Articles: chronic-pain.
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Clinical rheumatology · Sep 2011
Coping style as a predictor of compliance with referral to active rehabilitation in whiplash patients.
The objective of the study was to determine the odds ratio for compliance with referral to an active treatment program according to coping style in a cohort of acute whiplash-injured subjects. Sixty whiplash patients were assessed within 1 week of their collision for their coping styles and were then questioned 3 weeks later to determine if they had complied with a referral for an active treatment program. Coping style was assessed with the Vanderbilt Pain Management Inventory. ⋯ As a secondary outcome, the odds ratio for reporting prescription medication use for subjects who had a low active/high passive coping style was 6.7 (P=0.038) (95% CI, 1.1-40.4). Those whiplash patients who have a low active/high passive coping style are less likely to attend an active exercise-based rehabilitation program and more likely to use prescription medications in the first 3 weeks following injury. Coping style may affect recovery from whiplash injury through issues of compliance with active therapy and increased reliance on prescription medications.
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The differences in sagittal spino-pelvic alignment between adults with chronic low back pain (LBP) and the normal population are still poorly understood. In particular, it is still unknown if particular patterns of sagittal spino-pelvic alignment are more prevalent in chronic LBP. The current study helps to better understand the relationship between sagittal alignment and low back pain. ⋯ Sagittal spino-pelvic alignment was different between patients with chronic LBP and controls. In particular, there was a greater proportion of chronic LBP patients with low SS, low LL and small PI, suggesting the relationship between this specific pattern and the presence of chronic LBP.
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To observe the effect of Pulsed radiofrequency on patients presenting with complaints of chronic pain. ⋯ P Pulsed Radiofrequency implementation was found to be an effective and safe method for chronic pain treatment in our centre.
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Comparative Study
Adherence to clinical guidelines for opioid therapy for chronic pain in patients with substance use disorder.
Patients with chronic non-cancer pain (CNCP) have high rates of substance use disorders (SUD). SUD complicates pain treatment and may lead to worse outcomes. However, little information is available describing adherence to opioid treatment guidelines for CNCP generally, or guideline adherence for patients with comorbid SUD. ⋯ CNCP patients with SUD were more likely to have mental health appointments and receive UDS monitoring, but not more likely to participate in other aspects of pain care compared to those without SUD. Given data suggesting patients with comorbid SUD may need more intensive treatment to achieve improvements in pain-related function, SUD patients may be at high risk for poor outcomes.
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Review Practice Guideline
[Epidural spinal cord stimulation for therapy of chronic pain. Summary of the S3 guidelines].
Epidural spinal cord stimulation (SCS) is a reversible but invasive procedure which should be used for neuropathic pain, e.g. complex regional pain syndrome I (CRPS) and for mostly chronic radiculopathy in connection with failed back surgery syndrome following unsuccessful conservative therapy. Epidural SCS can also successfully be used after exclusion of curative procedures and conservative therapy attempts for vascular-linked pain, such as in peripheral arterial occlusive disease stages II and III according to Fontaine and refractory angina pectoris. ⋯ Epidural SCS should always be used within an interdisciplinary multimodal therapy concept. Implementation should only be carried out in experienced therapy centers which are in a position to deal with potential complications.