:00 +0100 4735483 http://www.medworm.com/index.php?rid=4654019&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00461.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4654019 Tue, 01 Mar 2011 00:00:00 +0100 4654019 http://www.medworm.com/index.php?rid=4632156&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00460.x AbstractTwo important groups of disorders result from an insufficient blood supply to the extremities: critical vascular disease and the Raynaud’s phenomenon. The latter can be subdivided into a primary and a secondary type. Critical ischemic disease is often caused by arteriosclerosis due to hypertension or diabetes. Primary Raynaud’s is idiopathic and will be diagnosed as such if underlying systemic pathology has been excluded. Secondary Raynaud’s is often a manifestation of a systemic disease. It is essential to try to establish a diagnosis as soon as possible in order to influence the evolution of the disease.A sympathetic nerve block can be considered in patients with critical ischemic vascular disease after extensive conservative treatment, preferably in the context of a study ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4632156 Tue, 01 Mar 2011 00:00:00 +0100 4632156 http://www.medworm.com/index.php?rid=4593552&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00445.x We present our first three patients with long‐standing cluster headaches who were treated with pulsed radiofrequency to the sphenopalatine ganglion. All three patients have had cluster headaches for more than 10 years' duration and experienced minimal relief with conservative treatment. An excellent midterm effect was achieved in two of the three patients and a partial effect in one. No neurological side effects or complications were reported. Quantitative sensory testing consisting of allodynia testing, pressure–pain thresholds, electrical pain thresholds, and conditioned pain modulation (CPM) response testing were used to monitor their sensory processing changes before and after the procedure. From this case series, it might be that cluster headache patients with an impaired CPM resp... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4593552 Tue, 01 Mar 2011 00:00:00 +0100 4593552 http://www.medworm.com/index.php?rid=4571421&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00453.x Conclusion:  Despite several comorbidity and drug use differences, most employee benefit outcomes and adherence did not differ between the cohorts. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4571421 Tue, 01 Mar 2011 00:00:00 +0100 4571421 http://www.medworm.com/index.php?rid=4545402&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00442.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4545402 Tue, 01 Mar 2011 00:00:00 +0100 4545402 http://www.medworm.com/index.php?rid=4545401&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00443_2.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4545401 Tue, 01 Mar 2011 00:00:00 +0100 4545401 http://www.medworm.com/index.php?rid=4545400&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00443_1.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4545400 Tue, 01 Mar 2011 00:00:00 +0100 4545400 http://www.medworm.com/index.php?rid=4545399&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00403.x AbstractMilnacipran has been shown to significantly improve the pain, global well‐being, and physical function of fibromyalgia (FM), and is approved by the U.S. Food and Drug Administration for the management of this disorder. Post hoc analyses of data from two pivotal trials were conducted to further assess the clinical benefits of milnacipran, to determine the impact of baseline pain severity on treatment outcomes, and to confirm the safety and tolerability of this medication in patients with FM. Patients in these trials were randomized to placebo (n = 624), milnacipran 100 mg/day (n = 623), or milnacipran 200 mg/day (n = 837). Two different composite responder analyses were used to evaluate efficacy: a 2‐measure analysis, requiring ≥ 30% improvement from baseline... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4545399 Tue, 01 Mar 2011 00:00:00 +0100 4545399 http://www.medworm.com/index.php?rid=4545398&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2011.00452.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4545398 Tue, 01 Mar 2011 00:00:00 +0100 4545398 http://www.medworm.com/index.php?rid=4295180&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00429.x AbstractMonophasic (one‐time) nerve injuries heal without clinically significant residua in most cases, but rare individuals are left with neuropathic pain, even after seemingly minor lesions. The effects of lesion size on risk for chronic pain persistence are not well understood, particularly as concerns the complex regional pain syndrome, which is defined in part by pain “disproportionate” to the severity of the causative lesion, and extending outside the autonomous territory of a single nerve. To better clarify the expected prevalence of pain behaviors after nerve injury, we compared the effects in rats of different‐sized axotomies on the prevalence and location of evoked pain behaviors. To highlight clinical relevance, we also describe a patient with iatrogenic tibial‐nerve i... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295180 Wed, 29 Dec 2010 00:00:00 +0100 4295180 http://www.medworm.com/index.php?rid=4295179&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00430.x Conclusion:  Compared with usual care, the addition of pregabalin to treat refractory neck pain seems to be associated with a higher reduction in pain severity and lost work‐days equivalents, which in turn results in a greater reduction of the indirect components of cost while maintaining similar healthcare cost levels despite its higher price. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295179 Wed, 29 Dec 2010 00:00:00 +0100 4295179 http://www.medworm.com/index.php?rid=4295178&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00431.x Conclusion:  Fibromyalgia patients with higher duloxetine ADD were more likely to adhere to the therapy. High duloxetine adherence was associated with lower (Commercial) or similar (Medicare supplemental) healthcare costs. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295178 Wed, 29 Dec 2010 00:00:00 +0100 4295178 http://www.medworm.com/index.php?rid=4295177&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00432.x AbstractHerpes zoster pain and postherpetic neuralgia (PHN) particularly affect older persons. This literature review presents how quality of life is evaluated and the consequences of shingles and PHN on the quality of life of older persons. Although more than 150 articles have been published on herpes zoster and its consequences, specific studies focusing on the older population are needed, in several domains like epidemiology, preventive medicine, neuropsychology, and pharmacology. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295177 Wed, 29 Dec 2010 00:00:00 +0100 4295177 http://www.medworm.com/index.php?rid=4295176&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00433.x AbstractWith few exceptions, anesthesiologists have not received training in the use of immune modulating drugs (IMDs); but recent evidence suggests that such drugs may be effective in reducing chronic pain. We therefore wished to learn how anesthesiologists working in pain medicine might envisage the treatment of their patients with IMDs in the future. We expected that anesthesiologists would want to refer patients for treatment with IMDs to medical colleagues, such as oncologists or rheumatologists, with prior experience in using these drugs, rather than treat these patients within their own practice. We conducted questionnaire surveys among anesthesiologists working in pain medicine in both the Netherlands and the U.K. to explore their views on using IMDs. Contrary to what we had expect... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295176 Wed, 29 Dec 2010 00:00:00 +0100 4295176 http://www.medworm.com/index.php?rid=4295175&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00434.x We present two different painful conditions of presumed neuropathic origin, with complex etiopathogenesis, which were successfully treated with buprenorphine. The results of treatment of these neuropathic pain syndromes with buprenorphine are encouraging, suggesting that it might represent a valid alternative to standard approaches for central neuropathic pain. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295175 Wed, 29 Dec 2010 00:00:00 +0100 4295175 http://www.medworm.com/index.php?rid=4295185&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00437.x Conclusions:  This study contributes to the human OIH literature. However, because of the potential confounders in this study, the issue of OIH in humans remains unresolved. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295185 Tue, 28 Dec 2010 00:00:00 +0100 4295185 http://www.medworm.com/index.php?rid=4295184&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00438.x This study challenged previous assumptions about DDEs in that advanced age was not positively associated with the risk of DDE. However, the number of prescriptions the patient received in the 90‐day window prior to the index date was a risk factor. For patients taking at least two medications in the 90‐day period prior to the index date, every additional prescription taken increased their risk for a DDE during the observation period by 138% (on average). The risk of DDE during the study period was threefold greater for patients with one medication in the 90‐day period before index date compared with similar patients with no prescriptions in that same period before the index date. DDEs are more common than may be generally believed in patients with osteoarthritis, regardless of age, a... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295184 Tue, 28 Dec 2010 00:00:00 +0100 4295184 http://www.medworm.com/index.php?rid=4295183&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00439.x We present a 48‐year‐old female with intractable and incapacitating low back pain because of metastatic bone tumor in the left lateral side of S1 and S2 with left sacroiliac invasion. Imaging identified a metastatic invasion of the sacrum. Percutaneous sacroplasty, a safe and effective procedure for sacral‐insufficient fractures, was performed under fluoroscopy guidance. However, the expected pain relief was not achieved. At 1 month, the patient remained invalided by severe back pain, which was localized to the left sacroiliac joint. In a second procedure, the sacroiliac joint was cemented. Pain relief was complete, immediate, and sustained until the patient's death related to the underlying oncologic disease. No complications were observed.Few reports exist about the treatment of sa... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295183 Tue, 28 Dec 2010 00:00:00 +0100 4295183 http://www.medworm.com/index.php?rid=4295182&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00440.x Conclusions:  The changes in health resource utilization and costs after initiation of pregabalin were not significantly different than the changes observed after initiation of duloxetine. These results not only demonstrate an overall similarity of resource utilization, but also suggest cost neutrality between pregabalin and duloxetine. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295182 Tue, 28 Dec 2010 00:00:00 +0100 4295182 http://www.medworm.com/index.php?rid=4295181&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00441.x Conclusion:  All eight active treatments displayed evidence suggesting improvement over placebo in the treatment of pain in patients suffering from fibromyalgia. Indirect comparison of active treatments found no strong differences. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295181 Tue, 28 Dec 2010 00:00:00 +0100 4295181 http://www.medworm.com/index.php?rid=4208310&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00424.x Discussion:  A fluoroscopically guided block injected into the supraglenoid tubercle may be effective in the management of bicipital tendonitis. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4208310 Sun, 28 Nov 2010 00:00:00 +0100 4208310 http://www.medworm.com/index.php?rid=4208309&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00426.x Conclusion:  In aggregate, these data indicate that IV acetaminophen is an effective analgesic across a variety of surgical procedures. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4208309 Sun, 28 Nov 2010 00:00:00 +0100 4208309 http://www.medworm.com/index.php?rid=4179642&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00423.x Discussion:  There is evidence that intercoccygeal disks can be a source of coccydynia. Immunohistochemistry has shown mechanoreceptors in intercoccygeal disks, and coccygeal discography has been shown to reproduce coccygeal pain. Intercoccygeal disk injection is described as a therapeutic option in the literature. Because various RFA techniques have been successfully used for intervertebral diskogenic pain, the decision was made to attempt RFA at the 1st intercoccygeal disk with resultant significant long‐term improvement. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4179642 Thu, 18 Nov 2010 00:00:00 +0100 4179642 http://www.medworm.com/index.php?rid=4295174&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00435.x AbstractIn the industrialized world, polyneuropathy induced by diabetes mellitus (DM) is one of the most prevalent forms of neuropathy. Diabetic neuropathy can result from a direct toxic effect of glucose on nerve cells. Additionally, the damage of the nerve structures (central and peripheral) is accompanied by a microvascular dysfunction, which damages the vasa nervorum. More than 80% of the patients with DM‐induced polyneuropathy have a distal and symmetric presentation. The initial symptoms are: signs of diminished sensation, burning feet, which may occur particularly during the night and worsen when touched, and tingling sensation in the feet. Attacks of shooting pain may also occur.Proper control of DM is mandatory. Based on the recently published National Institute for Health and C... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4295174 Mon, 01 Nov 2010 00:00:00 +0100 4295174 http://www.medworm.com/index.php?rid=4242265&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00422.x Conclusion:  The findings suggest that, although a small number of the items were identified from the overall scale, they adequately explain two relatively unique factors pertaining to pain management among older adults. This preliminary study suggests that the seven‐item PMQ may be useful in assessing opioid medication misuse in community‐dwelling older adults with chronic pain. Future studies are needed to confirm the reliability, validity, and factor structure of this modified PMQ in the geriatric population. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4242265 Mon, 01 Nov 2010 00:00:00 +0100 4242265 http://www.medworm.com/index.php?rid=4208308&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00428.x The objectives of treating herpes zoster are: (1) acute pain reduction; (2) promotion of recovery of epidermal defects and prevention of secondary infections; and (3) reduction or prevention of post‐herpetic neuralgia.The objective of the treatment of post‐herpetic neuralgia is primarily pain alleviation and improvement of the quality of life.Early treatment of the infection and the pain is believed to reduce the risk for post‐herpetic neuralgia. This persistent pain syndrome is difficult to treat. Antiepileptic drugs and tricyclic antidepressants are the first choice.Interventional treatments, such as epidural injections of corticosteroids and local anesthetic drugs, have an effect on the acute pain but are of limited use in preventing post‐herpetic neuralgia. When conservative tr... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4208308 Mon, 01 Nov 2010 00:00:00 +0100 4208308 http://www.medworm.com/index.php?rid=4179641&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00427.x AbstractNeuropathic pain (NeP) is prevalent in patients with peripheral neuropathy (PN), regardless of etiology. We sought to compare the efficacy of the cannabinoid nabilone as either monotherapy or adjuvant therapy with a first‐line medication for NeP, gabapentin, in a patient population with PN‐NeP. Patients diagnosed with PN‐NeP were permitted to initiate monotherapy (nabilone or gabapentin) or add one of these two medications (adjuvant therapy) to their existing NeP treatment regimen in a non‐randomized open‐label nature. Baseline data collected included a primary outcome (visual analog scores [VAS] of pain) and secondary outcomes (quality of life [EuroQol 5 Domains and Short‐Form 36] assessments and assessments of sleep [Medical Outcomes Sleep Study Scale {MOSSS}], anxiet... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4179641 Mon, 01 Nov 2010 00:00:00 +0100 4179641 http://www.medworm.com/index.php?rid=4155781&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00421.x AbstractDespite increasing numbers of Hispanic patients in the United States, this group continues to face disparities in access and quality of pain treatment. Although previous surveys have examined treatment disparities experienced by minority patients, none have provided a provider‐centric perspective on issues and concerns surrounding pain relief among pain patients of Hispanic/Latino origin. The goal of this study was to assess the relationship between provider characteristics (ie, Spanish fluency, Hispanic caseload size, and experience with Hispanic pain patients) and their perceptions of pain treatment in these patients. One hundred eighty‐seven health professionals completed an online survey. The major findings indicated that: (1) less than 20% of health professionals treating ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=4155781 Mon, 01 Nov 2010 00:00:00 +0100 4155781 http://www.medworm.com/index.php?rid=4144413&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00436.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4144413 Mon, 01 Nov 2010 00:00:00 +0100 4144413 http://www.medworm.com/index.php?rid=4109345&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00425.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=4109345 Fri, 29 Oct 2010 16:22:03 +0100 4109345 http://www.medworm.com/index.php?rid=3984180&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00420.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3984180 Tue, 21 Sep 2010 05:19:40 +0100 3984180 http://www.medworm.com/index.php?rid=3984179&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00417.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3984179 Tue, 21 Sep 2010 05:19:39 +0100 3984179 http://www.medworm.com/index.php?rid=3984178&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00418.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3984178 Tue, 21 Sep 2010 05:19:39 +0100 3984178 http://www.medworm.com/index.php?rid=3939102&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00384.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3939102 Wed, 08 Sep 2010 05:05:51 +0100 3939102 http://www.medworm.com/index.php?rid=3936778&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00404.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3936778 Tue, 07 Sep 2010 05:05:51 +0100 3936778 http://www.medworm.com/index.php?rid=3984177&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00419.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3984177 Tue, 31 Aug 2010 23:00:00 +0100 3984177 http://www.medworm.com/index.php?rid=3939101&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00407.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3939101 Tue, 31 Aug 2010 23:00:00 +0100 3939101 http://www.medworm.com/index.php?rid=3936777&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00408.x Abstract (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3936777 Tue, 31 Aug 2010 23:00:00 +0100 3936777 http://www.medworm.com/index.php?rid=3904403&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00411.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3904403 Fri, 27 Aug 2010 05:07:06 +0100 3904403 http://www.medworm.com/index.php?rid=3904402&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00412.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3904402 Fri, 27 Aug 2010 05:07:05 +0100 3904402 http://www.medworm.com/index.php?rid=3904401&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00413.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3904401 Fri, 27 Aug 2010 05:07:05 +0100 3904401 http://www.medworm.com/index.php?rid=3904400&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00414.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3904400 Fri, 27 Aug 2010 05:07:04 +0100 3904400 http://www.medworm.com/index.php?rid=3904399&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00416.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3904399 Fri, 27 Aug 2010 05:07:04 +0100 3904399 http://www.medworm.com/index.php?rid=3824584&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00406.x This study found a low adherence to national and international guidelines for analgesia in minor procedures: the underuse of neonatal pain scales (33%), sucrose solution administration before heel lance (23.3%), topical anesthetics before venipuncture, or other analgesic techniques. The presence of written pain control guidelines in these regions of Northern Italy increased in recent years (from 25% to 66%). (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3824584 Wed, 04 Aug 2010 23:00:00 +0100 3824584 http://www.medworm.com/index.php?rid=3834276&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00392.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834276 Sat, 31 Jul 2010 23:00:00 +0100 3834276 http://www.medworm.com/index.php?rid=3834275&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00401.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834275 Sat, 31 Jul 2010 23:00:00 +0100 3834275 http://www.medworm.com/index.php?rid=3834274&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00409.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834274 Sat, 31 Jul 2010 23:00:00 +0100 3834274 http://www.medworm.com/index.php?rid=3834273&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00402.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834273 Sat, 31 Jul 2010 23:00:00 +0100 3834273 http://www.medworm.com/index.php?rid=3834272&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00403.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834272 Sat, 31 Jul 2010 23:00:00 +0100 3834272 http://www.medworm.com/index.php?rid=3834271&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00398.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834271 Sat, 31 Jul 2010 23:00:00 +0100 3834271 http://www.medworm.com/index.php?rid=3834270&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00394.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3834270 Sat, 31 Jul 2010 23:00:00 +0100 3834270 http://www.medworm.com/index.php?rid=3799831&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00396.x Conclusion: Acupuncture, when compared with trigger point injection, combined with cyclobenzaprine chlorhydrate and sodium dipyrone provided similar pain relief and improvement in quality of life measures at 4 weeks. ▪ (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3799831 Thu, 29 Jul 2010 23:00:00 +0100 3799831 http://www.medworm.com/index.php?rid=3791697&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00394.x The sacroiliac joint accounts for approximately 16% to 30% of cases of chronic mechanical low back pain. Pain originating in the sacroiliac joint is predominantly perceived in the gluteal region, although pain is often referred into the lower and upper lumbar region, groin, abdomen, and/ or lower limb(s). Because sacroiliac joint pain is difficult to distinguish from other forms of low back pain based on history, different provocative maneuvers have been advocated. Individually, they have weak predictive value, but combined batteries of tests can help ascertain a diagnosis. Radiological imaging is important to exclude "red flags" but contributes little in the diagnosis. Diagnostic blocks are the diagnostic gold standard but must be interpreted with caution, because false-positive as well a... Pain Practice journals http://www.medworm.com/rss/comments.php?id=3791697 Mon, 26 Jul 2010 23:00:00 +0100 3791697 http://www.medworm.com/index.php?rid=3791698&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00393.x Although the existence of a "facet syndrome" had long been questioned, it is now generally accepted as a clinical entity. Depending on the diagnostic criteria, the zygapophysial joints account for between 5% and 15% of cases of chronic, axial low back pain. Most commonly, facetogenic pain is the result of repetitive stress and/or cumulative low-level trauma, leading to inflammation and stretching of the joint capsule. The most frequent complaint is axial low back pain with referred pain perceived in the flank, hip, and thigh. No physical examination findings are pathognomonic for diagnosis. The strongest indicator for lumbar facet pain is pain reduction after anesthetic blocks of the rami mediales (medial branches) of the rami dorsales that innervate the facet joints. Because false-positiv... Pain Practice journals http://www.medworm.com/rss/comments.php?id=3791698 Sun, 25 Jul 2010 23:00:00 +0100 3791698 http://www.medworm.com/index.php?rid=3765099&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00409.x Conclusion: Ozone-PIRFT is more efficacious than ozone alone in reducing pain scores, analgesic consumption, improving functional outcome, and satisfaction of patients with contained lumbar disc herniation. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3765099 Mon, 19 Jul 2010 23:00:00 +0100 3765099 http://www.medworm.com/index.php?rid=3765103&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00398.x Limb amputation is a leading cause of pain and disability. Limb amputation can be associated with a myriad of symptoms, including phantom limb sensation, phantom limb pain, and stump pain. Treatment of phantom limb pain and stump pain, remains difficult, therefore optimal management must include a multidisciplinary approach. This case report describes the use of ultrasound for diagnosis and successful management, of persistent stump-neuroma pain, using pulsed radiofrequency ablation. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3765103 Sun, 18 Jul 2010 23:00:00 +0100 3765103 http://www.medworm.com/index.php?rid=3765102&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00402.x Conclusion: This study demonstrated that IV-ibuprofen is an effective analgesic medication that is safe and well tolerated when administered as an 800 mg dose every 6 hours in patients undergoing total abdominal hysterectomy surgery. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3765102 Sun, 18 Jul 2010 23:00:00 +0100 3765102 http://www.medworm.com/index.php?rid=3765101&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00403.x Milnacipran has been shown to significantly improve the pain, global well-being, and physical function of fibromyalgia (FM), and is approved by the U.S. Food and Drug Administration for the management of this disorder. Post hoc analyses of data from two pivotal trials were conducted to further assess the clinical benefits of milnacipran, to determine the impact of baseline pain severity on treatment outcomes, and to confirm the safety and tolerability of this medication in patients with FM. Patients in these trials were randomized to placebo (n = 624), milnacipran 100 mg/day (n = 623), or milnacipran 200 mg/day (n = 837). Two different composite responder analyses were used to evaluate efficacy: a 2-measure analysis, requiring [ge] 30% improvement from baseline visual analog scale 24-hour ... Pain Practice journals http://www.medworm.com/rss/comments.php?id=3765101 Sun, 18 Jul 2010 23:00:00 +0100 3765101 http://www.medworm.com/index.php?rid=3765100&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00405.x Conclusion: Meningismus from malpositioned catheters is a rare complication that can mimic meningitis but should be considered in the differential for postimplant headaches. Given the increased use of IDDS, it is important to recognize and evaluate postimplant complication and treat it appropriately. We discuss this case report and appropriate work-up and differential diagnosis for meningismus following implant. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3765100 Sun, 18 Jul 2010 23:00:00 +0100 3765100 http://www.medworm.com/index.php?rid=3727520&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00401.x Conclusions: Treatment with duloxetine 60 mg to 120 mg QD was associated with significant pain reduction and improved function in patients with pain due to osteoarthritis of the knee. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3727520 Tue, 06 Jul 2010 23:00:00 +0100 3727520 http://www.medworm.com/index.php?rid=3727525&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00390.x Conclusions: We identified 13 measures of LBP that can be used to evaluate responsiveness to change. Choice of a measure warrants careful evaluation of its construct and responsiveness properties in order to maximize the observed impact on pain and functional improvement in subjects with LBP. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3727525 Sun, 04 Jul 2010 23:00:00 +0100 3727525 http://www.medworm.com/index.php?rid=3727524&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00391.x Conclusion: The disability statuses of the patients with primary LBP in this study were more significantly affected by comorbidities of BMI, depression and smoking than patients with report of LBLP. However, these comorbidities contribute little to the relationship of primary low back related leg pain and Oswestry scores [ge] 40. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3727524 Sun, 04 Jul 2010 23:00:00 +0100 3727524 http://www.medworm.com/index.php?rid=3727523&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00392.x Conclusions: DPNP patients who initiated duloxetine therapy were less likely to have subsequent opioid use and had lower health-care costs than SOC patients. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3727523 Sun, 04 Jul 2010 23:00:00 +0100 3727523 http://www.medworm.com/index.php?rid=3727522&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00399.x This study represents the second validation DN4 in a language different from the original after the Spanish adaptation. These results support the high discriminatory value of the DN4 questionnaire for identification of NP. (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3727522 Sun, 04 Jul 2010 23:00:00 +0100 3727522 http://www.medworm.com/index.php?rid=3727521&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00400.x Ex vivo photographic temperature mapping of bipolar radiofrequency (RF) lesions in animal tissue is performed over a wide range of electrode tip spacings, tip lengths, tip diameters, tip temperatures, and lesion times. In vivo temperature measurements collected during clinical treatment of sacroiliac joint (SIJ) pain corroborate those collected ex vivo. Generation of a "strip lesion" connecting two separated bipolar electrode tips is demonstrated ex vivo for tip spacings as large as 20 mm. A rounded rectangular bipolar lesion with midline dimensions 12 mm × 15 mm × 8 mm (L × W × D) is demonstrated using 10 mm parallel tip spacing, 10 mm tip lengths, 20 gauge cannulae, 90°C tip temperature, and 3-minute lesion time. Lesion length can be increased to 18 mm by using 15 mm tip lengths. Le... Pain Practice journals http://www.medworm.com/rss/comments.php?id=3727521 Sun, 04 Jul 2010 23:00:00 +0100 3727521 http://www.medworm.com/index.php?rid=3904398&cid=s_28808_5_f&fid=28808&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1533-2500.2010.00388.x (Source: Pain Practice) Pain Practice journals http://www.medworm.com/rss/comments.php?id=3904398 Wed, 30 Jun 2010 23:00:00 +0100 3904398