Articles: chronic-pain.
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Review Case Reports
Opioids in chronic noncancer pain: more faces from the crowd.
The use of opioids for chronic noncancer pain (CNCP) remains very controversial. There are several randomized controlled trials, mostly in neuropathic pain, reporting efficacy and safety in the short term, but more long-term data are needed. Randomized controlled trials may be limited in providing data about the patients who benefit from often high-dose opioids over the long term. The present article provides details of these patients and adds to a previous case series. ⋯ These 17 reports of patients with intractable CNCP treated with opioids with some success over many years puts a face on more of the participants in the larger survey of 84 subjects, suggesting that this approach is effective and safe for some patients over many years.
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Randomized Controlled Trial
Relationships among pain, depressed mood, and global status in fibromyalgia patients: post hoc analyses of a randomized, placebo-controlled trial of milnacipran.
Patients with fibromyalgia often experience depressive symptoms in addition to chronic pain and other characteristic symptoms associated with this disorder. ⋯ Symptom improvements with milnacipran were only weakly associated with baseline depressive symptoms and were largely independent of improvements in depressive symptomatology.
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Arch Phys Med Rehabil · Jul 2012
Randomized Controlled Trial Comparative StudyTraining mode-dependent changes in motor performance in neck pain.
To determine whether changes in motor performance after a course of exercise in patients with mechanical neck pain (MNP) were dependent on the primary behavioral demand of the exercise performed. ⋯ Changes in motor performance in individuals with MNP in response to an exercise program were dependent on the specific mode of exercise performed, with minimal improvement in other domains of motor performance.
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In the last 2 decades, a growing body of research aimed at investigating the health benefits of Tai Chi in various chronic health conditions has been recognized in the literature. This article reviewed the history, the philosophy, and the evidence for the role of Tai Chi in a few selected chronic pain conditions. The ancient health art of Tai Chi contributes to chronic pain management in 3 major areas: adaptive exercise, mind-body interaction, and meditation. ⋯ Only 5 pain conditions were reviewed: osteoarthritis, fibromyalgia, rheumatoid arthritis, low back pain, and headache. Of these, Tai Chi seems to be an effective intervention in osteoarthritis, low back pain, and fibromyalgia. The limitations of the Tai Chi study design and suggestions for the direction of future research are also discussed.
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Exercise is an effective treatment for various chronic pain disorders, including fibromyalgia, chronic neck pain, osteoarthritis, rheumatoid arthritis, and chronic low back pain. Although the clinical benefits of exercise therapy in these populations are well established (i.e. evidence based), it is currently unclear whether exercise has positive effects on the processes involved in chronic pain (e.g. central pain modulation). ⋯ A dysfunctional response of patients with chronic pain and aberrations in central pain modulation to exercise has been shown, indicating that exercise therapy should be individually tailored with emphasis on prevention of symptom flares. The paper discusses the translation of these findings to rehabilitation practice together with future research avenues.