Articles: chronic-pain.
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J. Occup. Environ. Med. · Feb 2012
Increases in the use and cost of opioids to treat acute and chronic pain in injured workers, 1999 to 2009.
Quantify temporal changes in opioid use. ⋯ The annual cumulative dose and cost of opioids per claim increased over the study period related to an increase in prescriptions for long-acting opioids.
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Editorial Comment
Chronic pelvic pain: is it time for an algorithmic approach?
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Clinical Trial
Pain processing in medication overuse headache: a functional magnetic resonance imaging (fMRI) study.
The primary aim was to investigate functional differences between medication overuse headache (MOH) patients and controls with the purpose of evaluating the presence of a global alteration in the processing of noxious stimuli throughout the pain matrix. The secondary aim was to investigate whether activations in MOH patients normalize after medication withdrawal, which would suggest a possible role of the pain matrix in headache chronification. ⋯ Our findings suggest that significant functional changes occur in the lateral pain pathway in MOH patients. These could result from different processes: 1) cortical down-regulation aimed at reducing painful input to the cortex; 2) activity-dependent plasticity induced by excessive painful input during migraine attacks; and 3) direct effect of medication overuse. At 6 months after withdrawal, activity in these regions normalized, suggesting that no irreversible changes occur due to medication overuse.