Pain medicine : the official journal of the American Academy of Pain Medicine
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Productive patient-clinician communication is an important component of effective pain management, but we know little about how patients and clinicians actually talk about pain in clinical settings and how it might be improved to produce better patient outcomes. The objective of this review was to create a conceptual model of patient-clinician communication about noncancer pain, review and synthesize empirical research in this area, and identify priorities for future research. ⋯ Published studies on patient-clinician communication about noncancer pain are few and diverse. The conceptual model presented here can help to identify knowledge gaps and guide future research on communication about pain. Investigating the links between communication and pain-related outcomes is an important priority for future research.
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Early childhood is a time of rapid development, particularly of the central nervous system, and can set a foundation for the entire life course. Complex pain in young children can impact the quality of life through limiting physical and social development, compromising psychological well-being, and disrupting sleep. The aim of this review is to identify the needs of young children who present to a tertiary-level pain service, what services they require, and their treatment outcomes. There are limited data on this vulnerable population, which may be due to small numbers represented and the complexities of pain assessment in this age group. ⋯ All but two young children had an obvious physical pathology as an explanation for pain; this is in contrast to studies of pain clinics servicing adolescents. A diverse range of conditions, some rare, were identified, requiring a high level of pediatric understanding of the disease process and an ability to work with primary teams with expertise in disease-modifying strategies.
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Randomized Controlled Trial
Effects of Stellate Ganglion Block on Analgesia Produced by Cervical Paravertebral Block as Established by Quantitative Sensory Testing: A Randomized Controlled Trial.
To use quantitative sensory testing (QST) to assess whether a stellate ganglion block (SGB) modulates the analgesia induced by cervical paravertebral block (CPVB). ⋯ We were unable to demonstrate any analgesic benefit of CPVB + SGB in arthroscopic shoulder surgery. It is therefore not unreasonable to suppose that pain from soft tissue injuries without bony lesions is transmitted mainly by somatic nerves with no or only minimal involvement of the sympathetic nervous system.
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Examine the longitudinal association between knee pain and prefrailty/frailty. ⋯ Knee pain (particularly bilateral knee pain) is associated with an increased risk of developing prefrailty and frailty over time.
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Exercise increases pressure pain thresholds (PPTs) in exercising and nonexercising muscles, known as exercise-induced hypoalgesia (EIH). No studies have investigated the test-retest reliability of change in PPTs after aerobic exercise. Primary objectives were to compare the effect on PPTs after an incremental bicycling exercise compared with quiet rest and to investigate the relative and absolute test-retest reliability of the test stimulus (PPT) and the absolute and relative EIH response in exercising and nonexercising muscles. ⋯ Incremental bicycling exercise increased PPTs with fair relative and absolute reliability of the EIH response. These data might have an impact on future studies investigating EIH and for clinicians designing exercise programs for pain relief.