Articles: pain-clinics.
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Vestibular stimulation has been reported to alleviate central pain. Clinical and physiological studies confirm pervasive interactions between vestibular signals and somatosensory circuits, including nociception. However, the neural mechanisms underlying vestibular-induced analgesia remain unclear, and previous clinical studies cannot rule out explanations based on alternative, non-specific effects such as distraction or placebo. ⋯ This transient reduction in pain perception was associated with reduced amplitude of all LEP components, including the early N1 wave reflecting the first arrival of nociceptive input to primary somatosensory cortex. We conclude that cold left ear CVS elicits a modulation of both nociceptive processing and pain perception. The analgesic effect induced by CVS could be mediated either by subcortical gating of the ascending nociceptive input, or by direct modulation of the primary somatosensory cortex.
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The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. ⋯ A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p < .05). This controlled pilot study indicates benefits of TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery.
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Innamorati and colleagues (Innamorati et al., J Headache Pain 16:2, 2015) validated the "stagnation scale" and proposed to use it to screen for psychopathology. I have some critical comments to consider about the theoretical and clinical value of the instrument. ⋯ The scale can thus not identify patients who repress emotions. Third, the routine use of this instrument will detract clinicians from what really is at stake in patients and what may help them.
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Pain clinics provide interdisciplinary therapy to treat chronic pain patients and to increase the return-to-work rate. In recent years and due to increased economic pressure in health care, a change in the management of pain in Austrian health care centers has been observed. For the analysis of the current situation, two surveys addressing all Austrian pain clinics were performed. ⋯ Our survey confirmed the closure of 9 pain clinics during the last 5 years due to lack of personnel and time. Pain clinics appear to provide the simplest economic saving potential. This development is a major concern. Although running a pain clinic seems to be expensive at the first sight, it reduces pain, sick leave, complications, and potential legal issues against health care centers, while simultaneously increasing the hospital's competitiveness. Our results show that 74% of Austrian chronic pain patients do not have access to an interdisciplinary pain clinic. Because of plans to further economize resources, Austria may lose its ability to provide state-of-the-art pain therapy and management.