Pain physician
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Randomized Controlled Trial
Effect of two contrasting interventions on upper limb chronic pain and disability: a randomized controlled trial.
Chronic pain and disability of the arm, shoulder, and hand severely affect labor market participation. Ergonomic training and education is the default strategy to reduce physical exposure and thereby prevent aggravation of pain. An alternative strategy could be to increase physical capacity of the worker by physical conditioning. ⋯ Resistance training at the workplace results in clinical relevant improvements in pain, disability, and muscle strength in adults with upper limb chronic pain exposed to highly repetitive and forceful manual work.
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Randomized Controlled Trial
Short-term treatment with parecoxib for complex regional pain syndrome: a randomized, placebo-controlled double-blind trial.
Complex regional pain syndrome (CRPS) is characterized by signs and symptoms of peripheral inflammation, which leads to peripheral neural sensitization associated most frequently (in about 70%) with blunt pressure hyperalgesia. Therefore, we hypothesized that treatment of CRPS patients with a selective COX-2-inhibitor would alleviate the abnormally low pressure pain threshold (PPT) and reduce pain intensity and edema. ⋯ In the present proof-of-concept trial, short-term treatment with the selective COX-2-inhibitor parecoxib influenced neither PPT nor edema or pain. COX-2 might be less important than previously assumed. However, the results are limited due to the small number of patients, short-term treatment, and focus on the PPT, which could have led to false negative results of the present study and covered the expected therapeutic effect.
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Randomized Controlled Trial Comparative Study
A pressure comparison between midline and paramedian approaches to the cervical epidural space.
In the cervical spine, the ligamentum flavum (LF) is often incompletely fused at the midline. Therefore, accessing the epidural space (ES) using the loss of resistance (LOR) technique via the midline approach could be less reliable than the paramedian approach. Since the tactile sensation of LOR is due to abrupt loss of pressure upon entering the ES, we have compared pressure changes between the 2 different cervical epidural techniques. ⋯ NCT01009385. Institutional Review Board (IRB): H-1208-107-422.