Articles: pain-management.
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Randomized Controlled Trial Multicenter Study
European randomized controlled trial evaluating differential target multiplexed spinal cord stimulation and conventional medical management in subjects with persistent back pain ineligible for spine surgery: 24-month results.
Differential target multiplexed spinal cord stimulation (DTM SCS) was shown to be superior to conventional SCS for treating chronic low back pain (CLBP) in subjects with persistent spinal pain syndrome with previous spinal surgery (PSPS-T2) or ineligible for it (PSPS-T1). This study reports 24-month efficacy and safety of DTM SCS vs. conventional medical management (CMM) in PSPS-T1 subjects across four European countries. ⋯ This randomized controlled trial shows that Differential Target Multiplexed SCS (DTM SCS) is an effective and safe long-term treatment for PSPS type 1 patients suffering from axial low back pain with or without leg pain and who are ineligible for spinal surgery. Currently, CMM treatments are their only option and provide limited benefits. Besides superior pain relief, DTM SCS provides significant improvements in functional disability, quality of life, high levels of satisfaction and perceived impression of change.
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Randomized Controlled Trial
Short- and medium-term effects of a single session of pain neuroscience education on pain and psychological factors in patients with chronic low back pain. A single-blind randomized clinical trial.
Biopsychosocial approach in patients suffering chronic low back pain (CLBP) promotes pain self-management strategies. Current evidence recommends high dose of Pain Neuroscience Education (PNE) for clinically significant differences. However, the workload and time constraints experienced by healthcare providers impede the application of the recommended treatment regimen. In fact, Back School with a biomechanical model is the main approach to manage CLBP in public systems. ⋯ Adding a single PNE session in the back school program did not reduce pain but improved psychological factors as central sensitization and pain catastrophism at medium-term.
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Randomized Controlled Trial
Enhancing placebo analgesia: Unravelling the powerful interplay of ownership and verbal suggestion.
Placebo analgesic research demonstrates pain reduction after using a placebo analgesic. Recent studies have documented that sometimes possessing a placebo analgesic induces placebo analgesia. These prior studies used a 'cream' as the stimulus and proposed that the effect is driven by an expectancy of obtaining benefits from the owned analgesic. This paper examines three pivotal components of placebo analgesia: placebo form, ownership and expectancy induced by verbal suggestion. We investigate analgesic expectancy between cream versus oil form of placebo stimulus and systematically isolate the effects of ownership, verbal suggestion and their interaction, comparing with the effect of use, to decipher the dynamics of placebo analgesia. ⋯ This study delves into the intricate dynamics of placebo analgesia, shedding light on the significant influence of ownership and verbal suggestion. Through a meticulous exploration of the relationship between ownership and expectancy induced by verbal suggestion, we propose novel avenues for enhancing placebo responses. This research has implications for clinical practice and pain management strategies, potentially revolutionizing approaches to pain relief and therapeutic outcomes. Our findings contribute to a paradigm shift in understanding placebo analgesia, emphasizing the pivotal interaction between ownership and verbal suggestion.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
The implementation of a pain navigator program in the department of Veterans Affairs' (VA) health care systems: a cluster randomized pragmatic clinical trial.
This manuscript describes the uptake of the AIM-Back Pain Navigator Pathway (PNP) designed to encourage use of non-pharmacologic care options within the Veterans Health Administration (VHA). ⋯ Implementation of the telehealth delivered PNP provides a nuanced understanding of the introduction of novel care programs within diverse clinical settings. These findings are most applicable to care programs that are delivered remotely and involve facilitation of existing care options.
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Randomized Controlled Trial Comparative Study
The effect of three different nonpharmacological methods on cannulation success during peripheral intravenous catheter placement in the emergency unit: a randomized controlled trial.
Peripheral intravenous catheterization is frequently performed in emergency units, but it is a procedure which is difficult for healthcare professionals and painful for patients. The primary objective of the present study was to examine the effect on venous dilation, procedure duration and pain severity of local heat, cold and vibration applications performed on the intervention area before peripheral intravenous catheterization in adults. The second objective of the study was to examine the effects of age and gender variables on the participants' pain intensity levels. ⋯ It was determined that local cold application for one minute to the area of peripheral intravenous catheterization increased venous dilation, shortened application time, and reduced pain.