The Clinical journal of pain
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Randomized Controlled Trial
Clinical and demographic characteristics of patients with chronic pain after major thoracotomy.
The characteristics and etiology of long-term pain after major thoracotomy and methods for its prevention have yet to be established. ⋯ Postoperative pain that persists but eventually dissipates was a common finding whose intensity was associated with immediate preoperative and postoperative pain levels. In contrast, pain later on during hospitalization, its impact, and perceived analgesic effectiveness best identified those who would continue to report pain almost 1 year after surgery.
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To assess the evidence from rigorous clinical trials, systematic reviews, and meta-analyses of complementary and alternative therapies for treating neuropathic and neuralgic pain. ⋯ On the basis of our findings, the evidence is not fully convincing for most complementary and alternative medicine modalities in relieving neuropathic or neuralgic pain. However, for topically applied capsaicin there is evidence of effectiveness beyond placebo. The evidence can be classified as encouraging and warrants further study for cannabis extract, magnets, carnitine, and electrostimulation.
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Complex regional pain syndrome (CRPS) type I, also known as reflex sympathetic dystrophy, usually develops after trauma or immobilization, is characterized by focal pain and autonomic dysregulation, and sometimes focal trophic changes such as osteoporosis. The pathophysiology is unknown and there have been few controlled treatment trials. The purpose of this study was to obtain pilot data on the safety and efficacy of a highly potent bisphosphonate, ibandronate, for the treatment of CRPS, which might be responsive to bisphosphonates' inhibition of osteoclast and anti-inflammatory activity. ⋯ These data justify a randomized, double-blind, placebo-controlled trial of ibandronate that should perhaps be limited to patients with hand CRPS.
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Empathy and empathic response are receiving greater attention in pain research as investigators acknowledge that other forms of interaction may impact the pain process. The purpose of this study was to examine validation and invalidation as forms of empathic and nonempathic responses in chronic pain couples. ⋯ This work suggests that empathic and nonempathic communication are distinct from solicitous spouse responses. The findings have implications for theoretical and clinical work on social factors in pain.
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This preliminary study examined aspects of pain communication (self-efficacy for pain communication and holding back from discussing pain and arthritis-related concerns) among patients with osteoarthritis (OA) and their partners, and associations between patient and partner pain communication and measures of patient and partner adjustment. ⋯ Taken together, results from this preliminary study suggest that self-efficacy for pain communication and holding back from discussions of pain and arthritis-related concerns may be important in understanding how patients with OA and their partners adjust to the demands of the patient's disease.