Pain practice : the official journal of World Institute of Pain
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Randomized Controlled Trial
Comparative Efficacy of Newer Antidepressants in Combination with Pregabalin for Fibromyalgia Syndrome: A Controlled, Randomized Study.
This controlled, randomized study investigated the hypothesis that the combined use of pregabalin plus paroxetine for fibromyalgia management would be associated with comparable Somatic Symptoms Scale-8 (SSS-8) and Center for Epidemiological Studies Depression Scale (CESDS) scores, but higher tolerability than the combined use of pregabalin plus either amitriptyline or venlafaxine. ⋯ The combined use of pregabalin plus paroxetine offers an effective method with increased tolerability to reduce the somatic and depressive symptoms of fibromyalgia and to enhance the quality of life in affected individuals.
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Clinical Trial
Focal Mechanical Vibration Does not Change Laser-Pain Perception and Laser-Evoked Potentials: A Pilot Study.
Nonpainful tactile and electrical stimulation of the large myelinated fibers reduces spontaneous pain and the amplitude of laser-evoked potentials (LEPs), which represent the most reliable technique to assess the nociceptive pathway function. Focal mechanical vibration stimulates the Aβ afferents selectively; thus, it is conceivable its action on nociceptive pathways. ⋯ We conclude that a vibratory stimulus is ineffective in reducing the laser-evoked potentials and laser-pain perception.
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Chronic pain is significantly influenced by behavioral, cognitive, and emotional factors. Few studies have investigated the health locus of control (HLC)-one's belief regarding where control over one's health lies-as it relates to patients with chronic pain. The purpose of this prospective, cross-sectional study was to examine the relationship between depression and health/pain locus of control (HLC) in adult patients with persistent pain. ⋯ The study shows that patients with an internal locus of control are less depressed compared to patients with fatalistic views on their health/pain in the chance group. The chance dimension of the Multidimensional Health Locus of Control scale was found to be a potential predictor of psychiatric comorbidities such as depression in the chronic pain patient population.
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Psychological inflexibility-the inability to take value-based actions in the presence of unwanted thoughts, feelings, or bodily symptoms-is associated with negative health outcomes including depression and anxiety. ⋯ Psychological inflexibility plays an important role in understanding the increased pain and decreased upper extremity physical function in patients with musculoskeletal pain. It also suggests that the cognitive error of pain catastrophizing is one of the mechanisms through which the general construct of psychological inflexibility may influence pain intensity and upper extremity physical function. Psychological treatments aimed at decreasing pain and increasing upper extremity physical function should target both pain catastrophizing and psychological inflexibility.
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Postmastectomy pain syndrome is common after surgical treatment for breast cancer and may be challenging to manage. Currently, there are a wide variety of approaches to treat this type of pain, including medications, physical therapy, and interventional procedures. ⋯ We present a case series of 8 patients who were successfully treated with serratus plane block for pain after treatment for breast cancer. We feel that this particular application for the serratus plane block deserves further investigation, as it is relatively easy to perform and has good clinical utility for this type of pain.