The Clinical journal of pain
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The main objectives of this study were to retrospectively characterize the rate of referrals to an outpatient chronic pain clinic among adolescents with chronic pain, and to identify factors associated with referral. ⋯ Referrals to our chronic pain clinic were more likely for adolescents with generalized chronic pain, regional pain syndromes, and patients with mental health comorbidities. Recent hospitalization or surgery, but not recent emergency department visits, were associated with pain clinic referral. The multivariable analysis did not find disparities in referral by race or socioeconomic status.
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Opioid analgesics may be associated with chronic adverse effects, such as opioid-induced constipation (OIC). Available and emerging prescription medications for OIC in patients with chronic noncancer pain are described, including concerns and challenges associated with OIC management. ⋯ Health care providers should be aware of this complication in patients receiving opioids and should monitor and address constipation-related symptoms to optimize pain management and improve patient quality of life.
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Offset analgesia (OA) is a test paradigm increasingly used to estimate endogenous pain modulation characterized by a disproportionally profound analgesia after a small decrease of a heat stimulus. This systematic review and meta-analysis examined the magnitude and difference of OA in healthy participants and chronic pain patients. ⋯ Results indicate that pain-free participants show a larger OA response when rating pain continuously compared with individuals with chronic pain.
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This systematic review aimed to identify and evaluate prognostic factors for long-term (≥6 mo) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation (MDR). ⋯ While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR, poor pretreatment physical and psychological functioning influenced the prognosis negatively. Thus, treatment should further target and optimize these modifiable factors and an increased focus on positive, psychological protective factors may perhaps provide an opening for yet untapped clinical gains.
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Randomized Controlled Trial
THE IMPACT OF THREE DIFFERENT DISTRACTION TECHNIQUES ON THE PAIN AND ANXIETY LEVELS OF CHILDREN DURING VENIPUNCTURE: A CLINICAL TRIAL.
Invasive procedures are important causes of pain and anxiety during hospitalization. This study aimed to evaluate the effect of 3 different distraction methods on the pain and anxiety levels of children during venipuncture. ⋯ The distraction techniques of playing VG, watching CM, and PI appear to be effective in reducing anxiety and pain perception in children during the procedure of venipuncture. The most effective method was playing VG.