Pain practice : the official journal of World Institute of Pain
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Review Meta Analysis
Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain.
Cost-effectiveness is a major criterion underpinning decisions in mainstream health care. Acupuncture is increasingly used in patients with chronic lower back pain (LBP), but there is a lack of evidence on cost-effectiveness. The objective of this study was to assess the cost-effectiveness of acupuncture in alleviating chronic LBP either alone or in conjunction with standard care compared with patients receiving routine care, and/or sham. ⋯ When comorbid depression is alleviated at the same rate as pain, cost is around $18,960 per DALY avoided. Acupuncture as a substitute for standard care was not found to be cost-effective unless comorbid depression was included. According to the WHO cost-effectiveness threshold values, acupuncture is a cost-effective treatment strategy in patients with chronic LBP.
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Headache Impact Test (HIT-6) measures the impact headaches in a 1-month period. We validated the Persian translation of HIT-6, compared the HIT-6 psychometric analysis between migraine and tension-type headache (TTH) patients, and evaluated the capability of HIT-6 to differentiate between TTH, chronic migraine, and episodic migraine. ⋯ Persian HIT-6 is a valid and reliable questionnaire for the evaluation of headache. However, it cannot differentiate between chronic migraine, episodic migraine, and TTH in Iranian population.
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Widespread sensory hypersensitivity has been observed in acute whiplash associated disorders (WAD). Changes in descending pain modulation take part in central sensitization. However, endogenous pain modulation has never been investigated in acute WAD. Altered perception of distorted visual feedback has been observed in WAD. Both mechanisms (ie, pain modulation and perception of distorted visual feedback) may be different components of one integrated system orchestrated by the brain. This study evaluated conditioned pain modulation (CPM) in acute WAD. Secondly, we investigated whether changes in CPM are associated with altered perception of distorted visual feedback. ⋯ Changes in CPM were observed in acute WAD, suggesting less efficient pain modulation. The results suggest that central pain and sensorimotor processing underlie distinctive mechanisms.
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Observational Study
Invasive Techniques for Pain Management in Palliative Care: A Single Center Experience.
To achieve a successful pain control, interventional techniques are required in approximately 15% of the patients admitted to the Palliative Care Service (PCS). ⋯ The analgesic efficacy of these techniques has been adequate in all groups. Patients who required epidural catheters had a higher rate of complications.
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Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve at the wrist that is characterized by pain, paresthesias, weakness, and loss of dexterity. This pilot study was conducted to evaluate the heated lidocaine/tetracaine patch (HLT patch) as a conservative treatment for pain of CTS. ⋯ The HLT patch resulted in clinically meaningful reduction in pain intensity in the majority of patients with mild-to-moderate CTS and may represent a targeted nonsurgical treatment for pain associated with CTS.