Pain practice : the official journal of World Institute of Pain
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Assess the efficacy of an outpatient-based interdisciplinary pain rehabilitation program for patients with active workers compensation claims. ⋯ Our results support the efficacy of an outpatient-based 4-week interdisciplinary pain rehabilitation program in decreasing emotional distress, reducing pain intensity, and improving return-to-work status in the majority of completers in this challenging population. Patients reporting increased pain at discharge or those discharged early may have been due to operant factors.
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Review Case Reports
Intentional intrathecal opioid detoxification in 3 patients: characterization of the intrathecal opioid withdrawal syndrome.
Intrathecal (IT) drug delivery systems for patients with chronic non-malignant pain are intended to improve pain and quality of life and reduce side effects of systemic use. A subset of patients may have escalating pain, functional decline, and/or intolerable side effects even as IT opioid doses are increased. Discontinuation of IT medications may represent a viable treatment option but strategies to accomplish this are needed. ⋯ This preliminary work demonstrates the safety of abrupt IT opioid cessation utilizing standardized inpatient withdrawal protocols. To our knowledge, these are among the first reported cases of intentional, controlled IT opioid cessation without initiation of an opioid bridge: self-reported pain scores, functional capacity, and quality of life improved. The IT opioid withdrawal syndrome is characterized based upon our observations and a review of the literature.
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We report a retrospective audit of transcutaneous pulsed radiofrequency treatment therapy (TCPRFT) for shoulder pain over a 4-year period. ⋯ These results suggest TCPRFT may provide clinically useful pain relief and be another treatment modality for shoulder pain. Our findings justifies further research, and we are proceeding with a double-blind placebo randomized controlled studies to determine the efficacy of TCPRFT in chronic shoulder pain.
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Letter Case Reports
Use of opioids for pain relief while driving: when the patient meets the police.