European journal of pain : EJP
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Case Reports
Spinal cord stimulation in adolescents with complex regional pain syndrome type I (CRPS-I).
Complex regional pain syndrome type I (CRPS-I) is not uncommon in children, particularly in adolescent girls. Most often, the condition involves a foot and is characterized by spontaneous pain, tactile allodynia and dysautonomic signs. There is usually a history of a minor, local trauma but sometimes no reasonable cause can be identified, and there are no signs of persistent tissue injury giving rise to ongoing nociception. ⋯ In one case, a local infection necessitated the removal of the electrode; nevertheless a few days of trial stimulation produced substantial pain relief that still persists. In four patients, the SCS use was gradually diminished and eventually the device could be removed. The favourable outcome in all seven cases with no or minor remaining symptoms and without severe recurrences illustrates that SCS may also be an efficient treatment in paediatric cases with exceptionally therapy resistant forms of CRPS I.
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The purpose of this study was to establish consensus on what factors might predict chronic pain and disability in whiplash injuries following motor vehicle collisions. A Delphi poll involving two rounds of data collection was used as a way to reach consensus among participating experts. ⋯ These findings may be used to help identify the specific domains that should be assessed in studies seeking to predict which individuals are at risk to develop chronic pain and disability following initial whiplash-associated disorders sustained in crash. If these results are supported by future studies, then they could be used to help develop intervention programs that could prevent long-term pain and disability in whiplash patients who are considered to be at risk to develop chronic disabling pain problems.
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Distraction is a commonly used strategy to control pain. However there is doubt about its effectiveness as a clinical tool, and results from both experimental and clinical studies remain inconclusive. Recent theoretical advancements suggest that distraction of attention may be less effective when pain is threatening. ⋯ The hypothesis that the effectiveness of distraction is modulated by the threat value of pain could not be confirmed. However, threatening information increased catastrophic thoughts and anxiety, and interfered with performance on the distraction task. These findings suggest that caution is required in using distraction as a pain control strategy when the threat value is high, because fearful appraisal of pain is associated with less engagement in distraction tasks.
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Multicenter Study
Care related pain in hospitalized patients: a cross-sectional study.
Care-related pain includes pain occurring during transportation, movement, diagnostic imaging, physical examination, or treatment. Its prevalence has never been assessed in a large adult inpatient population. ⋯ This survey gives new insight into our daily practice. Proper management of care-related pain should be a major concern of all hospital staff to improve the quality of our health care.
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Although the current clinical guideline of diagnostic criteria for the complex regional pain syndrome I (CRPS I) is a landmark endeavour to define this complex condition it does not prioritise its most important clinical manifestations. ⋯ This expert survey conveys an agreed set of relevant diagnostic parameters of CRPS I and proposes that in follow-up examinations treatment success should be based on restoration of those manifestations.