European journal of pain : EJP
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Randomized Controlled Trial Comparative Study Clinical Trial
Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erikson [correction of Erickson] hypnosis and Jacobson relaxation.
The present study investigates the effectiveness of Erikson hypnosis and Jacobson relaxation for the reduction of osteoarthritis pain. Participants reporting pain from hip or knee osteoarthritis were randomly assigned to one of the following conditions: (a) hypnosis (i.e. standardized eight-session hypnosis treatment); (b) relaxation (i.e. standardized eight sessions of Jacobson's relaxation treatment); (c) control (i.e. waiting list). Overall, results show that the two experimental groups had a lower level of subjective pain than the control group and that the level of subjective pain decreased with time. ⋯ Results also show that hypnosis and relaxation are effective in reducing the amount of analgesic medication taken by participants. Finally, the present results suggest that individual differences in imagery moderate the effect of the psychological treatment at the 6 month follow-up but not at previous times of measurement (i.e. after 4 weeks of treatment, after 8 weeks of treatment and at the 3 month follow-up). The results are interpreted in terms of psychological processes underlying hypnosis, and their implications for the psychological treatment of pain are discussed.
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Spinal cord stimulation (SCS) is an effective tool in alleviating neuropathic pain. However, a number of well-selected patients fail to obtain satisfactory pain relief. Previous studies have demonstrated that i.t. baclofen and/or adenosine can enhance the SCS effect, but this combined therapy has been shown to be useful in less than half of the cases and more effective substances are therefore needed. ⋯ In subsequent acute experiments, extracellular recordings from wide dynamic range neurones in the dorsal horn showed prominent hyperexcitability. The combination of SCS and gabapentin, at the same subeffective dose, clearly enhanced suppression of this hyperexcitability. In conclusion, electrical therapy and pharmacological therapy in neuropathic pain can, when they are inefficient individually, become effective when combined.
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The aim of this study was to describe the Quality of Life and pain coping strategies of school children in relation to headache severity. We conducted a cross-sectional study in 2815 children between the age of 9 and 17 years, who filled out Waters' Headache Questionnaire (WHQ), the Paediatric Pain Assessment Tool (PPAT), the Quality of Life Headache in Youth (QLH-Y) questionnaire and the Pain Coping Questionnaire (PCQ) in the class-room setting. ⋯ Results show that children with the highest headache severity report the lowest Quality of Life in general and the lowest Quality of Health, as well as the most problems with regard to physical functioning, impact of headache on daily and leisure activities, physical symptoms other than headache, and social functioning at home. With regard to using pain coping strategies, children with the most severe headaches seek more social support, they internalize and externalize more, they use less behavioural and cognitive distraction techniques, and seek information less.
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Shoulder pain is known to retard rehabilitation after stroke. Its causes and prognosis are uncertain. This study describes the incidence of poststroke shoulder pain prospectively, in an unselected stroke population in the first 6 months after stroke and identifies risk factors for developing pain. ⋯ Shoulder pain after stroke occurred in 40% of 123 patients surviving, consenting and not too unwell to participate. This included 52 patients of an original cohort of 205 patients presenting with stroke. Eighty percent of patients made a good recovery with standard treatment Patients with sensory and or motor deficits represent at risk sub-groups.
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To examine the hypothesis that psychological factors of psychological distress, maladaptive response to illness and perception of happiness in childhood, are associated with self-reported oro-facial pain (OFP). ⋯ This large cross-sectional community-based study showed significant association for all of the factors considered. The obtained data raise interesting questions of cause and effect for which further, longitudinal studies are required to establish temporal relationship between these factors and the onset, cause, and treatment of OFP.