European journal of pain : EJP
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Editorial Biography Historical Article
In Memoriam Jean-Marie Besson 1938-2014.
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The spinal cord is a prime site of action for analgesia. Here we characterize the effects of established analgesics on segmental spinal reflexes. The aim of the study was to look for the pattern of action or signature of analgesic effects on these reflexes. ⋯ morphine and duloxetine had general depressant effects on spinal reflexes, whereas the effects of clonidine, pregabalin and S1RA appeared to be restricted to signals originated by strong repetitive activation of C-fibres. Results are discussed in the context of reported behavioural effects of the compounds studied.
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Randomized Controlled Trial
Does the addition of visceral manipulation alter outcomes for patients with low back pain? A randomized placebo controlled trial.
This study aimed to investigate whether the addition of visceral manipulation, to a standard physiotherapy algorithm, improved outcomes in patients with low back pain. ⋯ Our study suggests that visceral manipulation in addition to standard care is not effective in changing short-term outcomes but may produce clinically worthwhile improvements in pain at 1 year.
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Motor dysfunction in complex regional pain syndrome (CRPS) has been associated with bilateral malfunction of sensory and motor circuits, which hints at abnormal coupling between the affected and the contralateral unaffected limb. In addition, clinical observations suggest that motor performance may depend on the (voluntary or automatic) context in which movements are executed. The present study aimed to examine the role of voluntary and automatic aspects of interlimb coupling in CRPS. ⋯ Impaired motor control of the affected limb interfered with bimanual coordination, in particular for tasks involving voluntary (intended) as opposed to automatic (unintended) interlimb coupling. Our findings suggest inappropriate functioning of higher order centres involved in motor control of the affected limb, probably due to pain-related processes and impaired processing of proprioceptive information. Motor function of the affected limb may benefit from intended synchronization with movements of the unaffected contralateral limb, suggesting that bilateral training may be useful in patients with unilateral CRPS.