Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Morning Versus Evening Bright Light Treatment at Home to Improve Function and Pain Sensitivity for Women with Fibromyalgia: A Pilot Study.
To test the feasibility, acceptability, and effects of a home-based morning versus evening bright light treatment on function and pain sensitivity in women with fibromyalgia. ⋯ Bright light treatment appears to be a feasible and acceptable adjunctive treatment to women with fibromyalgia. Those who undergo morning light treatment may show improvements in function and pain sensitivity. Advances in circadian timing may be one mechanism by which morning light improves pain sensitivity. Findings can inform the design of a randomized controlled trial.
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Multicenter Study
The Impact of Body Mass Index on Fluoroscopy Time During Lumbar Epidural Steroid Injection; A Multicenter Cohort Study.
This study aimed to assess the relationship between BMI and fluoroscopy time during lumbar epidural steroid injections (LESIs) performed for lumbosacral radicular pain. ⋯ The findings of this study indicate that fluoroscopy time is increased during interlaminar LESIs and during L5-S1 transforaminal LESIs in patients who are obese. These relationships are not affected by injection number, performance of bilateral injections, or trainee involvement. Further study is needed to determine if this increase in fluoroscopy time is indicative of a clinically significant associated increase in radiation dose.
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To investigate whether pain catastrophizing and personality traits bias recalled ratings of acute pain in an experimental tonic pain model. ⋯ This study demonstrated that memory for painful events in healthy subjects was reasonably accurate over a period of 1 week. Pain catastrophizing biased pain recall, whereas among personality traits only neuroticism exhibited a weak positive association with the recalled ratings.
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The most prominent sensory sign of the complex regional pain syndrome (CRPS) is blunt hyperalgesia, but longitudinal studies on its relation to the outcome of long-term multimodal treatment are lacking. ⋯ Thus, the persistence of blunt hyperalgesia seems to be associated with impaired paired-pulse suppression, both representing maladaptive central nervous changes in CRPS, which may account for the treatment non-response in this subgroup.
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For radiofrequency neurotomy of the medial branch of the lumbar dorsal rami, physicians use techniques guided either by fluoroscopy or computerized tomography (CT), and advocate for their respective techniques. Crucial to the choice of technique is how well each can capture the target nerve. The present study was, therefore, undertaken to assess in cadavers the accuracy of fluoroscopic-guided and CT-guided techniques. ⋯ The fluoroscopy-guided technique can be relied upon to achieve optimal placement of electrodes on the lumbar medial branches. The CT-guided technique fails to do so, and should not be used in practice until a modified version has been developed and validated.