Pain Medicine

Young adults with chronic pain and symptoms experience disruptions to their social, emotional, physical, and vocational functioning. Interdisciplinary pain rehabilitation programs for pediatric and adult populations are not designed specifically to address the developmental needs of young adults. This paper describes the development of a novel intensive interdisciplinary outpatient rehabilitation program tailored to the unique needs of young adults with chronic pain and symptoms. Tailored content included vocational assessment and consultation, financial literacy education, and sexual health education...

OBJECTIVE: Complex regional pain syndrome (CRPS) is associated with a range of sensory disturbances on the symptomatic side of the body but whether this includes olfaction is uncertain. To clarify this, the aims of this study were to compare ratings of intensity and hedonic appeal of household odorants in CRPS patients and controls, and to determine whether ratings differed between the symptomatic and contralateral sides within the sample of patients. METHODS: Six odorants (vanilla, fish sauce, vinegar, eucalyptus, almond essence and acetone) were presented sequentially in random order on cottonwool buds held in the midline approximately 1 cm from both nostrils in 37 CRPS patients and 21 pain-free controls...

OBJECTIVE: Central post-stroke pain (CPSP) refers to neuropathic pain in areas of the body corresponding to stroke lesions. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, is safe and effective against neuropathic pain. In this randomized double-blind placebo-controlled study, we studied the effect of duloxetine in CPSP patients. METHODS: Consecutive patients satisfying the inclusion criteria were enrolled in the study and were randomized in a simple 1:1 randomization to duloxetine and placebo groups...

OBJECTIVE: To assess whether brief mindfulness-based cognitive behavioral therapy (MBCBT) could enhance the benefits of total knee arthroplasty (TKA) in improving pain and pain-related disability. Specifically, to determine (1) whether patients who received MBCBT differed from matched controls who received treatment as usual (TAU) on post-surgical pain outcomes, and (2) whether changes in pain catastrophizing, depression, and/or anxiety explained the potential effects of MBCBT on pain outcomes...

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The Biobehavioral Working Group of BACPAC was charged to evaluate a range of psychosocial, psychophysical, and behavioral domains relevant to chronic low back pain, and recommend specific assessment tools and procedures to harmonize biobehavioral data collection across the consortium. Primary references and sources for measure selection were the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials, the Minimum Data Set from the NIH Research Task Force on Standards for Chronic Low Back Pain, the Patient-Reported Outcomes Measurement Information System, and NeuroQOL...

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OBJECTIVE: The study compared the efficacy and tolerability of piroxicam gel and a new topical combination of medicinal plant products (Soulagel®) to treat pain caused by soft tissue injuries. METHODS: 1525 patients were assigned to receive piroxicam gel or Soulagel®. Efficacy assessments included pain-on-movement (POM) VNS (visual numeric scale) change from emergency department (ED) discharge (baseline) by at least 50% at day-7 final assessment, the time required to reach pain resolution criteria, need for rescue analgesia, patients' satisfaction, and rate of adverse effects...

OBJECTIVE: Pathology can provide crucial insights into the etiology of disease. The goal of this review is to evaluate the rigor of histopathology reports of Complex Regional Pain Syndrome (CRPS). METHODS: A systematic search of multiple databases identified papers which described amputation for CRPS with pathology findings. Control pathology articles were randomly chosen from the same journals. Landmark articles in Surgical Pathology were previously identified...

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OBJECTIVE: Pain is a variably experienced symptom during pregnancy, and women scheduled for cesarean delivery, an increasingly common procedure, are a relatively understudied group who may be at higher pain risk. While biopsychosocial factors are known to modulate many types of chronic pain, their contribution to late pregnancy pain has not been comprehensively studied. We aimed to identify biopsychosocial factors associated with greater pain severity and interference during the last week of pregnancy...

OBJECTIVE: Depression frequently co-exists with chronic pain. Contemporary models suggest that these conditions share pathobiological mechanisms, prompting a need to investigate their temporal association. This investigation aimed to explore two distinctly different chronic pain conditions, and their cross-sectional and prospective associations with depression. METHODS: Self-reported information was available on chronic widespread pain (CWP), chronic low back pain (CLBP) (45y), and depression symptoms (45y and 50y) from up to 9377 participants in the 1958 British cohort...

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OBJECTIVE: To examine whether compared with a program without increased physical activity, an intervention program with increased physical activity can prevent the development of musculoskeletal pain in community-dwelling older adults. DESIGN: Randomized controlled trial. SETTING: Japanese community. SUBJECTS: Seventy-nine older adults without musculoskeletal pain were randomized into two groups: an intervention group (n = 40) that engaged in increased physical activity and an exercise class and a control group (n = 39) that participated only in the exercise class...

OBJECTIVE: To evaluate the analgesic efficacy of quadratus lumborum block (QLB) in adults undergoing nephrectomy. DESIGN: Systematic review and meta-analysis. PATIENTS: Adult patients (≥ 18 years) received nephrectomy under general anesthesia. METHODS: We searched PubMed, Embase, the Cochrane Library, and Web of Science on January 10, 2022, including randomized controlled trials (RCTs) that evaluated the analgesic efficacy of QLB for patients undergoing nephrectomy...

OBJECTIVE: Biomechanics represents the common final output through which all biopsychosocial constructs of back pain must pass, making it a rich target for phenotyping. To exploit this feature, several sites within the NIH Back Pain Consortium (BACPAC) have developed biomechanics measurement and phenotyping tools. The overall aims of this paper were to: 1) provide a narrative review of biomechanics as a phenotyping tool; 2) describe the diverse array of tools and outcome measures that exist within BACPAC; and 3) highlight how leveraging these technologies with the other data collected within BACPAC may elucidate the relationship between biomechanics and other metrics used to characterize low back pain (LBP)...

STUDY DESIGN: In vivo retrospective study of fully automatic quantitative imaging feature extraction from clinically acquired lumbar spine magnetic resonance imaging (MRI). OBJECTIVE: To demonstrate the feasibility of substituting automatic for human-demarcated segmentation of major anatomical structures in clinical lumbar spine MRI to generate quantitative image-based features and biomechanical models. SETTING: Previous studies have demonstrated the viability of automatic segmentation applied to medical images; however, the feasibility of these networks to segment clinically acquired images has not yet been demonstrated, as they largely rely on specialized sequences or strict quality of imaging data to achieve good performance...