European journal of pain : EJP
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Referred pain and pain characteristics evoked from the upper trapezius muscle was investigated in 20 patients with chronic tension-type headache (CTTH) and 20 age- and gender-matched controls. A headache diary was kept for 4 weeks in order to confirm the diagnosis and record the pain history. Both upper trapezius muscles were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. ⋯ Our results showed that manual exploration of TrPs in the upper trapezius muscle elicited referred pain patterns in both CTTH patients and healthy subjects. In CTTH patients, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual headache pain, consistent with active TrPs. Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients.
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Randomized Controlled Trial
Continuous brachial plexus blockade in combination with the NMDA receptor antagonist memantine prevents phantom pain in acute traumatic upper limb amputees.
Hyperexcitability of N-methyl-d-aspartate acid (NMDA) receptors may play an important role in the development of phantom limb pain (PLP). ⋯ We conclude that memantine can reduce intensity of phantom limb pain and might also prevent the development of PLP. However, despite the very early begin of treatment; no long-term effect on established PLP was evident.
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Multicenter Study Clinical Trial
Cross-sectional evaluation of patient functioning and health-related quality of life in patients with neuropathic pain under standard care conditions.
The purpose of this cross-sectional evaluation was to determine the impact of neuropathic pain (NeP) on patient functioning and Health-Related Quality of Life (HRQoL) under standard care conditions. ⋯ Under standard care conditions, neuropathic and mixed pain are associated with impaired physical and mental QoL, producing a substantial level of disability in these patients.
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Randomized Controlled Trial Comparative Study
Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia.
The aim of this prospective, randomized, double-blinded study was to evaluate the effect of pulsed radiofrequency (PRF) in comparison with conventional radiofrequency (CRF) in the treatment of idiopathic trigeminal neuralgia. A total of 40 patients with idiopathic trigeminal neuralgia were included. The 20 patients in each group were randomly assigned to one of the two treatment groups. ⋯ At the end of 3 months, we decided to perform CRF in Group 2, because all patients in this group still had intractable pain. After the CRF treatment, the median VAS score decreased (p<0.001) and PSS improved (p<0.001) significantly. In conclusion, the results of our study demonstrate that unlike CRF, PRF is not an effective method of pain treatment for idiopathic trigeminal neuralgia.
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Comparative Study Clinical Trial
Contextual cognitive-behavioral therapy for severely disabled chronic pain sufferers: effectiveness and clinically significant change.
Interdisciplinary pain management programs have an established record of significantly improving the functioning of persons disabled with chronic pain. There is a group of pain sufferers, however, who have difficulty accessing these programs and for whom the effectiveness of these treatments in unknown, these are patients whose mobility and self-care deficits leave them unable to meet the practical demands of many treatment environments. The purpose of this study was to examine the results of a treatment program designed to meet the needs of these highly disabled individuals (n=53) in comparison to results obtained from a standard less-disabled group attending treatment at the same facility (n=234). ⋯ Analysis of reliable change and clinical significance demonstrated that results were not merely statistically significant but clinically meaningful. Results appeared stable at three months following treatment. This research plays an important part in establishing an evidence base to inform service development, ensuring that chronic pain services do not exclude people on the basis of the severity of their disability.