The Clinical journal of pain
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Multicenter Study
Risk factors associated with opioid medication misuse in community-dwelling older adults with chronic pain.
The aim of the study was to identify physical, psychological, and social risk factors associated with opioid medication misuse among community-dwelling older adults with chronic pain. ⋯ High pain intensity scores may indicate undertreatment of pain or may represent a rationalization to justify opioid medication use. Higher levels of depressive symptoms have been noted in the chronic pain population and may contribute to misuse of opioid medications for psychic effects. Less physically disabled persons are more likely to misuse opioid medications or older person receiving multiple medications may wish to avoid potential adverse drug effects. While there was an association between lower levels of disability and higher risk for opioid medication misuse, a causal relationship could not be determined.
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Long-term social assistance recipients (LTRs) struggle with numerous health issues. However, no data are available on the prevalence of chronic pain in these individuals. The purpose of this study was to determine the prevalence and characteristics of chronic pain (ie, pain >3 mo) among LTRs in Norway compared to the general population (GP). ⋯ The fact that 44.0% of the LTRs reported chronic pain, compared to only 23.9% of the GP suggests that chronic pain is a significant problem for LTRs in Norway. Additional research is warranted to determine the exact etiologies for and the impact of chronic pain on LTRs.
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Randomized Controlled Trial
Pregabalin and transcutaneous electrical nerve stimulation for postherpetic neuralgia treatment.
Postherpetic neuralgia (PHN) is responsible for one of the most common types of neuropathic pain, described as a burning pain that shakes, hits, and tightens and includes allodynia and paresthesia. ⋯ These data support the conclusion that Pregabalin gives better results when combined with TENS therapy, which is an analgesic nonpharmacologic procedure. Therefore, a multidisciplinary treatment should be considered for this kind of pain.
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Randomized Controlled Trial Multicenter Study Comparative Study
Efficacy and safety of etodolac-paracetamol fixed dose combination in patients with knee osteoarthritis flare-up: a randomized, double-blind comparative evaluation.
To evaluate the efficacy and safety of etodolac-paracetamol combination in comparison with etodolac alone in patients with knee osteoarthritis (OA) flare-up. ⋯ For the treatment of painful OA flare-ups, the etodolac-paracetamol combination can offer improved clinical outcomes by targeting multiple pain pathways. The results of the current study show that etodolac-paracetamol is more effective in the treatment of OA flare-up than etodolac alone.
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Randomized Controlled Trial Comparative Study
Naprapathic manual therapy or conventional orthopedic care for outpatients on orthopedic waiting lists?: A pragmatic randomized controlled trial.
Traditionally, orthopedic outpatient waiting lists are long, and many referrals are for conditions that do not respond to interventions available at an orthopedic outpatient department. The overall objective of this trial was to investigate whether it is possible to reduce orthopedic waiting lists through integrative medicine. Specific aims were to compare the effects of naprapathic manual therapy to conventional orthopedic care for outpatients with nonurgent musculoskeletal disorders unlikely to benefit from surgery regarding pain, physical function, and perceived recovery. ⋯ The trial suggests that naprapathic manual therapy may be an alternative to consider for orthopedic outpatients with disorders unlikely to benefit from surgery.