Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Mathematical Validation and Credibility of Diagnostic Blocks for Spinal Pain.
Diagnostic blocks are used in different ways for the diagnosis of spinal pain, but their validity has not been fully evaluated. ⋯ Randomized, comparative local anesthetic blocks offer a credibility of 75%, but randomized, placebo-controlled blocks provide a credibility of 95%, and are thereby suitable as a criterion standard for diagnostic blocks.
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OBJECTIVES : This study translates the Pain Catastrophizing Scale (PCS) into Hindi and examines the psychometric properties of the translated version (Hindi PCS [Hi-PCS]) in patients with chronic low back pain (CLBP). METHODS : Forward and backward translations were performed from English to Hindi according to standard methodology. A final version was evaluated by a committee of clinical experts and Hi-PCS was then pilot-tested in 10 patients with CLBP. ⋯ Intraclass correlation coefficient for the Hi-PCS is 0.923 (95% CI: 0.875-0.953). Hi-PCS was moderately correlated with pain intensity (r = 0.651) and functional disability (r = 0.352), and negatively correlated with QoL (r = -0.380). CONCLUSIONS : PCS translation and cross-cultural adaptation to Hindi demonstrated good factor structure along adequate psychometric properties and could be recommended for use in CLBP research in India.
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To determine whether lidocaine test injections would increase the success rate of corticosteroid injection for treatment of impingement syndrome. ⋯ This was the first study to show that a lidocaine pre-injection increases the success rate of steroid injection in patients suspected of having impingement syndrome.
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Multicenter Study
Patients' Perspectives on Tapering of Chronic Opioid Therapy: A Qualitative Study.
OBJECTIVE : There is inadequate evidence of long-term benefit and growing evidence of the risks of chronic opioid therapy (COT). Opioid dose reduction, or opioid tapering, may reduce these risks but may also worsen pain and quality of life. Our objective was to explore patients' perspectives on opioid tapering. ⋯ These patients endorsed improved quality of life following tapering. CONCLUSIONS : Efforts to support opioid tapering should elicit patients' perceived barriers and seek to build on relationships with family, peers, and providers to facilitate tapering. Future work should identify patient-centered, feasible strategies to support tapering of COT.
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To determine the risk factors associated with clinical insomnia in postherpetic neuralgia (PHN) patients. ⋯ Insomnia should be addressed as an important part of pain management in PHN patients with these risk factors, especially in patients with severe pain.