The Clinical journal of pain
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Observational Study
Evaluation of the Neuropathic Component of Chronic Low Back Pain.
Assessment of neuropathic pain in chronic low back syndromes is important. However, there is currently no gold standard for its diagnosis. The aim of this observational cross-sectional study was to assess the neuropathic component of pain in various chronic low back pain syndromes using a range of diagnostic tests. ⋯ Neuropathic pain is quite frequent in CRS, and QST reveals sensory loss as a frequent abnormality in patients with CRS. Using a cut-off value of 19, PDQ identified a neuropathic component in a relatively low proportion of patients with CRS. CRS may be associated with a reduction in IENFD.
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Meta Analysis
The Effects of Motor Imagery on Pain and Range of Motion in Musculoskeletal Disorders: A Systematic Review With Meta-analysis.
In recent years, there has been an increase in the use of motor imagery (MI) in the rehabilitation of musculoskeletal pain conditions. Across the literature, most reviews have yet to consider Laterality Judgement Task training as a form of MI method. This review aimed to evaluate the effectiveness of using MI as an adjunct to standard rehabilitation on the improvement of pain and range of motion parameters when managing patients with musculoskeletal pain conditions. ⋯ The results suggest that MI may be effective for pain relief and improvement in range of motion among chronic musculoskeletal pain conditions, although conclusion is based on a limited certainty of evidence as assessed using the GRADES (Grading of Recommendation, Assessment, Development and Evaluation) approach.
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Randomized Controlled Trial
Staircase-evoked Pain may be More Sensitive than Traditional Pain Assessments in Discriminating Analgesic Effects: A Randomized, Placebo-controlled Trial of Naproxen in Patients with Osteoarthritis of the Knee.
Analgesic trials often fail to show a significant effect even when medications with known efficacy are tested. This could be attributed to insufficient assay sensitivity of analgesic trials, which may be due, in part, to the insensitivity of pain-related outcome measures. The aim of this methodological study was to assess the responsiveness of evoked pain generated by the staircase procedure compared with other commonly used pain outcomes in knee osteoarthritis. ⋯ Study results support our hypothesis that evoked pain using the StEPP may demonstrate greater responsiveness to treatment effects compared with traditional pain-related outcome measures. Accordingly, these results may facilitate development and validation of other chronic pain-related evoked pain models, which could contribute to future research and development of new analgesics.
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The effects of eccentric exercises on clinical outcomes and central pain mechanisms are unclear in neck/shoulder pain (NSP). The aims were to: (1) evaluate the clinical impact of unilateral eccentric training in female computer users with chronic NSP; (2) compare pressure pain sensitivity, temporal summation of pain (TSP); and conditioned pain modulation (CPM) in female office workers with and without NSP; and (3) assess sensitization and central pain responses after training. ⋯ Eccentric training improved pain and disability, reduced sensitization, and enhanced CPM efficiency in female computer users with NSP.
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Meta Analysis
Effects of the OPRM1 A118G Polymorphism(rs1799971) on Opioids Analgesia in Cancer Pain: A Systematic Review and Meta-Analysis.
Although previous studies have demonstrated that the OPRM1 A118G polymorphism may influence the analgesia response to cancer pain, the results are inconsistent. In this article we aimed to fully examine the association between OPRM1 A118G (rs1799971) polymorphism and opioid analgesia by analyzing published information. This will provide information for better cancer pain management. ⋯ Our meta-analysis indicates that G allele (AG+GG) carriers of OPRM1 A118G polymorphism required more opioid analgesia in cancer pain management. The OPRM1 A118G polymorphism may help predict individuals' response to analgesia and achieve satisfactory cancer pain control.