The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Acute pressure block of the sciatic nerve relieves clinical pain but not cold pressor pain.
Acute pressure applied to the sciatic nerve has been recently reported to offer immediate short-term pain relief in patients with various diseases. This study examined the analgesic effect of this novel method on cold pressor pain compared with clinical pain. ⋯ Our study indicated that cold pressor pain and clinical pain responded differently to acute pressure blockade of the sciatic nerve. Our findings indicate that caution should be exercised when attempting to extrapolate cold pressor pain findings to clinical pain.
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Randomized Controlled Trial Comparative Study
Different activation of opercular and posterior cingulate cortex (PCC) in patients with complex regional pain syndrome (CRPS I) compared with healthy controls during perception of electrically induced pain: a functional MRI study.
Although the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor. ⋯ Stronger PCC activation during painful stimulation may be interpreted as a correlate of motor inhibition during painful stimuli different from controls. Also, the decreased opercular activation in CRPS patients shows less sensory-discriminative processing of painful stimuli.These results show that changed cerebral pain processing in CRPS patients is less sensory-discriminative but more motor inhibition during painful stimuli. These changes are not limited to the diseased side but show generalized alterations of cerebral pain processing in chronic pain patients.
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Clinical Trial
The use of opioids for breakthrough pain in acute palliative care unit by using doses proportional to opioid basal regimen.
To determine the efficacy and safety of different opioids used in doses proportional to the basal opioid regimen for the management of breakthrough pain (BP). ⋯ This survey suggests that doses of opioids for BP proportional to the basal opioid regimen, are very effective and safe in clinical practice, regardless the opioid and modality used.
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Pain after breast cancer therapy is a recognized complication found to have an adverse impact on patient's quality of life, increasing psychosocial distress. In recent years, case reports about myofascial pain syndrome are emerging in thoracic surgery as a cause of postsurgery pain. Myofascial pain syndrome is a regional pain syndrome characterized by myofascial trigger points in palpable taut bands of skeletal muscle that refers pain a distance, and that can cause distant motor and autonomic effects. ⋯ Myofascial pain syndrome is a common source of pain in women undergoing breast cancer surgery that includes axillary lymph node dissection at least during the first year after surgery. Myofascial pain syndrome is one potential cause of chronic pain in breast cancer survivors who have undergone this kind of surgery.
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Fibromyalgia syndrome (FMS) is a chronic disorder defined by widespread muscle pain and multiple tender points. The objectives of this study were to estimate prevalence of comorbidities, healthcare resources utilization, and costs associated with FMS. ⋯ Results of this analysis of the RAMQ database illustrate the high prevalence of comorbidities among patients with a diagnosis of FMS and strongly indicate that the economic burden of FMS is substantial.