Pain practice : the official journal of World Institute of Pain
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Comparative Study Observational Study
Dorsal Column Stimulation versus Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Confined to the Knee; Patients' Preference Following the Trial Period.
Patients with complex regional pain syndrome (CRPS) confined to the knee are often therapy resistant. Neurostimulation is an accepted treatment for CRPS. Although results with dorsal column (DC) stimulation in patients with CRPS confined to the knee are often disappointing, the availability of dorsal root ganglion (DRG) stimulation may provide new opportunities for this complaint. Therefore, this study explores patients' preference for DC stimulation vs. DRG stimulation in treating chronic pain due to CRPS confined to the knee. ⋯ To our knowledge, this is the first study to compare these 2 neurostimulation methods in patients with CRPS confined to the knee. Results show that the probability of the preference for either neurostimulation treatment significantly deviates from chance in favor of DRG stimulation.
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Recognizing expectations and concerns of patients leads to more specialized management plans and greater adherence to treatment and improves outcomes. Little is known about how age impacts on expectations or concerns regarding pain in patients attending a chronic pain clinic. ⋯ We found differences in patient expectations and concerns by age of those attending a chronic pain clinic. These differences can inform the communication process between physician and patient on treatment plans and outcomes.
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To determine the use of clinical practice guidelines (CPGs) for chronic pain (CP) management; analyze the effects of training in pain and the attitudes of physicians toward pain and CP patients on the adherence to these CPGs; and assess the impact of adherence to CPGs on patient care. ⋯ Access to scientific information and specialized training are factors related to the use of CPGs for pain treatment. Therefore, the inclusion of CP training in university and during medical specialty training will be essential measures to improve adherence to CPG, thereby improving patient care and pain control.
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Sleep problems are common in people with low back pain (LBP); however, the mechanisms of how sleep influences pain are complex. To date there is a lack of prospective research on the timing and development of sleep problems in those who have LBP; such information would be useful to identify individuals at risk for poor outcomes. Our aims are to investigate the predictive role of sleep problems on self-report recovery and pain intensity using logistic regression reporting odds ratios (ORs). ⋯ Those with resolving sleep problems (ie, sleep problems present at baseline but not at follow-up) were at decreased odds for nonrecovery (OR 0.50) and pain intensity (0.49). Presenting, persistent, and developing sleep problems have a significant impact on recovery for those with LBP. Clinicians may wish to consider treatment options that can address sleep problems.
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According to existing literature, musicians are at risk of experiencing a range of painful musculoskeletal conditions. Recently, a novel digital technology was developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing (PD) analysis. Additionally, the association between PD variables and clinical features were explored in musicians with pain. ⋯ The high prevalence of pain among musicians has been confirmed using a digital technique for PD acquisition and analysis. In addition, positive correlations between pain extent and upper limb disability have been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.