The Clinical journal of pain
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Randomized Controlled Trial Comparative Study Clinical Trial
Sensitivity of pain rating scales in an endoscopy trial.
The purpose of this study was to compare the sensitivity of two commonly used pain-rating scales, the Visual Analog Scale and the 4-point verbal rating scale. Both are considered reliable and valid, but previous studies regarding sensitivity of rating scales have lead to different conclusions, and there is no firm agreement as to the best scale to choose. ⋯ Because each individual provided one Visual Analog Scale and one 4-point verbal rating scale rating for the same pain experience, the ability of the two scales to detect differences between groups of pain ratings could be compared. The use of a simulation model enabled estimation of a power function and reduced the probability of basing the conclusion on a chance finding.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tiagabine and gabapentin for the management of chronic pain.
Agents that modulate gamma-aminobutyric acid transmission, such as gabapentin, are widely used for the management of chronic pain disorders/syndromes; however, the usefulness of the selective gamma-aminobutyric acid reuptake inhibitor tiagabine in this therapeutic area has yet to be investigated. This study evaluated the effectiveness and safety of tiagabine and gabapentin for the treatment of chronic pain. ⋯ These results suggest that tiagabine and gabapentin are effective in the management of chronic pain, with tiagabine having a greater beneficial effect on sleep quality.
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The synthetic opioid methadone has generated much interest in recent years among clinicians involved in the management of intractable chronic cancer pain. Its use as an analgesic is starting to extend to the treatment of noncancer pain, particularly neuropathic pain. Unfortunately, the evidence for its use in the management of neuropathic pain is limited to a few case studies. ⋯ Methadone was effective at relieving pain and ameliorating quality of life and sleep in 62% of patients. These findings suggest that methadone can offer an acceptable success rate for the treatment of neuropathic pain. Prospective randomized, placebo-controlled studies are now needed to examine more rigorously the benefits of methadone for this type of pain.
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Comparative Study
Are the changes in postural control associated with low back pain caused by pain interference?
Voluntary limb movements are associated with involuntary and automatic postural adjustments of the trunk muscles. These postural adjustments occur prior to movement and prevent unwanted perturbation of the trunk. In low back pain, postural adjustments of the trunk muscles are altered such that the deep trunk muscles are consistently delayed and the superficial trunk muscles are sometimes augmented. This alteration of postural adjustments may reflect disruption of normal postural control imparted by reduced central nervous system resources available during pain, so-called "pain interference," or reflect adoption of an alternate postural adjustment strategy. ⋯ The results suggest that altered postural adjustments of the trunk muscles during pain are not caused by pain interference but are likely to reflect development and adoption of an alternate postural adjustment strategy, which may serve to limit the amplitude and velocity of trunk excursion caused by arm movement.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Local steroid injections for tennis elbow: does the pain get worse before it gets better?: Results from a randomized controlled trial.
To compare the early effects of local corticosteroid injection, naproxen, and placebo as treatments for tennis elbow in primary care. Specifically, to find out whether the extra pain reduction experienced by patients who are given the steroid injection in the short-term would be realized within the first 5 days of treatment and to attempt to assess how much extra pain may be associated with the injection initially. ⋯ Steroid injection was associated with an increase in reported pain for the first 24 hours of treatment, but the therapeutic benefits compared with naproxen and placebo were evident 3 to 4 days after the start of treatment.