The Clinical journal of pain
-
Randomized Controlled Trial Comparative Study Clinical Trial
Secondary prevention of work-related disability in nonspecific low back pain: does problem-solving therapy help? A randomized clinical trial.
Given the individual and economic burden of chronic work disability in low back pain patients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status. ⋯ The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain.
-
To test the predictive utility of the Orebro Musculoskeletal Pain Screening Questionnaire in identifying patients at risk for developing persistent back pain problems. ⋯ The results underscore that psychological variables are related to outcome 6 months later, and they replicate and extend earlier findings indicating that the Orebro Screening Questionnaire is a clinically reliable and valid instrument. The total score was a relatively good predictor of future absenteeism due to sickness as well as function, but not of pain. The results suggest that the instrument could be of value in isolating patients in need of early interventions and may promote the use of appropriate interventions for patients with psychological risk factors.
-
The present study examined the relation of pain catastrophizing to the severity of upper respiratory tract illness. ⋯ The results provide the preliminary evidence that the influence of pain catastrophizing may not be restricted to pain-specific domains. The data also provide some support for the view that the excessive focus on bodily sensations may account for more severe symptoms.
-
To describe the development, implementation, and preliminary outcome of the Pain-Disability Prevention (PDP) Program. The PDP Program is a 10-week cognitive-behavioral intervention program that aims to increase daily involvement in goal-directed activity and minimize psychological barriers to activity involvement after occupational injury. Workers' Compensation Board claimants with soft tissue injuries to the back, who were still off work 6 weeks after injury and showed evidence of at least one "yellow flag," were offered participation in the PDP Program. ⋯ The findings suggest that a psychologically based activity mobilization program can be an effective means of yielding reductions in psychological risk factors for occupational disability. Challenges to program implementation, fidelity to protocol, and issues related to cost efficacy are discussed.
-
Medial branch blocks are an important tool for the diagnosis of facet joint arthropathy. The most commonly used technique involves multiple needle placements, one for each nerve blocked. This multiple needle technique may require a large amount of local anesthetic for anesthetizing the skin, thereby increasing the rate of false-positive blocks. ⋯ When performed correctly, the single needle technique provides accuracy similar to the more conventional multiple needle approach during the performance of diagnostic facet joint nerve blocks. Because only one skin entry point is needed, however, this technique may afford several advantages over the multiple needle approach. These may include less patient discomfort, less time required and less radiation exposure since only one C-arm position is used, a smaller volume of local anesthetic, and possibly a lower incidence of false-positive blocks.