Articles: pain-management.
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The lack of objective parameters makes the measurement of pain and the efficacy of pain treatment in patients with chronic pain very difficult. We performed acupuncture therapy in fibromyalgia patients and established a combination of methods to objectify pain measurement before and after therapy. The parameters corresponded to patients' self-report. ⋯ This was accompanied by decreased serotonin concentration in platelets and an increase of serotonin and substance P levels in serum. These results suggest that acupuncture therapy is associated with changes in the concentrations of pain-modulating substances in serum. The preliminary results are objective parameters for acupuncture efficacy in patients with fibromyalgia.
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To evaluate the relationships between patient and physician pretreatment expectations of pain relief and subsequent pain relief reported by chronic pain patients immediately after treatment. ⋯ The results of this study suggest that physicians are better predictors than are patients of patients responses to these procedures and/or that physicians may somehow subtly communicate their expectations to patients during the procedure, and these expectations then influence patient response. Patient pretreatment expectations may not always play a significant role in nonspecific treatment effects.
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Randomized Controlled Trial Clinical Trial
Homoeopathy for delayed onset muscle soreness: a randomised double blind placebo controlled trial.
To pilot a model for determining whether a homoeopathic medicine is superior to placebo for delayed onset muscle soreness (DOMS). ⋯ The study did not find benefit of the homoeopathic remedy in DOMS. Bench stepping may not be an appropriate model to evaluate the effects of a treatment on DOMS because of wide variation between subject soreness scores.
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The purpose of this study was to develop an instrument to assess satisfaction with treatment of chronic pain, evaluate the reliability and validity of this instrument, and then examine predictors and consequences of satisfaction. The Pain Service Satisfaction Test (PSST) is the result of this effort. Fifty adult patients receiving services for chronic pain in a university pain clinic completed the PSST as part of a survey mailed to their homes. ⋯ These predictors together accounted for 60% of satisfaction with treatment. Treatment satisfaction was negatively correlated with depression, reported number of physicians consulted, and number of physician visits for pain in the past 12 months; and there was a trend toward a negative correlation with disability. Results of the present study support the importance of satisfaction with treatment as a predictor and possible determinant of later health, function, and service utilization.
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During the last two decades, knowledge has increased significantly regarding the treatment of acute pain. One of these advances has been the implementation of multidisciplinary Acute Pain Services in the hospital setting to take on accountability for acute pain management. Acute Pain Services are expanding rapidly in the Canadian health care system. ⋯ The purpose of this study was to examine the effectiveness of, and staff satisfaction with, one Canadian Acute Pain Service. Results of the study indicated that staff were generally satisfied with the Acute Pain Service and felt that the program had made a significant impact on the treatment of acute pain within the hospital; although improvements in pain outcomes were not noted. Adequate communication mechanisms and resources to allow for appropriate workload, education and clinical support are critical to the development and success of an Acute Pain Service.