Pain practice : the official journal of World Institute of Pain
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Lumbar spine transverse process fractures (LSTPFs) are uncommon and frequently overlooked on plain film radiographs. Even when recognized, they are often regarded as trivial and minimally painful injuries compared with combined serious major abdominal, pelvic, and spinal injuries. Conservative treatments are usually offered to patients with LSTPFs. ⋯ This patient's all films were meticulously re-examined, and it was determined that a transverse process fracture was present at not only L4 but also L1. This report introduces a method of active treatment to help patients with LSTPFs quickly return to their daily lives and professional activities. The positive results in these cases suggest that fracture site in situ block might be a useful option for treating patients with LSTPFs.
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Randomized Controlled Trial Multicenter Study
Written Pain Neuroscience Education in Fibromyalgia: A Multicenter Randomized Controlled Trial.
Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia. A double-blind, multicenter randomized controlled clinical trial with 6-month follow-up was conducted. ⋯ Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions. Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM.
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Review
End-of-Dose Pain in Chronic Pain: Does it Vary with the Use of Different Long-Acting Opioids?
A large percentage of patients with chronic pain on around-the-clock (ATC) opioids may experience increased pain occurring at the end of a scheduled dose, also known as end-of-dose pain. Despite the significant prevalence and impact of end-of-dose pain in patients using extended-release (ER) opioids, there are no detailed analyses examining how the frequency of end-of-dose pain is linked to the formulations of long-acting opioids. Consequently, we performed a systematic review to evaluate how many published studies on patients with chronic cancer or noncancer pain identified end-of-dose pain. ⋯ Overall, most studies showed that patients using ER preparations experienced fewer episodes of BTP compared with patients on placebo or an active comparator. This could reflect the favorable duration of action of these opioids compared with short-acting formulations. Future studies should examine the incidence of end-of-dose pain and use of rescue medicine in a longitudinal manner in patients with chronic pain taking short- vs. long-acting ATC opioids.
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Randomized Controlled Trial
A Randomized, Double-Blind, Placebo-Controlled Trial of Duloxetine for the Treatment of Pain in Patients with Multiple Sclerosis.
Patients with multiple sclerosis (MS) often report neuropathic pain (NP-MS). The purpose of this study was to assess the efficacy and tolerability of duloxetine as treatment for NP-MS. ⋯ This study found analgesic efficacy of duloxetine for NP-MS. Duloxetine is not approved for treatment of this condition. The duloxetine safety profile of this study was consistent with the known profile in other patient populations.
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Randomized Controlled Trial
Interdisciplinary Treatment of Patients with Fibromyalgia: Improvement of Their Health-Related Quality of Life.
To assess whether an interdisciplinary intervention is more effective than usual care for improving the health-related quality of life (HRQoL) among patients with fibromyalgia (FM), and to identify variables that were predictors of improvement in HRQoL. ⋯ This interdisciplinary intervention has shown effectiveness in improving the HRQoL of this sample of patients with FM. The number of physical illnesses was identified as a predictor of that improvement.