Pain practice : the official journal of World Institute of Pain
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Cluneal neuropathy is encompassed by three distinct clinical entities. Superior, middle, and inferior cluneal neuralgia make up the constellation of symptoms associated with cluneal neuropathy. Each has its own variable anatomy. ⋯ Adjusted incidence rates of superior cluneal neuropathy are 1.6%-11.7%. Accurate diagnosis remains challenging due to the lack of standardized criteria and the aforementioned variability. Treatment may include therapeutic nerve blocks, ablative techniques, neuromodulation, and surgical decompression. Gaps including those related to true incidence and work up exist. Outcomes from interventional studies are limited and mixed due to significant population heterogeneity and non-standardized treatment approaches coupled with very small sample sizes.
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Case Reports
Loss of effectiveness with an implanted drug delivery system for intrathecal pain therapy due to corrosion.
Intrathecal drug delivery is an established invasive treatment option. Most common complication is catheter malfunction, which can lead to overdose or withdrawal. ⋯ Recommendations on how to deal with the decreasing effectiveness of intrathecal drug delivery and on intraoperative catheter handling are provided.
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Pragmatic Clinical Trial
Pre-Implementation Formative Evaluation of Co-Operative Pain Education and Self-Management (COPES) Expanding Treatment for Real-World Access (ExTRA): A Pragmatic Pain Trial.
Cognitive behavioral therapy for chronic pain (CBT-CP) is an evidence-based treatment for improving functioning and pain intensity for people with chronic pain with extensive evidence of effectiveness. However, there has been relatively little investigation of the factors associated with successful implementation and uptake of CBT-CP, particularly clinician and system level factors. This formative evaluation examined barriers and facilitators to the successful implementation and uptake of CBT-CP from the perspective of CBT-CP clinicians and referring primary care clinicians. ⋯ This formative evaluation identified clinician and system barriers to widespread implementation of CBT-CP and allowed for refinement of the subsequent implementation of two forms of CBT-CP in an ongoing pragmatic trial. Identification of relative difference in barriers and facilitators in the two forms of CBT-CP may emerge more clearly in a pragmatic trial that evaluates how treatments perform in real-world settings and may provide important information to guide future system-wide implementation efforts.
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Chronic pain can trigger both physical and mental health complications. During the COVID-19 pandemic, patients with chronic diseases have had reduced access to some medications. ⋯ The pharmacological management of patients with chronic pain is heterogeneous, and this real-world study showed that a high proportion of patients experienced an interruption of pain management during the 12 months following the onset of the COVID-19 pandemic.
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Self-efficacy is one of the important factors affecting chronic diseases. In the current epidemiological context of low back pain (LBP), LBP self-efficacy has become a topic of great practical interest for researchers. However, no bibliometric analysis related to LBP self-efficacy has been performed to date. The purpose of this study was to conduct and explore the current state of research in LBP self-efficacy from 1980 to 2021, by using bibliometric analysis and scientific mapping. ⋯ The volume of literature on LBP self-efficacy has increased linearly over the past 41 years and will continue to increase. The field of study has become more refined. This bibliometric analysis provides valuable support for future directions and research trends in LBP self-efficacy.