The Clinical journal of pain
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To determine patterns of use, socioeconomic factors, and the impact on total health expenses associated with triptan therapy among patients with migraines. ⋯ The study suggested that socioeconomic factors were associated with triptan use in migraineurs. Higher total and migraine-related health expenses were observed in triptan users.
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Multicenter Study
Patients With Neck Pain are Less Likely to Improve if They Experience Poor Sleep Quality: A Prospective Study in Routine Practice.
To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at 3 months. ⋯ NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.
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Multicenter Study
Predictive Factors Associated with Success and Failure for Calmare (Scrambler) Therapy: A Multi-Center Analysis.
Calmare (Scrambler) therapy is a novel therapeutic modality that purports to provide pain relief by "scrambling" afferent pain signals and replacing them with "non-pain" information through conventional lines of neural transmission. The goal of this study is to identify which factors are associated with treatment outcome for Calmare therapy. ⋯ A neuropathic or mixed neuropathic-nociceptive pain condition was associated with a positive treatment outcome. Investigators should consider these findings when developing selection criteria in clinical trials designed to determine the efficacy of Calmare therapy.
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It has been suggested that tooth clenching may be associated with local metabolic changes, and is a risk factor for myofascial temporomandibular disorders (M-TMD). This study investigated the effects of experimental tooth clenching on the levels of 5-HT, glutamate, pyruvate, and lactate, as well as on blood flow and pain intensity, in the masseter muscles of M-TMD patients. ⋯ This experimental tooth clenching model increased jaw muscle pain levels in M-TMD patients and evoked low levels of jaw muscle pain in controls. M-TMD patients had significantly higher levels of 5-HT than controls and significantly lower blood flow. These 2 factors may facilitate the release of other algesic substances that may cause pain.
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Self-report is often represented as "the gold standard" in assessment of pain intensity in children. We evaluate arguments for and against this claim and consider its implications for pain management. ⋯ We conclude that self-report, when available, can be considered a primary source of evidence about pain intensity. However, it cannot be treated as an unquestioned gold standard. Instead, hierarchical or bundled approaches should be used, taking into account self-report as well as the many individual and contextual factors that influence pain including clinical history, patient preferences, and response to previous treatments. Alternate models are presented to guide further practice and research.