The Clinical journal of pain
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Review
The Shared Neuroanatomy and Neurobiology of Comorbid Chronic Pain & PTSD: Therapeutic Implications.
Chronic pain and posttraumatic stress disorder (PTSD) are disabling conditions that affect biological, psychological, and social domains of functioning. Clinical research demonstrates that patients who are affected by chronic pain and PTSD in combination experience greater pain, affective distress, and disability than patients with either condition alone. Additional research is needed to delineate the interrelated pathophysiology of chronic pain and PTSD, with the goal of facilitating more effective therapies to treat both conditions more effectively; current treatment strategies for chronic pain associated with PTSD have limited efficacy and place a heavy burden on patients, who must visit various specialists to manage these conditions separately. ⋯ The potential contribution of opioid and cannabinoid system factors also will be discussed. Finally, we address potential novel methods to restore the normal function of these systems. Such novel perspectives regarding disease and disease management are vital to the pursuit of relief for the many individuals who struggle with these disabling conditions.
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This study determined whether individuals with mild knee pain due to osteoarthritis (OA) experience hyperalgesia and central sensitivity by comparing them with age-matched and sex-matched control participants and determined whether these levels are associated with pain intensity. This study also determined whether these individuals experience significantly poorer quality of life than age-matched and sex-matched controls and whether pain and function predict quality of life. ⋯ Individuals with mild knee pain due to OA experience mechanical (but not thermal) hyperalgesia that relates to pain intensity. They have a reduced quality of life that is predicted by pain intensity. More aggressive pain management for mild knee OA pain is indicated to improve the quality of life for individuals who are not yet candidates for joint replacement.
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Randomized Controlled Trial Multicenter Study
The Effect of Neck-specific Exercise with, or without a Behavioral Approach, on Pain, Disability and Self-efficacy in Chronic Whiplash-associated Disorders: A Randomized Clinical Trial.
The aim of this study was to compare the effect on self-rated pain, disability, and self-efficacy of 3 interventions for the management of chronic whiplash-associated disorders: physiotherapist-led neck-specific exercise (NSE), physiotherapist-led NSE with the addition of a behavioral approach, or Prescription of Physical Activity (PPA). ⋯ NSE resulted in superior outcomes compared with PPA in this study, but the observed benefits of adding a behavioral approach to the implementation of exercise in this study were inconclusive.
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Randomized Controlled Trial Comparative Study
The Pain Quality Response Profile of a Corticosteroid Injections and Heated Lidocaine/Tetracaine Patch in the Treatment of Shoulder Impingement Syndrome.
To describe the effects of 2 pain treatments for shoulder impingement syndrome (SIS), and illustrate how investigators can use pain quality information to understand treatment response differences. ⋯ Examination of the effects of pain treatments on pain qualities over time will help researchers and clinicians understand if certain pain quality domains respond faster to one treatment versus another, and may identify differences between treatments that would not be observed by measures of global pain intensity alone.
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The aim of this study was to determine the ability of the central sensitization inventory (CSI), a new screening instrument, to assist clinicians in identifying patients with central sensitivity syndromes (CSSs). ⋯ The CSI is a useful and valid instrument for screening patients for the possibility of a CSS, although the chances of false positives are relatively high when evaluating patients with complex pain and psychophysiological disorders.