Pain
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The Italian version of the McGill Pain Questionnaire (MPQ) is presented. Unlike Melzack's version, it was developed by employing 3 groups of normal subjects, excluding physicians or patients suffering from chronic pain. ⋯ Procedure was also basically the same. The Italian version of the MPQ joins the English, French and Finnish ones and might provide the basis for future cross-cultural studies.
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Comparative Study Clinical Trial Controlled Clinical Trial
Efficacy and quality of ibuprofen and acetaminophen plus codeine analgesia.
Ibuprofen, 400 mg, was compared with 300 mg acetaminophen plus 30 mg of codeine and placebo in 120 post-orthopedic surgery patients with moderate to severe pain. The study was designed as a double-blind, single-dose, parallel-group analgesic efficacy assay. Estimates of analgesia were obtained up to 6 h using categorical and visual analog measures of pain intensity and pain relief. ⋯ Ibuprofen provided greater improvement in selected elements of mood than acetaminophen plus codeine at comparable levels of pain relief. While decreases in the sensory component of pain were most highly associated with pain relief provided by ibuprofen, decreases in the affective component were most highly associated with pain relief following acetaminophen plus codeine. These latter results indicate that mood assessment and the discrimination between sensory and affective components of pain could be particularly useful within analgesic drug assays, especially when comparing analgesics of differing pharmacologic class and when comparing the results of such assays in pain syndromes characterized by differing pain quality.
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The relationship between anxiety and chronic pain has been poorly studied. The authors studied the occurrence of symptoms of anxiety in chronic low back pain patients. ⋯ Anxious mood, tension and general somatic symptoms of the sensory type were more common than any other type of anxiety symptoms. The authors discuss the potential role of anxiety in chronic pain patients.
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A novel form of subcutaneous nerve stimulation (SCNS) was recently introduced for the relief of chronic pain. We present a study using this form of SCNS applied over the radial, median and saphenous nerves in patients with clinically diagnosed osteoarthritis of the hip. ⋯ We suggest that these results may be explained by the ability of SCNS to evoke a placebo response. The efficacy of the placebo effect and the ethical implications of its use in clinical practice are discussed.
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The current study investigated the utility of the Back Pain Classification Scale with chronic, intractable low back pain and headache patients. Subjects consisted of 50 chronic low back pain and 50 chronic headache patients referred to a university based Pain Center for evaluation. Data indicated that subjects were a representative sample of severely intractable chronic pain patients typically referred for Pain Center evaluation and treatment. ⋯ It was concluded that the Back Pain Classification Scale was an empirically valid instrument to use with chronic low back pain patients, but not with chronic headache patients. This lack of utility with chronic headache patients was also viewed as support for the construct validity of the scale. Wider use of the scale with chronic low back pain patients was suggested.