Journal of pain research
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Journal of pain research · Jan 2016
ReviewPrognostic value of quantitative sensory testing in low back pain: a systematic review of the literature.
Quantitative sensory testing (QST) measures have recently been shown to predict outcomes in various musculoskeletal and pain conditions. The aim of this systematic review was to summarize the emerging body of evidence investigating the prognostic value of QST measures in people with low back pain (LBP). The protocol for this review was prospectively registered on the International Prospective Register of Systematic Reviews. ⋯ None of them reported a significant association between the QST measures assessed and the LBP outcome. Three areas at high risk of bias were identified which potentially compromise the validity of these results. Due to the paucity of available studies and the methodological shortcomings identified, it remains unknown whether QST measures are predictive of outcome in LBP.
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Journal of pain research · Jan 2016
ReviewPsychosocial management of chronic pain in patients with rheumatoid arthritis: challenges and solutions.
There are numerous reviews and meta-analyses that confirm that psychological therapy is efficacious for patients with rheumatoid arthritis (RA) in terms of managing pain. Therefore, the literature has moved on to answer additional questions: 1) What types of interventions are most strongly supported by the current evidence? 2) Do different patients benefit from different approaches? 3) When is it best to intervene? 4) What modalities are best for administering the intervention? 5) What model of care should we be proposing that will result in widespread implementation and will ensure access for patients with RA? This review concludes that cognitive behavioral therapy (CBT) is the most efficacious treatment for pain management in RA; however, there are indications that mindfulness may have particular benefits for patients with a history of depression. ⋯ One of the major challenges is ensuring access to effective interventions for patients, particularly early on in the course of the disease, with a view to preventing physical and psychological morbidity. A stepped-care model is proposed; however, we urgently need more, better-quality trials of minimal interventions, particularly in Internet-delivered CBT, which appears promising and may form the cornerstone of future stepped-care models for providing psychosocial care to patients with RA.
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Journal of pain research · Jan 2016
Dysesthesia symptoms produced by sensorimotor incongruence in healthy volunteers: an electroencephalogram study.
Pathological pain such as phantom limb pain is caused by sensorimotor incongruence. Several studies with healthy participants have clearly indicated that dysesthesia, which is similar to pathological pain, is caused by incongruence between proprioception and/or motor intention and visual feedback. It is not clear to what extent dysesthesia may be caused by incongruence between motor intention and visual feedback or by incongruence between proprioception and visual feedback. The aim of this study was to clarify the neurophysiology of these factors by analyzing electroencephalograms (EEGs). ⋯ The present findings suggest that neural mechanisms of dysesthesia are caused by incongruence between proprioception associated with motor intention and visual feedback and, in particular, are a result of incongruence between proprioception only and visual feedback.
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Journal of pain research · Jan 2016
Repetitive transcranial magnetic stimulation versus botulinum toxin injection in chronic migraine prophylaxis: a pilot randomized trial.
Chronic migraine is a prevalent disabling disease, with major health-related burden and poor quality of life. Long-term use of preventive medications carries risk of side effects. ⋯ BTX-A injection and rTMS have favorable efficacy and safety profiles in chronic migraineurs. rTMS is of comparable efficacy to BTX-A injection in chronic migraine therapy, but with less sustained effect.
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Failed back surgery syndrome (FBSS) is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or without it radiating to the leg. The possible reasons and risk factors that would lead to FBSS can be found in distinct phases: in problems already present in the patient before a surgical approach, such as spinal instability, during surgery (for example, from a mistake by the surgeon), or in the postintervention phase in relation to infections or biomechanical alterations. ⋯ The dysfunction of the diaphragm muscle is a component that is not taken into account when trying to understand the reasons for this syndrome, as there is no existing literature on the subject. The diaphragm is involved in chronic lower back and sacroiliac pain and plays an important role in the management of pain perception.