Pain practice : the official journal of World Institute of Pain
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Chronic pain conditions are highly prevalent, with somatoform pain disorder accounting for a large proportion. However, the psychological forms of treatment currently used achieve only small to medium effect sizes. This retrospective study investigated the effectiveness of a 5-week multimodal pain program for patients with somatoform pain disorder. ⋯ The lowest effect sizes were found for improvement of pain-related disabilities (PDI: d = 0.42) and sensory items of the Pain Perception Scale (SES-S: d = 0.50). Despite high chronification of pain condition, with average pain duration of greater than 8 years, the multimodal treatment program showed medium to large effect sizes on the outcome of patients with somatoform pain disorder. Compared with previous data with small to moderate effect sizes, a multimodal program seems to be more effective than other interventions to address somatoform pain disorder.
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Vertebral compression fractures can result from advanced osteoporosis, or less commonly from metastatic or traumatic insults to the vertebral column, and result in disabling pain and decreased functional capacity. Various vertebral augmentation options including kyphoplasty aim at preventing the sequelae of pain and immobility that can develop as the result of the vertebral fractures. ⋯ We observed a mean of 45% of the lost vertebral height restored postprocedurally. Secondarily, kyphoplasty was associated with significant decreases in pain scores, daily morphine consumption and improvement in patient-reported functional measures.
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The aim of this study was to evaluate the differences in outcomes of long-term multiprofessional intervention in patients suffering from musculoskeletal pain. ⋯ These results indicate that multiprofessional assessment may also have beneficial effects in patients with musculoskeletal pain when measuring long-term outcomes.
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Growth in the number of patients with pain conditions, and the subsequent rise in prescription opioid use for treatment, has been accompanied by an increase in diagnosed opioid abuse. Understanding what drives the incremental healthcare costs of members diagnosed with prescription opioid abuse may assist in developing better screening techniques for abuse. ⋯ Costs of members diagnosed with prescription opioid abuse are driven by higher pain and psychiatric comorbidities relative to nonabuse controls.
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A subcostal transversus abdominis plane (TAP) phenol injection was performed on a patient with refractory cancer pain due a metastatic involvement of the abdominal wall. A diagnostic block with local anesthetic was performed under ultrasound guidance (USG), resulting in a decrease of 80% and 100% in dynamic and static visual analog scale (VAS) for pain, respectively, for 20 hours. ⋯ TAP blocks offer an interesting tool for either diagnosis or therapeutic purpose in chronic pain management. USG provides an optimal approach to soft-tissue lesions where fluoroscopy techniques are not useful.