The Clinical journal of pain
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The objective of the study was to examine patients' experiences of pain in Hospital in the Home (HITH) programs and identify the issues related to providing optimal pain management for acute care patients in the home environment. ⋯ Treatment of pain at home was suboptimal with patients experiencing moderate-to-severe pain and discomfort during the treatment phase of their illness. Lack of appropriate discharge planning strategies meant that patients went home without adequate analgesia and use of nonprescribed pain medication was common. The number of patients transferred home without analgesics indicates a worrying underrecognition of the need for analgesia in this care context and poses a risk to patient safety that is no less significant because patients are at home.
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The mild lumbar decompression procedure is a minimally invasive therapy for the treatment of symptomatic lumbar spinal stenosis (LSS). Mild offers LSS patients an early alternative after failed conservative therapy and before open surgery. This report describes 6-month safety and efficacy of mild patients treated at a single center. ⋯ The safety profile of mild, combined with the significant improvement in quality of life for these patients at 6-months is remarkable. Having failed conservative therapy, the high level of effectiveness of the mild procedure is particularly important in this patient population. In this series, mild has been shown to be a safe, effective, and cost-effective treatment for LSS patients with neurogenic claudication.
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To identify factors that were predictive of improved pain status among older adults with chronic back pain participating in the Adaptive Physical Activity (APA) program and to identify factors that were predictive of adherence to APA. ⋯ Given that adherence to APA is the key predictor of improved back pain, future efforts should focus on strategies to improve adherence. Our data suggest that enhanced training of exercise trainers, development of separate classes for people with different functional levels, and use of psychosocial interventions to reduce health pessimism and depression may be potential targets for improving adherence.
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Whiplash-associated disorders (WAD) have been associated with sensory disturbances such as hypersensitivity or hypoesthesia. Different psychological factors seem to be important for prognosis and symptom presentation in WAD. Multivariate correlations between pain thresholds for pressure (PPT), cold and heat (CPT, HPT), detection thresholds for cold and warmth, pain intensity variables, and psychological aspects in women with chronic WAD (n=28) and in healthy pain-free controls (n=29) were investigated. ⋯ Pain intensity aspects were generally the strongest predictors of PPT in WAD. In contrast, no correlations existed between QST and PPT variables and psychological variables in controls. These results indicate the need to consider that a blend of factors influences the pain thresholds in chronic WAD and emphasize the need for a biopsychosocial model when interpreting QST and PPT variables.
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The aim of this study was to culturally adapt into Spanish and validate the painDETECT questionnaire, a brief self-administered instrument designed to screen the presence of a neuropathic pain component in usual clinical practice. ⋯ The culturally adapted version of the painDETECT presents good psychometric properties and shows to be a valid patient-reported outcome for measuring the presence of a neuropathic component in patients with chronic pain.