Articles: chronic-pain.
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Objectives. The pain associated with herpes zoster can be classified as acute phase, persistent phase, or chronic phase, but if it is prolonged, it becomes resistant to treatment. It is clinically important to prevent transition to postherpetic neuralgia after the onset of herpes zoster, and the outcome depends on whether continuous and potent pain management can be achieved between the acute and persistent phases. We evaluated the effect of pain management leading to quick termination of pain using temporary spinal cord stimulation (SCS) which does not require implantation of a device. ⋯ Less epidural analgesia was required and the adverse reactions of lowered blood pressure in three cases and urinary retention in seven cases disappeared soon. The self-rated satisfaction was higher with SCS than with CEB in all 14 cases, because it is highly controllable and has minimal activities of daily living-lowering effects. Conclusion. Temporary SCS, which does not require implantation of a device, may have a potent analgesic effect on severe pain in patients in the persistent phase after herpes zoster, and prevent transition to postherpetic neuralgia.
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Stud Health Technol Inform · Jan 2009
Scientific evidence for the effectiveness of virtual reality for pain reduction in adults with acute or chronic pain.
The objective of this systematic review was to determine the level of scientific evidence for the effectiveness of VR for pain management in adults with pain. A comprehensive systematic search involving major health care databases was undertaken to identify randomized clinical trials (RCTs) and descriptive studies. Twenty-seven studies were identified that fulfilled the inclusion criteria. ⋯ Moreover, there is limited evidence (Level 2a) of effectiveness of immersive VR compared to no VR for reducing chronic pain. There is currently no published study that has explored the effectiveness of non-immersive VR for chronic pain (level 5). It is concluded that VR can be recommended as a standard or adjunct clinical intervention for pain management at least in the management of acute pain.
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The Contact Heat Evoked Potential Stimulator (CHEPS) utilises rapidly delivered heat pulses with adjustable peak temperatures to stimulate the differential warm/heat thresholds of receptors expressed by Adelta and C fibres. The resulting evoked potentials can be recorded and measured, providing a useful clinical tool for the study of thermal and nociceptive pathways. Concurrent recording of contact heat evoked potentials using electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI) has not previously been reported with CHEPS. Developing simultaneous EEG and fMRI with CHEPS is highly desirable, as it provides an opportunity to exploit the high temporal resolution of EEG and the high spatial resolution of fMRI to study the reaction of the human brain to thermal and nociceptive stimuli. ⋯ The results of this study demonstrate the feasibility of recording contact heat evoked potentials with EEG during continuous and simultaneous fMRI. The combined use of the two methods can lead to identification of distinct patterns of brain activity indicative of pain and pro-nociceptive sensitisation in healthy subjects and chronic pain patients. Further studies are required for the technique to progress as a useful tool in clinical trials of novel analgesics.
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To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain. ⋯ One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.
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Neuropsych Dis Treat · Dec 2008
Post-traumatic stress, depression, and anxiety in patients with injury-related chronic pain: A pilot study.
To investigate, in patients with injury-related chronic pain, pain intensity, levels of post-traumatic stress, anxiety and depressions. ⋯ The findings of relationships between pain intensity, post-traumatic stress, depression, and anxiety may have implications for clinicians and underline the importance of considering all these factors when managing patients with injury-related chronic pain.