Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
A Randomized Clinical Trial of Group Acupuncture for Painful Diabetic Neuropathy Among Diverse Safety Net Patients.
Existing pharmacologic approaches for painful diabetic neuropathy (PDN) are limited in efficacy and have side effects. We examined the feasibility, acceptability, and effects of group acupuncture for PDN. ⋯ Group acupuncture is feasible and acceptable among linguistically and racially diverse safety net patients. Findings suggest clinically relevant reduction in pain from PDN and quality of life improvements associated with acupuncture, with no differences based on frequency.
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Acute exercise can trigger a hypoalgesic response (exercise-induced hypoalgesia [EIH]) in healthy subjects. Despite promising application possibilities of EIH in the clinical context, its reliability has not been sufficiently examined. This study therefore investigated the between-session and within-subject test-retest reliability of EIH at local and remote body parts after aerobic cycling at a heart rate-controlled intensity. ⋯ Our results suggest fair test-retest reliability of EIH after aerobic cycling for local and semilocal body parts, but only in men, demonstrating the need for more standardized methodological approaches to improve EIH as a clinical parameter.
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Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. ⋯ Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.
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To determine the relationship between opioid dose change, pain severity, and function in patients with chronic pain. ⋯ The results suggest that escalating opioid doses may not necessarily result in clinically significant improvement of pain or disability. Similarly, significant opioid dose reductions may not necessarily result in worsened pain or disability. This exploratory investigation raised questions of possible subgroups of patients who might demonstrate improvement of pain and disability with opioid dose adjustments, and further research should prospectively explore this potential, given the limitations inherent in retrospective analyses. Prescribers should still consider reduction of opioid doses as recommended by current guidelines, in an effort to mitigate the potential risks associated with high-dose treatment.