Pain Medicine

OBJECTIVE: To apply the sequential up-down method to a human experimental pain model in order to examine the opioid-sparing effect of oral pregabalin on intravenous alfentanil. DESIGN: Double-blind, randomized, crossover. SETTING: Academic University Medical Center. SUBJECTS: 31 healthy males. METHODS: The EC50 of intravenous Alfentanil was determined under two conditions: Alfentanil alone (PHASE I) and Alfentanil + Pregabalin (300 mg po) (PHASE II)...

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OBJECTIVE: This study investigated the relationship between pain location and fracture type in the patients with acute osteoporotic vertebral fracture (OVF). DESIGN: A prospective observation study. SUBJECT: A total of 306 patients with acute OVF were included. METHODS: The site of pain of each patient was recorded, and the patients were divided into pain at fracture site group (group 1) and pain at non-fracture site group (group 2)...

OBJECTIVES: To describe the method and clinical efficacy of awake CT-guided percutaneous balloon compression (PBC) as a treatment for trigeminal neuralgia (TN). DESIGN: In this case-series, TN patients were treated with awake CT-guided PBC and followed for treatment efficacy and complications for 12 months. SETTING: A single-center study. SUBJECTS: 66 patients with medical treatment-refractory TN were recruited for the study...

OBJECTIVE: Multiple factors are involved in the physiology and variability of postsurgical pain, a great part of which can be explained by genetic and environmental factors and their interaction. Epigenetics refers to the mechanism by which the environment alters the stability and expression of genes. We conducted a scoping review to examine the available evidence in both animal models and clinical studies on epigenetic mechanisms involved in regulation of postsurgical and chronic postsurgical pain...

OBJECTIVE: Neck pain is a common health problem among both the general population and natural disaster survivors. However, the long-term course of neck pain has rarely been reported. The aim of this study was to elucidate the 5-year course of neck pain among survivors of the Great East Japan Earthquake (GEJE) by assessing the association of neck pain 2 and 4 years after the disaster with that at 7 years. STUDY DESIGN: Longitudinal study. METHODS: A panel study was conducted on GEJE survivors (n = 1,821) using a self-reported questionnaire at 2 (first time point), 4 (second time point), and 7 years (third time point) after the disaster...

OBJECTIVE: Recent neuroimaging studies have found that brain function is abnormal in primary dysmenorrhea (PDM). The present study aimed to explore frequency-specific brain alterations and their occurrence in the PDM. METHODS: Forty-seven patients with PDM and 36 matched healthy controls were enrolled in the study and underwent resting-state functional magnetic resonance imaging. The alterations in brain function in patients with PDM were assessed using different frequency filter bands (Slow5, Slow4, Slow3, and full low frequency) and functional connectivity density (FCD) approach...

OBJECTIVE: Chronic musculoskeletal pain (CMP) outcomes are affected by numerous variables including the clinical conversation. When good therapeutic/working alliances are formed, congruent clinical conversations can lead to improved CMP outcomes. Identifying patient/provider attitudes, beliefs, and biases in CMP that can influence the clinical conversation, and thus clinical management decisions, is foundationally important. DESIGN: The aims of this systematic review were to 1) summarize the evidence of the attitudes and beliefs of patients and healthcare providers (HCPs) involved in the clinical conversation of CMP; 2) examine if/how these perceptions impacted the process of care...

OBJECTIVE: Patients with myofascial trigger points (MTPs) frequently manifest restricted range of motion (ROM) during physical evaluation. Multiple manual therapy interventions have been developed for the treatment of MTPs, but their effect on ROM has not been clarified through a systematic review and meta-analysis. Thus, this systematic review aimed to assess the effect of manual therapy interventions on ROM among individuals with MTPs. METHODS: A systematic search was conducted in PubMed, Web of Science, Cochrane, Scopus and Clinical Trials...

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OBJECTIVE: The aims of the present study were to investigate white matter alterations and their associations with the clinical variables in cervical spondylotic (CS) patients with pain. DESIGN: Cross-sectional study. SETTING: Chinese community. SUBJECTS: Forty-two CS patients with pain and 42 matched healthy participants were ultimately recruited from August 2018 to September 2019. METHODS: Tract-based spatial statistics (TBSS) analysis was performed to investigate the differences of DTI-derived indices (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD)) between the patients and healthy controls throughout brain white matter...

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BACKGROUND: Neuroscience Education Therapy (NET) has been successfully used for numerous overlapping pain conditions, but few studies have investigated NET for migraine. OBJECTIVE: We sought to (1) review the literature on NET used for the treatment of various pain conditions to assess how NET has been studied thus far and (2) recommend considerations for future research of NET for the treatment of migraine. DESIGN/METHODS: Following the PRISMA guideline for scoping reviews (PRISMA-ScR) Co-author (TR), a Medical Librarian, searched the MEDLINE, PsychInfo, Embase & Cochrane Central Clinical Trials Registry databases for peer-reviewed articles describing NET to treat migraine and other chronic pain conditions...

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OBJECTIVE: Pain specialists treat patients with headache and interface with those who use opioids more so than neurologists and headache specialists. We assessed headache medicine knowledge and needs of pain specialists. DESIGN/SETTING: Cross-sectional online survey. SUBJECTS: Members of the American Academy of Pain Medicine. METHODS: Survey was based on a prior survey on primary care providers' knowledge and needs and was iteratively updated by four headache specialists, two with pain medicine affiliations...

BACKGROUND: Neurovascular compression (NVC) in patients with trigeminal neuralgia (TN) can be a factor of treatment outcome especially in microvascular decompression and stereotactic radiosurgery. No such effect has been reported in percutaneous radiofrequency rhizotomy (RF). This study is to investigate if NVC affects the efficacy of RF in patients with TN. METHODS: We retrospectively reviewed patients with TN who received RF in our institution. Pre-treatment MRI was performed in every patient, and the presence of NVC was reviewed independently by two physicians...

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OBJECTIVE: To examine associations between chronic pain conditions, pain level, and subclinical/clinical anxiety in community-dwelling older adults. DESIGN: Cross-sectional associations were analyzed using multinomial logistic regression to compare the odds of having subclinical/clinical anxiety by painful condition and pain level, controlling for confounders. SETTING: Participants were recruited in primary care waiting rooms to take part in the first wave of the Étude sur la Santé des Aînés (ESA)-Services study...

INTRODUCTION: Post Dural Puncture Headache (PDPH) is a well-known complication of neuraxial anesthesia, however the occurrence of seizures and vision loss within few days after dural puncture could be alarming. Posterior Reversible Encephalopathy Syndrome (PRES) is associated with reversible edema and leukoencephalopathy in the posterior parieto-occipital cortex. We report the co-presentation of PRES and PDPH after labor epidural analgesia. CASE PRESENTATION: 25-year-old multiparous African-American woman was admitted for evaluation of new onset seizures and headache in the postpartum period...

OBJECTIVE: Although virtual reality VR is shown to have short-term analgesic effects in acute pain settings, its long-term efficacy with chronic pain conditions has not been established. This scoping review aims to provide a summary of VR approaches explored in chronic primary and secondary pain conditions as defined by the International Association for the Study of Pain. METHODS: A systematic literature search in Ovid PubMed and Ovid Embase was conducted between January 5-10th 2021 using the Arksey and O'Malley six-step scoping review criteria...