Pain
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Comparative Study
Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain.
Patients with chronic low back pain (LBP) frequently demonstrate high scores for fear-avoidance beliefs and distress. We need better knowledge about fear-avoidance beliefs and distress in early stages of LBP. The objectives of this study were to compare the level of fear-avoidance beliefs and distress in patients with acute LBP to patients with chronic LBP, and to assess the relationship of fear-avoidance beliefs and distress to disability in acute and chronic LBP. ⋯ In addition, several of the pain and clinical variables were significantly associated with the Oswestry Disability Index and fingertip-floor distance was associated with work loss. In conclusion, fear-avoidance beliefs and distress influence pain-related disability both in early acute and long-term chronic LBP. The results replicate previous reports on the association between pain experience, fear-avoidance beliefs, distress, and disability in chronic LBP, and extend the findings to patients at an early stage of acute LBP.
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Comparative Study
Management of occupational back injuries: differences among African Americans and Caucasians.
This study examined differences in the case management of occupational low back injuries in a large, racially diverse population of Workers' Compensation claimants in Missouri. Participants were African Americans (N=580) and non-Hispanic whites (N=892) who had filed occupational injury claims that were settled over an 18-month period. Telephone interview data were gathered regarding diagnoses, legal representation, demographics, and socioeconomic status. ⋯ Simultaneous-entry, hierarchical multiple and logistic regression analyses showed significant and substantial effects for injury-related variables, socioeconomic status, and race across all Workers' Compensation variables. Differences remained for both injury and African Americans and lower socioeconomic status workers after controlling for injury, and for African Americans after controlling for both injury and socioeconomic status. Because Workers' Compensation mandates equal access to treatment and disability reimbursement for all injured workers, the differences observed in this study may reflect sociocultural biases in disability management among healthcare providers.
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Comparative Study
Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status.
The present study examined relationships between pain coping, hormone replacement therapy, and laboratory and clinical pain reports in post-menopausal women and age-matched men with osteoarthritis. Assessment of nociceptive flexion reflex threshold was followed by an assessment of electrocutaneous pain threshold and tolerance. Participants rated their arthritis pain using the Arthritis Impact Measurement Scales. ⋯ A comparison of men (n=58), post-menopausal women receiving hormone replacement therapy (n=32), and post-menopausal women not receiving hormone replacement therapy (n=42) revealed no significant group differences in arthritis pain, electrocutaneous pain threshold or tolerance, or nociceptive flexion reflex threshold. Thus, older adults with osteoarthritis do not exhibit the pattern of sex differences in response to experimental pain procedures observed in prior studies, possibly due to the development of disease-related changes in pain coping strategies. Accordingly, individual differences in clinical and experimental pain may be better predicted by pain coping than by sex or hormonal differences.
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Comparative Study
Development and validation of the Pain Treatment Satisfaction Scale (PTSS): a patient satisfaction questionnaire for use in patients with chronic or acute pain.
The purpose of this study was to develop and validate a measure of patient satisfaction for patients receiving treatment for either acute or chronic pain: the Pain Treatment Satisfaction Scale (PTSS). Development of the initial questionnaire included a comprehensive literature review and interviews with patients, physicians and nurses in the United States, Italy and France. After initial items were created, psychometric validation was run on responses from 111 acute pain and 89 chronic pain patients in the United States. ⋯ All dimensions except medical care discriminated well according to pain severity. The satisfaction with efficacy dimension, hypothesized to change in the acute pain population, indicated good preliminary responsiveness properties (effect size 0.37; P<0.001). The PTSS is a valid, comprehensive instrument to assess satisfaction with treatment of pain based on independent modules that have demonstrated satisfactory psychometric performance.
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Case Reports Comparative Study
Spinal cord stimulation in a patient with persistent oesophageal pain.
This study describes a man with a long history of oesophageal pain that led to inability to swallow food and drink. Over a period of 8 years, he had multiple oesophageal operations that were unsuccessful. He presented, to the pain management team, with persistent oesophageal pain and required jejunostomy tube feeding to maintain nutrition. ⋯ He feels that SCS has been worthwhile. The authors discuss the rationale for this treatment. The decision was based on the use of SCS for refractory angina, and the idea that the neural mechanisms that generate both these pain states may be similar.