The Clinical journal of pain
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Randomized Controlled Trial
Fulranumab in Patients with Pain Associated with Postherpetic Neuralgia and Postraumatic Neuropathy: Efficacy, Safety and Tolerability Results from a Randomized, Double-blind, Placebo-controlled, Phase-2 Study.
Fulranumab is an antibody that specifically neutralizes the biological activity of human nerve growth factor. This multicenter, phase-2, randomized, double-blind (DB), placebo-controlled study evaluated the analgesic efficacy and safety of fulranumab in postherpetic neuralgia (PHN) and posttraumatic neuropathy (PTN) patients. ⋯ Fulranumab did not demonstrate efficacy in either PHN or PTN patients, but was generally well-tolerated in this small underpowered and abbreviated study.
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Improvement in pain is a major expectation of patients undergoing lumbar spine surgery. ⋯ Pain is not uncommon after lumbar surgery and is associated with a network of clinical, surgical, and psychological variables. This study provides evidence that patients' expectations about pain are an independent variable in this network. Because expectations are potentially modifiable this study supports addressing pain-related expectations with patients before surgery through discussions with surgeons and through formal preoperative patient education.
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Comparative Study
Differences in Clinical Pain and Experimental Pain Sensitivity Between Asian Americans and Whites With Knee Osteoarthritis.
Ethnicity has been associated with clinical and experimental pain responses. Whereas ethnic disparities in pain in other minority groups compared with whites are well described, pain in Asian Americans remains poorly understood. The purpose of this study was to characterize differences in clinical pain intensity and experimental pain sensitivity among older Asian American and non-Hispanic white (NHW) participants with knee osteoarthritis (OA). ⋯ These findings add to the growing literature regarding ethnic and racial differences in clinical pain intensity and experimental pain sensitivity. Asian Americans in particular may be at risk for clinical pain and heightened experimental pain sensitivity. Further investigation is needed to identify the mechanisms underlying ethnic group differences in pain between Asian Americans and NHWs, and to ensure that ethnic group disparities in pain are ameliorated.
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Chronic musculoskeletal pain (CMP) is increasing in prevalence rapidly. Over the past 2 decades low back pain has been ranked globally as the primary cause of years lived with disability. The primary objective of this study was to investigate the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and chronic knee pain (CKP) and their related risk factors in the national Iranian population. ⋯ This is the first study investigating the prevalence of CNP, CLBP, and CKP in the national population of Iran. It shows some modifiable risk factors for CMP, and suggests that affordable planning for these risk factors can be valuable in preventing CMP globally. However, this is a cross-sectional study and future longitudinal studies in this field are necessary.
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Comparative Study
Myofascial Trigger Points and Migraine-related Disability in Women with Episodic and Chronic Migraine.
The aim of this study was to investigate the differences in the presence of head and neck-shoulder trigger points (TrPs) between women with episodic or chronic migraine and their association with migraine-related disability. ⋯ Women with episodic and chronic migraine had a similar number of TrPs. TrPs may be considered a trigger factor that can facilitate the onset of migraine or also can potentially be a promoting factor for pain once the migraine attack has started and hence may contribute to related disability. Nevertheless, we observed that the number of TrPs in the head and neck-shoulder muscles in an interictal state was not associated with the degree of migraine-related disability, suggesting a multifactorial nature of self-perceived disability in this population.