The Clinical journal of pain
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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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Controlled Clinical Trial
Suppression of Emotion Expression Mediates the Effects of Negative Affect on Pain Catastrophizing: A Cross-Sectional Analysis.
Negative affect is associated with individual differences in pain catastrophizing (PC). Research suggests that variations in emotion regulation may modify negative affect on PC. Using the process model of emotion regulation, this study examined the relationships of 2 emotion regulatory strategies, cognitive reappraisal and expressive suppression, with negative affect and PC. ⋯ These preliminary findings suggest that expressive suppression of emotion plays a mediating role in PC and subsequent pain adjustment outcomes. More research is needed to further examine other types of negative emotions and different emotion regulatory strategies used in chronic pain adjustment.
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Case Reports
An Alternative to Traditional Mirror Therapy: Illusory Touch Can Reduce Phantom Pain When Illusory Movement Does Not.
There is evidence that amputation leads to cortical reorganization, and it has been suggested that phantom pain might be related to a consequently emerging incongruence of motor intention, somatosensation and visual feedback. One therapeutic approach that has the potential to temporarily resolve this visuo-proprioceptive dissociation is mirror therapy, during which amputees typically move their intact limb while observing its reflection in a mirror, which in turn evokes the illusory perception of movement of their phantom limb. However, while the action of moving the phantom relieves pain for some patients, it can actually increase cramping sensations in others. In the current study we therefore implemented an alternative version of the mirror therapy involving a visuotactile illusion, to explore whether it might be effective with amputees for whom the action of moving the phantom increases phantom pain. ⋯ Albeit preliminary, our results represent an encouraging finding of possible future clinical relevance, and indicate that the type of multisensory stimulation that most efficiently reduces phantom pain can vary in different sub-populations of amputees.
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Case Reports
Percutaneous Trigeminal Rhizotomy for Facial Pain Secondary to Head and Neck Malignancy.
Nearly 80% of patients with head and neck cancers experience facial pain related to their tumor or treatment. The majority obtain pain relief with appropriate medical treatment. Occasionally some remain refractory to all analgesics or cannot tolerate the accompanying side effects. They may benefit from surgical intervention. ⋯ Percutaneous trigeminal rhizotomy is a surgical option for managing nociceptive pain secondary to a head and neck malignancy. This technique, last reported in the literature almost 30 years ago, must not be forgotten by the next generation of oncologists, pain specialists, and neurosurgeons.
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Comparative Study
Neuropathic Pain Components Are Common in Patients With Painful Cervical Radiculopathy, but Not in Patients With Nonspecific Neck-Arm Pain.
The aim of this study was to investigate, using quantitative sensory testing (QST) parameters and the painDETECT (PD-Q) screening questionnaire, the presence of neuropathic pain (NeP) in patients with unilateral painful cervical radiculopathy (CxRAD) and in patients with unilateral nonspecific neck-arm pain associated with heightened nerve mechanosensitivity (NSNAP). ⋯ QST data suggest that NeP is likely to be observed in patients with painful CxRAD, but not in patients with NSNAP.