European journal of pain : EJP
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In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with chronic back and leg pain. ⋯ A novel triage tool was developed to identify patients with chronic back and leg pain for an early referral to SCS. This tool, evaluated for feasibility, reliability, and predictive accuracy, shows promise in reducing waiting times and improving patient selection. It can be a prelude to the further development of decision support for SCS and an acceleration in the care process for SCS candidates.
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The internet is increasingly used as a primary source of information for patients with musculoskeletal pain. Private physiotherapy practices provide informative content on low back pain (LBP) and neck pain (NP) on their websites, but the extent to which this information is biopsychosocial, guidelines-consistent, and fear-inducing is unknown. The aim of this study was to analyse the information on websites of private physiotherapy practices in the Netherlands about LBP and NP regarding consistency with the guidelines and the biopsychosocial model and to explore the use of fear-inducing language. ⋯ This study revealed that the majority of private physiotherapy practice websites that provide information on LBP and NP are inconsistent with the biopsychosocial model and current guidelines. This information has a negative impact on patients' knowledge, attitudes, beliefs, and expectations, potentially affecting treatment outcomes. Consequently, most physiotherapy practice websites are unreliable sources of information on LBP and NP for patients. There is an urgent need to implement strategies to make websites reliable and helpful sources of information.
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Lung cancer surgery is associated with a high incidence of chronic postsurgical pain (CPSP), which necessitates long-term analgesic prescriptions. However, while essential for managing pain, these have shown various adverse effects. Current guidelines recommend using peripheral nerve blocks over epidural anaesthesia for perioperative analgesia in minimally invasive thoracic surgery (MITS). However, the impact of perioperative analgesia on chronic analgesic prescriptions remains unclear. Therefore, this study investigated chronic analgesic prescription patterns following MITS in patients with lung cancer who received either perioperative epidural anaesthesia or nerve block. ⋯ This nationwide retrospective study suggests that the choice between perioperative epidural anaesthesia or nerve block in patients with lung cancer undergoing MITS does not influence the proportion of postoperative chronic analgesic prescriptions.
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Complex regional pain syndrome (CRPS) is a debilitating condition characterised by significant heterogeneity. Early diagnosis is critical, but limited data exists on the condition's early stages. This study aimed to characterise (very) early CRPS patients and explore potential subgroups to enhance understanding of its mechanisms. ⋯ This study identifies distinct (very) early CRPS profiles, suggesting different pathophysiological mechanisms and challenging traditional classifications. It paves the way for improved diagnosis and tailored treatments.
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After lumbar spine surgery, a Core Outcome Set (COS) for acute pain is essential to ensure that the most meaningful outcomes are monitored consistently in the perioperative period. The aim of the present study was to consent on a COS for assessing the efficacy of acute pain management for patients undergoing lumbar spinal surgery. ⋯ This research proposes a clinically relevant spine-specific core outcome set (COS) of domains focusing on the acute postoperative phase (until 30 days). This is the first COS for evaluation of acute pain after lumbar spine surgery.