The Clinical journal of pain
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Randomized Controlled Trial
Sensory and affective pain descriptors respond differentially to pharmacological interventions in neuropathic conditions.
Pain management is limited by inability to match a patient's condition-and pain mechanisms-to optimal treatment(s). Much is known about pain treatment from animal investigations, but antinociceptive mechanisms cannot be readily explored in clinical studies. Evidence suggests that self-report verbal pain descriptors characterize important pain dimensions and may reflect diverse underlying mechanisms. ⋯ These results point to the hypothesis that sensory and affective pain descriptor profiles exhibit a treatment-specific response. Larger, more definitive, investigations to evaluate treatment-specific effects on multiple sensory and affective pain descriptors, and prediction of treatment response by these descriptors, will advance efforts toward developing and implementing more effective individualized pain therapies.
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Randomized Controlled Trial
Anxiety but not social stressors predict 12-month depression and pain severity.
To determine whether baseline anxiety and social stressors as well their early change (first 3 months) predict 12-month depression and pain severity. ⋯ Anxiety, but not social stressors predict 12-month depression and pain severity. The presence of comorbid anxiety should be considered in the assessment and treatment of patients with musculoskeletal pain and depression, particularly as a factor that may adversely affect treatment response.
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Randomized Controlled Trial
Combination of pregabalin and dexamethasone for postoperative pain and functional outcome in patients undergoing lumbar spinal surgery: a randomized placebo-controlled trial.
In this randomized-controlled study, we investigated the effects of combined administration of pregabalin and dexamethasone on postoperative pain and analgesic requirements, and functional outcome in patients who underwent lumbar spinal surgery. ⋯ Combined administration of pregabalin and dexamethasone conferred analgesic benefits superior to those of pregabalin alone. This regimen also helped facilitate return to normal daily activity after surgery.
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Randomized Controlled Trial
A randomized-controlled trial of using a book of metaphors to reconceptualize pain and decrease catastrophizing in people with chronic pain.
Reconceptualization of pain and reduction of pain-related catastrophizing are primary objectives in chronic pain rehabilitation. Teaching people about the underlying biology of pain has been shown to facilitate these objectives. The objective of this study was to investigate whether written metaphor and story can be used to increase knowledge of the biology of pain and reduce pain-related catastrophizing. ⋯ We conclude that providing educational material through metaphor and story can assist patients to reconceptualize pain and reduce catastrophizing. Metaphor and story could be used as a precurser to other interventions that target functional capacity.
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Randomized Controlled Trial
Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study.
To test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic nonspecific low back pain. ⋯ These results do not provide evidence that tDCS is effective in the treatment of chronic back pain. The use of a small convenience sample limits the generalizability of these findings and precludes definitive conclusions on the efficacy of tDCS in chronic nonspecific low back pain.