The Clinical journal of pain
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This study seeks to determine the impact that celecoxib has on patients' postoperative opioid consumption on the basis of whether the patient is opioid naive or opioid tolerant for total hip and knee arthroplasty. ⋯ Both opioid-tolerant and opioid-naive patients benefited from celecoxib therapy, although in different ways. Opioid-tolerant patients saw benefits other than reductions in opioid use; opioid-naive patients had similar benefits, but also had significant reductions in opioid use.
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Cognitive-behavior therapy (CBT) leads to a reduction of fatigue and pain in chronic fatigue syndrome. The processes underlying the reduction in pain have not been investigated. Recently, it was shown that increased self-efficacy, decreased focusing on symptoms, increased physical functioning, and a change in beliefs about activity contribute to the decrease in fatigue. ⋯ Pain and fatigue most probably decrease simultaneously during CBT. Pain reduction can partly be explained by a reduction of symptom focusing and increased physical functioning. Additional, yet unknown cognitive-behavioral factors also play a role in the reduction of pain.
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The Relationship of Pain and Nausea in Postoperative Patients for One Week after Ambulatory Surgery.
The purpose of this study was to determine if pain level was associated with demographic or surgery-specific characteristics among patients recovering from ambulatory surgery; and to assess the relationship between pain level and nausea over the 7-day postoperative period, controlling for demographic and surgery-related covariates. ⋯ Younger patients and those receiving orthopedic procedures may be at greatest risk for postoperative pain. Patients with high pain reported a significantly greater degree of nausea on DOS through the first 5 days postdischarge. As the majority of surgeries are now conducted in the ambulatory setting, it is imperative that we determine pain management regimens and patient education practices that will allow for a more comfortable recovery for our patients.
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To compare the relative thickness change of the transversal abdominal (TrA) and lumbar multifidus (LM) muscles during activation in individuals with and without low back pain (LBP), and to establish a relationship between surface electromyography (sEMG) signal amplitude and the relative thickness change of the corresponding muscle during clinically relevant activity, with preferential activation of TrA/LM. ⋯ US and sEMG measurements can be used for objective TrA/LM assessment. Correlation results suggest that the relative change of the muscle thickness could be used as the indicator of the muscle activity. Insight into the activity of TrA/LM in pain-free individuals and LBP patients during and after painful episodes may clarify the role of functional abnormalities of these muscles in LBP.
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Pain catastrophizing is thought to play a causal role in the development and maintenance of chronic pain and its negative impact on functioning. However, few studies have examined the factors that might contribute to the development and maintenance of catastrophizing. The Anterior Asymmetry and Emotion (AAE) model hypothesizes that more activity in left anterior brain regions is associated with a tendency to engage in approach responses (often, but not always, associated with positive valance), and that more right anterior activity is associated with a tendency to engage in more withdrawal responses (often associated with negative valance). Given the consistent associations found between catastrophizing and both (1) approach versus avoidance pain coping style; and (2) affective responses to pain, the AAE model would predict that more left (vs. right) anterior brain activity would prospectively predict future catastrophizing. ⋯ The study findings identify a biological factor that may be associated with greater vulnerability to pain-related catastrophizing. If replicated in future research, the findings suggest new possibilities for treating catastrophizing, which may then contribute to improved pain treatment outcomes.