Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Modulation of mRNA expression of IL-6andmTORC1 and efficacy and feasibility of an integrated approach encompassing cognitive behavioral therapy along with Pregabalin for management of neuropathic pain in Postherpetic Neuralgia: A Pilot Study.
This study was designed to explore the efficacy and feasibility of cognitive behavioral therapy (CBT) along with pregabalin and compare it with pregabalin monotherapy for the management of neuropathic pain in post-herpetic neuralgia (PHN) patients and to explore the modulation of messenger RNA (mRNA) expression of interleukin (IL)-6 and mammalian target of rapamycin-1 (mTORC1) genes in these patients. ⋯ A significant downregulation of mRNA expression of IL-6 was observed; however, no significant correlation was observed between NRS pain score and ΔCt values of mRNA expression of both mTORC1 gene and IL-6 gene at baseline and at the end of 12th week. In addition, we note a significant decrease in pain intensity, depressive symptoms, and pain-related catastrophizing while improving QOL was observed with the use of CBT as a clinical adjunct along with pregabalin in PHN patients.
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Myofascial trigger point diagnosis is a clinical palpatory skill dependent on the patient's subjective response. The inter- and intra-rater reliability of trigger point physical evaluation in the lower leg muscles has rarely been reported. Previous reliability studies suffered from the Kappa paradox. ⋯ Physical examination is a reliable method of trigger point evaluation in lower leg muscles, and it can be used as a diagnostic method for trigger point evaluation.
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This study aimed to capture day-to-day changes in pain intensity in individuals with low back pain (LBP), which may be indicative of patients' ability to modulate their pain levels. A secondary aim was to explore the presence of latent subgroups characterized by pain level, intraindividual pain variability, and change in pain over a 14-day period. ⋯ These findings provide support that day-to-day changes in pain, coping, and affective responses are meaningful and provide additional evidence of pain variability as a potential phenotypic characteristic.
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Individuals with obesity frequently contend with chronic pain, but few studies address the clinical impact of coordinated pain services on this population. The current study addresses this topic by comparing the effectiveness of a comprehensive pain rehabilitation program for patients with and without obesity. ⋯ Multidisciplinary pain rehabilitation programs appear to be an effective treatment intervention for patients who have concomitant chronic pain and obesity, to a degree comparable to patients who have chronic pain but do not contend with obesity. Implications for program development, clinical interventions, and future research are discussed.