The Clinical journal of pain
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Randomized Controlled Trial Clinical Trial
Trial of intravenous lidocaine on painful neuropathy in cancer patients.
In 10 cancer patients with cutaneous allodynia, intravenous lidocaine (5 mg/kg body weight) or 0.9% NaCl was given in a double blind, cross-over study to determine the analgesic effect. One patient had complete and one had partial pain relief with lidocaine infusion, whereas three patients experienced partial pain relief with placebo. Neither lidocaine nor placebo reduced pain intensity or consumption of analgesics significantly during the study period. Intravenous infusion of lidocaine cannot be recommended as routine pain treatment in cancer patients with cutaneous allodynia or pain, but further studies are needed to test the effect of lidocaine on different peripheral stimuli.
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Randomized Controlled Trial Comparative Study Clinical Trial
Diode laser in cervical myofascial pain: a double-blind study versus placebo.
We present a double-blind trial in which a pulsed infrared beam was compared with a placebo in the treatment of myofascial pain in the cervical region. The patients were submitted to 12 sessions on alternate days to a total energy dose of 5 J each. ⋯ Pain was monitored using the Italian version of the McGill pain questionnaire and the Scott-Huskisson visual analogue scale. The results show a pain attenuation in the treated group and a statistically significant difference between the two groups of patients, both at the end of therapy and at the 3-month follow-up examination.
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Randomized Controlled Trial Clinical Trial
A controlled trial of the treatment of migraine by acupuncture.
A randomised controlled trial comparing true and sham acupuncture was conducted on 30 patients suffering from chronic migraine. Diary measures of headache and medication intake were recorded throughout the study, and measures of headache quality, anxiety, and pain behaviour were taken. ⋯ True acupuncture was significantly more effective than the control procedure in reducing the pain of migraine headache. Posttreatment reductions in pain scores and medication of 43 and 38%, respectively, were recorded in the true acupuncture group and were maintained at 4-month and 1-year follow-up.
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Reflex sympathetic dystrophy (RSD) usually occurs in an individual who has been experiencing significant personal stress, a state associated with increased discharge of norepinephrine (NE) from perivascular postganglionic sympathetic neurons. RSD is often precipitated by this sequence: traumatic arterial spasm, regional ischemia, neurogenic inflammation, and ischemic/edematous damage to membranes of preterminal perivascular nociceptive neurons. In the natural repair of these membranes, it is suggested that adrenoceptors appear and are ordinarily transitory; but in RSD, they are retained by the increased adjacent NE. This process delays further healing, produces pain, and releases inflammatory substances, resulting in interacting pathophysiologic vicious cycles.
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Comparative Study
Why do people seek medical advice for back pain: a comparison of consulters and nonconsulters.
Respondents with back pain who had answered affirmatively to the question about back pain in a population study were divided into two groups depending on whether they had consulted or had not consulted a physician due to their back pain. There were 17 nonconsulters and 37 consulters. ⋯ Based on the results, we found that the nonconsulters differed from the consulters on many issues but had nevertheless rated their constant level of pain on two different occasions as being equally severe on a graphic rating scale (GRS). The groups differed as follows: The nonconsulters rated their work to be more stressful; had less frequently a spouse suffering or having suffered from chronic pain; had fewer abnormal pain drawings; woke up less frequently during the night; used sleeping pills less frequently; participated more often in sports; and had a higher frequency of repression on the MCT compared to a group of painless subjects.