Pain practice : the official journal of World Institute of Pain
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The objective of this study was to determine whether self-reported visual analogue scale (VAS) low back pain (LBP) scores are valid against matched psychophysically induced pressure pain scores. Two hundred thirty-six chronic LBP patients (some with neck pain) reported their LBP and neck pain scores on a VAS immediately before psychophysical pressure pain induction used to determine pain threshold (PTHRE), pain tolerance (PTOL), and a psychophysical pressure pain score which matched (PMAT) their current LBP. Pearson Product-Moment correlation coefficients were calculated between reported VAS neck scores, reported VAS LBP scores, and the psychophysically determined LBP PMAT scores. ⋯ There was a significant correlation between the LBP PMAT scores and the reported LBP VAS scores for both types of psychophysical LBP PMAT score calculations; however, there were insignificant correlations between the LBP PMAT scores and reported neck VAS scores. Chronic LBP patients can match their self-reported VAS LBP scores to psychophysically determined LBP PMAT scores. As such, self-reported VAS chronic LBP scores appear to be valid against one type of psychophysical measurement.
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Review Meta Analysis
Assessment of research quality of telehealth trials in pain management: a meta-analysis.
Although telehealth-based pain management research has grown over the last decade, it is difficult to determine the state of the research because of methodological differences and variability in quality among existing studies. In a previous systematic review, we outlined these differences and preliminarily explored the promise of telehealth for pain intervention. We completed a PRISMA compliant meta-analysis of telehealth pain management research to more precisely describe the state of the research and to uncover gaps in the existing literature that highlight directions for future research. ⋯ However, some of the reviewed studies found no benefit for telehealth over control conditions. Some methodological concerns among the examined research included poor research quality, small sample sizes, and the examination of telehealth pain interventions without proven efficacy for in-person treatment. Recommendations for future studies are reviewed.
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Treatment for rib fracture pain can be broadly divided into pharmacologic approaches with oral and/or parenteral medication and interventional approaches utilizing neuraxial analgesia or peripheral nerve blocks to provide pain relief. Both approaches attempt to control nociceptive and neuropathic pain secondary to osseous injury and nerve insult, respectively. Success of treatment is ultimately measured by the ability of the selected modality to decrease pain, chest splinting, and to prevent sequelae of injury, such as pneumonia. ⋯ Articles addressing rib fracture pain are relatively scarce in the pain medicine literature. As life expectancy increases, and as healthcare system modifications are implemented, pain medicine physicians may be consulted to treat increasing number of patients suffering rib fracture pain and may need to resort to novel therapeutic measures because of financial constraints imposed by those changes. Here we present the first published case series of thoracic epidural steroid injections used for management of rib fracture pain.
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Bone metastases are very frequent in patients with cancer and usually are located in the patient's long bones and spine. Various approaches to pain relief and stability to the affected bone have been used. The aim of the study is to report our experience with a new minimally invasive percutaneous technique in patients with bone metastases located in the head, neck, and proximal femur. ⋯ Our descriptive, retrospective, longitudinal case series included 15 patients who underwent femoroplasty. All patients reported pain reduction and improved mobility, with no complications observed. The femoroplasty procedure caused pain relief by stabilizing the bone through the consolidation of the microfractures because of bone metastases.
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Case Reports
Ultrasound imaging of embedded shrapnel facilitates diagnosis and management of myofascial pain syndrome.
Trigger points can result from a variety of inciting events including muscle overuse, trauma, mechanical overload, and psychological stress. When the myofascial trigger points occur in cervical musculature, they have been known to cause headaches. Ultrasound imaging is being increasingly used for the diagnosis and interventional management of various painful conditions. ⋯ Ultrasound guided trigger point injection, followed by physical therapy resolved his symptoms. This is a unique report of embedded shrapnel and coexisting myofascial pain syndrome revealed by ultrasound imaging. The association between shrapnel and myofascial pain syndrome requires further investigation.