Pain medicine : the official journal of the American Academy of Pain Medicine
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To evaluate the analgesic, physical, and psychological outcomes of percutaneous radiofrequency neurotomy for persistent zygapophysial and sacroiliac joint pain in a community setting. ⋯ Neurotomy of the cervical, thoracic, lumbar, and sacroiliac joints were uniformly successful with 72% recipients obtaining an average of 86% reduction in pain for a period of 12 months.
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Socioeconomic status influences the relationship between fear-avoidance beliefs work and disability.
Biopsychosocial models are currently accepted for study of low back pain (LBP), but there is little evidence investigating socioeconomic status (SES) influence on disability, pain intensity, and physical impairment. The present study examined SES (income and education) and fear-avoidance model (fear-avoidance beliefs and pain catastrophizing) for their influence on disability, pain intensity and physical impairment. ⋯ This study adds to the growing literature examining biopsychosocial models by considering SES. Our results suggest SES had a minimal influence on pain intensity and physical impairment, but did interact with fear-avoidance beliefs to influence disability.
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To examine whether the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) screening tool can satisfy Rasch model expectations and therefore be transformed into an interval level measurement scale, suitable for use as an outcome measure in clinical studies. ⋯ Neuropathic screening tools such as the LANSS have been used as outcome measures in clinical studies. Rasch analysis demonstrates that the LANSS can be used as such in specific populations of patients with neuropathic pain, however it's reliability in this context does not support use at the individual level and it cannot be used as a generalised measurement tool across pain diagnostic groups. The LANSS remains primarily a diagnostic tool.
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Improvements in clinical pain care have not matched advances in scientific knowledge, and innovations in medical education are needed. Several streams of evidence indicate that pain education needs to address both the affective and cognitive dimensions of pain. Our aim was to design and deliver a new course in pain establishing foundation-level knowledge while comprehensively addressing the emotional development needs in this area. ⋯ Innovations in medical education about pain are needed. Our aim was to design and deliver a new course for medical students addressing both the affective and cognitive dimensions of pain. Combining small-group sessions with pain specialists, active-learning approaches to pain knowledge, and design-built elements to strengthen emotional skills was highly effective.
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The objective of this study was to examine the associations between chronic pain and psychiatric morbidity using interview-based assessments of psychiatric symptomatology. We compared the prevalence of common mental disorder (CMD; consistent with neurotic and somatic symptoms, fatigue, and negative affect), depression, and anxiety disorder(s), and associated factors with these psychiatric illnesses among Chinese patients with chronic pain attending specialist orthopedics clinic and multidisciplinary pain clinic. ⋯ Chronic pain is associated with psychiatric morbidity. The higher rate of depression than anxiety disorder(s) among patients with chronic pain is consistent with previous studies that have found depression to be highly prevalent in chronic pain.