Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Clinically significant placebo analgesic response in a pilot trial of botulinum B in patients with hand pain and carpal tunnel syndrome.
We conducted a pilot trial to assess the effect of botulinum toxin B on palmar pain and discomfort in carpal tunnel syndrome (CTS) patients. Design. Randomized, double-blind, placebo-controlled. ⋯ Botulinum toxin B is not dramatically superior to placebo for the relief of CTS symptoms. Possible explanations of the improvements in each study group are explored.
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To examine the association between pain-coping strategies and adjustment to cerebral palsy (CP)-related pain. ⋯ Changes in pain-coping strategies over time are associated with changes in functioning in persons with CP-related pain, consistent with biopsychosocial models of chronic pain. Some coping strategies (e.g., catastrophizing, task persistence), however, appear to be more closely linked to functioning than others. These results provide preliminary empiric guidance for the coping strategies that may be most fruitfully targeted in the treatment of CP-related pain.
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Chronic pain and cognitive impairment are prevalent and disabling in older adults (OA), but their interrelationship has not been rigorously tested. We did so in OA with chronic low back pain (CLBP). ⋯ OA with CLBP demonstrated impaired NP performance as compared with pain-free OA. Further, pain severity was inversely correlated with NP performance, and NP performance mediated the relationship between pain and physical performance. Future research should examine whether cognitive function and impaired physical performance can be improved with pain reduction.
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Randomized Controlled Trial
Defining worthwhile and desired responses to treatment of chronic low back pain.
To describe patients' perceptions of minimum worthwhile and desired reductions in pain and disability upon commencing treatment for chronic low back pain. ⋯ Inquiring directly about patients' expectations of reductions in pain and in disability is important in establishing realistic treatment goals and setting benchmarks for success. There is a wide disparity between the reductions that they regard as minimum worthwhile and reductions that they hope to achieve. However, there is a high internal consistency between reductions in pain and disability that they expect.
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Case Reports
Discitis after lumbar epidural corticosteroid injection: a case report and analysis of the case report literature.
The primary objective is to document the first case report of discitis after a lumbar epidural corticosteroid injection. The second objective is to analyze the case report literature to identify clinical features and trends of patients with infectious complications after spinal injections. ⋯ The identified clinical features and trends could prove useful to the practitioner when an infectious complication is suspected or has occurred.