The Clinical journal of pain
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This study investigated the psychometric properties of eight pain intensity measures used with chronic low back pain patients. All measures were similar in terms of scale distribution and rates of incorrect responses, with all scales apart from the Pain Rating Index significantly correlated. ⋯ The 101-point Numeric Rating Scale and the Box Scale had the strongest relationship, with loadings of 0.90. The Numeric Rating Scale and the Box Scale appear to be the scales of choice for the measurement of pain intensity in the low back pain patient.
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A 74-year-old woman with peripheral vascular disease suffered from rest pain in the right big toe and intermittent claudication. Because of concomitant venous congestion, a chemical lumbar sympathectomy was considered to carry an increased risk of leg edema. A continuous lumbar sympathetic block with local anesthetic abolished the pain in the toe without side effects. After this reversible block, a chemical lumbar sympathectomy was performed producing pain relief for 4 weeks when the patient was last seen.
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There is a lack of information about the precise strength of the relationship between chronic pain and depression. In a prior study, women with temporomandibular pain and dysfunction syndrome (TMPDS) had much higher scores than did controls on a measure of nonspecific psychological distress. The question arose as to whether rates of clinical depression are also unusually high in TMPDS patients. ⋯ A subset of those rated as likely depressed then had their diagnoses verified independently through a structured clinical interview by a psychiatrist and clinical psychologist. Results revealed a minimum lifetime prevalence rate for major depression of 41%. A rate of this magnitude in TMPDS cases is clearly much higher than would be found for women of similar background in the general population.
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Munchausen's syndrome is a popular name for a factitious disorder with physical symptoms. We have identified four Munchausen patients within a sample of 2,860 chronic pain patients for a frequency of 0.14%. These patients are described and an attempt is made to develop a profile of the Munchausen patient presenting with chronic pain.