Articles: chronic-pain.
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Spinal cord injury-induced pain is a common clinical problem affecting adversely the quality of daily lives of spinal cord injured patients. Management with current pain medications can only lead to partial pain relief in some spinal cord injured patients, which is usually associated with unfavorable side effects. ⋯ We describe here the generation of a spinal cord contusion injury model that mimics the etiology and phenotypes of chronic pain states in spinal cord injured patients. Therefore, this model can be a useful tool for studying spinal cord injury mechanisms, functional recovery, research, and development of new medications for better functional and symptomatic improvements, including pain management.
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Bmc Musculoskel Dis · Jan 2012
Reliability of the Multidimensional Pain Inventory and stability of the MPI classification system in chronic back pain.
This cross validation study examined the reliability of the Multidimensional Pain Inventory (MPI) and the stability of the Multidimensional Pain Inventory Classification System of the empirically derived subgroup classification obtained by cluster analysis in chronic musculoskeletal pain. Reliability of the German Multidimensional Pain Inventory was only examined once in the past in a small sample. Previous international studies mainly involving fibromyalgia patients showed that retest resulted in 33-38% of patients being assigned to a different Multidimensional Pain Inventory subgroup classification. ⋯ Test-retest reliability of the German Multidimensional Pain Inventory was moderate to good and comparable to other language versions. Multidimensional Pain Inventory subgroup classification is substantially stable in chronic back pain patients when compared to other diagnostic groups and other examiner-based subgroup Classification Systems. The MPI Classification System can be recommended for reliable and stable specification of subgroups in observational and interventional studies in patients with chronic musculoskeletal pain.
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Physiother Theory Pract · Jan 2012
Case ReportsUse of an abbreviated neuroscience education approach in the treatment of chronic low back pain: a case report.
Chronic low back pain (CLBP) remains prevalent in society, and conservative treatment strategies appear to have little effect. It is proposed that patients with CLBP may have altered cognition and increased fear, which impacts their ability to move, perform exercise, and partake in activities of daily living. Neuroscience education (NE) aims to change a patient's cognition regarding their pain state, which may result in decreased fear, ultimately resulting in confrontation of pain barriers and a resumption of normal activities. ⋯ Immediately following the 75-minute evaluation and NE session, the patient reported improvement in all four outcome measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to 1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE aimed at decreasing fear associated with movement may be a valuable adjunct to movement-based therapy, such as exercise, for patients with CLBP.
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Case Reports
Management of chronic symphysis pubis pain following child birth with spinal cord stimulator.
The case of a 39 year old woman who had diastasis of pubic symphysis following childbirth and later developed severe chronic neuropathic pain and disability is presented. She received extensive surgical and medical treatment for 6 years with no improvement of symptoms. The VNRS (Visual Numerical Rating Scale) pain score was 7/10 or more most of the time. ⋯ A spinal cord stimulator was inserted after failure of other modalities of pain management which resulted in dramatic improvement in the quality of life measured with SF-36 questionnaire. Her pain score became 0/10 VNRS and she was free from opioids and psychotropic medications within 3 months post insertion. Spinal cord stimulator can be considered for the management of pain due to diastasis of pubic symphysis, not amenable to other therapies.
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Bmc Musculoskel Dis · Jan 2012
Chronic low back pain is associated with reduced vertebral bone mineral measures in community-dwelling adults.
Chronic low back pain (CLBP) experienced in middle-age may have important implications for vertebral bone health, although this issue has not been investigated as a primary aim previously. This study investigated the associations between CLBP and dual energy X-ray absorptiometry (DXA)-derived vertebral bone mineral measures acquired from postero-anterior and lateral-projections, among community-dwelling, middle-aged adults. ⋯ CLBP in males is associated with some lumbar vertebral BMD measures, raising important questions about the mechanism and potential clinical impact of this association.