Pain medicine : the official journal of the American Academy of Pain Medicine
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The primary aim of this pilot investigation was to identify structural brain differences in older adults with chronic low back pain (CLBP) as compared with pain-free individuals. ⋯ Older adults with CLBP have structural brain changes in the middle CC, middle cingulate WM, and the GM of the posterior parietal cortex as well as impaired attention and mental flexibility. Additional investigation is needed to corroborate and extend these findings and more clearly elucidate their relationship to physical function and the risk of disability.
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This study was conducted to examine the psychometric properties of a Chinese translation of the Pain Catastrophizing Scale (HK-PCS). ⋯ This study has illustrated satisfactory psychometric properties of the HK-PCS. We provide evidence for the validity and reliability of the HK-PCS as an instrument for measuring pain catastrophizing in the Chinese patient with chronic pain.
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1) To determine if the neuropathic pain scale (NPS) can be used to classify chronic pain patients (CPPs) as having primarily neuropathic vs non-neuropathic pain, and furthermore; 2) to determine what, if any, cut-off score can be used to reliably make this determination. ⋯ The NPS appears to be able to discriminate between neuropathic and non-neuropathic pain. A debate is currently raging as to whether diagnoses, such as fibromyalgia and complex regional pain syndrome 1, can be classified as neuropathic. Our NPS cut-off score results suggest that these diagnoses may have a neuropathic pain component. The reliability and validity of our NPS method will need to be tested further in other neuropathic pain models, such as diabetic peripheral neuropathic pain.
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Randomized Controlled Trial
A randomized double-blind placebo-controlled study of low-dose intravenous Lorazepam to reduce procedural pain during bone marrow aspiration and biopsy.
To evaluate the efficacy of intravenous lorazepam as premedication for bone marrow aspiration and biopsy (BMAB). ⋯ Intravenous lorazepam was safe in patients undergoing BMAB and was more effective than placebo in enhancing cooperation during BMAB and willingness to undergo another procedure. However, use of lorazepam 1 mg provided no reduction in the pain associated with BMAB. Further studies should focus on providing appropriate analgesia for this potentially painful procedure.
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Case Reports
An N-of-1 trial as an aid to decision-making prior to implanting a permanent spinal cord stimulator.
Limited evidence supports the efficacy of spinal cord stimulation (SCS). Therefore, it is crucial to assess the usefulness of this invasive procedure before implanting permanent electrodes in each patient. An N-of-1 trial is an experiment in which a single participant undergoes periods of comparative treatments. We illustrate how an N-of-1 trial design may permit clinicians to conduct such an assessment in an individual patient. ⋯ We encourage clinicians to perform an N-of-1 trial in every patient before implanting permanent electrodes for SCS.