The Clinical journal of pain
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Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed non-specific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. ⋯ The RTF believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect that the RTF recommendations will become a dynamic document and undergo continual improvement.
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Cognitive and emotional factors are known to influence peoples' pain experiences in many conditions, including low back pain. However, in complex regional pain syndrome (CRPS), their role is unclear. This study aimed to assess the relationships between psychological factors, pain, and disability in CRPS, compared with low back pain. This could help to identify target variables for psychological treatment. ⋯ In CRPS, disability and pain severity were more strongly associated with psychological factors than they were in low back pain. Cause and effect relationships could not be established by this cross-sectional study.
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The volume of opioid medications being prescribed in the United States is increasing rapidly. Problems associated with the misuse of opioid medications are also increasing, in part because of medication diversion from legitimate prescriptions. However, little is known about what patients do with any unused opioid medications. This paper uses a qualitative analysis of patients' self-report of medication storage and retention habits to begin to address this gap. ⋯ A majority of patients retain unused opioids, and medication sharing is common. Interventions to improve monitoring of patient experience with opioid medication, educate patients about the dangers of opioid use by nonprescribed others, and increase information about medication disposal options could decrease the supply of opioid medications available for misuse.
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Prescription opioid analgesics play an important role in managing moderate to severe pain. An unintended consequence of the availability of these drugs is nonmedical use. We report rates and methods of nonmedical use of the analgesic tapentadol immediate release (IR) and other commonly prescribed opioid analgesics among US college students following the launch of tapentadol IR in June 2009. ⋯ Since its launch, rates of nonmedical tapentadol IR use by college students have been low and have decreased over time. The initial levels of reported nonmedical use may represent a brief period of experimentation after introduction.
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Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied on English-speaking individuals with chronic pain. It is possible that the associations between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjust to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies on English-speaking individuals. ⋯ The findings provide support for the importance of the psychosocial factors studied in terms of adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.