The Clinical journal of pain
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Do physical findings that are used to indicate location and extent of tissue damage and a measure of the severity of initial pain predict subsequent reports of pain and of disability? ⋯ The studies provide moderate evidence (level 2) that reports of the intensity of pain in acute musculoskeletal injury predict subsequent reports of pain. There is limited evidence (level 3) that the location and extent of injury predict reports of pain and poor functional activity outcomes. There is moderate evidence (level 2) that physical symptoms and signs cannot be considered individual predictors of chronic pain disability as measured by participation outcomes. Instead, in the transition from subacute to chronic pain disability, functional disability and psychological distress play a more important role than pain intensity.
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This study examined the effects of peripheral nerve block with high-concentration tetracaine for the management of trigeminal neuralgia, and evaluated sensory function by measuring the postblock current perception threshold. ⋯ Peripheral nerve block with high-concentration tetracaine is a relatively safe and useful technique in the management of trigeminal neuralgia, particularly among older patients and those with systemic problems.
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The mechanisms underlying chronic pain after whiplash injury are usually unclear. Injuries may cause sensitization of spinal cord neurons in animals (central hypersensitivity), which results in increased responsiveness to peripheral stimuli. In humans, the responsiveness of the central nervous system to peripheral stimulation may be explored by applying sensory tests to healthy tissues. The hypotheses of this study were: (1) chronic whiplash pain is associated with central hypersensitivity; (2) central hypersensitivity is maintained by nociception arising from the painful or tender muscles in the neck. ⋯ The authors found a hypersensitivity to peripheral stimulation in whiplash patients. Hypersensitivity was observed after cutaneous and muscular stimulation, at both neck and lower limb. Because hypersensitivity was observed in healthy tissues, it resulted from alterations in the central processing of sensory stimuli (central hypersensitivity). Central hypersensitivity was not dependent on a nociceptive input arising from the painful and tender muscles.
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The purpose of this study was to assess relations and concordance between behavioral and physiologic reactivity to pain in preterm neonates at 32 weeks postconceptional age as a function of gestational age at birth. ⋯ The study findings confirm the value of measuring domains independently, especially in neonates born at a very young gestational age.
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The primary aim of this study was to describe pain characteristics, coping strategies, depression, and functional disability in children and adolescents with chronic pain and to examine potential factors that are associated with functional disability in a pediatric pain population. The secondary aim of this study was to compare functional disability in two chronic pain conditions: localized musculoskeletal pain and chronic daily headaches. ⋯ The implications for treatment of chronic pain in children are discussed with an emphasis on greater attention to developmental issues and their relation to coping, emotional functioning, and disability in pediatric pain. Further research examining differences in coping and disability between different pediatric pain groups is also warranted.