Articles: chronic-pain.
-
Fibromyalgia (FM) is a mysterious pain syndrome with progressive and widespread pain, explicit areas of tender points, stiffness, sleep disturbance, fatigue, and psychological distress without any obvious disease. FM is commonly perceived as a condition of central pain and sensory augmentation. There are documented functional abnormalities in pain and sensory processing in FM. ⋯ Pre-emptive analgesia and pro-active treatment may offer the momentum for acute pain control based on model of central sensitization and pain in FM. This review article on FM appraises the modern practice of multimodal therapy focus on both acute and chronic pain management. Meanwhile, the evolving nonpharmacological approach is summarized and stressed as an essential component of integrated care in FM.
-
Multicenter Study
Assessment, stratification, and monitoring of the risk for prescription opioid misuse and abuse in the primary care setting.
To evaluate potential for and incidence of aberrant drug-related behaviors among patients with chronic, moderate-to-severe pain in a primary care setting and to determine investigator compliance with universal precautions (UP) approach to pain management. ⋯ Most patients in these primary care study centers were categorized as at least moderate risk for opioid misuse/abuse at baseline. Most primary care investigators complied with the UP approach to pain management and risk assessment. The completion of the brief training and clinical use of the tools during the study led to retained behavior change, but there was a tendency for investigators to assign lower risk levels than those that were protocol-specified, suggesting a need for better understanding of factors influencing investigator decisions.
-
Randomized Controlled Trial
Assessing fibromyalgia-related fatigue: content validity and psychometric performance of the Fatigue Visual Analog Scale in adult patients with fibromyalgia.
To document 1) the content validity and 2) measure improvements in fatigue, using the Fatigue Visual Analogue Scale (VAS) assessment tool in patients with fibromyalgia. ⋯ Previous studies have confirmed that fatigue is a major component of the fibromyalgia experience. This current study reports that fibromyalgia patients spontaneously rated fatigue as a highly significant feature of their illness, and supports the use of the Fatigue VAS as a valid questionnaire in fibromyalgia clinical trials.
-
Clinical rheumatology · Nov 2011
Impact of musculoskeletal pain on physical function and health-related quality of life in a rural community in south India: a WHO-ILAR-COPCORD-BJD India study.
Musculoskeletal (MSK) pain poses a major burden on individuals and health care systems. Assessing its pervasive impact has broadened the horizon of treatment strategies. The aim of this study was to determine the prevalence of MSK pain and its relationship with the health-related quality of life (HRQL) in a rural community. ⋯ MSK pain, both due to specific and non-specific disorders, showed an important impact on HRQL in this community study. Combined with ascertainment of risk factors and associations, this has implications on planning treatment and prevention. We plan to continue using HAQ in time to monitor the community.
-
There is good support for the effectiveness of interdisciplinary chronic pain management programs in improving functional outcomes; however, relatively little is known about patients who report deterioration following participation in such programs. ⋯ Participants endorsed significant pre- and post-treatment improvements in all domains. Nevertheless, some participants reported deterioration. The findings shed light on variables associated with negative treatment outcomes and have practical applications for interdisciplinary chronic pain management programs.