The Clinical journal of pain
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To investigate the relation between localized pressure pain sensitivity and the amplitude and specificity of semispinalis cervicis muscle activity in patients with chronic neck pain. ⋯ In contrast to asymptomatic individuals, the semispinalis cervicis muscle displays reduced and less-defined EMG activity during a multidirectional isometric contraction in patients with chronic neck pain. The altered behavior of the semispinalis cervicis is weakly associated to pressure pain sensitivity.
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Multicenter Study
Construct and Predictive Validity of the Chronic Pain Grade in Workers With Chronic Work-related Upper-extremity Disorders.
To evaluate the ability of Chronic Pain Grade (CPG) questionnaire to predict upper-extremity physical disability, at-work disability, and work status in workers with chronic work-related upper-limb injuries. ⋯ CPG has low to moderate ability to predict 6-month work status in patients with chronic upper-extremity disorders. Both a lack of CPG and work transition variability may have contributed to this finding. Extension of the upper end of CPG range might be investigated as a means to increase discrimination at the upper end spectrum of chronic pain, which predominate the population of patients with chronic musculoskeletal disorders.
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Slipping rib syndrome (SRS) is a musculoskeletal cause of severe and recurrent thoracic or abdominal pain. The etiology of SRS is unknown, it seems to arise from costal hypermobility with a tendency of one of the ribs (usually from 8th to 10th but also 11th and 12th have been described) to slip under the superior adjacent rib. Its prevalence is underestimated because SRS is mainly a clinical diagnosis, frequently missed. The critical aspect of the diagnosis is knowledge of the condition itself, which, when lacking, often results in the patient being referred to many different specialists and exposed to unnecessary and costly investigations. The management of the condition includes conservative techniques such as manipulation, localized anesthetic, and steroid or anesthetic nerve block. However, where conservative therapy fails, surgical treatment, with excision of the rib, may be performed. ⋯ To our knowledge botulinum toxin has never been proposed before for the treatment of SRS. We believe that it should be considered as a therapeutic option, especially where other medical treatments have failed or as an intermediate step before surgical intervention.
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Randomized Controlled Trial
Pain Physiology Education Improves Health Status and Endogenous Pain Inhibition in Fibromyalgia: A Double-Blind Randomized Controlled Trial.
There is evidence that education on pain physiology can have positive effects on pain, disability, and catastrophization in patients with chronic musculoskeletal pain disorders. A double-blind randomized controlled trial (RCT) was performed to examine whether intensive pain physiology education is also effective in fibromyalgia (FM) patients, and whether it is able to influence the impaired endogenous pain inhibition of these patients. ⋯ These results suggest that FM patients are able to understand and remember the complex material about pain physiology. Pain physiology education seems to be a useful component in the treatment of FM patients as it improves health status and endogenous pain inhibition in the long term.