Articles: pain-management.
-
A plea is made for the early recognition of the possible development of painful conditions affecting peripheral nerves, since it is believed that the experience of our institution, which is detailed here, confirms that while rehabilitation programmes are of benefit to the patient, successful therapy depends upon prompt institution of prophylactic measures to prevent sensitization to sympathetic outflow. Patients are encouraged to use their hands, and it is considered important that they would understand that their complaints arise from a genuine organic condition.
-
Comparative Study
The behavioral management of chronic pain: long-term follow-up with comparison groups.
To assess the long-term efficacy of an operant inpatient treatment program for severely disabled chronic pain patients, 26 treated patients were compared with 20 rejected for treatment by a clinic team and 12 who refused treatment. At follow-up ranging from 1 to 8 years, 77% of treated participants were leading normal lives without medication for pain compared to one patient in the other two groups. At time of evaluation, unsuccessfully treated patients used more medications and were higher on MMPI measures of paranoia and lower on ego-strength than successfully treated patients. Spouses of unsuccessfully treated patients had higher MMPI scores on hypochondriasis and hysteria than spouses of successfully treated patients.
-
Southern medical journal · Jan 1980
Chronic neck and back pain: a reassessment of usual surgical treatment.
One hundred seventeen patients with chronic (noncancerous) back or neck pain had multidisciplinary evaluation in the Medical College of Virginia Pain Center and were followed up for one year. They ranged in age from 26 to 57 years. The 57 patients who had surgery had an average of 2.5 procedures (either laminectomies or back fusion) and only five of them returned to work. By contrast, 16 of 60 patients who had not had operation were able to secure employment after evaluation and treatment in the Pain Center.
-
A survey of the literature is presented in two areas of biofeedback treatment for headache--muscle contraction and migraine--and a variety of miscellaneous pain syndromes. The studies done to date are characterized largely by lack of proper no-treatment or placebo control groups, by confounding biofeedback with a variety of other strategies, or by sample sizes too small to afford any reasonable conclusions about efficacy. There is some evidence that biofeedback works better for muscle contraction headache than false feedback, but it also appears that biofeedback is no more effective than relaxation training. ⋯ The potential influence of extraneous factors linked to the therapeutic situation is pervasive in these studies, but examination of their specific roles in symptom reduction is largely missing. Some variables are listed which need to be examined and which may contribute to the alleviation of pain with much less expenditure of clinical resources than that demanded by biofeedback. Perhaps the main contribution of biofeedback has been to highlight such extraneous variables in the pain treatment setting.
-
An evaluation of acupuncture for pain relief was made in 10 patients with sickle cell anaemia during 16 pain crises. A model was developed in which the patient served as his own control and in which both patient and examiner were unaware of whether an acupuncture point or a sham site was treated. The results show (1) that pain relief was obtained in 15 of the 16 painful episodes regardless of whether an acupuncture point or a sham site was treated, demonstrating considerable overlap between the effects of needling acupuncture points and sham sites; (2) that needling at acupuncture points for pain relief is not significantly superior to treatment at sham sites; (3) that needling, per se, whether at acupuncture points of at sham sites can be useful for alleviating pain in sickle cell crises. The model could be useful for evaluation of pain relief by needling in other diseases.