PM & R : the journal of injury, function, and rehabilitation
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To evaluate patient expectations, concerns, and satisfaction during physical medicine and rehabilitation (PM&R) inpatient hospitalization. Patients were also asked to comment on what resources might benefit them during their stay. ⋯ Results support the idea that the multidisciplinary approach inherent in PM&R positively alters many patient expectations related to outcomes. This has direct relevance to patient satisfaction and outcomes and warrants further investigation. The authors offer some potential interventions for future improvement in this area.
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To compare anxiety levels, fear-avoidance beliefs, and disability levels over 1 year for patients with acute (< or =3 months) and chronic (>3 months) low back pain (LBP). ⋯ The group with chronic LBP exhibited a higher level of trait anxiety at baseline than those with acute LBP and, unlike the acute LBP group, did not have improved fear-avoidance beliefs over 1 year. The relationship between anxiety and chronic LBP is novel. Because anxiety is potentially modifiable, future studies that evaluate the relationship between LBP and anxiety are warranted.
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More than 75 million Americans have chronic or recurring pain [1]. Such pain negatively impacts emotional and mental health, quality of life, and productivity and increases the use of health care resources [1-5]. Prescription opioids are widely used and may be effective analgesics for chronic, moderate-to-severe pain in appropriately selected patients, particularly when used as part of comprehensive pain management plans [4,6]. ⋯ The US Food and Drug Administration recently initiated hearings to examine a potential change in the government's risk management plan, Risk Evaluation and Mitigation Strategies [9], which could dramatically change the development, release, marketing, and prescription of extended-release opioids. Pharmaceutical companies have remained active in developing products that are potentially less attractive for abuse. The challenge of balancing the availability of prescription opioids to treat patients who have pain while discouraging illicit use is complex, requiring effective efforts on many levels.
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Biological and psychological bases for the covariation of pain and fatigue in fibromyalgia (FM) are reviewed. FM is characterized as a disorder of central sensitization, with pain and fatigue as the most prominent symptoms. ⋯ It is argued that a positive affective disturbance may uniquely characterize pain and fatigue symptoms in FM. Finally, pharmacological and nonpharmacological treatments for FM are highlighted, with an emphasis on the efficacy of these treatments in alleviating pain and fatigue symptoms.
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Randomized Controlled Trial
Efficacy of intra-articular botulinum toxin type A in painful knee osteoarthritis: a pilot study.
To evaluate the efficacy and safety of botulinum toxin type A (BoNT-A) injected intra-articularly in 60 subjects with moderate pain and functional impairment secondary to knee osteoarthritis. The study investigators hypothesized that intra-articular BoNT-A would result in statistically significant improvements in pain and function at 8 weeks. ⋯ This pilot study supports a possible role for BoNT-A as a treatment option for symptomatic knee osteoarthritis; however, larger double-blind randomized studies are needed to determine whether BoNT-A is more effective than placebo in this patient population.