The Clinical journal of pain
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Multicenter Study Meta Analysis
Treatment of chronic, intractable pain with a conventional implantable pulse generator: a meta-analysis of 4 clinical studies.
To provide further short-term (6 mo) and long-term (1 y) evidence for the use of spinal cord stimulation (SCS) with a conventional implantable pulse generator in the management of chronic, intractable pain. ⋯ This analysis provides further evidence of the safety and effectiveness of SCS in treating chronic intractable pain of the trunk and/or limbs. Specifically, it underscores a high level of effectiveness and acceptable safety concerns in the use of nonrechargeable SCS devices.
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Randomized Controlled Trial
Combination of pregabalin and dexamethasone for postoperative pain and functional outcome in patients undergoing lumbar spinal surgery: a randomized placebo-controlled trial.
In this randomized-controlled study, we investigated the effects of combined administration of pregabalin and dexamethasone on postoperative pain and analgesic requirements, and functional outcome in patients who underwent lumbar spinal surgery. ⋯ Combined administration of pregabalin and dexamethasone conferred analgesic benefits superior to those of pregabalin alone. This regimen also helped facilitate return to normal daily activity after surgery.
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Many studies have reported putative factors for the development of chronic pain after surgery. However, advances in knowledge about the etiology and prognosis of chronic postsurgical pain (CPSP) could be gained by improving methodology within studies of surgical pain. The purpose of this study was to review predictive factors and to propose core risk factor and outcome domains for inclusion in future epidemiological studies investigating CPSP. ⋯ There is potential to advance the field of CPSP research by striving for consensus among pain experts; this would advance current evidence by improving our ability to compare findings from different studies and would facilitate the aggregation of surgical cohort datasets to allow international comparisons. We propose these findings as a starting point to build a comprehensive framework for epidemiological studies investigating chronic pain after surgery.
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Randomized Controlled Trial
A randomized-controlled trial of using a book of metaphors to reconceptualize pain and decrease catastrophizing in people with chronic pain.
Reconceptualization of pain and reduction of pain-related catastrophizing are primary objectives in chronic pain rehabilitation. Teaching people about the underlying biology of pain has been shown to facilitate these objectives. The objective of this study was to investigate whether written metaphor and story can be used to increase knowledge of the biology of pain and reduce pain-related catastrophizing. ⋯ We conclude that providing educational material through metaphor and story can assist patients to reconceptualize pain and reduce catastrophizing. Metaphor and story could be used as a precurser to other interventions that target functional capacity.
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Randomized Controlled Trial
Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study.
To test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic nonspecific low back pain. ⋯ These results do not provide evidence that tDCS is effective in the treatment of chronic back pain. The use of a small convenience sample limits the generalizability of these findings and precludes definitive conclusions on the efficacy of tDCS in chronic nonspecific low back pain.