The Clinical journal of pain
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Investigations have shown that expectancies are significant prognostic indicators of recovery outcomes following whiplash injury. However, little is currently known about the determinants of recovery expectancies following whiplash injury. The purpose of the present study was to examine the cross-sectional and prospective correlates of recovery expectancies in individuals admitted to a rehabilitation program for whiplash injury. ⋯ The discussion addresses the processes linking pain-related psychosocial factors to recovery expectancies and makes recommendations for interventions that might be effective in increasing recovery expectancies.
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Meta Analysis
Efficacy of Intra-articular Botulinum Toxin in Osteo-articular Joint Pain: A Meta-analysis of Randomized Controlled Trials.
This study was conducted with the aim of evaluating the efficacy of intra-articular injections of botulinum toxin type A (BT-A) into the painful joint diseases through a systematic review of the literature and a meta-analysis of controlled randomized trials. Intra-articular therapies (corticosteroids, hyaluronic acid) have limited efficacy and run a risk of toxicity in patients with joint pain. New therapeutic options are needed to treat painful osteoarticular disease. ⋯ BT-A intra-articular injections have short-term benefits with a statistically significant decrease in the NRS pain score of around 1 point in patients with refractory joint pain. A decrease in the pain score was also observed at 6 months but with a nonsignificant result.
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Randomized Controlled Trial Comparative Study
Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy versus Supportive Care for Chronic Back Pain.
The objective of this study was to evaluate the efficacy of a telephone-delivered, home-based cognitive-behavioral intervention for chronic low back pain in comparison to a matched supportive care (SC) treatment. ⋯ Results from this clinical trial suggest that home-based, telephone-delivered CBT and SC treatments did not significantly differ in their benefits for back pain severity and disability, and may warrant further research for applications to hospital settings. Major limitations included recruitment difficulties that underpowered primary analyses, the lack of objective improvement measures, and the absence of a usual care/untreated control group for comparisons.
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Posttraumatic stress disorder (PTSD) is prevalent in chronic pain, and associated with increased pain, hyperalgesia, and psychological distress. This study aimed to investigate antinociceptive and pronociceptive pain mechanisms, pain intensity, and psychological distress (depression, anxiety, pain catastrophizing, and fear of movement) in patients with accident-related chronic spinal pain with (N=44) and without (N=64) comorbid PTSD characteristics. ⋯ The association between PTSD and pain intensity is in accordance with the mutual-maintenance and fear-avoidance models. Future studies should investigate changes in pain intensity and mechanisms after treatment targeting comorbid PTSD in chronic pain patients.
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Certain forms of social support have been shown to improve pain-coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure. ⋯ Among older adults experiencing trauma, low perceived social support was associated with higher levels of pain at 6 weeks.