The Clinical journal of pain
-
To determine perception and pain thresholds in patients with fibromyalgia syndrome and in healthy controls, and to investigate whether patients with fibromyalgia syndrome can be grouped with respect to thermal hyperalgesia and whether these subgroups differ from healthy controls and in clinical appearance. ⋯ Patients with fibromyalgia syndrome were subgrouped by quantitative sensory testing (i.e., thermal pain thresholds). Subgroups show clinical differences in pain intensities, number of tender points, and sleep quality. Cold pain threshold was especially linked to these clinical aspects.
-
Review Case Reports
Chemical sympathectomy for neuropathic pain: does it work? Case report and systematic literature review.
To determine if chemical sympathectomy successfully reduces limb neuropathic pain. ⋯ Based on the case reported and systematic literature review, chemical sympathectomy seems to have at best a temporary effect, limited to cutaneous allodynia. Despite the popularity of chemical sympatholysis, only few patients and poorly defined outcomes are reported in the literature, substantiating the need for well-designed studies on the effectiveness of the procedure.
-
The literature contains many different viewpoints on the impact of compensation on recovery from chronic pain. ⋯ Filing a compensation claim for costs, retaining a lawyer, or higher pain intensities were limited predictors of longer claims (level 3). As the ratio of compensation to preinjury wage increases, there is moderate evidence (level 2) that the duration of the claim increases and that disability is more likely. Compensation status, particularly combined with higher pain intensities, is associated with poorer prognosis after rehabilitation treatment programs (level 3).
-
Biopsychosocial treatments address the range of physical, psychological, and social components of chronic pain. ⋯ Multimodal biopsychosocial treatments that include cognitive-behavioral and/or behavioral components are effective for chronic low back pain and other musculoskeletal pain for up to 12 months (level 2). There is limited evidence (level 3) that electromyogram feedback is effective for chronic low back pain for up to 3 months. The remaining evidence of longer-term effectiveness and of effectiveness of other interventions was inadequate (level 4a) or contradictory (level 4b). Future studies of cognitive-behavioral treatments should be condition specific, rather than include patients with different pain conditions.