Pain medicine : the official journal of the American Academy of Pain Medicine
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Review Case Reports
Neuromodulation in Postherpetic Neuralgia: Case Reports and Review of the Literature.
Postherpetic neuralgia (PHN) is common in the United States. Current treatment options for PHN are fairly limited. Spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) are considered mostly experimental and still rarely performed in patients with PHN. ⋯ Based on our review of the literature and the two cases at MCF, subcutaneous PNS seems to be a promising intervention in the treatment of PHN.
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To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. ⋯ Smartphones that focus on supporting medication management, enhancing communication with providers, and facilitating connectedness within social networks to reduce feelings of isolation may help to improve CNCP outcomes in older adults.
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Randomized Controlled Trial
How Classical Conditioning Shapes Placebo Analgesia: Hidden versus Open Conditioning.
To investigate the influence of expectancy of pain intensity, fear of pain (trait), and fear (state) on the effectiveness of hidden and open conditioning to produce placebo analgesia. ⋯ Fear seems to be a more important factor than expectancy in producing placebo analgesia induced by hidden conditioning.
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Observational Study
A Survey of Physicians' Knowledge and Adherence to the Diagnostic Criteria for Fibromyalgia.
In 2010, Wolfe et al. demonstrated poor physician use of the 1990 fibromyalgia diagnostic criteria and proposed the 2010 criteria to address physician shortcomings. No follow-up studies have investigated whether physicians are using these criteria. The purpose of this study was to provide seminal data on physician knowledge and use of the fibromyalgia diagnostic criteria. ⋯ Physicians do not have adequate and homogenous knowledge of the fibromyalgia diagnostic criteria. Approximately half of physicians did not adhere to the criteria. Poor knowledge and adherence to the criteria may increase diagnosis delays and misdiagnoses. Knowledge translation strategies should be implemented to address this problem.
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Family physicians in Canada receive little training in chronic pain management; concomitantly, they face increasing pressure to reduce their prescribing of opioids. Project ECHO Ontario Chronic Pain/Opioid Stewardship (ECHO) is a telementoring intervention for primary care practitioners that enhances their pain management skills. This qualitative study reports participants' experiences and assessment of ECHO. ⋯ Managing patients with chronic pain in primary care can be difficult, particularly in remote or underserved practices. Project ECHO offers guidance to primary care practitioners for their most challenging patients, promotes knowledge acquisition and diffusion, and stimulates the development of a "community of practice."