Pain medicine : the official journal of the American Academy of Pain Medicine
-
Post-laminectomy syndrome (PLS) patients who have previously undergone spinal cord stimulation and failed to have significant improvement create a unique challenge for ongoing pain management. We hypothesize that, following successful completion of intensive, interdisciplinary pain rehabilitation (IPR), this patient population can achieve a significant reduction in pain, improvement in mood, functional levels, and self-efficacy. ⋯ Intensive, interdisciplinary pain rehabilitation provides an effective therapeutic modality for patients with post-laminectomy syndrome who have failed spinal cord stimulation by decreasing pain levels and by increasing functional status and self-efficacy.
-
Observational Study
Does Immediate Pain Relief After an Injection into the Sacroiliac Joint with Anesthetic and Corticosteroid Predict Subsequent Pain Relief?
To determine if immediate pain response following an injection with local anesthetic and corticosteroid predicts subsequent relief. ⋯ Patients who fail to achieve initial relief after SIJ injection with anesthetic and steroid are very unlikely to achieve significant pain relief at follow-up; negative likelihood ratios (LR) in this study, based on how success is defined, range between 0 and 0.9. Clinically significant positive likelihood ratios of anesthetic response to SIJ injection are more limited and less robust, but are valuable in predicting 50% relief or 100% relief at two to four weeks.
-
The Specialty Care Access Network-Extension for Community Health Outcomes (SCAN-ECHO) is a video teleconferencing-based training program where primary care providers are trained by a specialty care team to provide specialty care. A multidisciplinary team of pain management specialists at the Cleveland Veterans Affairs Medical Center established such a program for pain management; a description and preliminary effectiveness assessment of this training program is presented. ⋯ This pilot study reveals positive outcomes in terms of primary care providers' confidence and knowledge in treating patients with chronic pain. Results suggest that involving primary care providers in a one-year academic project such as this can improve their knowledge and skills and has the potential to influence their opioid prescribing practices.
-
Cognitive processes may be characterized as how individuals think, whereas cognitive content constitutes what individuals think. Both cognitive processes and cognitive content are theorized to play important roles in chronic pain adjustment, and treatments have been developed to target both. However, the evaluation of treatments that target cognitive processes is limited because extant measures do not satisfactorily separate cognitive process from cognitive content. The current study aimed to develop a self-report inventory of potentially adaptive and presumed maladaptive attentional processes that may occur when someone is experiencing pain. ⋯ The developed PCPQ scales offer a comprehensive assessment of important cognitive processes specific to pain. Overall, the findings suggest that the PCPQ scales may prove useful for evaluating the role of pain-related cognitive processes in studies of chronic pain.