The Clinical journal of pain
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Multicenter Study
Construct and Predictive Validity of the Chronic Pain Grade in Workers With Chronic Work-related Upper-extremity Disorders.
To evaluate the ability of Chronic Pain Grade (CPG) questionnaire to predict upper-extremity physical disability, at-work disability, and work status in workers with chronic work-related upper-limb injuries. ⋯ CPG has low to moderate ability to predict 6-month work status in patients with chronic upper-extremity disorders. Both a lack of CPG and work transition variability may have contributed to this finding. Extension of the upper end of CPG range might be investigated as a means to increase discrimination at the upper end spectrum of chronic pain, which predominate the population of patients with chronic musculoskeletal disorders.
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Randomized Controlled Trial
Pain Physiology Education Improves Health Status and Endogenous Pain Inhibition in Fibromyalgia: A Double-Blind Randomized Controlled Trial.
There is evidence that education on pain physiology can have positive effects on pain, disability, and catastrophization in patients with chronic musculoskeletal pain disorders. A double-blind randomized controlled trial (RCT) was performed to examine whether intensive pain physiology education is also effective in fibromyalgia (FM) patients, and whether it is able to influence the impaired endogenous pain inhibition of these patients. ⋯ These results suggest that FM patients are able to understand and remember the complex material about pain physiology. Pain physiology education seems to be a useful component in the treatment of FM patients as it improves health status and endogenous pain inhibition in the long term.
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Meta Analysis
Lives on Hold: A Qualitative Synthesis Exploring the Experience of Chronic Low-back Pain.
Chronic nonspecific low-back pain (CLBP) is a prevalent, costly condition that is remarkably resistant to intervention. Substantial evidence suggests that a mismatch exists between the biomedical beliefs held by clinicians and patients and the biopsychosocial nature of CLBP experience. The aim of this metasynthesis of qualitative studies was to provide clinicians with a richer understanding of their patients' CLBP experience to highlight the importance of moving away from biomedical paradigms in the clinical management of CLBP. ⋯ The authors conceptualize the experience of CLBP as biographical suspension in which 3 aspects of suspension are described: suspended "wellness," suspended "self," and suspended "future". The implications of improved clinician understanding of the CLBP experience and directions for future research are discussed.
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Randomized Controlled Trial
Botulinum Toxin A in Postherpetic Neuralgia: A Parallel, Randomized, Double-Blind, Single-Dose, Placebo-controlled Trial.
Cumulative evidence support a beneficial effect of botulinum toxin A (BTX-A) in postherpetic neuralgia (PHN). We aimed to assess efficacy, safety, and tolerability of BTX-A in the management of PHN, performing a randomized, double-blind, single-dose, placebo-controlled trial. ⋯ Data confirm that BTX-A is effective and well tolerated in the treatment of PHN.
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Catheterization to measure bladder sensitivity is aversive and hinders human participation in visceral sensory research. Therefore, we sought to characterize the reliability of sonographically estimated female bladder sensory thresholds. To demonstrate this technique's usefulness, we examined the effects of self-reported dysmenorrhea on bladder pain thresholds. ⋯ Sonographic estimates of bladder sensory thresholds were reproducible and reliable. In these healthy volunteers, dysmenorrhea was associated with increased bladder pain and urgency during filling but unrelated to capacity. Plausibly, women with dysmenorrhea may exhibit enhanced visceral mechanosensitivity, increasing their risk to develop chronic bladder pain syndromes.