Pain practice : the official journal of World Institute of Pain
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Randomized Controlled Trial Comparative Study
Comparing pain neuroscience education followed by motor control exercises with group-based exercises for chronic low back pain: a randomized controlled trial.
Different individualized interventions have been used to improve chronic low back pain (CLBP). However, their superiority over group-based interventions has yet to be elucidated. We compared an individualized treatment involving pain neuroscience education (PNE) plus motor control exercise (MCE) with group-based exercise (GE) in patients with CLBP. ⋯ PNE and MCE seem to be better at reducing pain intensity and disability compared to GE, while no significant differences were observed for fear-avoidance beliefs and self-efficacy between the 2 groups in patients with CLBP. With regard to the superiority of individualized interventions over group-based ones, more studies are warranted.
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Clinical Trial
Long-term inhibition of soleus H-reflex with epidural adhesiolysis and pulsed radiofrequency in lumbosacral neuropathic pain.
Scientific data about neurophysiological changes subsequent to pulsed radiofrequency (PRF) are still lacking. The goal of this study was to evaluate sural nerve conduction and Hoffmann reflex (H-reflex) in soleus muscle following adhesiolysis and PRF in patients with unilateral chronic lumbosacral L5-S1 neuropathic radiating pain. ⋯ Epidural adhesiolysis and PRF of the dorsal root ganglion seem to significantly affect spinal reflexes in patients with lumbosacral neuropathic radiating pain.
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Review Meta Analysis
A Meta-Analysis of Therapeutic Pain Neuroscience Education, Using Dosage and Treatment Format as Moderator Variables.
This meta-analysis aimed to assess the overall effect of therapeutic pain neuroscience education (TPNE) on chronic musculoskeletal pain and to further assess whether such an effect differs by TPNE dosage as well as other treatment format components. Dosage included the number of TPNE sessions provided as well as the amount of time per TPNE session. Structural components included TPNE provided alone as treatment or combined with other pain management modalities, as well as the inclusion of group-based treatment sessions. ⋯ This meta-analysis examined the efficacy of TPNE for patients with chronic pain. It assessed various pain outcome measures following intervention. In addition, this research identified that various moderator variables do not have and do have an impact on the treatment modality of TPNE.
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The reliability of pain assessment in frail and older adults has seldom been assessed. This study aims to assess the test-retest reliability of (1) the number of painful body sites, (2) pain intensity, and (3) pain extent in institutionalized older adults. ⋯ The vertical pain rating scale and the body chart seem reliable to assess pain intensity and number of pain sites, respectively. The wide CI for the ICC found for pain area and the high measurement error compromise its potential clinical relevance.
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Case Reports
Lumbar sympathetic block for intractable lower limb postherpetic neuralgia: Report of two cases.
Lumbar sympathetic block is a commonly used technique for sympathetically mediated pain syndromes. Postherpetic neuralgia (PHN) is also accepted to be associated with sympathetic system activation. While sympathetic blocks were utilized for upper-extremity or face-related PHN, there has not been any report regarding lower-extremity PHN, as it is an uncommon region. ⋯ Both patients had at least 50% reduction in numeric rating scale (NRS) scores at the end of 6 months. Lumbar sympathetic block could be considered in the treatment of lower-limb PHN. More reports and controlled trials are needed for further understanding the role of the intervention in this neuropathic pain syndrome.