European journal of pain : EJP
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Objective of this study is to develop an evidence-based guideline for the noninvasive management of soft tissue disorders of the shoulder (shoulder pain), excluding major pathology. ⋯ Shoulder pain of any duration can be effectively treated with laser therapy, multimodal care (i.e., heat/cold, joint mobilization, range of motion exercise), or cervicothoracic manipulation and mobilization. Shoulder pain (>3 months) can be effectively treated with exercises, laser acupuncture, or general physician care (information, advice, and pharmacological pain management if necessary).
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Observational Study
Seven-year follow up of Persistent Postsurgical Pain in cardiac surgery patients: a prospective observational study of prevalence and risk factors.
Our aim was to describe the long-term prevalence, risk factors and impact on quality of life of persistent postsurgical pain (PPP) following cardiac surgery. ⋯ Seven years after cardiac surgery, almost 10% of patients in this cohort described persistent pain in and around the incision. While higher than previous reports in the literature (limited to up to five post-operative years), this assessment was made following three maximal coughs and therefore is movement or function evoked. High incident of persistent postsurgical pain may adversely affect long-term quality of life which is measured using a validated tool.
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The ultimate goal of pain research is to provide effective routes for pain relief. Nevertheless, the perception pain relief as a change in pain intensity and un-/pleasantness has only been rarely investigated. It has been demonstrated that pain relief has rewarding and reinforcing properties, but it remains unknown whether the perception of pain relief changes when pain reductions occur repeatedly. Further, it remains an open question whether the perception of pain relief depends on the controllability of the preceding pain. ⋯ When in pain, pain relief can become an all-dominate goal. The perception of such pain relief can vary depending on external and internal characteristics and thus modulate, e.g., requests for pain killers in clinical settings. Here, we show that perceived intensity and pleasantness of pain relief changes with repetitions and whether the preceding pain is perceived as uncontrollable. Such mechanistic knowledge needs to be considered to maximize the effects of pain relief as a rewarding and reinforcing stimulus.
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Review
Self-reported prognostic factors in adults reporting neck or low back pain: An umbrella review.
Numerous systematic reviews have attempted to synthesize evidence on prognostic factors for predicting future outcomes such as pain, disability and return-to-work/work absence in neck and low back pain populations. ⋯ Although there was conflicting evidence for the strength of association with outcome, these factors may be used for identifying vulnerable subgroups or people able to self-manage. Further research can investigate the impact of using such prognostic information on treatment/referral decisions and patient outcomes.