The Clinical journal of pain
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Malfunction of the sympathetic nervous system (SNS) is common in early complex regional pain syndrome type I (CRPS I). This study was designed to evaluate the function of the SNS in patients with chronic CRPS I and to correlate the obtained data with hand function measurements. ⋯ Even 5 years after the diagnosis of CRPS I of the upper extremity we detected significant impairments of the pSNS in nearly two thirds of our patients. Patients still have pain and present with a significant deterioration of their hand function in comparison with the not affected hand. In our study we could not identify any correlation between pSNS function and clinical outcome as measured by MHQ.
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Costs of compensated work loss for low back pain have risen dramatically. Current healthcare management of this condition may contribute to this trend. Researchers are currently investigating the degree to which healthcare practitioners' attitudes and beliefs may influence their patient management. Measures used to assess healthcare practitioners' attitudes and beliefs have often been adapted from patient tools. The degree to which they have been assessed for use with different populations varies. ⋯ Statistical methods used suggest that the measure demonstrates good reliability with a GP population. The influence of training on attitudes and beliefs of GPs is discussed.
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To determine the correlation between magnetic resonance imaging (MRI) pathology and the response to diagnostic facet medial branch block (MBB) and L5 dorsal ramus medial branch block and radiofrequency (RF) denervation of lumbar facet joints. ⋯ Whereas some relationships were noted between MRI findings and the response to lumbar facet joint interventions, many of these correlations tended to be weak. However, this study does suggest the possibility that patients with spinal stenosis, often considered an exclusion criterion for facet interventions, may respond to RF denervation of facet joints. Prospective studies are needed to confirm these observations.
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To compare a central analgesic mechanism known as diffuse noxious inhibitory controls (DNIC) using somatic test stimuli and somatic conditioning stimuli, (CS) in irritable bowel syndrome (IBS) patients and healthy controls. ⋯ These data demonstrate deficient DNIC in IBS. This is the first study to adequately control for alternative explanations of pain reduction during counterirritation. Only by controlling for nonspecific effects can evidence of deficient DNIC be attributed to dysregulation in endogenous analgesic mechanisms.
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Randomized Controlled Trial Clinical Trial
Intraperitoneal lidocaine instillation and postcesarean pain after parietal peritoneal closure: a randomized double blind placebo-controlled trial.
To evaluate the effects of intraperitoneal instillation of lidocaine on postcesarean pain in patients with pariental periotoneal closure. ⋯ Intraperitoneal instillation of 200 mg of lidocaine decreased the incidence and scores of postcesarean pain when the parietal peritoneum was sutured. Further studies in a setting offering more effective acute pain control protocols, preferably with patient-controlled analgesia, are recommended to assess the use of lidocaine before it can be widely practiced.