The Clinical journal of pain
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Randomized Controlled Trial
High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial.
Transcutaneous electrical nerve stimulation (TENS) is an effective adjunctive therapy for postoperative pain; however, effects of different frequencies of stimulation have not been systematically investigated. Laparoscopic sterilization (LS) causes significant pain in the early postoperative period and requires substantial postoperative medication. Therefore, we studied the effects of TENS on postoperative pain after LS through placement of Yoon fallopian rings in a prospective, randomized, double-blinded, and placebo-controlled study. ⋯ We recommend regular use of multimodal therapy with TENS and analgesic drugs after LS with placement of Yoon rings.
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Review Meta Analysis
Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature.
Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting. ⋯ No study to date has reported the reliability of trigger point diagnosis according to the currently proposed criteria. On the basis of the limited number of studies available, and significant problems with their design, reporting, statistical integrity, and clinical applicability, physical examination cannot currently be recommended as a reliable test for the diagnosis of trigger points. The reliability of trigger point diagnosis needs to be further investigated with studies of high quality that use current diagnostic criteria in clinically relevant patients.
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This study aimed to provide a comprehensive profile of a representative sample of patients with acute low back pain drawn from the primary care setting. A secondary aim was to determine whether patient characteristics are associated with pain intensity or disability at the initial consultation. ⋯ In a representative sample of acute low back pain patients in primary care, we found that the profile included only a small proportion of patients with compensable low back pain. Those without compensation were more likely to remain at work despite low back pain. Psychologic and other patient characteristics were associated with pain intensity and level of disability at the initial consultation.
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The present study sought to develop 1-item and 2-item versions of subscales from the Multidimensional Pain Readiness to Change Questionnaire, Version 2 (MPRCQ2), a measure of readiness to adopt a variety of pain management and coping strategies commonly taught in multidisciplinary treatment programs. ⋯ The findings support the validity of these brief versions of the MPRCQ2 subscales. We would recommend the use of these versions of the MPRCQ2 when a measure of patient readiness to use a range of pain self-management coping strategies is needed (eg, treatment process research, prediction of success in multidisciplinary treatment), but response burden is a significant issue.
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Important scientific principles of pain medicine pharmacology affect urine drug testing (UDT). This paper reviews sources of variability in pharmacokinetics, pharmacodynamics, pharmacogenetics, and issues relating to the collection, handling, and assay of urine and how these factors may affect test interpretation and application. ⋯ UDT, when used with an understanding of the principles of pharmacokinetics, pharmacodynamics, and pharmacogenetics of opioids, can be a useful tool in chronic pain management. Clinicians must keep in mind the limitations, purpose, and value of UDT, and the inability to predict patient compliance with a drug dosage using commercial algorithms.