The Clinical journal of pain
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To test whether the prognostic definition of chronic pain, which has previously been applied in specific anatomic areas, performed well in a cohort of older adults with a range of musculoskeletal pain sites. ⋯ The prognostic approach to defining chronic pain is suitable for use in older adults consulting primary care with musculoskeletal pain at a range of sites, but new cutoffs are needed to allow for the higher risk profile in this group. An adapted version of this method may also have the potential for application directly within the clinical consultation.
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The underlying mechanism of trichodynia (scalp/hair pain, is unknown). The aim of this study was to characterize chronic trichodynia and to conduct, for the first time, sensory testing in patients with trichodynia to learn about possible underlying mechanisms. ⋯ The cranial hyperalgesia and allodynia, the generalized hyperalgesia, and the correlation between hyperalgesia and chronic pain suggest that trichodynia is related with both peripheral and central sensitization, respectively. The coexistence of hair cycle abnormalities and chronic pain might suggest a common denominator for both phenomena, possibly mediated by proinflammatory agents. Clinical implications are discussed.
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Review Meta Analysis
A systematic review and meta-analysis of yoga for low back pain.
To systematically review and meta-analyze the effectiveness of yoga for low back pain. ⋯ This systematic review found strong evidence for short-term effectiveness and moderate evidence for long-term effectiveness of yoga for chronic low back pain in the most important patient-centered outcomes. Yoga can be recommended as an additional therapy to chronic low back pain patients.
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Multicenter Study Controlled Clinical Trial
Establishing an optimal "cutoff" threshold for diagnostic lumbar facet blocks: a prospective correlational study.
Diagnostic medial branch blocks (MBB) are considered the reference standard for diagnosing facetogenic pain and selecting patients for radiofrequency (RF) denervation. Great controversy exists regarding the ideal cutoff for designating a block as positive. The purpose of this study is to determine the optimal pain relief threshold for selecting patients for RF denervation after diagnostic MBB. ⋯ Employing more stringent selection criteria for lumbar facet RF is likely to result in withholding a beneficial procedure from a substantial number of patients, without improving success rates.
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Activity pacing (AP) is a concept that is central to many chronic pain theories and treatments, yet there remains confusion regarding its definition and effects. ⋯ Future research on AP should be based on a clear theoretical foundation, consider the context in which the AP behavior occurs and the type of pacing problem ("underactivity" vs. "overactivity"), and should examine the impact of AP treatment on multiple clinical outcomes. We provide a provisional definition of AP and specific recommendations that we believe will move the field forward.