Articles: pain-management.
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During the past decade, the multidisciplinary pain clinic has become a popular alternative to the traditional treatment of persistent pain. There is, however, little information describing this population of health care users nor the impact this new demand has on utilization of health care services. The objectives of this study were three fold: to develop a profile of the characteristics of patients referred to a specialty pain clinic including their psychosocial adjustment to their condition; to identify predictors of the use of the specialty services; and to estimate the cost of health service utilization. ⋯ In addition, users of specialty pain clinic services generated proportionately less costs in the use of other health services when they were compared to non-users. The importance of social support and meaning of illness variables in predicting psychosocial adjustment to chronic pain is corroborated in this study as is the relevance of the pain clinic cognitive behavioural approach for these problems. In addition, compared to other chronic pain sufferers with similar characteristics, it appears that the use of the pain clinic contains the use of other services and thus has an important economic impact.
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Baseline measures associated with outcome are described for amitriptyline and brief psychotherapy used in the outpatient treatment of chronic "psychogenic" pain. The results delineate patient profiles associated with suitability for these treatments. These may serve as guidelines for choice in the treatment of heterogeneous pain clinic patients.
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We review the development of the anatomical and physiological basis for nociception. We point out the ability of babies, even those who are born very prematurely, to feel pain. ⋯ A sick infant in intensive care may be particularly sensitive to the destabilizing effects of pain, and analgesics will very often be indicated in such infants. We discuss various types of analgesia suitable for infants, and doses of commonly used analgesics.
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J Manipulative Physiol Ther · Nov 1992
Randomized Controlled Trial Clinical TrialThe immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial.
The main objective of this study is to compare the immediate results of manipulation to mobilization in neck pain patients. ⋯ This study demonstrates that a single manipulation is more effective than mobilization in decreasing pain in patients with mechanical neck pain. Both treatments increase range of motion in the neck to a similar degree. Further studies are required to determine any long-term benefits of manipulation for mechanical neck pain.