The Clinical journal of pain
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Meta Analysis
High Rate of Pain Sensitization in Musculoskeletal Shoulder Diseases: A Systematic Review and Meta-analysis.
Pain sensitization, defined as an increased responsiveness of nociceptive neurons to normal input, is detected in several musculoskeletal diseases, but there are no systematic reviews or meta-analyses about pain sensitization in shoulder pain. ⋯ Pain sensitization has a high rate among patients with musculoskeletal shoulder pain, regardless of the specific etiology, and this may lead to worse clinical outcome after treatment of the primary disease. The best way to assess pain sensitization still needs to be identified as the assessment methods results in used high variability in the documented pain sensitization rate.
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The benefits of family-based interventions for patients with musculoskeletal pain have been previously shown in individual randomized controlled trials (RCTs), but no systematic review has summarized their effects. ⋯ There is moderate-quality evidence that family-based interventions result in small, significantly better pain and disability outcomes in the short-term compared with individual-focused interventions in patients with musculoskeletal pain. Based on low-quality evidence, family-based interventions result in small improvements on pain in the short-term compared with usual care. Future studies should review the content and optimize the mechanisms underpinning family-based interventions in musculoskeletal pain so that the approach could be further tested in adequately powered RCTs.
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Meta Analysis
Perioperative Pregabalin for Preventive Analgesia in Breast Cancer Surgery: A Meta-analysis of Randomized Controlled Trials.
Pregabalin is a drug for neuropathic pain. Antipronociceptive properties of pregabalin have led to its recent use as an adjuvant to the multimodal postoperative pain regimen. This meta-analysis was conducted to evaluate the efficacy of perioperative pregabalin on acute and chronic postsurgical pain (CPSP) after breast cancer surgery. ⋯ This study demonstrated that pregabalin showed more efficacy on chronic pain than acute pain after a breast cancer surgery. Further study based on doses and treatment course of pregabalin should be conducted to establish stronger evidence of treatment effects.
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Meta Analysis
Efficacy of Pulsed Radiofrequency in Herpetic Neuralgia: A Meta-Analysis of Randomized Controlled Trials.
Herpes zoster and postherpetic neuralgia (PHN) are often refractory to current standard treatments and can reduce patients' quality of life (QoL). Pulsed radiofrequency (PRF) effectively controls intractable neurological pain. The aim of the study was to conduct a systematic review and meta-analysis to evaluate the efficacy of PRF in PHN management. ⋯ PRF safely and effectively reduced pain scores and improved QoL in patients with herpes zoster in the cervical to lumbosacral areas. PRF could be considered during refractory PHN treatment. Future studies require standardized PRF settings and outcome assessment tools, including physical and emotional function assessments.
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This systematic review and meta-analysis examined the effectiveness of multidisciplinary-based rehabilitation (MBR) in comparison with active physical interventions for adults with chronic pain. ⋯ Overall, the results suggest that MBR may lead to greater improvements in pain intensity and disability compared with active physical interventions, and the effects appear to be sustained in the long term. However, these findings should be interpreted with caution in light of the low quality of the evidence, with all but one trial judged to be at high risk of bias. Further research is required to assess the effectiveness of MBR for people with chronic pain conditions other than low back pain.