The Clinical journal of pain
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Myofascial trigger points (MTPs) are extremely frequent in the human musculoskeletal system. Despite this, little is known about their etiology. Increased muscular tension in the trigger point area could be a major factor for the development of MTPs. To investigate the impact of muscular tension in the taut band with an MTP and thereby, the spinal excitability of associated segmental neurons, we objectively measured the tissue tension in MTPs before and during the administration of anesthesia using a transducer. ⋯ An increased muscle tension in MTPs, and not a primary local inflammation with enhanced viscoelasticity, was the main result of our investigation. We interpret this increased muscular tension in the taut band with an MTP as increased spinal segmental excitability. In line with this, we assume a predominant, but not unique, impact of increased spinal excitability resulting in an augmented tension of segmental-associated muscle fibers for the etiology of MTP. Consequently, postisometric relaxation might be a promising therapeutic option for MTPs.
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Randomized Controlled Trial
Paraspinal Stimulation Combined With Trigger Point Needling and Needle Rotation for the Treatment of Myofascial Pain: A Randomized Sham-controlled Clinical Trial.
There are different types and parameters of dry needling (DN) that can affect its efficacy in the treatment of pain that have not been assessed properly. ⋯ This study highlighted the greater efficacy of MDIMST over the placebo-sham and LTrP-I and indicated that both active treatments are more effective than placebo-sham for MPS associated with limitations in active and routine activities.
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To describe revisions to the Premature Infant Pain Profile (PIPP) and initial construct validation and feasibility of the Premature Infant Pain Profile-Revised (PIPP-R). ⋯ Initial construct validation and feasibility of the PIPP-R was demonstrated. Further testing with infants of varying gestational ages, diagnoses, and pain conditions is required; as is exploration of PIPP-R in relation to other types of physiological and cognitive responses.
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Randomized Controlled Trial
Thiamine, Cobalamin, Locally Injected Alone or Combination for Herpetic Itching: A Single-Center Randomized Controlled Trial.
The present study was designed to explore the efficacy of locally injected thiamine or cobalamin in relieving itch or pain and improving the daily living activities among patients with herpetic itching. ⋯ Locally injected thiamine had a significant antipruritic effect, cobalamin had an analgesic effect, and their combination had the dual effect with no obvious synergies. This intervention was efficacious, tolerable, and safe for herpetic itching.
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Early tissue injury and recurrent pain in sickle cell disease (SCD) may alter pain and sensory processing. In this study, we evaluate thermal pain and sensory processing for 27 children aged 10.3 to 18.3 years with SCD and 28 African-American control patients. ⋯ Three of ten quantitative sensory tests were found to differ between groups. These results suggest that SCD may influence pain and sensory processing in children, but our interpretation is necessarily cautious. Due to the small differences in measures found between groups, further investigation is required to confirm our findings. If confirmed, the development of population-specific reference standards for quantitative sensory testing may emerge as a useful clinical tool for pain physicians in identifying and quantifying pain and sensory processing in children with SCD.