European journal of pain : EJP
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Randomized Controlled Trial
Predicting rapid recovery from acute low back pain based on the intensity, duration and history of pain: A validation study.
Clinical prediction rules can assist clinicians to identify patients with low back pain (LBP) who are likely to recover quickly with minimal treatment; however, there is a paucity of validated instruments to assist with this task. ⋯ The results suggest that the rule can be used to provide accurate information about expected recovery from acute LBP, within the first few weeks of patients presenting to primary care. Impact analysis to determine if the rule influences clinical behaviours and patient outcomes is required.
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Heterotopic and homotopic nociceptive conditioning stimulation: Distinct effects of pain modulation.
Within an area, habituation and sensitization represent well-established modulatory effects to repetitive noxious input. Less is known regarding the nociceptive conditioning effects between body sites - i.e., how stimulating one site may affect another. Therefore, we investigated the effects of nociceptive stimulation of anatomically distinct locations (shoulder and hand) on pain rating and evoked potentials (i.e., contact heat-evoked potentials). ⋯ Overall, these findings indicate that response modulation to noxious contact heat stimulation depends upon conditioning stimulus location. These effects represent changes beyond conventional habituation due to repeated stimulation in the same area.
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Whether fibromyalgia syndrome (FMS) can be classified as a somatoform disorder is under debate. ⋯ The clinical features of FMS and persistent somatoform pain disorder or somatization disorder according to the International Classification of Diseases (ICD)-10 overlap in individuals with chronic widespread pain without specific somatic disease factors. FMS is not synonymous with somatoform disorder.
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Physical deconditioning in combination with societal and emotional factors has been hypothesized to compromise complete recovery from low back pain (LBP). However, there is a lack of longitudinal studies designed to specifically investigate physical activity as an independent prognostic factor. We conducted a prognostic study to investigate whether levels of leisure time physical activity are independently associated with clinical outcomes in people seeking care for chronic and persistent LBP. ⋯ Our findings suggest that physical activity levels may have a role in the prognosis of LBP. Specific domains of physical activity warrant further investigation to better understand this association.
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A 50% reduction in pain intensity difference (50%PID) between baseline and follow-up evaluation is commonly accepted as adequate pain relief in emergency departments (EDs). However, 50%PID seems to be problematic with the 11-point numerical rating scale (NRS) since even baseline values are more divisible by 2 (50% reduction) than odd baseline values. This study evaluated the impact of this bias and integrated time between baseline and follow-up measurements, hypothesizing that the slope of relative pain intensity difference (SRPID) is a more accurate gauge of pain relief that can decrease bias and incorporate the time component of pain relief. ⋯ The 50%PID method with an 11-point NRS for assessing adequate pain relief is significantly biased for specific baseline pain intensity level. In the particular context of ED acute pain, the SRPID seems less biased.