Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
"Managing" the Placebo Effect: The Single-Blind Placebo Lead-in Response in Two Pain Models.
"Placebo effects" in analgesic medication trials for chronic pain are pervasive; however, little is known regarding mechanisms or factors that may influence the presence or magnitude of these effects. Our objective is to consider elements of the placebo response in the context of two pain models using a "single-blind placebo lead-in" design (SBPLI). ⋯ Placebo effects emerged across psychometric and performance-based measures, indicating the pervasiveness of this phenomenon. In this design, diagnostic and (to a lesser extent) gender categories differentials were observed during the placebo period. The SBPLI design may prove not only a robust method in studying the placebo phenomena, but also as a design element to mitigate some aspects of the placebo response in clinical trials.
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Although surgery using a polyglycolic acid-collagen (PGA-c) tube is effective for peripheral nerve injury-induced chronic hand pain, it has not been applied to trigeminal nerve lesions because of the difficult approach. We used a PGA-c tube during surgery for trigeminal neuropathy and evaluated its prognosis based on the outcomes. ⋯ Use of a PGA-c tube for surgical treatment of intractable pain due to LN or IAN neuropathy helps alleviate sensory impairment. The possibility of new dysesthesias emerging postoperatively, however, should be noted.
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Randomized Controlled Trial
Chronic Whiplash Associated Disorders (WAD): Responses to Nerve Blocks of Cervical Zygapophyseal Joints.
This study explores the prevalence of facet joint pain in chronic Whiplash Associated Disorder (WAD). ⋯ A substantial amount of patients with chronic WAD have their persistent pain emanating from cervical zygapophyseal joints.
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Multicenter Study
Immediate Adverse Events in Interventional Pain Procedures: A Multi-Institutional Study.
Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures. ⋯ This study demonstrates that interventional pain procedures are safely performed with extremely low immediate adverse event rates when evidence-based guidelines are observed.
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Randomized Controlled Trial
Does a Brief Educational Session Produce Positive Change for Individuals Waiting for Tertiary Chronic Pain Services?
To examine: 1) whether a single brief pre-clinic educational session improved the well-being and quality of life of individuals entering the wait-list for a tertiary chronic pain (CP) service; and 2) the impact of waiting for services on these outcomes. ⋯ Attending a brief pre-clinic education session did not improve function. There was no deterioration in wait-listed participants who agreed to be involved in research and who completed study measures at 2 and 6 months, but referral was associated with short-term functional improvements. This is the first study to link positive change with referral to, rather than treatment by, a tertiary CP service.