The Clinical journal of pain
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Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. ⋯ These results suggest that purchase of analgesics after hysterectomy is related to preoperative factors. Compared with women with high SES, women with low SES had less favorable changes in analgesic purchase after hysterectomy.
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The current medical treatment of neuropathic pain (NP) is inadequate with more than two thirds of patients having no suitable solution for their morbid disease and deteriorating quality of life. Currently, medications for the treatment of NP are mostly systemic (affecting the central nervous system) and are dose limited because of serious and debilitating adverse effects. Scientific evidence suggests that localized cutaneous NP can be treated effectively and safely by topical medications; however, only a few topical medications are indicated for NP. This lack of topica medications stems from the limited resources that have been dedicated to exploring the role of the peripheral nervous system in NP or to the development of peripherally active topical analgesics. ⋯ This article discusses the role of topical medications in treating localized cutaneous NP and the role of the compounding pharmacists in applying this therapeutic approach (eg, the scientific considerations that the pharmacist should take into account).
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Randomized Controlled Trial Multicenter Study
The Reciprocal Effects of Pain Intensity and Activity Limitations: Implications for Outcomes Assessment in Clinical Trials.
To examine the reciprocal effects of pain intensity and limitations in physical functioning over time. ⋯ These analyses showed that a decrease in activity limitations results in a decrease in pain intensity. However, changes in pain intensity had no effect on subsequent activity limitations in the study sample. None of the 3 outcome variables emerged as being more responsive to treatment than the others.
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Clinical Trial
Treatment Expectations Among Adolescents With Chronic Musculoskeletal Pain and Their Parents Before an Initial Pain Clinic Evaluation.
To understand expectations regarding treatment recommendations among treatment-seeking adolescents with chronic musculoskeletal pain and their parents. ⋯ Our results document that adolescents and parents show modest levels of agreement on expectations for treatment at the time of an initial pain clinic evaluation. This may relate to expectations being internal perspectives not clearly expressed within families; thus, the initial treatment consultation may provide an important opportunity to create and align appropriate expectations. Implications of our findings are considered with respect to education, treatment, and future research to understand factors that contribute to treatment adherence and outcomes.
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To understand relationships between pain-related beliefs and readiness to change among treatment-seeking adolescents with chronic musculoskeletal pain and their parents. ⋯ This study documents initial relationships among pain catastrophizing, biopsychosocial perspectives of pain, and readiness to engage in a self-management approach to pain coping for adolescents with chronic pain and their parents. Although agreement exists between dyads regarding catastrophizing and readiness to change, differences were noted in biopsychosocial perspective and dominant readiness to change stage before an initial pain clinic encounter. Findings are considered in terms of future research to advance knowledge regarding the role these factors may play in treatment adherence and outcomes.