The Clinical journal of pain
-
Coping is shown to affect outcomes in chronic pain patients; however, few studies have examined the role of coping in the course of recovery in whiplash-associated disorders (WAD). The purpose of this study was to determine the predictive value of coping style for 2 key aspects of WAD recovery, reductions in neck pain, and in disability. ⋯ Passive coping style predicts neck pain and self-assessed disability recovery. It may be beneficial to assess and improve coping style early in WAD.
-
Review Meta Analysis
A Systematic Review and Meta-Analysis of Medical Leech Therapy for Osteoarthritis of the Knee.
Osteoarthritis of the knee is a common chronic disease among older adults. Therapeutic approaches mainly consist of physiotherapy or pharmacological therapy, but these approaches are limited over time by their cost and/or side effects. This paper presents a systematic review and meta-analysis of the effectiveness of medical leech therapy for osteoarthritis of the knee. ⋯ This systematic review found moderate to strong evidence for the reduction of pain, functional impairment, and joint stiffness after medical leech therapy in patients with osteoarthritis of the knee. Given the low number of reported adverse events, leech therapy may be a useful approach in treating this condition. Further high-quality RCTs are required for the conclusive judgment of its effectiveness and safety.
-
Randomized Controlled Trial Multicenter Study
The Reciprocal Effects of Pain Intensity and Activity Limitations: Implications for Outcomes Assessment in Clinical Trials.
To examine the reciprocal effects of pain intensity and limitations in physical functioning over time. ⋯ These analyses showed that a decrease in activity limitations results in a decrease in pain intensity. However, changes in pain intensity had no effect on subsequent activity limitations in the study sample. None of the 3 outcome variables emerged as being more responsive to treatment than the others.
-
The current medical treatment of neuropathic pain (NP) is inadequate with more than two thirds of patients having no suitable solution for their morbid disease and deteriorating quality of life. Currently, medications for the treatment of NP are mostly systemic (affecting the central nervous system) and are dose limited because of serious and debilitating adverse effects. Scientific evidence suggests that localized cutaneous NP can be treated effectively and safely by topical medications; however, only a few topical medications are indicated for NP. This lack of topica medications stems from the limited resources that have been dedicated to exploring the role of the peripheral nervous system in NP or to the development of peripherally active topical analgesics. ⋯ This article discusses the role of topical medications in treating localized cutaneous NP and the role of the compounding pharmacists in applying this therapeutic approach (eg, the scientific considerations that the pharmacist should take into account).
-
Clinical Trial
Treatment Expectations Among Adolescents With Chronic Musculoskeletal Pain and Their Parents Before an Initial Pain Clinic Evaluation.
To understand expectations regarding treatment recommendations among treatment-seeking adolescents with chronic musculoskeletal pain and their parents. ⋯ Our results document that adolescents and parents show modest levels of agreement on expectations for treatment at the time of an initial pain clinic evaluation. This may relate to expectations being internal perspectives not clearly expressed within families; thus, the initial treatment consultation may provide an important opportunity to create and align appropriate expectations. Implications of our findings are considered with respect to education, treatment, and future research to understand factors that contribute to treatment adherence and outcomes.