The Clinical journal of pain
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Randomized Controlled Trial
The influence of physical activity on pain thresholds in patients with depression and multiple somatoform symptoms.
Pain is a common symptom with high occurrence in somatoform syndromes and depressive disorders. Research in this area often focuses on experimental induction of pain and subsequent assessment of pain thresholds, ensuring repeatable stimuli of defined quality. Results on sensitivity to experimental pain in major depression are inconclusive, and data on pain thresholds in multiple somatoform symptoms are scarce. The goals of the present study were to differentiate between groups regarding the pressure pain thresholds, and to investigate the possible influence of physical activity on the pain thresholds in these groups. We postulate that physical fitness and physical activity influence pain thresholds in depression and persons with multiple somatoform symptoms. ⋯ Short low-graded exercise can have reducing effects on perception of pressure pain. Physical activity level is a relevant covariate when using pressure pain assessment. Reduced general fitness can partially account for lower pain thresholds in depression.
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Review Case Reports
Updated perspectives on occipital nerve stimulator lead migration: case report and literature review.
Patients with occipital neuralgia are often refractory to or intolerant of standard pharmacological and interventional management strategies. Although occipital nerve stimulation (ONS) may provide a unique alternative for such cases, a steep technical learning curve still exists. Lead migration (LM) is among the most challenging issues facing implanters performing ONS implantation. We present an unusual case of LM after ONS implantation and discuss technical aspects for successful revision. ⋯ In an era in which reducing health care expenditures is becoming increasingly important, current complication rates could curtail future acceptance and utilization of ONS. This fact and our case report underscore the importance of a continued drive toward technical advances and a reduction in complications associated with this important treatment modality. Further prospective investigation into the mechanism of action, mechanism of complications, optimization of surgical techniques, and long-term efficacy is warranted.
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Randomized Controlled Trial
Follow-up of yoga of awareness for fibromyalgia: results at 3 months and replication in the wait-list group.
Published preliminary findings from a randomized-controlled trial suggest that an 8-week Yoga of Awareness intervention may be effective for improving symptoms, functional deficits, and coping abilities in fibromyalgia. The primary aims of this study were to evaluate the same intervention's posttreatment effects in a wait-list group and to test the intervention's effects at 3-month follow-up in the immediate treatment group. ⋯ These findings indicate that the benefits of Yoga of Awareness in fibromyalgia are replicable and can be maintained.
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To examine clinical outcomes of an interdisciplinary day-hospital treatment program (comprised of physical, occupational, and cognitive-behavioral therapies with medical and nursing services) for pediatric complex regional pain syndrome (CRPS). ⋯ A day-hospital interdisciplinary rehabilitation approach seems effective in reducing disability and improving physical and emotional functioning and occupational performance among children and adolescents with CRPSs that have failed to improve with outpatient treatment.
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Clinical Trial
Computerized mobilization of the cervical spine for the treatment of chronic neck pain.
Manual therapies for chronic neck pain (NP) are imprecise, inconsistent, and brief because of therapist fatigue. ⋯ These preliminary results demonstrate the safety of a novel computerized mobilization of the cervical spine. In addition, the data suggest that this method is effective in increasing CROM and in alleviating NP and associated headache.