The Clinical journal of pain
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Comparative Study
Is temporomandibular pain in chronic whiplash-associated disorders part of a more widespread pain syndrome?
The prevalence of temporomandibular disorders in patients with chronic whiplash-associated disorder is a controversial issue that may be influenced by the widespread pain character and psychologic distress frequently observed in patients with chronic pain. The aim of this study was to determine the prevalence of temporomandibular disorder pain, widespread pain, and psychologic distress in persons with chronic whiplash-associated disorder pain, using a controlled, single blind study design. The prevalence of temporomandibular disorder pain in the chronic whiplash-associated disorder pain group was compared with 2 control groups: a chronic neck pain group and a no neck pain group. ⋯ The higher prevalence of widespread pain and psychologic distress in patients with chronic whiplash-associated disorder suggests that the higher prevalence of temporomandibular disorder pain in these patients is part of a more widespread chronic pain disorder.
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Comparative Study Clinical Trial
A prospective cost-effectiveness study of trigeminal neuralgia surgery.
Approximately 8000 patients with trigeminal neuralgia undergo surgery each year in the United States at an estimated cost exceeding $100 million. We compared 3 commonly performed surgeries (microvascular decompression, glycerol rhizotomy, and stereotactic radiosurgery) to evaluate the relative cost-effectiveness of these operations for patients with idiopathic trigeminal neuralgia. ⋯ This analysis supports the practice of percutaneous surgeries for older patients with medically unresponsive trigeminal neuralgia. At longer follow-up intervals, microvascular decompression is predicted to be the most cost-effective surgery and should be considered the preferred operation for patients if their risk for general anesthesia is acceptable. More data are needed to assess the role that radiosurgery should play in the management of patients with trigeminal neuralgia.
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Comparative Study
Patient satisfaction with treatment for chronic pain: predictors and relationship to compliance.
Patient satisfaction with treatment has been extensively researched in a variety of medical patients. However, satisfaction with treatment of chronic pain has received considerably less attention. The present study sought to identify the predictors of patient satisfaction with treatment of chronic pain. In addition, the relationship between patient satisfaction and compliance with treatment recommendations was explored. ⋯ Results suggest the importance of distinguishing between satisfaction with care and satisfaction with improvement in assessments. Satisfaction with treatment of chronic pain is not merely a matter of pain relief. To increase the probability of treatment success and satisfaction, attention to the interpersonal aspects of the health care provider-patient relationship appear critical. Explanations for satisfaction's stronger relationship to health care provider-rated compliance were discussed.
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Comparative Study
The effect of opioids on driving and psychomotor performance in patients with chronic pain.
This study compared the psychomotor performance and driving ability of patients with chronic pain managed with stable regimens of opioid analgesics with that of normal healthy volunteers. The hypothesis was that patients with chronic pain on stable opioid analgesic regimens operate their automobiles safely with proficiency equal to normal volunteer controls. ⋯ Many patients with chronic pain, even if treated with potent analgesics such as morphine and hydromorphone, show comparable driving ability as normals.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Radiofrequency denervation of lumbar facet joints in the treatment of chronic low back pain: a randomized, double-blind, sham lesion-controlled trial.
Radiofrequency facet joint denervation procedures have been common practice for 2 decades in treatment of chronic low back pain. We designed this multicenter, randomized, double-blind, sham treatment controlled trial to determine the efficacy of radiofrequency facet joint denervation, as it is routinely performed. ⋯ The combined outcome measure and VAS showed no difference between radiofrequency and sham, though in both groups, significant VAS improvement occurred. The global perceived effect was in favor of radiofrequency. In selected patients, radiofrequency facet joint denervation appears to be more effective than sham treatment.