The Clinical journal of pain
-
The objective of the study was to report the evidence for effectiveness of different self-management course characteristics and components for chronic musculoskeletal pain. ⋯ Serious consideration should be given to the development of short (<8 weeks) group and healthcare professional-delivered interventions but more research is required to establish the most effective and cost-effective course components.
-
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is a rare type of trigeminal autonomic cephalalgia. SUNCT syndrome is typically idiopathic, and secondary SUNCT syndrome after indirect injury is very rare. We report a case of SUNCT syndrome manifested dramatically after a whiplash injury and treated by greater occipital nerve (GON) block. ⋯ Secondary SUNCT syndrome induced by whiplash injury is rare. Our case showed good outcome of SUNCT syndrome treated by GON.
-
Randomized Controlled Trial
The effects of music intervention in the management of chronic pain: a single-blind, randomized, controlled trial.
A music intervention method in the management of pain was recently developed while taking account of recommendations in the scientific literature. The objective of this study was to assess the usefulness of this music intervention to the management of patients with chronic pain. ⋯ These results confirm the value of music intervention to the management of chronic pain and anxiety/depression. This music intervention method appears to be useful in managing chronic pain as it enables a significant reduction in the consumption of medication.
-
Patients with medication overuse headache (MOH) experience decreased quality of life (QoL) and increased psychiatric comorbidity. We performed an observational study in patients with MOH to assess whether QoL (primary outcome parameter), depression, and anxiety (secondary outcome parameters) improve after inpatient withdrawal therapy. ⋯ QoL is impaired in patients with MOH, and many patients are depressed and anxious. Inpatient withdrawal therapy lead to a statistically significant improvement of QoL, depression, and anxiety. Poor baseline mental QoL as well as depression and anxiety are associated with poor outcome in terms of headache frequency.
-
Opioid-induced constipation persists as a challenge in the management of chronic pain treated with opioid therapy. Multiple opioid antagonists have been applied in attempt to combat the gastrointestinal side effects of opioid analgesia, however their lipid-soluble nature allows passage into the central nervous system and consequent antagonism of centrally mediated analgesia. In contrast, methylnaltrexone offers the advantage of peripheral receptor-specific opioid antagonism due to chemical alterations conferring greater polarity and less lipid solubility. We present use of enteral methylnatrexone to treat severe opioid-induced constipation in a young boy who had failed treatment with the non-specific opioid antagonist, naloxone. This case reports describes the safe transition from enteral naloxone to enteral methylnaltrexone and discusses the potential risk of relative opioid toxicity during the transition. ⋯ Our case report demonstrates safe transition from enteral naloxone to enteral methylnaltrexone in a pediatric patient, avoiding the serious consequences of relative opioid toxicity. This patient experienced significant improvement of opioid-induced constipation and reduction in opioid requirements and it is possible that other patients would benefit as well. The role of enteral methylnaltrexone deserves further investigation.