Articles: back-pain.
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Back pain is a common and recurrent health complaint in adolescence. Psychosocial factors may be associated with the onset and persistence of back pain symptoms. This systematic review aims to determine the association between bullying victimization and back pain in young people. ⋯ Our synthesis of evidence found a weak-moderate association between bullying victimization and back pain in young people. Methodological shortcomings and heterogeneity in the field limit causal inference. Future longitudinal studies are required.
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Low peak alpha frequency (PAF) is an electroencephalography (EEG) outcome associated reliably with high acute pain sensitivity. However, existing research suggests that the relationship between PAF and chronic pain is more variable. This variability could be attributable to chronic pain groups typically being examined as homogenous populations, without consideration being given to potential diagnosis-specific differences. Indeed, while emerging work has compared individuals with chronic pain to healthy controls, no previous studies have examined differences in PAF between diagnoses or across chronic pain subtypes. ⋯ Our work suggests that, contrary to previous hypotheses, inter-individual differences in PAF reflect diagnosis-specific mechanisms rather than the general presence of chronic pain, and therefore may have important implications for future work regarding individually-tailored pain management strategies.
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Understanding how large language model (LLM) recommendations vary with patient race/ethnicity provides insight into how LLMs may counter or compound bias in opioid prescription. Forty real-world patient cases were sourced from the MIMIC-IV Note dataset with chief complaints of abdominal pain, back pain, headache, or musculoskeletal pain and amended to include all combinations of race/ethnicity and sex. Large language models were instructed to provide a subjective pain rating and comprehensive pain management recommendation. ⋯ Race/ethnicity and sex did not influence LLM recommendations. This study suggests that LLMs do not preferentially recommend opioid treatment for one group over another. Given that prior research shows race-based disparities in pain perception and treatment by healthcare providers, LLMs may offer physicians a helpful tool to guide their pain management and ensure equitable treatment across patient groups.
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Pain profiles (e.g. pro- and anti-nociceptive) can be developed using quantitative sensory testing (QST) but substantial variability exists. This study describes the variability in temporal summation of pain (TSP) and conditioned pain modulation (CPM) in chronic musculoskeletal pain patients, proposes cut-off values, and explores the association with clinical pain intensity. ⋯ This analysis shows that there is variability when assessing TSP and CPM in both pain-free subjects and patients with chronic pain. A cut-off for determining when a person is pain-sensitive is proposed, and data based on this cut-off approach suggest that significantly more patients with osteoarthritis and fibromyalgia are pain-sensitive (i.e. higher TSP and lower CPM) compared to pain-free subjects. This analysis does not find an association between pain sensitivity and clinical pain.
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Reg Anesth Pain Med · Feb 2025
Analysis of complications of minimally invasive approaches for symptomatic lumbar spinal stenosis.
Current treatment modalities of lumbar spinal stenosis range from conservative medical management and physical therapy to open surgical decompression. Minimally invasive lumbar decompression (MILD) and Superion interspinous spacers (SISS) Vertiflex offer the promise of effective pain relief with shorter recovery time and lesser potential complications compared with open surgical decompression procedures and general anesthesia. Despite their increasing utilization, their complication profile is not well established in the literature. ⋯ As with any new intervention, we must proceed with caution and evaluate the procedure performance over time. Such data should aid physicians to make informed decisions before choosing either technique for their patients. The findings from this study provide insight into the complication profile associated with both MILD and Vertiflex procedures, highlighting the need for continued evaluation and careful consideration in clinical decision-making.