Pain medicine : the official journal of the American Academy of Pain Medicine
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In the multimodal treatment approach to chronic back pain, interventional back procedures are often reserved for those who do not improve after more conservative management. Psychological screening prior to lumbar surgery or spinal cord stimulation (SCS) has been widely recommended to help identify suitable candidates and to predict possible complications or poor outcome from treatment. However, it remains unclear which, if any, variables are most predictive of pain-related treatment outcomes. ⋯ At present, while there is insufficient empirical evidence that psychological screening before surgery or device implantation helps to improve treatment outcomes, the current literature suggests that psychological factors such as somatization, depression, anxiety, and poor coping, are important predictors of poor outcome. More research is needed to show if early identification and treatment of these factors through psychological screening will enhance treatment outcome.
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Randomized Controlled Trial Comparative Study
Impact of chronic musculoskeletal pathology on older adults: a study of differences between knee OA and low back pain.
The study aimed to compare the psychological and physical characteristics of older adults with knee osteoarthritis (OA) vs those of adults with chronic low back pain (CLBP) and to identify psychological and physical predictors of function as measured by gait speed. ⋯ Older adults with chronic pain may have distinct psychological and physical profiles that differentially impact gait speed. These findings suggest that not all pain conditions are the same in their psychological and physical characteristics and may need to be taken into consideration when developing treatment plans.
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To examine the role of abuse-related injury and posttraumatic stress disorder (PTSD) symptom severity in mediating the effects of assaultive intimate partner violence (IPV) severity, psychological IPV severity, and child abuse severity on chronic pain severity in women survivors of IPV. ⋯ Management of chronic pain in IPV survivors requires attention to symptoms of PTSD, abuse-related injury, and lifetime experiences of violence. Ensuring that acute pain from injury is adequately treated and followed over time may reduce the extent of chronic pain in abused women. The results also support the importance of routine assessment for IPV and child abuse.
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Case Reports
Opioid-free balanced anesthesia for cervical ganglionectomy subsequent to recent ultra rapid opioid detoxification.
To perform an opioid-free, balanced anesthetic for an Active Duty soldier undergoing cervical ganglionectomy for intractable occipital neuralgia 7 days after ultra rapid opioid detoxification (UROD) under general anesthesia. ⋯ This patient successfully completed a perioperative and postoperative course using ketamine and dexmedetomidine infusions, in addition to other non-opioid adjuncts. The patient returned to her Active Duty station, with increased functional capacity and remains opioid-free.
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1) To determine the psychometric properties of a Persian-language version of the Pain Self-Efficacy Questionnaire (P-PSEQ) in Iranian chronic pain patients; and 2) to evaluate the validity of the P-PSEQ in another Iranian chronic pain sample. ⋯ The psychometric properties of the P-PSEQ were confirmed. Consistent with findings in other countries with other language versions of the same scale, pain self-efficacy beliefs are associated with levels of physical disability, depression and general health status of chronic pain patients, over and above the influence of pain severity in this sample of Iranians with chronic pain.