The Clinical journal of pain
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To study the prevalence of upper extremity disorders (UEDs) and neck as a total and complaints of the arm, neck and/or shoulder (CANS) not caused by acute trauma or any systemic disease as defined in the CANS model in the open population and to assess sociodemographic and health characteristics of chronic symptoms. ⋯ UEDs and CANS frequently occur in the open population. Excluding acute traumas and systemic diseases reduced the prevalence of CANS and resulted in a relatively healthier population. A compound definition of CANS seems indicated because of the large overlap of affected anatomic sites.
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Randomized Controlled Trial Multicenter Study
Acupuncture in migraine: investigation of autonomic effects.
A dysregulation of the autonomic nervous system is discussed as a pathogenetic factor in migraine. As acupuncture has been shown to exhibit considerable autonomic effects, we tested whether the clinical effects of acupuncture in migraine prophylaxis are mediated by changes of the autonomic regulation. ⋯ The data indicate, that VA and SA acupuncture might have a beneficial influence on the autonomic nervous system in migraineurs with a reduction of the LF power of HRV related to the clinical effect. This might be due to a reduction of sympathetic nerve activity. VA and SA induce different effects on the high-frequency component of HRV, which seem, however, not to be relevant for the clinical outcome in migraine.
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Randomized Controlled Trial
Acupuncture in migraine prevention: a randomized sham controlled study with 6-months posttreatment follow-up.
To assess the efficacy of acupuncture in migraine prophylaxis. ⋯ Individualized treatment based on traditional Chinese medicine plays a role in preventing migraine attacks. Nevertheless, sham acupuncture had similar effects. Major conclusions were limited by the small sample sizes however the observed trends may contribute to design future trials.
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Although there have been a few case reports in the literature of self-inflicted symptoms presenting as complex regional pain syndrome (CRPS), there has been no systematic study. This report investigates the period prevalence and characteristics of self-induced disorders in patients referred to a comprehensive pain clinic with a diagnosis of CRPS. ⋯ This is the first report of a case series of patients diagnosed as CRPS with self-induced symptoms. We discuss in detail limitations of the study, factors that contribute to the index of suspicion, and the complex nature of the behavior including the overlap between factitious disorder, somatoform disorders, and malingering, whereas we stress the legitimacy of CRPS as a diagnosis.
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Randomized Controlled Trial
Mirtazapine decreases the pain feeling in healthy participants.
The treatment of neuropathic pain is mainly based on antiepileptics, tricyclic antidepressants, and opiates. These drugs have important side effects disturbing the patient's quality of life. Mirtazapine (MTZ) is a new and well-tolerated tricyclic antidepressants with both monoaminergic and opioid properties that might favorably influence pain. The aim of this study was to assess whether MTZ can reduce the pain induced by a standardized stimulus presented to healthy human participants. The nociceptive flexion reflex (NFR) to an electric stimulus was chosen to determine the pain threshold. ⋯ MTZ increases the pain tolerance in healthy participants. The potential benefit of this effect on pain should be investigated more thoroughly in chronic neuropathic pain patients. The NFR might serve as an additional tool for the monitoring of these patients.