Pain medicine : the official journal of the American Academy of Pain Medicine
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To review clinical strategies for long-term opioid management as well as strategies to assess and monitor patients with moderate to severe chronic pain who may be at risk for aberrant drug-related behaviors. ⋯ Vigilance and frequent interactions may sometimes be inadequate to prevent problematic behaviors; therefore, pharmacologic strategies designed to deter abusive behaviors are also discussed.
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The aim of this study was to examine the association of pain catastrophizing and pain coping strategies with characteristic pain intensity (an average of worst, least, and typical pain intensity in the past week) and recent pain-related disability (an average of three measures of past week pain interference) in opioid-dependent patients enrolled in a methadone maintenance treatment program (MMTP) who reported recent pain. ⋯ Consistent with studies of patients with chronic pain who are not opioid dependent, our findings emphasize the importance of assessing and addressing catastrophizing in MMTP patients with pain.
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Comparative Study
Widespread mechanical pain hypersensitivity as a sign of central sensitization after breast cancer surgery: comparison between mastectomy and lumpectomy.
To investigate the differences in widespread pressure pain hypersensitivity after two surgery approaches for breast cancer: mastectomy or lumpectomy. ⋯ The current study found widespread pressure pain hyperalgesia in women who received breast cancer surgery suggesting central spreading sensitization. The degree of central sensitization was similar between lumpectomy and mastectomy surgery.
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Two Australian public hospital multidisciplinary pain centers (MPCs) situated on opposite sides of the country. ⋯ System plasticity is as important to the process of integrated health care as it is to our understanding of the complexity of the lived experience of pain. Better-informed consumers partnered with responsive health professionals drive the proposed paradigm shift in service delivery. The changes better align the needs of consumers with the ability of health care providers to meet them, thus achieving the twin goals of patient empowerment and system efficiency.
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The purpose is to define the origin of radiculopathy of patients with degenerative lumbar scoliosis-stenosis and to assess the correlation between percentage of initial radicular leg pain relief with selective nerve root injections and lateral canal dimensions. ⋯ In degenerative lumbar scoliotic curves, radicular symptoms are attributed mainly to nerve roots exiting from the concavity of the lumbosacral hemicurve. No evidence was found that the rate of initial relief from selective nerve root injections correlates with the degree of stenosis noted in the MRI.