The Clinical journal of pain
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study.
The aim of the study was to compare the therapeutic effect of the superficial and in-depth insertion of acupuncture needles in the treatment of patients with chronic lumbar myofascial pain. ⋯ Clinical results show that deep stimulation has a better analgesic effect when compared with superficial stimulation.
-
To investigate integrative thermal perception in a patient with multiple sclerosis. ⋯ The absence of thermal grill-evoked pain is consistent with the hypothesis that in some cases of central pain the loss of the thermosensory pathway results in disruption of the normal cold inhibition of burning pain.
-
Comparative Study
A comparison of modality-specific somatosensory changes during menstruation in dysmenorrheic and nondysmenorrheic women.
The objective was to evaluate somatosensory thresholds to a multimodality stimulation regimen applied both within and outside areas of referred menstrual pain in dysmenorrheic women, over four phases of confirmed ovulatory cycles, and to compare them with thresholds in nondysmenorrheic women during menstruation. ⋯ The results show reduced somatosensory pain thresholds during menstruation to heat and pressure stimulation, both within and outside areas of referred menstrual pain in dysmenorrheic women. Dysmenorrheic women showed a lower HPT at the control sites and a lower PPT at all the sites than those for nondysmenorrheic women in the menstrual phase. The altered somatosensory thresholds may be dependent on a spinal mechanism of central hyperexcitability, induced by recurrent moderate to severe menstrual pain.
-
The objective was to evaluate whether the Multidimensional Pain Inventory (MPI) is effective for predicting response to interdisciplinary treatment in a heterogeneous group of patients with chronic pain. Changes in patients' profiles to a predominantly adaptive coping status after treatment also were assessed. ⋯ Although there were major differences in psychosocial functioning before treatment, the MPI was not found to significantly predict response to interdisciplinary treatment in a heterogeneous group of patients with chronic pain. Thus, a comprehensive interdisciplinary treatment program may achieve its full effectiveness across a wide array of pain/disability-related outcome variables, regardless of initial MPI profile categorization.
-
Sexual dysfunction and low testosterone levels have been observed previously in males with chronic noncancer pain treated with intrathecal opioids. To investigate the hypothesis that intrathecal opioids suppress the hypothalamic-pituitary-gonadal axis, a prospective nonrandomized investigation of the function of this axis was undertaken. ⋯ Administration of intrathecal opioids may result in hypogonadotrophic hypogonadism. As part of the consent for therapy process, patients should be informed about this effect and its management. With long-term intrathecal opioid administration, the hypothalamic-pituitary-gonadal axis should be monitored. Where indicated, testosterone replacement should be undertaken to improve sexual function and prevent the potential metabolic effects of hypogonadism, in particular, osteoporosis.