Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Evoked pain analgesia in chronic pelvic pain patients using respiratory-gated auricular vagal afferent nerve stimulation.
Previous vagus nerve stimulation (VNS) studies have demonstrated antinociceptive effects, and recent noninvasive approaches, termed transcutaneous-vagus nerve stimulation (t-VNS), have utilized stimulation of the auricular branch of the vagus nerve in the ear. The dorsal medullary vagal system operates in tune with respiration, and we propose that supplying vagal afferent stimulation gated to the exhalation phase of respiration can optimize t-VNS. ⋯ Chronic pain disorders such as CPP are in great need of effective, nonpharmacological options for treatment. RAVANS produced promising antinociceptive effects for quantitative sensory testing (QST) outcomes reflective of the noted hyperalgesia and central sensitization in this patient population. Future studies should evaluate longer-term application of RAVANS to examine its effects on both QST outcomes and clinical pain.
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Clinical Trial
Home-based aerobic conditioning for management of symptoms of fibromyalgia: a pilot study.
This pilot study was designed to evaluate the impact of a home-based aerobic conditioning program on symptoms of fibromyalgia and determine if changes in symptoms were related to quantitative changes in aerobic conditioning (VO(2) max). ⋯ Patients suffering from fibromyalgia who can participate in an aerobic conditioning program may experience physiological and psychological benefits, perhaps with improvement in symptoms of fibromyalgia, specifically pain ratings. More definitive trials are needed, and this pilot demonstrates the feasibility of the quantitative VO2 max method. Subjects who experience significant perceived disability and negative affective symptoms are not likely to maintain a home-based conditioning program, and may need a more comprehensive interdisciplinary program offering greater psychological and social support.
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Intradiscal high-pressure injection of saline (IDHP) is a noninvasive procedure for a lumbar intervertebral disc extrusion and an alternative treatment to surgery, such as microendoscopic discectomy (MED). The purpose of this study was to compare the representative outcomes of IDHP with MED in terms of pain relief, reduction of disability, and risk of complications. ⋯ IDHP produced significant effects on patients with radicular pain, leading to the improvement of VAS and JOA. Although IDHP displayed slightly less efficacy than MED, IDHP appears to be an alternative as a nonoperative treatment for a lumbar intervertebral disc extrusion.