Pain medicine : the official journal of the American Academy of Pain Medicine
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Diabetic neuropathic pain is associated with small fiber neuropathy. We aimed to assess the functionality of small fibers in patients with diabetes by using a practical method. ⋯ There is an unmet need to practically assess the functionality of small fibers in patients with pain. In this study, a practical and objective method that does not need special expertise for the measurement of the functional properties of small fibers by using axon-flare responses is presented. The LASCA method could potentially facilitate a practical, quick (within 5 minutes), and very early diagnosis of small fiber hypo-functionality in both patients with IGT and DNP.
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To describe differences between patients with chronic, non-cancer pain (CNCP) who were successfully able to cease full mu agonist chronic opioid analgesic therapy (COAT), and those who exhibited refractory COAT reliance, among those who participated in a multidisciplinary program designed for COAT cessation. ⋯ Results suggest that fear avoidance beliefs and behavior, as measured by the FAB, play a significant role in refractory COAT reliance for patients with CNCP.
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The placebo effect is important in determining the outcome of the treatment of pain for which expectancy and context are the main contributors. The variable success of thermal neurotomy spinal pain procedures is often seen as evidence of the placebo effect. Conversely, proponents of pain procedures explain poorer outcomes by technical procedure deficiencies, including inadequate diagnosis. This cohort study set out to determine whether patient expectancy is a contributing factor in the outcome of thermal neurotomy to the cervical, thoracic, and lumbar zygapophysial and sacroiliac joints. ⋯ Altogether, patient expectation of outcome, hope, and desire are not associated with the outcome of effective pain relief by thermal neurotomy that has been performed to the appropriate and commonly available technical standards. Further work is needed to determine the influence of patient expectation across a range of pain intervention modalities.
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Meta Analysis
Effects of Acupuncture on Postoperative Pain after Total Knee Replacement: Systematic Literature Review and Meta-Analysis.
To identify the analgesic effectiveness of acupuncture after total knee replacement by systematic review. ⋯ As an adjunct modality, the use of acupuncture is associated with reduced pain and use of analgesic medications in postoperative patients. In particular, ear acupuncture 1 day before surgery could reduce analgesia .
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Pain is a common complaint in maintenance hemodialysis (MHD) patients, and it is often inadequately assessed and inappropriately treated. ⋯ According to the PMI, most dialysis patients were found to be inappropriately treated. About one third received opioids, but even among them, inappropriate treatment was common. Pain management in MHD patients needs to be improved.