Pain medicine : the official journal of the American Academy of Pain Medicine
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Multicenter Study Clinical Trial
Defining patient-centered, multidimensional success criteria for treatment of chronic spine pain.
This study aimed to define patient-determined success criteria for treatment of chronic spine pain across four domains: pain, fatigue, emotional distress, and interference with daily activities. ⋯ Future research should validate these success criteria, particularly for the less studied domains of fatigue, distress, and interference, and investigate how these criteria evolve over the course of different treatments.
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Randomized Controlled Trial
The ability of single site, single depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex.
To determine the physiologic effectiveness of single site, single depth sacral lateral branch injections. ⋯ Anatomic limitations exist with single site, single depth sacral lateral branch injections rendering them physiologically ineffective on a consistent basis.
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Controlled Clinical Trial
Interpreting urine drug tests: prevalence of morphine metabolism to hydromorphone in chronic pain patients treated with morphine.
Pain medicine practitioners frequently use urine drug testing (UDT) to monitor adherence to opioid therapy. It can be difficult to interpret a result as normal or abnormal in relation to which opioid compounds are expected to be found in the urine. We investigated whether hydromorphone may be a metabolite of morphine normally appearing in UDT of patients prescribed morphine. ⋯ Hydromorphone is likely a minor metabolite of morphine, normally appearing in the UDT of patients taking morphine. This finding assists in determining whether a UDT result is normal or abnormal, and subsequently whether a patient is compliant with opioid therapy. This observation should be confirmed by a prospective study in a controlled environment. Variables such as gender, morphine dose, morphine urine concentration, and genetic determinants of morphine metabolism should be investigated further.
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To assess the influence of fear avoidance beliefs (FAB) and catastrophizing on low back pain (LBP)-related disability in Spanish community dwelling retirees. ⋯ In Spanish community dwelling retirees, the influence of FAB and catastrophizing on LBP-related disability is clinically small.
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To evaluate the prevalence, characteristics, and correlates of chronic pain in a population of predominantly employed, alcoholic patients attending an outpatient drug and alcohol treatment program. ⋯ Chronic severe pain was prevalent in this predominantly employed, alcoholic population attending an outpatient drug and alcohol treatment program. Pain was associated with significant functional impairment, medical and psychiatric comorbidities, and abuse behaviors. Few patients accessed adequate pain treatment. Efforts should be made to better address the pain problems in this patient population.