The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Does systematic graded exposure in vivo enhance outcomes in multidisciplinary chronic pain management groups?
Graded exposure in vivo (GEXP) treatment has been successfully used to reduce levels of pain-related fear and disability in some chronic pain patients, but its effectiveness has not been evaluated in general clinical settings using group-design studies. The purpose of this study was to determine if the systematic incorporation of GEXP into a multidisciplinary chronic pain management group (PMG) treatment program would result in better treatment outcomes than usual PMG treatment. ⋯ The addition of systematic graded exposure into a multidisciplinary chronic pain management program did not result in better clinical outcomes than the usual group treatment program. The validity of GEXP to the broader population of chronic pain patients warrants further investigation.
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Randomized Controlled Trial Multicenter Study
Making pain assessment more accessible to children and parents: can greater involvement improve the quality of care?
To determine whether nursing and parental pain assessment documentation and analgesia administration increased with the use of a temporary tattoo of a pain intensity scale (TTPS) compared with a paper version of the pain scale (PPS). To document any adverse skin reactions from the use of the TTPS and to assess the feasibility and acceptability of the PPS and TTPS for use as postoperative pain assessment tools in the home and clinical setting. ⋯ The TTPS is a new method to engage children in pain assessment, which may have positive effects on the quality of postoperative pain assessment and management in hospital and home settings. Larger trials are needed to determine the effectiveness of the TTPS across all pediatric settings and for children with nonsurgical and also surgical pain. The findings from these pilot trials provide useful information for design and power estimation for further research in inpatient and home settings.
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Clinical Trial
Long-term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study.
To evaluate the outcomes associated with the use of controlled-release (CR) oxycodone for up to 3 years in the treatment of noncancer pain. ⋯ These registry data demonstrate that a subgroup of patients with noncancer pain experienced prolonged relief with tolerable side effects and modest need for dose escalation during long-term therapy with CR oxycodone.
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Randomized Controlled Trial
Thermal and visceral hypersensitivity in irritable bowel syndrome patients with and without fibromyalgia.
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by both visceral and somatic hyperalgesia, producing a similar effect seen with the central hypersensitivity mechanism in fibromyalgia (FM). ⋯ FM+IBS patients show greater thermal hypersensitivity compared with IBS patients. However, IBS patients exhibit higher pain ratings to rectal distension compared with FM+IBS patients. This data suggests that regions of primary and secondary hyperalgesia are dependent on the primary pain complaint.
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Referred pain and pain characteristics evoked from the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum communis, and brachioradialis muscles was investigated in 20 patients with lateral epicondylalgia (LE) and 20-matched controls. ⋯ Our results suggest that in patients with LE, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual elbow and forearm pain, consistent with active TrPs. Lower PPT and larger referred pain patterns suggest that peripheral and central sensitization exists in LE.