The Clinical journal of pain
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This study examined the relationship between back pain and gastrointestinal (GI) symptoms in a large scale population study with consideration of possible confounding factors. ⋯ This study has identified a strong association between back pain and GI symptoms in women. Possible factors that may account for this relationship include referred pain through viscerosomatic convergence, altered pain perception, increased spinal loading when straining during defecation, or reduced support of the abdominal contents and spine secondary to changes in function of the abdominal muscles.
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Spinal cord stimulation (SCS) has been used for almost 40 years to treat refractory neuropathic pain after failed back surgery. Fully implantable non-rechargeable pulse generators have a battery life of between 2 and 5 years. A new SCS system with a rechargeable power source may last 10 to 25 years, or longer. The potential economic implications of longer battery life with a new SCS system has yet to be assessed. The study objective is to estimate the average difference in lifetime costs between rechargeable and non-rechargeable pulse generators used in treatment with SCS for failed back surgery syndrome. ⋯ A rechargeable SCS system is projected to save up to $100,000 over a patient's lifetime. Fewer pulse generator replacements will also decrease patient discomfort and morbidity from procedural complications.
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Randomized Controlled Trial Clinical Trial
Acupuncture for treatment of persistent arm pain due to repetitive use: a randomized controlled clinical trial.
To compare true and sham acupuncture in their abilities to relieve arm pain and improve arm function in individuals with arm pain due to repetitive use. ⋯ Sham acupuncture reduced arm pain more than true acupuncture during treatment, but the difference did not persist after 1 month. Mild side effects from true acupuncture may have blunted any positive treatment effects. Overall, this study did not find evidence to support the effectiveness of true acupuncture in treatment of persistent arm pain due to repetitive use.
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The Brief Pain Inventory (BPI) is a highly recommended and frequently used multidimensional pain assessment tool. The BPI includes 2 dimensions: pain intensity and pain's interference with functions. Our aims were to explore how patients respond to pain interference items by comparing responses from patients who had cancer with patients who had noncancer chronic pain (NCCP), and to explore how different levels of health-related quality of life affect upon pain's interference with functions. ⋯ The results indicate that patients are unable to report isolated pain's interference using the BPI. When reporting pain's interference with physical functioning, the level of physical functioning is more important than the level of pain. Patients' diagnoses have to be taken into account when interpreting reported pain's interference with functions.
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There is little agreement about a differential response of men and women to opioid analgesics. Some experimental and clinical studies have shown that women have a better response to opioids, others have found no difference, and still others have found opioids to be more effective analgesics for men than women. ⋯ Men and women presenting to the Emergency Department did not have a differential response to a single weight-based dose of morphine for alleviation of acute pain. Women without baseline nausea had more adverse events than men.