The Clinical journal of pain
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This review aims to analyze the current data for the use of botulinum toxin type A (BTX-A) in the treatment of trigeminal neuralgia (TN) and highlight the evidence for its efficacy and safety. Pain management in patients with TN is challenging, as facial pain often does not respond well to conventional therapies. BTX-A has been suggested as a potential treatment option, but there is limited evidence regarding its long-term efficacy. ⋯ Current evidence indicated BTX-A injection is an effective and safety option for patients with refractory TN or not responding to medical or surgical management. However, more high-quality studies are needed to further confirm its efficacy.
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This study aimed to determine the incidence of complications after landmark-based paravertebral blocks for breast surgery. ⋯ Our study suggests that landmark based paravertebral blocks for breast surgery result in a very low complication rate and are a safe technique for post-surgical analgesia.
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Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain. ⋯ Adolescents often demonstrated active and sound participation in shared opioid decision-making, influenced by complex integration of inputs and self-reflection. Conversely, potential factors that could contribute to risky behaviors included low personal risk perceptions, uncertainty about what constitutes opioid misuse, and avoidance of prescribed opioids despite extreme pain. Future studies may explore associations of adolescents' opioid decision-making with longer-term pain and opioid-related outcomes.
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Perceived injustice (PI), assessed by the Injustice Experience Questionnaire (IEQ), is an important trigger of anger. Both PI and anger are associated with adverse chronic pain outcomes, and with comorbid mental health severity. We aimed to examine the roles of PI and anger in mediating pain across Fibromyalgia patients, with and without comorbid anxiety/depression (FM+A/D, FM-A/D respectively), as well as Rheumatoid Arthritis (RA), and healthy controls (HC). We hypothesized the highest levels of PI, anger, and pain in FM+A/D patients, followed by FM-A/D, RA, and HC, thus also validating a Hebrew version of the IEQ. ⋯ Our findings validate a Hebrew IEQ, and highlight the importance of PI and state and trait anger in the differential manifestation of mental health comorbidity in FM.
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Chronic pain is a significant public health concern. Psychological treatments are effective for treating chronic pain, but long term follow up studies are limited, and treatment effects sizes are small. Identifying modifiable treatment targets, such as emotion regulation, is critical to improve interventions. Emotion regulation (ER; i.e., cognitive and attentional strategies to modulate or maintain emotional experience) has been linked to psychopathology and pain experience in adults. Yet, the existing work is limited and has largely focused on the relationship between emotional experience, not ER, and pain. ⋯ Given that emotion regulation is readily targeted in psychological treatments for chronic pain, the results from the current study provide initial evidence to target these ER strategies in treatment.