The Clinical journal of pain
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Review Meta Analysis Comparative Study
Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia.
Little is known of the effectiveness of nonpharmacological interventions for fibromyalgia syndrome (FMS). The authors therefore carried out a systematic review from 1980 to May 2000 of randomized controlled trials (RCTs) of nonpharmacological interventions for FMS. ⋯ The varying combinations of interventions studied in the RCTs and the wide range of outcome measures used make it hard to form conclusions across studies. Strong evidence did not emerge in respect to any single intervention, though preliminary support of moderate strength existed for aerobic exercise. There is a need for larger, more methodologically rigorous RCTs in this area.
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Randomized Controlled Trial Comparative Study Clinical Trial
The lidocaine patch 5% effectively treats all neuropathic pain qualities: results of a randomized, double-blind, vehicle-controlled, 3-week efficacy study with use of the neuropathic pain scale.
Several controlled clinical trials have demonstrated the efficacy and safety of the lidocaine patch 5% (LP) for the treatment of postherpetic neuralgia (PHN). ⋯ This study demonstrates that LP reduces the intensity of all common neuropathic pain qualities and thus may be of potential benefit for nonallodynic neuropathic pain states. Furthermore, these findings suggest that peripheral mechanisms may play a role in the pathophysiological development of pain qualities that heretofore have been assumed not to involve peripheral mechanisms, such as "dull," "deep," "sharp," and "burning" pains.
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The authors reviewed the available pediatric pain literature and selected those studies that reported quantitative information on the reliability and validity of, and the optimal cutoff points for, the visual analog scale (VAS) when used as an observational pediatric pain tool. ⋯ Further psychometric testing needs to be conducted on intraobserver reliability, responsiveness, and optimal cutoff points. Future research may guide the choice between VAS (obs) and the numerous behavioral pain instruments.
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Chronic pain is prevalent in many Western countries. Its prevalence in a non-Caucasian population is not known. The authors performed this study to measure the prevalence of chronic pain in the Hong Kong Chinese adult population, as well as the pattern of pain and the demographic characteristics, the impact on social and work function, and the help-seeking behavior of those with pain. ⋯ The study showed that the prevalence of chronic pain in Hong Kong adults was approximately 10.8%. Work and daily life are significantly affected and there is considerable demand on the health care system. Despite the ethnic difference, the prevalence, pattern, and demographic characteristics of chronic pain in Hong Kong are very similar to those seen in Western countries.
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This study examined the relation between level of educational achievement (LOE) and the clinical morbidity associated with chronic pain. ⋯ After controlling for relevant covariates, LOE was unrelated to pain intensity, severity of depressive symptoms, or affective distress, but was inversely related to self-reported disability. Persons with lower LOEs possessed a greater belief that pain is a "signal of harm," unrelated to emotional experience, disabling and uncontrollable. They also endorsed more passive and maladaptive coping strategies, including a tendency to catastrophize about their pain. Path analysis indicated that, after controlling for the influence of both the belief that pain is a "signal of harm" and catastrophizing on the association between LOE and disability, this relation loses statistical significance. These results suggest that pain-related cognitions mediate the relation between LOE and pain disability and that persons with lower LOEs are more likely to develop maladaptive pain beliefs and coping strategies.