The Clinical journal of pain
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Review Meta Analysis
Adverse events attributable to nocebo in randomized controlled drug trials in fibromyalgia syndrome and painful diabetic peripheral neuropathy: systematic review.
The objectives of the study were to determine the impact of nocebo effects on adverse events (AEs) in drug trials in fibromyalgia syndrome (FMS) and painful diabetic peripheral neuropathy (DPN). ⋯ Nocebo effects substantially accounted for AEs in drug trials of FMS and DPN. Standards to assess and report AEs should be defined by regulatory agencies. Strategies to minimize nocebo effects in both clinical trials and clinical practice should be developed.
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Review Meta Analysis
Transcranial direct current stimulation for the reduction of clinical and experimentally induced pain: a systematic review and meta-analysis.
To evaluate the effectiveness of transcranial direct current stimulation on clinical and experimental pain, and to identify the most beneficial stimulation parameters. ⋯ The level of evidence for the efficacy of transcranial direct current stimulation in experimental and chronic pain reduction is low. Evidence from high quality randomized controlled trials is required before this treatment should be recommended.
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Comparative Study
Pain-related insomnia versus primary insomnia: a comparison study of sleep pattern, psychological characteristics, and cognitive-behavioral processes.
Recent applications of cognitive-behavior therapy for primary insomnia in the management of pain-related insomnia are based on the implicit assumption that the 2 types of insomnia share the same presentation and maintaining mechanisms. The objectives of this study were to compare the characteristics of patients who have pain-related insomnia with those reporting primary insomnia and to identify psychological factors that predict pain-related insomnia. ⋯ There are more similarities than differences between the 2 types of insomnia. Besides pain, mood, and presleep, thought processes also seem to have a role in the manifestation of pain-related insomnia. It is suggested that hybrid treatments that seek to simultaneously address factors across these domains may represent more effective treatments than 1-dimensional interventions.
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A prospective follow-up study of patients with anterior cervical discectomy and fusion (ACDF) for single-level cervical disc disease was conducted to determine the extent of impact of pain, sensory function, motor function, and range of motion (ROM) of the neck on patient satisfaction after ACDF. ⋯ Improvement in pain seemed to be most important aspect in ACDF patients regarding the subjective SQ. Therefore, we strongly recommend focusing on pain-reducing therapies when choosing treatment for these patients during the postoperative period.
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Isolated proximal-without-distal (buttock but not calf) exercise-related lower-limb ischemia (IPI) might develop in the presence of arterial lesions impairing the blood flow supply toward the hypogastric vascular bed. In IPI, lower-limb sensory nerve dysfunction might occur from the sacral nerve plexus becoming ischemic during exercise. The purpose of this study was to compare patients with IPI with healthy controls for the presence of sensory nerve dysfunction, as assessed using somatosensory testing (SST). ⋯ The SST data suggest that patients with IPI have abnormal functioning of Aβ-fiber and C-fiber inputs in their affected limb(s). These sensory abnormalities might contribute to the exercise-induced ischemic symptoms experienced by these patients.