Articles: pain-management.
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Randomized Controlled Trial Clinical Trial
Cognitive-behavioral treatment in unselected rheumatoid arthritis outpatients.
This trial was performed to evaluate the efficacy of an adjunctive cognitive-behavioral treatment compared with rheumatological treatment alone in unselected rheumatoid arthritis outpatients. ⋯ Cognitive-behavioral therapy has proven an effective adjunct to standard treatment of rheumatoid arthritis outpatients. These effects were shown in an unselected sample with increasing disease activity and with comparable changes in medication during treatment. We recommend cognitive-behavioral treatment as an desirable adjunct to standard medical treatment of rheumatoid arthritis.
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Comparative Study Clinical Trial
The effect of compression and regional anaesthetic block on referred pain intensity in humans.
The mechanisms underlying local and referred muscle pain are poorly understood. The aim of this experiment was to determine to which degree referred pain is dependent on peripheral or central mechanisms. This was studied by blocking sensory input from the referred pain area. ⋯ In the combined nerve block experiment, a significant reduction of referred pain intensity (38.5%) was seen after 20 min and until the release of the tourniquet. There was no significant difference in the referred pain intensity between the two types of blocks. The present findings suggest that both peripheral and central mechanisms play a role in referred pain and that the myelinated fibres mediate the peripheral component.
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Randomized Controlled Trial Clinical Trial
Chronic pain management in a health maintenance organization.
The purpose of this study is to investigate the management of chronic pain in a large health maintenance organization using cognitive-behavioral techniques and a blinded control group. ⋯ Gains were achieved in pain severity, negative mood, pain affect, self-control, and pain interference with the patient's life. Other behavioral variables and activity did not improve. Except in self-control, pain affect, and distracting responses from their significant others, the blinded minimal treatment group demonstrated similar findings. Patient satisfaction with treatment strongly favored the treatment group with over 78% of the treatment participants satisfied with the care provided.