European journal of pain : EJP
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Review Meta Analysis
Patients with sciatica still experience pain and disability 5 years after surgery: A systematic review with meta-analysis of cohort studies.
The clinical course of patients with sciatica is believed to be favourable, but there is conflicting evidence on the postoperative course of this condition. We aimed to investigate the clinical course of sciatica following surgery. ⋯ Although surgery is followed by a rapid decrease in pain and disability by 3 months, patients still experience mild to moderate pain and disability 5 years after surgery. WHAT DOES THIS REVIEW ADD?: This review provides a quantitative summary of the postoperative course of patients with sciatica. Patients with sciatica experienced a rapid reduction in pain and disability in the first 3 months, but still had mild to moderate symptoms 5 years after surgery. Although no significant differences were found, microdiscectomy showed larger improvements compared to other surgical techniques.
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Randomized Controlled Trial
The effects of total knee replacement and non-surgical treatment on pain sensitization and clinical pain.
The objective was to compare the effect of total knee replacement (TKR) followed by a 3-month non-surgical treatment with the non-surgical treatment alone in reducing pain sensitization and other pain-related measures in patients with knee osteoarthritis. ⋯ At 3 months, TKR followed by non-surgical treatment is more effective in reducing localized and spreading pain sensitization than non-surgical treatment alone. Both treatments are equally efficacious in reducing the pain-related measures of this study. WHAT DOES THIS STUDY ADD?: Knee replacement followed by non-surgical treatment is more effective in reducing pain sensitization, but not other pain-related measures, as compared to non-surgical treatment alone at 3 months.
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Randomized Controlled Trial
Adjunctive cognitive behavioural treatment for chronic pain couples improves marital satisfaction but not pain management outcomes.
Data have consistently shown that patient coping with chronic pain can be affected by various factors associated with the primary relationship, and hence efforts to include the patient's partner in the treatment process have merit. This study evaluated the benefit of adding an adjunctive, couples-based, cognitive behavioural treatment (CBT) for chronic pain to a standard cognitive behavioural pain management programme. ⋯ These data demonstrate that a brief CBT intervention can significantly improve marital satisfaction for spouses of chronic pain patients, but the treatment does not translate to improvements in function on any outcomes, including marital satisfaction, for patients of chronic pain. WHAT DOES THIS STUDY ADD?: A brief, telephone-based intervention for couples living with chronic pain is an acceptable format for intervention. This intervention can significantly improve marital satisfaction for partners of chronic pain patients. Patients who are already participating in a multidisciplinary pain programme will not obtain further benefit.
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Randomized Controlled Trial
Effects of the carrier frequency of interferential current on pain modulation and central hypersensitivity in people with chronic nonspecific low back pain: A randomized placebo-controlled trial.
Interferential current (IFC) is commonly used for pain relief, but the effects of carrier frequency of the current and its action on pain mechanisms remain unclear. This randomized placebo-controlled trial tested the effects of IFC in people with chronic nonspecific low back pain. ⋯ These results suggest that although the IFC has changed some physiological mechanisms of pain and showed decrease frequency use of pain medication, there was no change in the primary aim, pain intensity. WHAT DOES THIS STUDY ADD?: The interferential current (IFC) presented advantages in the physiological measures of pain and showed decrease frequency use of pain medication. Future studies should investigate analgesic intake with IFC treatment.
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Habituation refers to the brain's inhibitory mechanism against sensory overload and its brain correlate has been investigated in the form of a well-defined event-related potential, N100 (N1). Fibromyalgia is an extensively described chronic pain syndrome with concurrent manifestations of reduced tolerance and enhanced sensation of painful and non-painful stimulation, suggesting an association with central amplification of all sensory domains. Among diverse sensory modalities, we utilized repetitive auditory stimulation to explore the anomalous sensory information processing in fibromyalgia as evidenced by N1 habituation. ⋯ Fibromyalgia patients failed to demonstrate auditory N1 habituation to repetitively presenting stimuli, which indicates their compromised early auditory information processing. Our findings provide neurophysiological evidence of inhibitory failure and cortical augmentation in fibromyalgia. WHAT'S ALREADY KNOWN ABOUT THIS TOPIC?: Fibromyalgia has been associated with altered filtering of irrelevant somatosensory input. However, whether this abnormality can extend to the auditory sensory system remains controversial. N!00, an event-related potential, has been widely utilized to assess the brain's habituation capacity against sensory overload. WHAT DOES THIS STUDY ADD?: Fibromyalgia patients showed defect in N100 habituation to repetitive auditory stimuli, indicating compromised early auditory functioning. This study identified deficient inhibitory control over irrelevant auditory stimuli in fibromyalgia.