The Clinical journal of pain
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Comparative Study Clinical Trial
Contribution of individual spa therapies in the treatment of chronic pain.
The aim of the present study was to evaluate the contribution of individual spa therapies administered during a period of 3 weeks on measures of well being and pain in a sample of patients with chronic back pain. ⋯ The results indicate that, in addition to the individual therapies, other factors relating to spa therapy as a whole must contribute to overall treatment outcome. In addition, the results support the efficacy of exercise therapy for chronic back pain.
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Clinical Trial
Dextromethorphan for phantom pain attenuation in cancer amputees: a double-blind crossover trial involving three patients.
Phantom limb pain is an intriguing pain syndrome that may result from damage to peripheral nerve tissue but could also involve central amplifying congeners. N-methyl-D-aspartate (NMDA)-receptor antagonists were recently shown to alleviate neuropathic pain in both animal and human models. Dextromethorphan is a noncompetitive NMDA-receptor antagonist. ⋯ Further clinical trials are warranted to determine the optimal dosage and identify which patients with phantom pain would benefit the most from this therapeutic approach.
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Review Meta Analysis Comparative Study
Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia.
Little is known of the effectiveness of nonpharmacological interventions for fibromyalgia syndrome (FMS). The authors therefore carried out a systematic review from 1980 to May 2000 of randomized controlled trials (RCTs) of nonpharmacological interventions for FMS. ⋯ The varying combinations of interventions studied in the RCTs and the wide range of outcome measures used make it hard to form conclusions across studies. Strong evidence did not emerge in respect to any single intervention, though preliminary support of moderate strength existed for aerobic exercise. There is a need for larger, more methodologically rigorous RCTs in this area.
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Randomized Controlled Trial Comparative Study Clinical Trial
The lidocaine patch 5% effectively treats all neuropathic pain qualities: results of a randomized, double-blind, vehicle-controlled, 3-week efficacy study with use of the neuropathic pain scale.
Several controlled clinical trials have demonstrated the efficacy and safety of the lidocaine patch 5% (LP) for the treatment of postherpetic neuralgia (PHN). ⋯ This study demonstrates that LP reduces the intensity of all common neuropathic pain qualities and thus may be of potential benefit for nonallodynic neuropathic pain states. Furthermore, these findings suggest that peripheral mechanisms may play a role in the pathophysiological development of pain qualities that heretofore have been assumed not to involve peripheral mechanisms, such as "dull," "deep," "sharp," and "burning" pains.
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The authors reviewed the available pediatric pain literature and selected those studies that reported quantitative information on the reliability and validity of, and the optimal cutoff points for, the visual analog scale (VAS) when used as an observational pediatric pain tool. ⋯ Further psychometric testing needs to be conducted on intraobserver reliability, responsiveness, and optimal cutoff points. Future research may guide the choice between VAS (obs) and the numerous behavioral pain instruments.