The Clinical journal of pain
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This study examined the acceptability and preliminary outcomes of an internet-delivered pain management program, the Pain Course, when offered by a specialist pain management clinic in a large public hospital. ⋯ These findings highlight the potential value of internet-delivered programs when provided by specialist pain management clinics as a part of their services and the value of larger scale studies in this area.
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Observational Study
Development of a Simple Preoperative Risk Score for Persistent Pain After Breast Cancer Surgery: A Prospective Observational Cohort Study.
Persistent postoperative pain is reported by 30% to 50% of patients following breast cancer surgery. Studies testing preventive measures, however, have so far failed to produce consistent positive results. If preventive measures could be targeted to a subgroup of patients at high risk of persistent pain, positive results would be more likely. Our aim was to develop a simple risk score predicting persistent pain after breast cancer surgery. ⋯ We studied known risk factors for persistent pain in patients scheduled for breast cancer surgery and constructed a preoperative risk score simple enough to select high-risk patients in future prevention studies.
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The symptoms of posttraumatic stress disorder (PTSD) and chronic pain are thought to interact to increase the severity and impact of both conditions, but the mechanisms by which they interact remain unclear. This study examines the relationship between PTSD and chronic pain and whether indices of Psychological Flexibility mediate the relationship between these 2 conditions. ⋯ Processes from the Psychological Flexibility model were identified as mediators of the relationship between PTSD and chronic pain in people seeking treatment for chronic pain. The Psychological Flexibility model may be useful as an overarching model to help understand the relationship between PTSD and chronic pain. It is possible that targeting pain-related acceptance, committed action, and cognitive fusion (among other processes) in the treatment of chronic pain may produce corresponding improvements in comorbid symptoms of PTSD when these are present and may reduce impacts of PTSD on outcomes of chronic pain. Conversely, targeting of these processes in the treatment of PTSD may produce similar improvements for symptoms of chronic pain. Further research to evaluate these possibilities is needed.
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To investigate the correlates of a recent history of disabling low back pain (LBP) in older persons. ⋯ Our study supports the link between disabling LBP and other age-related chronic conditions in a middle-income country with a rapidly aging population.
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Many psychopharmacologic agents are used as primary or adjuncts in pain management. Atypical antipsychotics (AAs) have also been used as adjuncts in pain management regimens in a variety of manners; however, their efficacy in this capacity is unclear. ⋯ Few studies have been conducted to evaluate the analgesic effects of AAs. The collective findings of multiple studies evaluating olanzapine in pain syndromes suggest a high, yet preliminary level of evidence of efficacy, warranting prospective studies in various pain syndrome contexts. Pharmacological mechanisms of AA action are elaborated, and the findings of this review are discussed. Risk and benefits of using AAs in chronic pain are described, and investigational implications and future directions are explored.