The Clinical journal of pain
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Comparative Study Clinical Trial
Prognosis of multifactorial outcome in lumbar discectomy: a prospective longitudinal study investigating patients with disc prolapse.
Although previous research has shown that certain medical data and psychosocial factors predict postoperative pain, it remains unclear whether they also contribute to a more distinct outcome measure that is based on classification of self-reported outcome criteria. To assess the prognostic power of somatic, psychologic, and social predictors when evident outcome criteria of surgical treatment are investigated, this study used a prospective longitudinal design examining preoperative factors associated with outcome six months after lumbar discectomy. ⋯ Classification of patients regarding their individual outcome profiles showed that patients responded differently to lumbar disc-surgery. High risk factors for poor outcome of surgery are Laseque-sign and depression.
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Review Comparative Study
Is there a relationship between nonorganic physical findings (Waddell signs) and secondary gain/malingering?
This is a structured evidence based review of all available studies addressing the concept of nonorganic findings (Waddell signs) and their potential relationship to secondary gain and malingering. The objective of this review is to determine what evidence, if any, exists for a relationship between Waddell signs and secondary gain and malingering. Waddell signs are a group of 8 physical findings divided into 5 categories, the presence of which has been alleged at times to indicate the presence of secondary gain and malingering. ⋯ Overall, 75% of these reports reported no association between Waddell signs and the 4 possible methods of identifying patients with secondary gain and/or malingering. Based on the above results, it was concluded that there was little evidence for the claims of an association between Waddell signs and secondary gain and malingering. The preponderance of the evidence points to the opposite: no association.
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Comparative Study
Blood supply and oxidative metabolism in muscle biopsies of female cleaners with and without myalgia.
Pathomechanisms of work-related myalgia are poorly understood. Myalgia is thought to be caused by excitation of nociceptors present in the muscular tissue but not in the muscle fiber itself. Muscle contraction in combination with hypoxia is known to excite nociceptors. Morphologic analysis can contribute to the knowledge of the excitation of nociceptors. This study thoroughly examines the morphology of the trapezius muscle's capillary supply and signs of disturbed oxidative metabolism to understand their role in work-related myalgia. ⋯ This work indicates that the capillary supply of trapezius is affected in work-related trapezius myalgia. More studies are needed to understand possible mechanisms that would explain the occurrence of moth-eaten fibers.