Pain practice : the official journal of World Institute of Pain
-
Efficacy of pain assessment is the basis for effective therapy. Clinically, assessing pain is by subjective scale, but these methods have some shortcomings. Therefore, studies have been conducted on assessment of pain using physiological signals. Photoplethysmography (PPG) signals provide much information about the cardiovascular system. PPG-derived parameters (PPG parameters) reflect nociceptive stimulation, and obtain an approximation of the R-R interval from the PPG period. The aim of this study was to evaluate PPG signals for assessment of pain intensity in chronic myofascial pain syndrome (MPS) patients. ⋯ The results of the study indicated that PRV substituted for HRV in assessment of pain intensity in chronic MPS reflected parasympathetic nervous tone increase, and PPG parameters might reflect stress stimulation on skin.
-
Randomized Controlled Trial
Methadone versus Fentanyl in Patients with Radiation Induced Nociceptive Pain with Head and Neck Cancer, a randomized controlled non-inferiority trial.
Pain is still a burden for many patients with cancer. A recent trial showed the superiority of methadone over fentanyl in neuropathic pain, and we expect that this finding could influence the number of patients treated with methadone. ⋯ This is the first study to show noninferiority of methadone compared to fentanyl at 1 and 3 weeks in the treatment of radiation-induced nociceptive pain in patients with head and neck cancer.
-
Randomized Controlled Trial
Increased sympathetic outflow induces adaptation to acute experimental pain.
There are interrelationships between the autonomic nervous system and pain. This study aims to explore the effect of different autonomic manipulations on pain perception and modulation. ⋯ Different effects of acute autonomic manipulations on experimental pain were found: an increase in sympathetic tone induced by yohimbine led to reduced pain sensitivity; a decrease in sympathetic tone with no effect on vagal-parasympathetic tone induced by phenylephrine led to reduction in pain adaptation capacity; and a decrease in sympathetic tone and increase in vagal parasympathetic tone by clonidine led to no change in pain adaptation capacity. While increased sympathetic outflow does facilitate pain adaptation, activation of either the sympathetic or parasympathetic limbs of the autonomic nervous system does not affect pain thresholds or CPM. Finally, a correlation exists between nociception and cardiovascular parameters only due to baroreflex activation.
-
Case Reports Clinical Trial
Radial Extracorporeal Shock Wave Therapy for Relief of Arthralgia in Rheumatoid Arthritis.
More than one-third of the population with rheumatoid arthritis requires adjuvant analgesic treatment after antirheumatic therapy. In addition to analgesics, another option is radial extracorporeal shock wave therapy (rESWT), a novel physical therapy that has been successfully used in the treatment of many types of chronic soft tissue pain. We report a series of 15 patients who suffered from arthralgia after being on disease-modifying antirheumatic drugs for more than 3 months. ⋯ By the end of treatment, 11 participants stopped analgesics completely; the other 4 participants were on a smaller dosage. No severe adverse effects related to rESWT were observed. To our knowledge, this is the first report using this therapy to treat arthralgia in rheumatoid arthritis.
-
Pregnancy is known to aggravate pre-existing chronic painful conditions. Trigeminal neuralgia (TN), albeit a disease of the elderly, may afflict pregnant females, which can further complicate its management. ⋯ This rare coexistence of TN in pregnancy has not been reported before. Here we present a case of TN in a young woman, whose pain was aggravated when she became pregnant, and she was treated successfully by conventional radiofrequency ablation of the Gasserian ganglion.