Pain medicine : the official journal of the American Academy of Pain Medicine
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To identify, in community dwelling elders, the determinants of sustained pain improvement or worsening. ⋯ With a 1-month time lag between predictor variable assessment and follow-up pain measures, the study supports temporal associations between depressive symptoms and SRH and subsequent pain change. Clinicians providing care to community dwelling elders are advised to evaluate and attend to both the depressive symptoms and SRH of their patients.
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Specialists in pain medicine commonly experience psychological assaults on their self-esteem, especially from patients who seem unreasonably demanding, overly critical, or threatening. This article will discuss how these challenges can trigger a professional's self-protective and defensive coping mechanisms that, in turn, can provoke decidedly unempathic responses. ⋯ The first set will focus on certain pragmatics of empathy skill development. The second will discuss the Eastern notion of "bare attention" as an ideal form of empathic engagement that can also counteract an unhealthy degree of defensiveness when self-esteem is threatened.
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Advanced complex regional pain syndrome (CRPS) remains very difficult to treat. While subanesthetic low-dose ketamine has shown promise in early localized CRPS, its use in advanced CRPS has not been as effective. Since ketamine's analgesic potency and duration of effect in neuropathic pain are directly dose-dependant, we investigated the efficacy of ketamine in anesthetic dosage in refractory CRPS patients that had failed available standard therapies. ⋯ This open-label trial suggests benefit in pain reduction, associated CRPS symptoms, improved quality of life and ability to work following anesthetic ketamine in previously refractory CRPS patients. However, a randomized controlled trial will be necessary to prove its efficacy.
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To study the relationship between tobacco use and pain intensity. ⋯ Pain intensity was highest among daily smokers and those who had quit. Thus, interventions to prevent smoking (to stop smoking and in particular not to start smoking) among people with chronic pain may not only be considered a method to improve health but also to reduce pain.