The Clinical journal of pain
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An overview is presented of neuropathic pain syndromes, their characteristic symptoms and signs, and recent approaches to identifying their pathophysiologic mechanisms. ⋯ Precise estimates of the prevalence of neuropathic pain are not available, but chronic neuropathic pain may be much more common than has generally been appreciated and its prevalence can be expected to increase in the future. There is considerable agreement that both peripheral and central processes contribute to many chronic neuropathic pain syndromes, and that these different mechanisms may explain the qualitatively different symptoms and signs that patients experience. The limitations of existing treatments for neuropathic pain and the inability to provide relief for many patients has stimulated ongoing studies that examine different approaches to preventing neuropathic pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lack of both sex differences and influence of resting blood pressure on muscle pain intensity.
To test whether muscle pain intensity caused by different intensities of unaccustomed eccentric exercise was moderately and negatively associated with resting blood pressure, and whether women reported higher pain ratings compared with men in response to such exercise. ⋯ The negative findings, contrary to those predicted from previous experiments in which other types of noxious stimuli have been used, suggest that sex and blood pressure associations with pain intensity are stimulus dependent.
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The aim of this study was to examine childhood traumatic experiences and dissociative characteristics in women with chronic headache and low back pain. ⋯ There were no significant differences between the headache and low back pain groups in terms of prevalence of history of neglect; abuse; or sexual, physical, and emotional abuse separately. In addition, no significant differences were found between the groups with respect to the Dissociative Experiences Scale scores. However, analysis of the SDQ scores showed that the neglect rate in the two groups differed significantly. According to our findings, the neglect rate was higher in the headache group, thus warranting further research to investigate the sensitivity of the SDQ for neglect.
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Comparative Study Clinical Trial
Contribution of individual spa therapies in the treatment of chronic pain.
The aim of the present study was to evaluate the contribution of individual spa therapies administered during a period of 3 weeks on measures of well being and pain in a sample of patients with chronic back pain. ⋯ The results indicate that, in addition to the individual therapies, other factors relating to spa therapy as a whole must contribute to overall treatment outcome. In addition, the results support the efficacy of exercise therapy for chronic back pain.
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Clinical Trial
Dextromethorphan for phantom pain attenuation in cancer amputees: a double-blind crossover trial involving three patients.
Phantom limb pain is an intriguing pain syndrome that may result from damage to peripheral nerve tissue but could also involve central amplifying congeners. N-methyl-D-aspartate (NMDA)-receptor antagonists were recently shown to alleviate neuropathic pain in both animal and human models. Dextromethorphan is a noncompetitive NMDA-receptor antagonist. ⋯ Further clinical trials are warranted to determine the optimal dosage and identify which patients with phantom pain would benefit the most from this therapeutic approach.