Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
The Effectiveness of Tuina in Relieving Pain, Negative Emotions, and Disability in Knee Osteoarthritis: A Randomized Controlled Trial.
To evaluate the effectiveness of Tuina in relieving the pain, negative emotions, and disability of patients with knee osteoarthritis (KOA). ⋯ Tuina produced superior effects for pain, negative emotions, and disability over time, as compared to celecoxib in patients with KOA.
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Preclinical and clinical studies suggest that activation of the µ-opioid receptor may reduce overall survival and increase the risk for all-cause mortality in patients with cancer and noncancer pain. Methylnaltrexone, a selective, peripherally acting µ-opioid receptor antagonist, has demonstrated efficacy for the treatment of opioid-induced constipation. This retrospective analysis of 12 randomized, double-blind, placebo-controlled studies of methylnaltrexone evaluated the treatment of opioid-induced bowel disorders in patients with advanced illness or noncancer pain. ⋯ Methylnaltrexone reduced all-cause mortality vs placebo treatment across multiple trials, suggesting methylnaltrexone may confer survival benefits in patients with opioid-induced bowel disorders taking opioids for cancer-related or chronic noncancer pain.
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Randomized Controlled Trial
Analgesic Electrical Stimulation Combined with Wrist-ankle Acupuncture Reduces the Cortical Response to Pain in Patients with Myofasciitis: A Randomized Clinical Trial.
Transcutaneous electrical nerve stimulation (TENS) based on wrist-ankle acupuncture has been shown to relieve pain levels in patients with myofascial pain syndrome (MPS). However, its efficacy is highly subjective. The purpose of this study was to evaluate the feasibility and effectiveness of TENS based on wrist-ankle acupuncture for pain management in patients with MPS from the perspective of cerebral cortex hemodynamics. ⋯ Compared to no intervention, TENS based on wrist-ankle acupuncture can be effective in relieving pain in patients with MPS in terms of cerebral cortical hemodynamics. However, further studies are necessary to quantify the analgesic effect in terms of cerebral hemodynamics and brain activation.
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During routine clinical evaluation, it can be challenging to differentiate between lumbar radiculopathy (RAD) and lower back pain with non-radicular somatic referred pain (SRP) or even axial non-radiating low back pain (LBP). The aim of this study was to characterize patients with RAD, axial LBP (aLBP), and SRP on the basis of somatosensory profiles. ⋯ Patients with RAD demonstrated more somatosensory abnormalities than did patients with aLBP and SRP, including increased mechanical hyperalgesia and a loss of mechanical detection. The combination of pressure pain threshold, mechanical detection threshold, numbness, and prickling in the area of LBP can be a time-efficient tool to identify patients with RAD.
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Randomized Controlled Trial
Percutaneous Radiofrequency Ablation for Trigeminal Neuralgia Management: A Randomized, Double-blind, Sham-Controlled Clinical Trial.
Trigeminal neuralgia, considered by many the worst pain that humankind can experience, has been called "the suicide disease." Neuroablative procedures are good options when conservative treatment fails to promote pain relief or in those whose side effects are unbearable. The objective was to compare the effectiveness and safety of trigeminal percutaneous radiofrequency ablation in classical refractory trigeminal neuralgia in a prospective, randomized, double-blind, sham-controlled clinical trial. We included 30 consecutive patients with classical trigeminal neuralgia who had failed to respond to drug treatment. ⋯ Changing groups was allowed after one month, after which the pain reduction was similar between the two groups. Percutaneous trigeminal radiofrequency ablation results in statistically and clinically significant greater pain relief than the sham procedure after 1 month of follow-up. These results support using radiofrequency nerve ablation as a treatment for refractory trigeminal neuralgia.