The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain.
The objective of this study was to determine the efficacy of percutaneous radiofrequency (RF) thermocoagulation of the ramus communicans nerve in patients suffering from chronic discogenic low back pain. ⋯ In patients with chronic discogenic low back pain, percutaneous RF denervation of the ramus communicans nerve should be considered as a treatment option.
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Review Comparative Study
Manual therapies for pain control: chiropractic and massage.
To evaluate the effectiveness of chiropractic and massage therapy for the reduction of any type of pain. ⋯ The notion that chiropractic or massage are effective interventions for pain control has not been demonstrated convincingly through rigorous clinical trials.
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The factor structure, reliability and validity of the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) were determined in the current study. Furthermore, the ability of the HC-PAIRS to serve as a predictor for work and activity recommendations of paramedical health care providers was examined. ⋯ The HC-PAIRS appears to be a reliable and valid measure of health care providers' attitudes and beliefs about the relationship between pain and impairment. The role of health care providers' attitudes in the treatment of low back pain is discussed.
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This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the following recommendations can be made: 1) multi-component mind-body approaches that include some combination of stress management, coping skills training, cognitive restructuring and relaxation therapy may be an appropriate adjunctive treatment for chronic low back pain; 2) multimodal mind-body approaches such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be an effective adjunct in the management of rheumatoid and osteoarthritis; 3) relaxation and thermal biofeedback may be considered as a treatment for recurrent migraine while relaxation and muscle biofeedback can be an effective adjunct or stand alone therapy for recurrent tension headache; 4) an array of mind-body therapies (eg, imagery, hypnosis, relaxation) when employed pre-surgically, can improve recovery time and reduce pain following surgical procedures; 5) mind-body approaches may be considered as adjunctive therapies to help ameliorate pain during invasive medical procedures.
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The purpose is to examine what is known about the efficacy of selected complementary and alternative medicine (CAM) therapies for pain from arthritis and related conditions based on systematic reviews and meta-analyses. ⋯ Despite support for some of the most popular CAM therapies for pain from arthritis-related conditions, additional high quality research is needed for other therapies, especially for herbals and homeopathy.