The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Differential effects of neuropathic analgesics on wind-up-like pain and somatosensory function in healthy volunteers.
To investigate the effects of gabapentin, carbamazepine, and amitriptyline on temporal summation, simple nociceptive pain, and innocuous touch sensation in healthy volunteers. ⋯ We have shown that gabapentin, carbamazepine, and amitriptyline, three pharmacologically different drugs, have distinct and quantifiable effects on somatosensory pathways in healthy volunteers. These findings provide a link between pharmacology of the study drugs and clinical effectiveness. The effects of gabapentin and carbamazepine on temporal summation pain show that these drugs can block centrally amplified wind-up pain in the absence of a neuropathic disorder.
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Multicenter Study Clinical Trial
Parents' views about infant pain in neonatal intensive care.
The purpose of this study was to describe parents' perceptions and feelings about their infant's pain experience and pain care in the neonatal intensive care unit. ⋯ The findings from this study expand knowledge about how parents understand and respond to the difficult situation in which their newborn infant is subjected to essential but painful procedures. The findings provide direction for research and clinical practice interventions aimed at: 1) helping parents to gain knowledge and correct their misperceptions; 2) engaging parents in meaningful dialog about their concerns and preferences for involvement; and 3) helping parents to develop effective coping strategies to reduce psychologic distress related to their infant's pain.
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Randomized Controlled Trial Clinical Trial
Patterns of pain variation related to myogenous temporomandibular disorders.
Myogenous temporomandibular disorders are characterized by jaw muscle pain. The aims were: 1) to characterize this pain generally in terms of intensity, frequency, duration, and behavior across a period of 2 weeks; 2) to identify main intraday pain patterns and to examine whether subgroups of patients in this respect differed in clinical, demographic, pain and sleep variables, psychosocial factors, and use of medication; and 3) to investigate some possible interday trends of pain intensity at a group level. ⋯ Two main daily pain patterns occur in patients with myogenous temporomandibular disorders (79%: maximal pain late in the day; 21%: early in the day), which might be related to differences in processes that influence pain sensitivity and patterns of jaw muscle activation. The interday similarities in pain level suggest that a sustained influence of counseling after the intake or an influence of a common behavioral pattern with a cycle duration of a week are not involved.
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Randomized Controlled Trial Clinical Trial
The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: a randomized controlled trial.
To assess the effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia in comparison to standard medical care. ⋯ Positive health-related outcomes in this mostly unresponsive condition can be obtained with a low-cost, group multidisciplinary intervention in a community-based, nonclinical setting.
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Case Reports
The fasciitis-panniculitis syndrome presenting as complex regional pain syndrome type 1: report of a case.
A 28-year-old man presented with a clinical picture suggestive of complex regional pain syndrome type I following a blow to the thenar eminence and thumb. Symptoms, including swelling of the hand and distal forearm, progressed until an amputation was carried out to rid the patient of an unendurable painful and nonfunctioning wrist and hand. The histologic evaluation of the amputation specimen showed: 1) dermal edema, perivascular dermatitis, and epidermal hyperkeratosis; 2) subcutaneous chronic inflammation with subtotal replacement of the adipose lobules by fibrous tissue associated with thickening of the muscular fascia, implying the fasciitis-panniculitis reaction pattern; 3) atrophy, degeneration, necrosis, and focal calcifications of the skeletal muscles; 4) phlebosclerosis, phlebectasias and lymphocytic arteritis; and 5) increased cortical porosity of the bones. It seems that the pathogenetic process underlying the fasciitis-panniculitis syndrome may rarely manifest as a complex regional pain syndrome-like disorder.