The Clinical journal of pain
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Randomized Controlled Trial Comparative Study
Naprapathic manual therapy or evidence-based care for back and neck pain: a randomized, controlled trial.
To compare naprapathic manual therapy with evidence-based care for back or neck pain regarding pain, disability, and perceived recovery. Naprapathy that is common in the Nordic countries and in some states in the United States is characterized by manual manipulations with a focus on soft and connective tissues, aiming to decrease pain and disability in the musculoskeletal system. ⋯ This trial suggests that combined manual therapy, like naprapathy, might be an alternative to consider for back and neck pain patients.
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Psychosocial variables are acknowledged predictors of back disability, but multivariate studies are needed to understand their independent and overlapping effects. The objective of this prospective cohort study was to evaluate independent and shared associations of psychosocial variables on work status after first onset of low back pain (LBP) in working men. ⋯ After first onset of men with subacute LBP, self-reported pain intensity and functional limitation account for most of the variance in work status explained by psychosocial factors; however, the resulting disability can be accompanied by mild to moderate mood symptoms. This suggests that interventions to improve function, if commenced early in the course of subacute pain, might prevent work disability.
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The aim of this prospective investigation was to evaluate child and parental expectancies as a predictor of pain perception in pediatric oncology patients undergoing painful medical procedures. ⋯ It is concluded that parental expectancies are reliable predictors of pediatric procedure-related pain and possible useful targets for psychologic interventions to manage such pain.
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Comparative Study Clinical Trial
Imaging in early posttraumatic complex regional pain syndrome: a comparison of diagnostic methods.
The complex regional pain syndrome type I (CRPS I) still is difficult to diagnose in posttraumatic patients. As CRPS I is a clinical diagnosis the characteristic symptoms have to be differentiated from normal posttraumatic states. Several diagnostic procedures are applied to facilitate an early diagnosis, although their value for diagnosing posttraumatic CRPS I is unclear. ⋯ The poor sensitivity of all tested procedures combined with a reasonable specificity produced a low positive predictive value (17% to 60%) and a moderate negative predictive value (79% to 86%). These results suggest, that those procedures cannot be used as screening tests. Imaging methods are not able to reliably differentiate between normal posttraumatic changes and changes due to CRPS I. Clinical findings remain the gold standard for the diagnosis of CRPS I and the procedures described above may serve as additional tools to establish the diagnosis in doubtful cases.