The Clinical journal of pain
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Coping and beliefs are cornerstones to our understanding of adjustment to chronic pain. This study sought to test the hypothesis that maladaptive pain-related coping and beliefs are more strongly related to measures of patient adjustment than are adaptive coping and beliefs. ⋯ The findings suggest that the relative importance of adaptive versus maladaptive beliefs and coping may differ as a function of the outcome domain in question. The findings support current cognitive-behavioral interventions that focus on reducing the frequency of maladaptive coping responses and beliefs as a way to improve patient functioning.
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Pelvic muscle tenderness occurs often in patients with urologic chronic pelvic pain syndrome; symptoms frequently can be reduced with pelvic myofascial physical therapy. This open-label pilot study evaluated the safety of a personal wand that enables patient's self-treatment of internal myofascial trigger points in the pelvic floor and its effect in reducing pelvic muscle tenderness. ⋯ A multimodal protocol using an internal pelvic therapeutic wand seems to be a safe, viable treatment option in select refractory patients with pelvic pain.
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A mixture of sensory loss and gain is a hallmark of neuropathic pain. But hypesthesia and hyperalgesia also occur with experimentally induced acute pain. Here, we assessed sensory profiles in chronic non-neuropathic pain (osteoarthritis, OA) using the quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain (DFNS). ⋯ These results suggest that chronic non-neuropathic pain may induce slight sensory impairment for large fiber function (bilateral) and small fiber function (ipsilateral). However, all changes are within the normal range, in contrast to patients with neuropathy. Inhibition of central pathways by nociceptive input and altered sensory processing due to disuse of the hand are possible mechanisms. These functional sensory alterations do not interfere with the diagnosis of neuropathy.
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Buerger disease (or thromboangeiitis obliterans) is an inflammatory disease of the medium and small caliber arteries and veins that predominantly affects young males and presents with ischemia in the hands or the feet. It is closely associated with smoking. Critical ischemia of the lower limbs is a threat to the survival of the patient s extremities, and often disables its victims severely. This takes on an even greater significance in younger individuals who are still actively employed, as is the case in patients suffering from Buerger disease. Our aim was to evaluate the efficiency of the spinal cord stimulation as an alternative therapeutic option in acute stages of Buerger disease. ⋯ Spinal cord stimulation is an accepted therapy for the treatment of chronic ischemic pain and ulcer healing and to avoid amputation in patients with severe, nonrevascularisable peripheral occlusive arteriopathy, and specially in the subgroup of patients with Buerger disease. It should not only be considered as a last resort strategy for pain control, but as a valid therapeutic option to improve perfusion of the limbs in the initial stages of the disease, however larger studies still remain necessary.
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To determine the differences in widespread pressure pain and thermal hypersensitivity in women with minimal, moderate, and severe carpal tunnel syndrome (CTS) and healthy controls. ⋯ The similar widespread pressure and thermal hypersensitivity in patients with minimal, moderate, or severe CTS and pain intensity suggests that increased pain sensitivity is not related to electrodiagnostic findings.