Articles: pain-management-methods.
-
Physiother Theory Pract · Nov 2011
Randomized Controlled Trial Comparative StudyComparison of post-treatment effects of conventional and acupuncture-like transcutaneous electrical nerve stimulation (TENS): A randomised placebo-controlled study using cold-induced pain and healthy human participants.
TENS can be administered in conventional (high frequency, low intensity) or acupuncture-like (AL-TENS: low frequency, high intensity) formats. It is claimed that AL-TENS produces stronger and longer-lasting hypoalgesia than conventional TENS, although evidence is lacking. This randomised controlled parallel group study compared the effects of 30 minutes of AL-TENS, conventional TENS, and placebo (no current) TENS, on cold-pressor pain threshold (CPT), in 43 healthy participants. ⋯ There were no statistically significant differences between conventional TENS vs. placebo or between AL-TENS vs. conventional TENS at 5 or 15 minutes after TENS was switched off. In conclusion, AL-TENS but not conventional TENS prolonged post-stimulation hypoalgesia compared to placebo TENS. However, no differences between AL-TENS and conventional TENS were detected in head-to-head comparisons.
-
Haemophilia patients experience acute pain during joint bleeds and chronic pain from haemophilic arthropathy. More than 50% of haemophilia patients have painful joints that cause disability and impair quality of life. Unfortunately, only a few clinical studies have investigated the non-pharmacological or pharmacological treatments for pain or the adverse effects of pain on the health and quality of life of children and adults with haemophilia. ⋯ A pain treatment protocol should include a definition of the problem of pain and best practices for physicians. A call to action is needed to standardize treatment approaches to pain and to develop algorithms/protocols for the management of pain in haemophilia patients. This review will highlight the prevalence and devastating impact of pain in haemophilia patients, currently available treatment options and identify the unmet needs for pain management.
-
There is good support for the effectiveness of interdisciplinary chronic pain management programs in improving functional outcomes; however, relatively little is known about patients who report deterioration following participation in such programs. ⋯ Participants endorsed significant pre- and post-treatment improvements in all domains. Nevertheless, some participants reported deterioration. The findings shed light on variables associated with negative treatment outcomes and have practical applications for interdisciplinary chronic pain management programs.
-
Comparative Study
Peripheral nerve field stimulation in the treatment of postlaminectomy syndrome after multilevel spinal surgeries.
Chronic low back pain in patients with postlaminectomy syndrome (PLS) is challenging to treat, especially for patients who have undergone multilevel surgical procedures. Despite conservative therapy and available interventional pain procedures including spinal cord stimulation (SCS) and intrathecal therapies, patients may continue with intractable low back pain. Peripheral nerve field stimulation (PNFS) may represent an effective alternative treatment option for these patients when conventional treatments do not provide adequate relief of intractable low back pain. ⋯ PNFS may be more effective in treating intractable low back pain than SCS in patients with PLS after multilevel spinal surgeries.
-
Conflicting representations of pain: a qualitative analysis of health care professionals' discourse.
Studies regarding health care professionals' representations of pain indicate that doctors and nurses tend to concentrate on the organic origin of pain, and to view pain as subordinate to diagnosis and treatment of the disease; they also tend to underestimate the psychological and psychosocial components of pain, which means that they generally view the patient's subjective experience as secondary. This leads to an underestimation of pain. ⋯ To promote significant change regarding pain management within hospital organizations, it is essential to construct shared representations of the problem and its implications, particularly as regards relations with the patient. This change should take place at the educational as well as the socio-organizational level, and it should take into account ideas and proposals from the subjects involved.