Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Meta Analysis Comparative Study
Experimental approaches in the study of pain in the elderly.
The present review summarizes experimental data on age-related changes in pain processing. These data suggest an increase in pain threshold and a decrease in tolerance threshold, which both are dependent on the physical nature of the stressor, as well as a developing deficiency in endogenous pain inhibition, which might be paralleled by an enhanced disposition to central sensitization (stronger temporal summation). These findings are arranged in a model that allows for explaining the two seemingly divergent perspectives: age both dulls the pain sense and increases the prevalence of pain complaints. This model is based on the assumption that both excitatory and inhibitory processes are dampened with age but that the later processes age at a faster rate, leading to increasingly unbalanced pain excitation.
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The objectives of this study were 1) to determine the level of education around the world and to identify strong evidence upon which future educational initiatives could be established; and 2) to establish a collaboration who could lead the way in terms of recommendations and educational developments for the care of older adults around the world. ⋯ Several recommendations can be made from this work: 1) establish an expert working group who can provide the experience and skills necessary to develop a multidisciplinary curriculum on pain in older adults--this has been achieved through this current work; 2) conduct a thorough systematic review of the literature around pain assessment and management, which could inform a curriculum; and 3) seek representation for membership of the expert group on the IASP core curriculum working group.
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Review Comparative Study
A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter?
Pain is a subjectively complex and universal experience. We examine research investigating ethnic group differences in experimental pain response and factors contributing to group differences. ⋯ There are potentially important ethnic/racial group differences in experimental pain perception. Elucidating ethnic group differences has translational merit for culturally competent clinical care and for addressing and reducing pain treatment disparities among ethnically/racially diverse groups.
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Multicenter Study
Occipital nerve pulsed radiofrequency treatment: a multi-center study evaluating predictors of outcome.
Occipital neuralgia (ON) is a challenging condition for which there is no reference standard for treatment. The purpose of this study was to provide outcome data on the largest study to date evaluating pulsed radiofrequency (PRF) for ON and to determine whether any demographic, clinical, or treatment characteristics are associated with success. ⋯ PRF may provide intermediate-term benefit in ON to a significant proportion of refractory cases. Careful attention to selection criteria and treatment parameters may further improve treatment outcomes.