The Clinical journal of pain
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To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. ⋯ Blue-collar and white-collar workers exhibited a similar number of TrPs in the upper quadrant musculature. The referred pain elicited by active TrPs reproduced the overall pain pattern. The distribution of TrPs was not significantly different between groups. Clinicians should examine for the presence of muscle TrPs in blue-collar and white-collar workers.
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Physical activity assessments in chronic pain research have mostly been based on self-report. However, earlier research indicated that chronic pain patients have difficulties in estimating their own daily life activity level. Movement registration systems have been introduced to overcome the limitations of self-reported measures. However, no uniform guidelines for researchers on how to analyze and interpret movement registration data in chronic pain exist. The aim of the study was to provide recommendations for physical activity assessment based on movement registration in patients with chronic pain. ⋯ It is recommended that studies in chronic pain research explicitly apply and report the criteria that have been used to define an assessment day, the total assessment time, and the method for calculating the final test outcome.
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mild interlaminar decompression is a minimally invasive procedure for the treatment of patients with symptomatic lumbar spinal stenosis. This report describes the mild procedure and presents 1-year clinical outcomes of patients treated with mild. ⋯ The mild technique provides an attractive early option for the treatment of symptomatic lumbar spinal stenosis after failed injection therapy, but before more invasive surgical treatment. For 17 patients with 1-year follow-up, the mild procedure provided significant pain relief and increased mobility. This procedure leaves no implants behind, and therefore does not limit subsequent, more invasive procedures that require implants.
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Low back pain (LBP) remains a common health problem that is characterized by ambiguity and can progress to chronic disability. In recent years researchers have started to focus on understanding whether and how the attitudes and beliefs of the health care providers influence the management and the outcome of LBP. ⋯ Health care practitioners play a significant role in the management of LBP. Research on the process of knowledge translation, clinical decision making, and dealing with uncertainty to avoid aggravating LBP disability is clearly warranted.
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Case Reports
A case of potential treatment of remote pain after sacral nerve stimulation for chronic urinary retention.
A case is presented in which a 58-year-old man developed a potential unintended and durable treatment of pain at remote sites (cervical region and low back) after sacral nerve stimulation for chronic urinary retention. ⋯ The current case presents a potential example of neurological crosstalk and highlights the inherent complexity in human neural physiology. Further research may reveal novel treatment strategies for patients with voiding dysfunction and chronic pain syndromes.