The Clinical journal of pain
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Chronic pain in children is associated with significant negative impact on social, emotional, and school functioning. Previous studies on the impact of pain on children's functioning have primarily used mixed samples of pain conditions or single pain conditions (eg, headache and abdominal pain) with relatively small sample sizes. As a result, the similarities and differences in the impact of pain in subgroups of children with chronic pain have not been closely examined. ⋯ Results indicate important differences in subgroups of pediatric pain patients and point to the need for more intensive multidisciplinary intervention for JFM patients.
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Case Reports
Cauda Equina Syndrome After Spinal Epidural Steroid Injection Into an Unrecognized Paraganglioma.
Clinically significant spinal hemorrhage is an extremely rare but potentially devastating complication of spinal epidural steroid injection. We report a rare case of cauda equina syndrome after spinal epidural injection that inadvertently penetrated an unrecognized spinal paraganglioma. ⋯ The presented case indicates the importance of a thorough history, physical examination, and imaging assessment before spinal epidural steroid injection.
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To examine the relationship between individual and work-related psychosocial factors and low back pain (LBP) and associated time off work in an occupational cohort. ⋯ Somatization and low job security were found to be independently associated with occupational LBP, whereas negative beliefs, pain catastrophizing, reduced job satisfaction, and high job support were independently related to time off work. Longitudinal studies are needed to determine whether these individual and work-related psychosocial factors predict, or alternatively, are outcomes of pain and time off work associated with LBP.
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Clinical Trial
A 3-Year, Open-Label, Flexible-Dosing Study of Milnacipran for the Treatment of Fibromyalgia.
To evaluate the effects of long-term milnacipran treatment in fibromyalgia patients. ⋯ No new safety concerns were identified in this long-term study. Sustained symptom improvements were found in fibromyalgia patients who received up to 3.25 years of milnacipran treatment.
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Managing neuropathic pain can be very challenging, with standard medical therapies often providing inadequate relief. It has recently been reported in the literature that statins alleviate neuropathic pain in the rat model. We present a case report in which an above-the-knee amputee achieved relief of his neuropathic stump pain with atorvastatin. ⋯ More studies are needed to characterize the analgesic effects of statins better. In patients who have neuropathic pain refractory to traditional treatment options or, rather, decline traditional treatment options, statin therapy may be helpful.