The Clinical journal of pain
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Randomized Controlled Trial
Local pain and spreading hyperalgesia induced by intramuscular injection of nerve growth factor are not reduced by local anesthesia of the muscle.
Injections with local anesthesia for therapeutic and diagnostic purposes are common clinical practice. This double-blind placebo controlled study explores the rational of local anesthetic blocks for the detection of muscle pain as the primary generator in spreading hyperalgesic conditions. ⋯ Muscle pain and spreading hyperalgesia induced by NGF is maintained despite anesthesia of the primary nociceptive locus. This indicates that intramuscular injection of local anesthetics may not be a valid diagnostic method for primary muscle pain.
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Randomized Controlled Trial
Intermediate and long-term effects of a standardized back school for inpatient orthopedic rehabilitation on illness knowledge and self-management behaviors: a randomized controlled trial.
A back school is a mandatory part of the multimodal rehabilitation program for patients with chronic low back pain in Germany. However, no standardized and evaluated back school program has been available for routine use. In this study, we report the evaluation of a new back school that was developed based on theories of health behavior, treatment evidence, practice guidelines, and quality criteria for patient education. ⋯ The superior effectiveness of the back school based on a biopsychosocial approach was demonstrated with regard to illness knowledge and self-management behaviors up to 1 year. Thus, the program may be recommended for dissemination within medical rehabilitation.
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Although the economic costs of substance misuse have been extensively examined in the published literature, information on the costs of nonmedical use of prescription opioids is much more limited, despite being a significant and rapidly growing problem in the United States. ⋯ The economic cost of nonmedical use of prescription opioids in the United States totals more than $50 billion annually; lost productivity and crime account for the vast majority (94%) of these costs.