Pain medicine : the official journal of the American Academy of Pain Medicine
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Pain is multi-dimensional and may be better addressed through a holistic, biopsychosocial approach. Massage therapy is commonly practiced among patients seeking pain management; however, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy in treating pain, function-related and health-related quality of life outcomes across all pain populations. ⋯ Based on the evidence, massage therapy, compared to no treatment, should be strongly recommended as a pain management option. Massage therapy is weakly recommended for reducing pain, compared to other sham or active comparators, and improving mood and health-related quality of life, compared to other active comparators. Massage therapy safety, research challenges, how to address identified research gaps, and necessary next steps for implementing massage therapy as a viable pain management option are discussed.
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Pre-existing chronic pain has been associated with severe postoperative pain. To analyze the impact of chronic pain on non-surgical acute pain, a cohort of patients with acute herpes zoster was studied. ⋯ Patients with chronic pain had higher intensity of zoster-related acute pain. Furthermore, they showed more pain-related dysfunction and needed longer hospitalization than patients without chronic pain. These results go along with findings for acute postoperative pain.
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Clinical Trial
Reliability and Convergent Validity of the Algometer for Vestibular Pain Assessment in Women with Provoked Vestibulodynia.
Women with provoked vestibulodynia (PVD) suffer pain at the entry of the vagina elicited by pressure as during vaginal penetration. To quantify vestibular pain, we developed a new instrument, an algometer. The aim of this study was to investigate the test-retest reliability of the algometer and evaluate its convergent validity for vestibular pain assessment in women with PVD. ⋯ Findings showed that the algometer is a reliable and valid instrument for measuring PPTs and PPTols in the vestibular area in women with PVD. This technology is promising for pinpointing treatment mechanisms and efficacy.
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Pain from the abdominal wall can be caused by nerve entrapment, a condition called abdominal cutaneous nerve entrapment syndrome (ACNES). As an alternative to surgery, ACNES may be treated with injection of local anesthetics, corticosteroids, or botulinum toxin at the point of maximal pain. ⋯ Perforator-guided injection enables precise drug administration at the location of nerve entrapment in ACNES in contrast to blind injections.
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While increasing evidence suggests that observers discount high-severity chronic pain, factors that occasion such discounting are poorly understood, particularly regarding health provider vs lay perspectives. ⋯ The results indicate differing expectations of chronic pain treatment for health care providers relative to the lay public that could impact clinical care, especially at high pain severity levels, where lay expectations diverge significantly from those of health professionals.