Pain medicine : the official journal of the American Academy of Pain Medicine
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Cigarette smoking and musculoskeletal pain are prevalent among Department of Veterans Affairs (VA) health care system users. These conditions frequently co-occur; however, there is limited empirical information specific to Afghanistan/Iraq era veterans. The present study sought to examine gender differences in the association between cigarette smoking and moderate to severe musculoskeletal pain in US veterans with Afghanistan/Iraq era service. ⋯ Survey data from Operation Enduring Freedom/Operation Iraqi Freedom veterans suggest an association between current smoking, gender, and moderate to severe musculoskeletal pain. The stronger relationship between smoking and pain in women supports the need for interventional and longitudinal research that can inform gender-based risk factors for pain in veteran cigarette smokers.
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Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). ⋯ Genicular C-RFA demonstrated a success rate of 35% based on a robust combination of outcome measures, and 19% of procedures resulted in complete relief of pain at a minimum of six months of follow-up. Report of 80% or greater relief from diagnostic blocks and duration of pain of less than five years are associated with high accuracy in predicting treatment success. Further prospective study is needed to optimize the patient selection protocol and success rate of this procedure.
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The pathophysiology of fibromyalgia has been related to central pain sensitization. This study tested a laboratory protocol evaluating responses to slowly repeated evoked pain stimuli (SREP) that may index central pain sensitization in fibromyalgia. ⋯ A protocol employing a single series of nine low-suprathreshold-intensity slowly repeated pain stimuli elicits increased perceived pain in fibromyalgia patients, consistent with central sensitization despite relatively long interstimulus intervals. SREP appears to be more useful than traditional evoked pain threshold tolerance measures in terms of predicting levels of clinical pain and discriminating between fibromyalgia patients and healthy individuals.
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To evaluate current opioid prescribing patterns nationally and regionally across several northern New England states and compare with prescription data on an institutional level over a two-year period, between 2013 and 2014. ⋯ The review of opioid prescriptions filled in 2013-14 suggests that national opioid utilization may be reaching a plateau. Initiatives such as prescription monitoring programs, prescriber opioid education, addiction treatment programs, public addiction awareness, and availability of medical cannabis may play a role in interstate variability of opioid use. National and regional data served as a benchmark for local institutional comparison, laying groundwork for efforts to explore areas where opioids can be prescribed more judiciously.
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Increasing evidence suggests the potential involvement of metalloproteinase family proteins in the pathogenesis of neuropathic pain, although the underlying mechanisms remain elusive. ⋯ Our findings indicate that neuron-derived ADAM10 production stimulates peripheral nerve injury-induced neuropathic pain by cleaving E-cadherin in satellite glial cells.