Pain
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Clinical Trial Controlled Clinical Trial
Afferent large fiber polyneuropathy predicts the development of postherpetic neuralgia.
Acute zoster infection may be followed by a chronic pain syndrome, i.e., postherpetic neuralgia (PHN). Besides older age, the intensity of pain and neuronal damage within the acutely affected body region are regarded as predictors or risk factors for PHN. As an alternative approach an underlying peripheral polyneuropathy may be considered as potential co-factor. ⋯ Nociceptive C-fiber and parasympathetic fiber function demonstrated no significant differences in both groups. Acute zoster pain was slightly more intense in the PHN group. We concluded that (i) a mild generalized impairment of afferent A beta-fiber function (A beta-polyneuropathy) seems to be an important co-factor in the development of PHN and (ii) impairment of vibration sense, i.e., impairment of afferent A beta-fiber function, may be used as a predictor of PHN.
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This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. ⋯ These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.
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Randomized Controlled Trial Clinical Trial
Lamotrigine (lamictal) in refractory trigeminal neuralgia: results from a double-blind placebo controlled crossover trial.
Lamotrigine is a chemically novel antiepileptic drug which has not been adequately assessed for its antineuralgic properties. It was used in a double-blind placebo controlled crossover trial in 14 patients with refractory trigeminal neuralgia. Patients continued to take a steady dose of carbamazepine or phenytoin throughout the trial over a 31-day period. ⋯ The adverse reactions with both lamotrigine and placebo were predominantly dose-dependent effects on the central nervous system. A 14th patient withdrew from the study due to severe pain during the placebo arm of the trial. It would appear that lamotrigine has antineuralgic properties.
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Randomized Controlled Trial Comparative Study Clinical Trial
The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between 40 degrees C and 67 degrees C treatments.
The efficacy of radiofrequency lesion treatment of the cervical dorsal root ganglion (RF-DRG) in cervicobrachialgia was investigated in 61 patients by a randomized prospective double blinded study. Before lesion treatment the putative pain provoking spinal root was identified by diagnostic blocks with a local anesthetic agent. One group of patients (n = 32, group I) was treated with a radiofrequency lesion of 67 degrees C and in a control group (n = 29, group II) a temperature of 40 degrees C was applied. ⋯ A VAS reduction of 2 or more occurred in group I in 15/31 (47%) and in group II in 15/29 (51%) of patients. This study suggests that treatment with 40 degrees C radiofrequency application of the dorsal root ganglion is equally effective as treatment at 67 degrees C. Further appraisal of this treatment is required.
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Comparative Study Clinical Trial Controlled Clinical Trial
Pain coping strategies that predict patients' and spouses' ratings of patients' self-efficacy.
This study examined the relationship of pain coping strategies to osteoarthritis patients' ratings of self-efficacy and to spouses' ratings of the patients' self-efficacy. Subjects, 130 individuals having osteoarthritis of the knees and persistent knee pain, completed a pain coping strategies measure (the Coping Strategies Questionnaire), a measure of self-efficacy (the Arthritis Self-Efficacy Scale), and a measure of pain (the McGill Pain Questionnaire). Two sets of regression analyses were conducted, one examining the degree to which pain coping strategies predicted patients' self-efficacy ratings, and the other examining the degree to which coping strategies predicted spouses' ratings of the patients' self-efficacy. ⋯ The findings regarding coping strategies were particularly interesting in that they were obtained even after controlling for pain intensity and demographic variables. The pain coping strategies identified are potentially important targets for cognitive-behavioral assessment and treatment efforts. Interventions designed to increase the use of adaptive pain coping strategies and decrease the use of maladaptive pain coping strategies could enhance self-efficacy, reduce pain, and improve the physical and psychological functioning of individuals having osteoarthritis.