The Clinical journal of pain
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Review Historical Article
Psychologic factors in the development of complex regional pain syndrome: history, myth, and evidence.
The present paper examines the literature that addresses psychologic aspects involved in complex regional pain syndrome from a historic perspective to provide a rationale for the emergence of psychologic theories to explain its pathogenesis. The support of such perspective is then analyzed through the review of evidence-based studies. ⋯ An analysis of the Zeitgeist when complex regional pain syndrome was first described helps to understand the long-standing theories associated with a psychological theory of its etiology. This understanding should help to undermine the perpetuation of such claims which may contribute to undertreatment and misdiagnosis. To be consistent with todays Zeitgeist we must incorporate psychologic aspects, which while not causal in nature or exclusive of complex regional pain syndrome, are strongly associated with a wide spectrum of chronic pain disorders.
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Earlier studies have associated improvements in chronic pain outcomes with various consultation attributes, including: the legitimization of people's chronic pain experience, affective components of the therapeutic relationship, and reaching decisions about people's care through collaboration. Although studies have used patient self-report measures to examine how certain aspects of consultations contribute to managing chronic pain. The psychometric quality of these measures seems to have not been independently appraised to date. ⋯ Each of the included measures assessed differing aspects of consultations, and their potential clinical and research uses are discussed. Recommendations are made to improve the psychometric quality of the included measures. In summary, more psychometric research needs to be undertaken to improve the existing measures' quality and broaden the scope of chronic pain consultation measures before studies may be conducted to develop a comprehensive understanding of the manner in which consultation attributes influence chronic pain outcomes.
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Comparative Study
A comparison of analgesic management for emergency department patients with sickle cell disease and renal colic.
To determine whether there is a difference in time to initial analgesic for patients with acute pain from sickle cell disease (SCD) versus renal colic (RC) and to identify factors contributing to variance in time to analgesic. ⋯ ED patients with SCD experienced longer delays in the administration of the initial analgesic compared with RC patients, despite higher arrival pain scores and triage acuity levels.
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Randomized Controlled Trial
Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome.
Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. Several methods have been recommended for the inactivation of trigger points (TrPs). We carried out this study to investigate the effectiveness of miniscalpel-needle (MSN) release and acupuncture needling and self neck-stretching exercises on myofascial TrPs of the upper trapezius muscle. ⋯ The effectiveness of MSN release for MPS is superior to that of acupuncture needling treatment or self neck-stretching exercises alone. The MSN release is also safe, without severe side effects in treatment of MPS.
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The complex regional pain syndrome type I (CRPS I) is one of the main complications after a fracture of the distal radius. The underlying pathology is not fully understood. Different theories have been put forward to explain the pathogenesis of this disease, some including genetic models. The aim of this study was to find a possible genetic involvement in the occurrence of CRPS I. ⋯ This study suggests the rs1048101 single nucleotide polymorphism within the alpha1a-adrenoceptor as one risk factor for the development of CRPS I after the distal radius fracture.