European journal of pain : EJP
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Following peripheral nerve injury sensory loss is taken as a sign of denervation. However, based on reports of improved sensitivity following relief of pain it has been suggested that a functional block produced by the activity in the nociceptive system itself may be responsible for at least part of the sensory aberrations. The aim was to examine if pain reduction by high-frequency TENS influenced somatosensory functions in patients with long-term unilateral painful traumatic peripheral partial nerve injury. ⋯ Before and following TENS there was no difference in sensory functions between nine patients with ≥ 50% pain reduction and nine patients with a smaller or no reduction in pain. Compared to baseline, only minor TENS-induced alterations in somatosensory functions were found at BE in conjunction with decreased sensitivity to light touch at QST (p < 0.01) in both groups alike. In conclusion ≥ 50% pain reduction by TENS did not alter sensory functions differentially compared to a smaller or no reduction in pain.
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This study tested the hypothesis that chronic widespread pain (CWP) would predict low levels of physical activity (PA). Pain status and PA levels were ascertained at baseline and 32 months in community subjects. Three PA questions were used: "in comparison with others your own age, is your PA "the same" (referent), "more-much more" or "less-much less"", and "during the past month on average how many days/week have you taken exercise that has (i) lasted at least 20 min? and (ii) made you sweat?: "4-7" (referent), "1-3" or "none"". ⋯ This relationship remained after adjustment for confounders (RRR=1.9 (1.3-2.9)). A similar association was observed with exercise that lasted at least 20 min (RRR=1.9 (1.3-2.8)). The current study suggests that low self-reported levels of physical activity are a consequence of having CWP.
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Review Meta Analysis Comparative Study
Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review.
The optimal effective dose of epidural morphine that provides postoperative analgesia after caesarean section with minimal side effects remains debated. ⋯ A single bolus of epidural morphine provides better analgesia than parenteral opioids but with an effect limited to the first postoperative day after caesarean section and with an increase in morphine side effects.
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Comparative Study
Comparison of daily and weekly retrospectively reported pain intensity in patients with localized and generalized musculoskeletal pain.
The purpose of the study was to compare daily and weekly recalled pain intensity over time and their correspondence with real-time pain intensity in patients with localized (LP) and generalized (GP) musculoskeletal pain. Daily recalled pain, averaged over seven consecutive days, and weekly recalled pain at day 8 were recorded on 100 mm visual analogue scales monthly over 4 months for 40 LP and 50 GP patients. Multiple real-time pain ratings on numerical rating scales (0-10) were averaged over the week for 23 LP and 33 GP patients in Month 4. ⋯ Weekly ratings were higher than real-time ratings in the GP group, and the overestimation increased with increasing pain intensity. The results of the present study indicated that reliability was improved by using ratings of daily recalled pain averaged over a week rather than single ratings of weekly recalled pain in subjects with localized or generalized pain. Weekly recalled pain was overestimated in subjects exhibiting generalized pain and high pain intensity.
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Pain and symptoms of depression and anxiety have been observed to co-exist in the community-dwelling elderly. While depression and pain have been suggested to be predictive of one another temporally, the longitudinal associations between anxiety and pain remain undefined. The aim of this study was to investigate the reciprocal longitudinal associations of self-reported pain interference and affective symptoms, as measured by the Hospital Anxiety and Depression Scale, in community-dwelling older adults and report the potentially modifying effect of co-morbid anxiety or depression on these relationships. ⋯ Adjusting for age, gender and co-morbid anxiety or depression slightly reduced the strength of the relationships, though most remained statistically significant. In conclusion, we have found evidence for both pain-depression and pain-anxiety relationships longitudinally, and in a reciprocal manner. Such findings have important implications for the future management of primary care patients presenting with symptoms of pain, anxiety or depression.