Pain medicine : the official journal of the American Academy of Pain Medicine
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To determine the patterns of referred pain in patients with proven cervical zygapophysial joint pain. ⋯ Pain maps based on areas in which patients are relieved of pain by controlled blocks provide a more representative guide to the recognition of the segmental origin of cervical zygapophysial joint pain than do maps derived from normal volunteers.
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Smokers may report more pain and may be at greater risk for psychiatric comorbidity. Smoking may be a major problem in chronic pain patients (CPPs). The goal of this study was to determine if pain and psychiatric comorbidity are associated with smoking status in CPPs. ⋯ Smoking status in CPPs is associated with some variables that are similar for smoking in the general and psychiatric populations (education, race, alcoholism). However, a number of variables expected to be relevant (e.g., mood disorders) were not associated with smoking status in CPPs. These results may not be generalizable to all CPPs as they are derived from CPPs who are return-to-work candidates.
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To examine the taxonomic categories derived from a reorganization of the popular and useful Multidimensional Pain Inventory (MPI)/Multiaxial Assessment of Pain (MAP) system. ⋯ Meaningful differences exist between the new MPI clusters and those previously reported. The results provide a contribution toward improvements on the original and popular MPI/MAP system.
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Our study was designed to document fiscal data for emergency department admissions for acute exacerbation of chronic back pain. ⋯ Emergency department care may be a costly venue for the management of chronic back pain. Because most patients obtain only short-term relief, they are likely to continue seeking urgent care intermittently until effective long-term pain management is widely available and reimbursable on an outpatient basis.
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Intrathecal inflammatory masses or granuloma have been described extensively in the literature in patients receiving chronic spinal infusions for pain. After an extensive literature review, no reported cases of baclofen causing this disorder when administered as a sole agent were identified. Intrathecal baclofen has been used to treat spasticity secondary to stroke, multiple sclerosis, cerebral palsy, spinal cord injury, and other neurological disease. ⋯ We report two cases of inflammatory mass in patients receiving baclofen as a sole intrathecal agent. The authors would recommend vigilance in any patient receiving intrathecal baclofen. If the suspicion arises of this problem, a magnetic resonance imaging or computerized tomography myelogram should be obtained with a focus on the catheter tip.