Articles: pain-management.
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The authors tried to evaluate the benefit of sympathetic nerve blocks with guanethidine in 32 patients with a sympathetic dystrophy syndrome who failed to respond to conventional treatment.
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A computer and a hand search of the literature recovered 33 papers from which 25 trials suitable for meta-analysis were identified. We compared the effectiveness of cognitive-behavioural treatments with the waiting list control and alternative treatment control conditions. There was a great diversity of measurements which we grouped into domains representing major facets of pain. ⋯ Differences on the following domains were not significant; mood/affect (depression and other, non-depression, measures), cognitive coping and appraisal (negative, e.g. catastrophization), and social role functioning. We conclude that active psychological treatments based on the principle of cognitive behavioural therapy are effective. We discuss the results with reference to the complexity and quality of the trials.
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J Bone Joint Surg Am · Mar 1999
An outcome study of chronic patellofemoral pain syndrome. Seven-year follow-up of patients in a randomized, controlled trial.
We determined prospectively the long-term outcomes of nonoperative treatment of chronic patellofemoral pain syndrome. ⋯ The seven-year overall outcome was good in approximately two-thirds of the patients. However, the remaining patients still had symptoms or objective signs of a patellofemoral abnormality.