Pain medicine : the official journal of the American Academy of Pain Medicine
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The objective of this study was to evaluate the effects of coexisting fibromyalgia syndrome (FS) on pain intensity, disability, and treatment outcome in patients with chronic lateral epicondylitis (LE). ⋯ Coexisting FS may increase the pain intensity and disability, and negatively affect the treatment outcome in patients with chronic LE.
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Comparative Study
An in vivo canine study to assess granulomatous responses in the MedStream Programmable Infusion System (TM) and the SynchroMed II Infusion System®.
A rare, but consistently reported complication of intrathecal (IT) delivery of opioids via programmable implantable infusion pumps is aseptic granuloma formation around the tip of the IT catheter. In the current study, the incidence and severity of IT granuloma formation was assessed for the MedStream Programmable Infusion and SynchroMed II Infusion pumps when delivering saline, baclofen, or morphine at varying concentrations and daily doses. ⋯ In this in vivo canine model of IT drug delivery, catheter tip granuloma formation was associated with higher concentrations and daily doses of morphine infusion while none were seen with baclofen or saline, and was not associated with catheter type. For both pumps, granulomas were only produced in the presence of morphine infusion. These results suggest that the MedStream Programmable Infusion System has a granuloma safety profile at least equivalent to that of the SynchroMed II pump.
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The objectives of this study were to investigate the associations of key constructs of relationship quality (cohesion, consensus, and satisfaction) and perceived partner responses to pain behavior (e.g., solicitous and negative responses) with the outcomes of pain and disability in those with long-term low back pain, and to explore the role of the patient's depressive symptom mood state on those associations. ⋯ Depressive symptoms play a significant role in determining the associations between relationship quality, perceived partner reactions, and pain and disability. The relationship construct of consensus and perceived solicitous responses were associated with pain and disability. These findings illustrate the importance of social context and patient mood state on the outcomes for those with low back pain.
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Clinical Trial
Pain processing in medication overuse headache: a functional magnetic resonance imaging (fMRI) study.
The primary aim was to investigate functional differences between medication overuse headache (MOH) patients and controls with the purpose of evaluating the presence of a global alteration in the processing of noxious stimuli throughout the pain matrix. The secondary aim was to investigate whether activations in MOH patients normalize after medication withdrawal, which would suggest a possible role of the pain matrix in headache chronification. ⋯ Our findings suggest that significant functional changes occur in the lateral pain pathway in MOH patients. These could result from different processes: 1) cortical down-regulation aimed at reducing painful input to the cortex; 2) activity-dependent plasticity induced by excessive painful input during migraine attacks; and 3) direct effect of medication overuse. At 6 months after withdrawal, activity in these regions normalized, suggesting that no irreversible changes occur due to medication overuse.