The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multicenter Randomized Clinical Trial.
To compare the effects of adding electrical dry needling into a manual therapy (MT) and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA). ⋯ Level 1b-therapy. Prospectively registered February 10, 2015 on www.clinicaltrials.gov (NCT02373631).
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Randomized Controlled Trial
Clinical Pain-Related Outcomes and Inflammatory Cytokine Response to Pain Following Insomnia Improvement in Adults With Knee Osteoarthritis.
Clinical insomnia is known to affect pain, but mechanisms are unclear. Insomnia can dysregulate inflammatory pathway, and inflammation plays a mediating role in pain. It is unclear whether insomnia-related alterations in inflammation can be modified with insomnia improvement, and if such alterations parallel improvement in pain. The current study objective was to provide proof of concept for the role of insomnia in inflammation and pain by testing whether improving insomnia would reduce pain and related physical function, and, concurrently, modulate inflammatory responses. ⋯ These findings suggest further exploration of inflammatory pathways linking clinical insomnia, and its improvement, to chronic pain.
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This cross-sectional study examined the associations among optimism, psychological resilience, endogenous pain inhibition, and clinical knee pain severity. Two hypotheses were tested. First, we hypothesized that experimentally tested endogenous pain inhibition would mediate the relationship between optimism and clinical knee pain severity. Second, it was also hypothesized that optimism would moderate the relationships of psychological resilience with endogenous pain inhibition and clinical knee pain severity, particularly for individuals with high optimism. ⋯ This study suggests that an optimistic outlook may beneficially impact clinical pain severity by altering endogenous pain modulatory capacity. Furthermore, individuals with low optimism (ie, pessimists) may be more adept at engaging resources that promote psychological resilience, which in turn, enhances endogenous pain modulatory capacity. Therefore, this study supports consideration of psychological resilience factors when evaluating experimental and clinical pain outcomes.
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The assessment of pain-related disability in pediatric chronic pain patients plays an important role in research on the effectiveness of pain treatment. The present study aimed to compare the 2 available measures of pain-related disability in the German language, the Functional Disability Inventory (FDI) and Pediatric Pain Disability Index (PPDI), in terms of psychometric properties and convergent validity. In addition, associations between FDI/PPDI scores and sex, age, and pain locations were investigated. ⋯ In conclusion, both measures are equally suited to assess pain-related disability in adolescents with chronic pain. The FDI should be used with caution in epidemiological studies due to the risk of floor effects. Further research is needed with regard to the relationship between pain-related disability and sex.
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Neuromodulation, particularly intrathecal drug delivery systems and spinal cord stimulators (SCSs), can be a valuable tool when treating chronic pain in adults. However, there is a paucity of literature with regard to its use in pediatrics. ⋯ Neuromodulation can offer important options in treating some pediatric chronic pain patients. In-depth knowledge of primary disease and strict patient selection in the context of the patient's social situation is vital to successful treatment.