Pain medicine : the official journal of the American Academy of Pain Medicine
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In recent years, several published articles have demonstrated that quantitative sensory testing (QST) is useful in the analysis of musculoskeletal pain disorders. Based on the evidence from these studies, it is assumed that QST might be a useful tool in the analysis of the pathogenesis, classification, differential diagnosis, and prognosis of chronic musculoskeletal pain. ⋯ Musculoskeletal pain management may benefit from treatment algorithms that consider mechanism, pain quality, or neurophysiological correlates. Non-invasive QST may be helpful to find sensory array of altered nociceptive process. Due to the diverse etiopathogenetic basis of musculoskeletal pain disorders, a broad range of reliable and valid QST tests may be needed to analyze the various disease entities.
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An Online Survey of Patients' Experiences Since the Rescheduling of Hydrocodone: The First 100 Days.
To conduct an Internet patient survey through the National Fibromyalgia & Chronic Pain Association on reactions to the first 100 days following the rescheduling of hydrocodone. ⋯ The unintended consequences for people with chronic pain that have been caused by the rescheduling effort to impede hydrocodone abuse are negatively impacting thousands. These consequences include suffering from being placed on less effective drugs, increased cost, inconvenience, and negative influence on physician-patient and pharmacist-patient relationships.
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Randomized Controlled Trial
Comparison of the Ventral Epidural Spreading in Modified Interlaminar Approach and Transforaminal Approach: A Randomized, Double-Blind Study.
To evaluate the effectiveness of a modified interlaminar (MIL) approach for accessing ventral epidural space compared with the transforaminal (TF) approach. ⋯ In cases where access to the ventral epidural space by conventional approach is limited, our MIL approach can be considered a suitable alternative, especially in the case of foraminal stenosis.
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Despite current guideline recommendations against the use of opioids for the treatment of fibromyalgia pain, opioid use is reported in approximately 30% of the patient population. There is a lack of information describing the process and results of tapering of chronic opioids. The purpose of this study is to describe opioid tapering and withdrawal symptoms in fibromyalgia patients on opioids. ⋯ Fibromyalgia patients on higher doses of opioids were tapered off over a longer period of time but no differences in withdrawal symptoms were seen based on opioid dose. Duration of opioid use did not affect the time to complete opioid taper or withdrawal symptoms. Despite opioid tapering, pain-related measures improved at the completion of the rehabilitation program.