The Clinical journal of pain
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Randomized Controlled Trial Multicenter Study
Acupuncture for chronic low back pain in routine care: a multicenter observational study.
To investigate patient characteristics and outcomes after undergoing acupuncture treatment for chronic low back pain (cLBP) in Germany and to analyze chronification, pain grading, and depression as predictors for treatment outcomes. ⋯ Acupuncture treatment is associated with clinically relevant improvements in patients suffering from cLBP of varying degrees of chronification and/or severity.
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Randomized Controlled Trial
Involvement of intra-articular corticotropin-releasing hormone in postoperative pain modulation.
Opioid receptors are expressed on peripheral nerve endings and opioid peptides (beta-endorphin, END) are produced in various immune cells of synovial tissue after knee trauma. Because corticotropin-releasing hormone (CRH) acts through its receptors on END-containing immune cells, this randomized controlled trial investigated whether the intra-articular (IA) injection of CRH reduces postoperative pain intensity and supplemental analgesic consumption in patients undergoing arthroscopic knee surgery. ⋯ In conclusion, this first clinical trial provides preliminary evidence for a short but not robust analgesic effect of a single dose of IA CRH in patients undergoing arthroscopic knee surgery. Further clinical studies will have to examine different doses of IA CRH-induced analgesia and to support the involvement of opioid peptides.
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Randomized Controlled Trial
Myofascial trigger points are very prevalent in patients with chronic tension-type headache: a double-blinded controlled study.
Myofascial pain syndromes due to trigger points (TrPs) are clinical entities, but more evidence is needed to evaluate TrP palpation. Chronic tension-type headache (CTTH) is the most prevalent chronic headache with high socioeconomic costs. The primary aim was to study whether TrP palpation can distinguish patients with headache patients from healthy controls. ⋯ These findings suggest that active TrPs are much more frequent in CTTH than in controls and the number and pain intensity of TrPs may be used to distinguish between the 2 groups. Spontaneous electromyographic activity could not be demonstrated, and the underlying biology of TrPs is still unclear.
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Randomized Controlled Trial
A randomized controlled trial on the effectiveness of mild water-filtered near infrared whole-body hyperthermia as an adjunct to a standard multimodal rehabilitation in the treatment of fibromyalgia.
To evaluate whether mild water-filtered near infrared whole-body hyperthermia (NI-WBH) produces an additional benefit when applied as an adjunct to a standard multimodal rehabilitation (MR) compared with MR only in patients with fibromyalgia (FM). ⋯ The study indicates that NI-WBH is a worthwhile adjunct to MR in the treatment of FM.
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Randomized Controlled Trial
A randomized, placebo-controlled study of fentanyl buccal tablet for breakthrough pain in opioid-treated patients with cancer.
Cancer-related breakthrough pain (BTP) is typically managed with a short-acting oral opioid, taken as needed during a fixed-schedule opioid regimen. The conventional approach may not provide the onset of analgesia required for BTP for many patients, because the onset of analgesia with short-acting opioids lags behind the time course of the majority of episodes of BTP. The fentanyl buccal tablet (FBT) employs a novel delivery system that enhances the rate and extent of absorption of fentanyl through the buccal mucosa. This double-blind, randomized, placebo-controlled study evaluated the efficacy, safety, and tolerability of FBT in opioid-treated patients with cancer-related BTP. ⋯ FBT is efficacious and safe in the treatment of cancer-related BTP.