The Clinical journal of pain
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The authors examined whether self-reported menopausal status is associated with musculoskeletal pain in a multiethnic population of community-dwelling middle-aged women after considering sociodemographics, medical factors, smoking, depression, and body mass index using a cross-sectional study design. ⋯ This study demonstrates an association between pain and self-reported menopausal status, with postmenopausal women experiencing greater pain symptoms than premenopausal women.
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Comparative Study
The cognitive risk profile for pain: development of a self-report inventory for identifying beliefs and attitudes that interfere with pain management.
An extensive body of research suggests that maladaptive beliefs about chronic pain can have a negative impact on patient adherence and treatment response. A series of studies to develop and validate a clinically-based, self-report instrument for pain beliefs, the Cognitive Risk Profile for Pain (CRPP), was undertaken. We sought to expand the existing body of knowledge for pain beliefs by development of an instrument with a somewhat different content and format than prior pain belief measures, and a primary focus on clinical risk assessment for treatment planning. ⋯ Results provide initial support for the CRPP as a reliable, valid, and useful measure of general cognitive risk for pain management. Results were supportive of the content and reliabilities of the majority of scale scores. Scales for denial of mood impact on pain, perception of blame, and desire for medical breakthrough will require further evaluation. Data indicate an association of CRPP total risk with multidimensional outcome from medical treatment of chronic pain, supporting relevance to treatment planning. The unique content and format of the CRPP may be useful in some clinical pain settings. Possible applications of the CRPP for risk assessment and treatment planning for chronic pain are discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Factors that influence the applicability of sham needle in acupuncture trials: two randomized, single-blind, crossover trials with acupuncture-experienced subjects.
In recent years the retractable type of sham needle has been anticipated to be a possible solution for masking patients in acupuncture research. However, this needle has been intended mainly for acupuncture-naïve subjects. The authors' goal in this study was to assess the validity of the retractable type of sham needle. ⋯ Potential factors that influence the applicability of "placebo" needling include not only inter-tester variability but also the patient's knowledge and experience of acupuncture, acupuncture point selection, the visual impact of needling, and so on.
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Randomized Controlled Trial Comparative Study Clinical Trial
Manual therapy, physical therapy, or continued care by the general practitioner for patients with neck pain: long-term results from a pragmatic randomized clinical trial.
The authors' goals were to compare the effectiveness of manual therapy (MT; mainly spinal mobilization), physical therapy (PT; mainly exercise therapy), and continued care by the general practitioner (GP; analgesics, counseling and education) over a period of 1 year. ⋯ Short-term results (at 7 weeks) have shown that MT speeded recovery compared with GP care and, to a lesser extent, also compared with PT. In the long-term, GP treatment and PT caught up with MT, and differences between the three treatment groups decreased and lost statistical significance at the 13-week and 52-week follow-up.
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Comparative Study
Complex regional pain syndromes in children and adolescents: regional and systemic signs and symptoms and hemodynamic response to tilt table testing.
Complex regional pain syndromes (CRPS) involve neuropathic limb pain and localized circulatory abnormalities. The authors hypothesized that (1) pediatric CRPS patients exhibit systemic autonomic symptoms and orthostatic and/or cardiac sympatho-vagal dysregulation and (2) their orthostatic regulation differs from healthy controls and pediatric patients with postural orthostatic tachycardia syndrome (POTS). ⋯ CRPS patients reported multiple regional and systemic autonomic symptoms that improved during the study course, and they experienced minimal and transient tilt table-induced hemodynamic changes compared with POTS patients but relatively similar to controls.