Pain medicine : the official journal of the American Academy of Pain Medicine
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Fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren's syndrome are chronic rheumatic diseases with very different clinical characteristics, but which share symptoms such as pain and fatigue. The aim of the study was to examine the impact of the disease on psychological adaptation in fibromyalgia compared with other rheumatic diseases (rheumatoid arthritis, spondyloarthritis, and Sjögren's syndrome). ⋯ Compared with other rheumatic diseases, fibromyalgia has a greater impact on daily life; patients have more difficulty adjusting to the disease and generally use poorer strategies to cope with pain.
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Randomized Controlled Trial
Integrated Meditation and Exercise Therapy: A Randomized Controlled Pilot of a Combined Nonpharmacological Intervention Focused on Reducing Disability and Pain in Patients with Chronic Low Back Pain.
This pilot trial examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise compared with a control condition in chronic low back pain patients. We hypothesized that meditation before exercise would reduce disability, pain, and anxiety by increasing mindfulness prior to physical activity compared with an audiobook control group. ⋯ . Overall, 4 weeks of MedExT produced suggestive between-group trends for disability, significant between-group differences for measures of pain, and significant within-group increases in mindfulness.
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Pain is prevalent and functionally impactful in older adults. The prefrontal cortex is involved in pain perception, attentional control, and cortical control of locomotion. Although pain is a known moderator of attentional capacity, its moderating effect on cortical control of locomotion has not been assessed. This study aimed to examine the effects of subjective pain on changes in functional near-infrared spectroscopy-derived measurements of oxygenated hemoglobin (HbO2), gait velocity, and cognitive accuracy from single- to dual-task walking conditions among older adults. ⋯ Task-related changes in the hemodynamic response in the prefrontal cortex during walking may be a sensitive marker of the effects of subjective pain on brain function in healthy older adults.
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Cancer-related pain is progressive and therefore requires a stepwise approach to management, such as the World Health Organization's Pain Ladder. This approach calls for increasingly strong pain medications in addition to interventional options for patients with medication-refractory pain or intolerable medication side effects. Here, we discuss a case involving cancer-related pain which ultimately required intrathecal drug delivery system placement for optimal pain management.