Articles: pain-management.
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This study investigated the value of the sense of coherence (SOC), self-esteem, and the Mental Health Inventory subscales as predictors of response to a brief pain management program. One hundred and seven chronic pain patients who participated in a pain management program, which included education about pain, relaxation training, and stress management, were sent a follow-up questionnaire 6 months after the course. ⋯ The use of relaxation and other techniques taught in the course was correlated with positive affect and well-being. The results suggest that health-promoting variables may offer advantages over pathological measures as predictors of patient response to pain management programs, and SOC is worthy of further study.
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Case Reports
Utilization of transcutaneous electrical nerve stimulation in managing craniofacial pain.
This article describes a protocol for clinical application of variable parameter transcutaneous electrical nerve stimulation (TENS) for the management of craniofacial pain. The method described is easily applied and has been used successfully for several years in clinical practice. Several selected cases are presented that demonstrate the use of TENS along the prescribed protocol.
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Spinal cord stimulation was undertaken in 45 patients referred to the University Hospital in Ghent. Failed back surgery was the major indication for implantation. Raynaud's phenomenon, causalgia, polyneuropathy, phantom limb pain, and diverse causes were the other indications. ⋯ Eight patients stopped using the stimulation system. To ensure good results, strict selection criteria and many surgical reinterventions seemed to be necessary. Although spinal cord stimulation is a nonablative technique, many complications may occur.
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In a postal survey, 1,009 randomly chosen individuals, aged 18-84, were asked about their pain problems. The pain prevalence depended on the kind of questions and definitions used, but prevalence was high overall. ⋯ At least 12% of the population was calculated as having sufficient pain problems to need some kind of care. This high figure indicates that the establishment of special treatment facilities can never be sufficient to meet the total demand for care due to pain.
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A great number of patients with gynaecological malignant diseases suffer from severe pain, caused, for example, by bone metastases of breast cancer or tumour infiltration of the pelvis and the lumbar plexus in uterine cancer. Several methods of treatment are available depending upon the origin of pain. It is possible to achieve pain relief by radiotherapy or by cytostatic therapy. ⋯ If possible, the oral route should be selected. If vomiting occurs, or if patients are unable to take oral medication, morphine can be given peridurally, intrathecally or by infusion. Often, an additional treatment is necessary with different medicaments like tricyclic antidepressants and corticosteroids.