The Clinical journal of pain
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The purpose of this prospective cohort study with 1-year follow-up was to determine prognostic factors for duration of sickness absence due to musculoskeletal disorders. ⋯ High pain intensity is a major prognostic factor for duration of sickness absence, especially in low back pain. The different disease-specific risk profiles for prolonged sickness absence indicate that low back pain and upper extremity disorders need different approaches when applying intervention strategies with the aim of early return to work. The interaction of perceived physical workload with time suggests that perceived physical workload would increasingly hamper return to work and, hence, supports the need for workplace interventions among workers off work for prolonged periods.
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Comparative Study
Content comparison of low back pain-specific measures based on the International Classification of Functioning, Disability and Health (ICF).
The objective of this study was to compare the content covered by the North American Spine Society Lumbar Spine Outcome Assessment Instrument, the Oswestry Low Back Disability Questionnaire, and the Roland-Morris Disability Questionnaire based on the International Classification of Functioning, Disability and Health (ICF). ⋯ Comparison based on the ICF provides insight into both the breadth of health dimensions measured as well as the thoroughness and depth of measurement. Therefore, it can be a useful tool when selecting specific measures for a study. Compared with other types of qualitative review, the most important advantage of the content comparison of measures based on the ICF is the use of an external and independent reference to which all the instruments can be linked and by which all the instruments can be compared. The three back-specific measures are comparable, with their common focus on physical aspects of body functions and activities and participation.
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Case Reports
Warning headache of subarachnoid hemorrhage and infarction due to vertebrobasilar artery dissection.
The authors describe the clinical features of headache in patients with vertebrobasilar artery dissection (VBAD) and emphasize the importance of recognition of warning headaches preceding subarachnoid hemorrhage. Headache in VBAD is already recognized, but the natural history and clinical features of the warning headache have not been well elucidated. ⋯ The present study confirms a high frequency of headache in patients with VBAD. Sudden severe occipital and nuchal pain, even without subarachnoid hemorrhage or any neurologic deficit, should be considered as a warning sign of subarachnoid hemorrhage. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography should be performed urgently for screening of patients with a warning headache to prevent resultant life-threatening major vascular events.
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Case Reports
Intravenous regional block with lidocaine for treatment of complex regional pain syndrome.
The goal of this article is to report the successful treatment of a patient with complex regional pain syndrome (CRPS) type 1 involving the hand with the use of an intravenous regional block. ⋯ Intravenous regional block with lidocaine was well tolerated and associated with relief in this case of CRPS type 1.
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To determine whether healthcare professionals believe the pain of infants at risk for neurologic impairment differs from that of typical infants. ⋯ Professionals expressed the belief that neurologically impaired infants' pain experience is reduced, relative to infants without impairment, as their level of risk for neurologic impairment increases. This belief did not vary due to professional experience or personal factors. Future studies should investigate the source of these beliefs and their impact on the pain management provided to infants with risk for neurologic impairment.