The Clinical journal of pain
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Observational Study
Muscle Pain Induces a Shift of the Spatial Distribution of Upper Trapezius Muscle Activity During a Repetitive Task: A Mechanism for Perpetuation of Pain With Repetitive Activity?
An association exists between repetitive movements and the development or perpetuation of neck-shoulder muscle pain. The mechanisms underlying this association remain unclear. This observational study investigated the effect of upper trapezius muscle pain on the distribution of upper trapezius activity during repetitive lifting. It was hypothesized that nociception would change the distribution of activity resulting in activation of muscle regions which would not normally be active during the task. ⋯ Novel mapping of the spatial distribution of upper trapezius muscle activity showed that nociception induced a redistribution of activity during repetitive lifting. This knowledge provides new insights into the mechanisms underlying the perpetuation of pain with repetitive activity.
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Assess patient-physician agreement on management goals for chronic musculoskeletal pain and its associations with patient and physician visit experiences. ⋯ Patients and physicians prioritize substantially different goals for chronic pain management, but there is no evidence that agreement predicts patient experience or physician-reported visit difficulty. Primary care physicians may have adapted to new recommendations that emphasize functional goals and avoidance of long-term opioid therapy, whereas patients continue to focus on reducing pain intensity.
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Review
Review of the Evidence on the Efficacy of Dexamethasone on Postoperative Analgesic Consumption.
The effect of dexamethasone on analgesic consumption has not been adequately studied. The aim of this review was to investigate recent literature regarding the possible effect of dexamethasone on postoperative analgesic consumption. ⋯ Dexamethasone administered at a dose of 8 mg before surgical incision may be beneficial in laparoscopic cholecystectomies, thyroid, laparoscopic gynecologic and breast surgery, and tonsillectomies in children. Dexamethasone's potential impact on reducing postoperative analgesic requirements should be investigated in more detail in a systematic manner, to support its use in other kinds of operations.
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Meta Analysis
Gray Matter Abnormalities Associated with Chronic Back Pain: A Meta-analysis of Voxel-based Morphometric Studies.
Studies employing voxel-based morphometry have reported inconsistent findings on the association of gray matter (GM) abnormalities with chronic back pain (CBP). We, therefore, performed a meta-analysis of available studies to identify the most consistent GM regions associated with CBP. ⋯ The present study demonstrates a pattern of GM alterations in CBP. These data further advance our understanding of the pathophysiology of CBP.
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Randomized Controlled Trial
Happy Despite Pain: A Randomized Controlled Trial of an 8-week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients with Chronic Pain.
There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. ⋯ The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.