Pain medicine : the official journal of the American Academy of Pain Medicine
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To assess whether computed tomography (CT)-guided injections of local anesthetic and corticosteroid into chronic lumbar pars interarticularis defects may identify and provide benefit to a cohort of patients where the pars defects act as a primary axial pain generator. ⋯ This practice audit suggests that in patients with axial low back pain and chronic pars defects, the pars defects may be implicated as the primary axial pain generator in a small subgroup of patients. Local deposition of corticosteroids into the pars defect may provide significant pain relief in one out of three patients, and complete relief in one out of five patients. This data suggest there may be benefit to pursuing randomized controlled trials of pars injections comparing steroid injection with placebo.
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To investigate associations of pain intensity in those with long-term back pain, with their partners' rating of key constructs of relationship quality: cohesion (activities together), consensus (affection, sexual relations), satisfaction (conflict, regrets). ⋯ These findings illustrate the association of pain outcomes beyond the patient within a primary care sample. Moderators of the responses about the relationship construct of consensus generated by partners appear to be partners' own level of depressive symptoms and whether their depressive symptoms are associated with the patients' pain intensity. Consultations should consider the social context of patients with pain.
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Post-traumatic stress disorder (PTSD) and pain have a well-documented high comorbidity; however, the underlying mechanisms of this comorbidity are currently poorly understood. The aim of this psychophysical study was to investigate the behavioral response to a prolonged suprathreshold pain stimulus in subjects with combat-related PTSD and combat controls (CC) for clinical evidence of central sensitization. ⋯ These findings are consistent with a significantly higher degree of acute central sensitization in individuals with PTSD. Increased acute central sensitization may underlie increased vulnerability for developing pain-related conditions following combat trauma.
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It has been documented that pain in people with dementia is often under-reported and poorly detected. The reasons for this are not clearly defined. This project aimed to explore semantic concepts of pain in people with dementia and whether this is associated with clinical pain report. ⋯ This study is the first to show that semantic memory for pain is diminished in dementia patients. When using clinical pain tools, clinicians should consider these effects which may bias clinical pain ratings when they evaluate and manage pain in these patients. This might improve the recognition and management of pain in people with dementia.
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We aimed to determine Axis-I psychiatric disorders in patients with chronic pain (CP) and compare control subjects determined by a structured clinical interview. Another objective of the study was to examine whether there is an association between psychiatric disorders and quality of sleep, quality of life, and demographic and clinical characteristics in patients with CP. ⋯ Results of this study suggest that psychiatric morbidity in patients with CP is frequently seen and may adversely affect quality of sleep and quality of life of the patients. Therefore, the patients with CP should be examined with respect to their mental status.