The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study Comparative Study
Effectiveness and Safety of Transdermal Buprenorphine Versus Sustained-Release Tramadol in Patients with Moderate to Severe Musculoskeletal Pain: An 8-Week, Randomized, Double Blind, Double Dummy, Multi-Center, Active-controlled, Non-inferiority Study.
The aim of this noninferiority study was to investigate clinical effectiveness and safety of buprenorphine transdermal system (BTDS) in patients with moderate to severe musculoskeletal pain inadequately controlled with nonsteroidal anti-inflammatory drugs, compared with sustained-release tramadol tablets. ⋯ Our results suggest that BTDS is a good therapeutic option for patients experiencing chronic musculoskeletal pain of moderate to severe intensity that is insufficiently controlled by nonsteroidal anti-inflammatory drugs.
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To examine the relative validity of 2 conceptual models-Specific, General-by which therapeutic mechanisms in cognitive-behavioral therapy (CBT) for chronic pain achieve favorable outcomes. ⋯ Change with CBT may occur both by theory-specified mechanisms and general mechanisms. However, the results provide the most support for a General Mechanism model in which changes on coping skills have spreading effects on the use of other coping skills. Significant relationships between some skill changes and indexes of patient-therapist working alliance and outcome expectations suggest that nonspecific factors also play a role in treatment-related changes in the use of pain coping strategies.
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The active straight leg raise (ASLR) test is widely used clinically to assess severity of lumbopelvic pain due to decreased stability of the sacroiliac joint (SIJ). This study aimed to bypass the influence of decreased SIJ stability on the ASLR test by investigating the effect of experimental pelvic pain and hyperalgesia on the outcome of the ASLR test. ⋯ These data demonstrate that pain and hyperalgesia in conditions unaffected by biomechanical SIJ impairments change the outcome of the ASLR test toward what is seen in clinical lumbopelvic pain. This may implicate pain-related changes in motor control strategies potentially relevant for the transition from acute into chronic pain.
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The Tampa Scale of Kinesiophobia (TSK) has been used to identify people with back pain who have high levels of "fear of movement" to direct them into fear reduction interventions. However, there is considerable debate as to what construct(s) the scale measures. Somatic Focus and Activity Avoidance subscales identified in factor analytic studies remain poorly defined. Using a mixed methods design, this study sought to understand the beliefs that underlie high scores on the TSK to better understand what construct(s) it measures. ⋯ The TSK may be better described as a measure of the "beliefs that painful activity will result in damage and/or increased suffering and/or functional loss."