Pain medicine : the official journal of the American Academy of Pain Medicine
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Normative data for the coping styles and psychogenic attitudes of the Millon Behavioral Health Inventory (MBHI) for male and female chronic pain patients (CPPs) with mixed pain diagnoses have previously been reported and compared with normative MBHI manual data. However, results from other studies have suggested that CPPs with myofascial pain syndrome (MPS) may need to be considered as a distinct group in psychiatric/psychological studies. The purpose of the present study was then to provide normative data for each MBHI scale for male and female CPPs with MPS and to compare these data with MBHI manual norms for similarities and differences. ⋯ The pattern of the results indicated that CPPs with MPS, especially males, differ from the MBHI Manual normative data counterparts. These differences appear to be greater than those for CPPs with mixed pain diagnoses. Differences in MBHI scale scores between CPPs with MPS and MBHI Manual normative data counterparts may be related to a number of issues, such as whether differences in state factors reflecting depression and anxiety might affect trait factors purportedly measured by the MBHI.
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The role of physician variability in pain management is unknown. ⋯ Lower expectations for relief and less satisfaction in its management may contribute to the undertreatment of chronic pain. Perceptions of regulatory scrutiny may contribute to suboptimal pain management. These preliminary data highlight physician variability in pain decision making while providing insights into educational needs.
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The goals of this study were to define the endpoints of pain research that are important to patients with chronic pain and to identify clinical and demographic variables that are associated with patients' choices of endpoints. ⋯ These data suggest that empirical research can provide data to guide the choice of endpoints in clinical studies of pain interventions.
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To review the pathophysiology of fibromyalgia syndrome. ⋯ Multiple abnormal findings in fibromyalgia patients strongly indicate a neuropathic pain syndrome, reminiscent of complex regional pain syndrome or postherpetic neuralgia. In addition, fibromyalgia syndrome seems to share similar characteristics with these neuropathic pain syndromes, including ineffective response to many analgesics.
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Adverse and analgesic effects of acupuncture during the second and third trimesters of pregnancy were studied retrospectively in an observational study including 167 consecutive patients with lower back pain, pelvic pain, or both. In each patient acupuncture was given on at least two different occasions by three manual stimulations of two or more acupuncture or tender points, mainly LR-3 and LI-4 together with local tender points, at 15-min intervals. Possible adverse and analgesic effects were assessed by the midwife responsible for the acupuncture given in each patient. ⋯ Analgesia, as assessed by midwives involved, was good or excellent in 72% of patients. Acupuncture seems to be safe and effective for pain relief in lower back pain, pelvic pain, or both during the second and third trimesters of pregnancy. Nevertheless, prospective randomized studies are needed to confirm these findings.