Pain medicine : the official journal of the American Academy of Pain Medicine
-
There is a lack of objective measurements of the spinal cord stimulator (SCS) trial results, which leads to increased number of failed permanent placements. Certain modes of sensory functions were tested as possible correlates with trial success. ⋯ PTT may possibly serve as an objective measurement of the SCS trial outcome.
-
To assess the relative frequency of violent ideation [VI] in physical rehabilitation and community samples, and to identify associated factors. ⋯ Recent research supports the contention that there is a relationship between ideation, angry affect, aggressive behavior and delayed recovery. Thus the presence of VI in the patient should be a cause for concern, and has clear ramifications for those working in the clinical setting. Primary prevention should involve not only the identification of hostile patients at risk for VI and aggression, it should also involve identifying programs or systems where a higher incidence of VI is likely to be observed. As VI was found to be associated with a range of variables, including characterological disorders, mood and social conflict, a further evaluation of factors contributing to VI would be recommended prior to intervention.
-
Neuropathic pain is often resistant to opioids, so other medication classes, such as tricyclic antidepressants, anticonvulsants, and local anesthetics, are often used. Central sensitization, or pain 'wind-up', may perpetuate chronic neuropathic pain even when ongoing peripheral sensory input is absent. Wind-up is thought to cause allodynia, hyperalgesia, and hyperpathia. ⋯ No significant side effects were reported. Ketamine Gel may provide clinicians with a new option in the battle against chronic neuropathic pain. Until further information is available and larger trials can be conducted, we can only recommend this type of therapy for refractory cases in which all primary and secondary options have been exhausted.
-
The current study investigated marital satisfaction and pain severity as mediators of the relationship between spouse responses to pain and depressive symptoms. The study also investigated possible gender differences in these relationships. ⋯ The current results suggest that marital therapy aimed at improving communication and coping skills may be an appropriate treatment for depression and pain in married chronic pain patients, regardless of sex.
-
To assess the reliability of an augmented SF-36 instrument, the Treatment Outcomes in Pain Survey ("TOPS"), in patients treated in two pain management programs, and present norms for initial values and treatment-related improvements. ⋯ The accuracy of the TOPS is sufficient to monitor the response of individual patients during multidisciplinary treatment of chronic pain. The TOPS provides needed documentation (e.g., to third-party payors) of the aggregate value of multidisciplinary outpatient treatment of chronic pain as well as its benefit for individual patients.