Pain
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Randomized Controlled Trial Clinical Trial
Sex differences in response to cutaneous anesthesia: a double blind randomized study.
The existing literature on experimentally induced pain indicates that there are sex differences, with females displaying greater sensitivity. In epidemiological studies, sex differences are also noted in the prevalence of a number of pain syndromes, with females reporting more severe pain, more frequent pain, and pain of longer duration. Complicating the interpretation of pain differences between men and women in clinical samples are reports of sex differences in response to pain-reducing medications. ⋯ This study did not show sex differences in the placebo condition. These results are particularly interesting in light of previous work that has shown similar pain stimuli (pressure pain) to be the stimulation most sensitive to sex differences. Results of this study suggest that the protocol employed (pressure pain stimulus with magnitude matching task) is sensitive to both anesthetic treatment and sex differences and represents an improvement in pain assessment methodology for use in experimental studies and in the clinic.
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Randomized Controlled Trial Clinical Trial
Treatment of myofascial trigger-points with ultrasound combined with massage and exercise--a randomised controlled trial.
The effect of treatment with ultrasound, massage and exercises on myofascial trigger-points (MTrP) in the neck and shoulder was assessed in a randomised controlled trial. The outcome measures were pain at rest and on daily function (Visual Analogue Scale, VAS), analgesic usage, global preference and index of MTrP. Long-term effect for treatment and control groups was assessed after 6 months using a questionnaire. ⋯ No difference between groups given ultrasound or sham ultrasound were found. It is concluded that US give no pain reduction, but apparently massage and exercise reduces the number and intensity of MTrP. The impact of this reduction on neck and shoulder pain is weak.
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Randomized Controlled Trial Clinical Trial
Effects of antihyperalgesic drugs on experimentally induced hyperalgesia in man.
In a double-blind, cross-over study, ibuprofen (600 mg), a peripherally-acting selective kappa-opioid receptor agonist (7.5 mg), or placebo were given orally in experiments on healthy volunteers 1 h before assessment of pain thresholds to radiant heat and of pain ratings to controlled mechanical impact stimuli. Mechanical and thermal hyperalgesia had been induced 24 h before by irradiating skin patches on the ventral side of the upper leg. UVB irradiation induced mechanical and thermal hyperalgesia at radiation dosages of three times the minimal erythema dose. ⋯ In contrast, the kappa-agonist showed no antihyperalgesic efficacy in the chosen models. It is concluded that the UVB model, as the pinch model, is suitable for establishing antihyperalgesic effects of NSAIDs, but probably not of kappa-receptor agonists, in healthy human volunteers. Compared to the pinch stimulus model, the UVB model offers additional advantages: (a) drugs may be tested after induction of the skin trauma by UV and this situation is more similar to the clinical use of antihyperalgesic drugs. (b) Since mechanical and thermal hyperalgesia is induced by UVB, drug effects can be tested upon both forms of hyperalgesia.
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Randomized Controlled Trial Clinical Trial
A placebo-controlled randomized clinical trial of nortriptyline for chronic low back pain.
To assess the efficacy of nortriptyline, a tricyclic antidepressant, as an analgesic in chronic back pain without depression, we conducted a randomized, double-blind, placebo-controlled, 8-week trial in 78 men recruited from primary care and general orthopedic settings, who had chronic low back pain (pain at T-6 or below on a daily basis for 6 months or longer). Of these 57 completed the trial; of the 21 who did not complete, four were withdrawn because of adverse effects. The intervention consisted of inert placebo or nortriptyline titrated to within the therapeutic range for treating major depression (50-150 ng/ml). ⋯ Also, completers with radicular pain on nortriptyline (n = 5) had significantly (P < 0.05) better analgesia and overall outcome than did those on placebo (n = 6). The results suggest noradrenergic mechanisms are relevant to analgesia in back pain. This modest reduction in pain intensity suggests that physicians should carefully weigh the risks and benefits of nortriptyline in chronic back pain without depression.
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Randomized Controlled Trial Comparative Study Clinical Trial
The influence of film-induced mood on pain perception.
It has been shown that a person's mood can influence pain tolerance. Films have been used as a means of inducing a desired mood. The effect on pain perception of film type and film length to induce mood was investigated. ⋯ Each subject was given a baseline trial of cold-pressor pain, a trial immediately following the film and a trial 30 min later. Results indicated an advantage in increased pain tolerance for the humorous film and an increased pain tolerance for the longer film regardless of type only after the 30-min waiting period. Results were discussed from a pain theoretical perspective with emphasis placed on returning to psychological manipulations of the sensory aspects of pain and not just the cognitive/emotional/motivational dimensions.