Articles: back-pain.
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Bmc Musculoskel Dis · Jan 2015
The Psychological Inflexibility in Pain Scale (PIPS) - validation, factor structure and comparison to the Chronic Pain Acceptance Questionnaire (CPAQ) and other validated measures in German chronic back pain patients.
Acceptance and Commitment Therapy (ACT) for pain offers an alternative to traditional Cognitive Behavioural Therapy (CBT) approaches. ACT focuses on the enhancement of 'psychological flexibility' that enables individuals to pursue their values and goals despite pain. To assess specific treatment effect or mediators and moderators of change, questionnaires measuring ACT constructs are needed. ⋯ The PIPS subscale Avoidance may be a valuable instrument to assess treatment processes in future RCTs. The PIPS subscale Fusion seemed more problematic in the German sample with chronic back pain. More research on the comparison between PIPS and other questionnaires assessing psychological flexibility and the usefulness of the concept 'Fusion' for chronic pain are needed.
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Background. Direct intra-articular injection of low doses of local anesthetic (IALA) after closure of the joint capsule remains controversial for pain control after total knee arthroplasty (TKA). Methods. ⋯ Three patients in the IALA group but none in the FNB group walked within 12 hours after the end of operation. Summary. IALA with high doses of local anesthetics provides comparable analgesic efficacy as single-shot FNB after TKA and might be associated with earlier ambulation than FNB postoperatively.
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Clinical Trial
Effect of transforaminal anterior epidural steroid injection on neuropathic pain, quality of sleep and life.
Transforaminal anterior steroid injections are frequently used for low back pain. In the current study, It was aimed to investigate the effects of transforaminal anterior epidural steroid injection (TAESI) in patients with low back pain in regards to quality of life and sleep, and neuropathic pain. ⋯ It was determined in the study that transforaminal epidural steroid injection provided a substantial improvement in patients' pain and neuropathic pain and quality of sleep, but had no effect on the quality of life.
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Comparative Study
Is preoperative pain duration important in spinal cord stimulation? A comparison between tonic and burst stimulation.
Conflicting data have been published as to whether the success rate of spinal cord stimulation (SCS) is inversely proportional to the time interval from the initial onset of symptoms to implantation. Recently, a new stimulation design called burst stimulation has been developed that seems to exert its effect by modulating both the medial and lateral pain pathways and has a better effect than tonic stimulation on global pain, back pain, and limb pain. ⋯ These results suggest that the duration of pain is not an exclusion criterion for SCS and that similar success rates can be obtained for longstanding pain and pain of more recent onset.
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Some, smaller studies have investigated the effect of preoperative depression on postoperative improvement in quality of life (QOL). However, they have not used the Patient Health Questionnaire 9 (PHQ-9) in self-reported depression. ⋯ Increased preoperative pain and depression were shown to be associated with significantly reduced improvement in postoperative QOL, as measured by the EQ-5D.