Pain Medicine

BACKGROUND: Since the pioneering reports of the so-called "leonine face" in cluster headache (CH) patients, cranial and facial features of these patients have been poorly investigated with conflicting results. We aimed to investigate whether abnormalities in craniometric measurements could characterize male CH patients and represent reliable and reproducible diagnostic biomarkers able to identify CH patients. METHODS: Brain CT images were recorded between 2018 and 2020 in 24 male patients with CH, and in 24 matched healthy controls (HC)...

OBJECTIVE: The placebo effect is important in determining the outcome of the treatment of pain for which expectancy and context are the main contributors. The variable success of thermal neurotomy spinal pain procedures is often seen as evidence of the placebo effect. Conversely proponents of pain procedures explain poorer outcomes on technical procedure deficiencies including inadequate diagnosis.This cohort study set out to determine if patient expectancy is a contributing factor in the outcome of thermal neurotomy to cervical, thoracic, and lumbar zygapophysial and sacroiliac joints...

OBJECTIVE: To examine the extent to which self-reported experiences of discrimination are associated with pain interference among men and women with chronic non-cancer pain. METHODS: Data are from the Study of Midlife in the United States (MIDUS) Refresher Cohort. The analytic sample consisted of 207 adults with chronic pain (54.2 ± 12.8 years; 53.6% female) who completed the Major Experiences of Discrimination and Everyday Discrimination scales. Regression analyses examined cross-sectional relations between discrimination and pain interference...

OBJECTIVE: Dry needling is commonly used for the management of musculoskeletal pain patients. However, the effects of patient expectations are uncertain. Our aim was to determine the effect of patient expectations on short-term clinical outcomes after the application of a single session of dry needling in individuals with neck pain. METHODS: We conducted a randomized, placebo controlled, clinical trial including fifty patients with mechanical neck pain. Participants received a single session of dry needling or sham needling in a blinded design...

INTRODUCTION: Radiofrequency ablation (RFA) is a demonstrated safe and effective treatment for chronic low back pain. RFA delivers high density electrical current near lumbar medial branch nerve. The success of RFA is contingent upon creating a lesion that overlaps the sensory nerve supplying the affected facet joint(s). Both bipolar-RFA and V-shaped active tip cannulas increase lesion size in experimental models. We describe successful application of concomitant bipolar and V-shaped lesions in a single patient with chronic low back pain caused by lumbar spondylosis...

No abstract text is available yet for this article.

OBJECTIVE: While Provocation Lumbar Discography has been used to identify discs responsible for low back pain, the biomechanical effects of disc injection have received little attention. The purpose of this study was to assess the motion of the Functional Spinal Unit including the Endplate and Facet/Pedicle region during disc injection including comparison between normal and degenerative discs. SUBJECTS: 91 consecutive patients referred for Discography with chronic low back pain...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: This study aimed to capture day-to-day changes in pain intensity in individuals with low back pain (LBP), which may be indicative of patients' ability to modulate their pain levels. A secondary aim was to explore the presence of latent subgroups characterized by pain level, intraindividual pain variability, and change in pain over a 14-day period. SUBJECTS: Participants were 54 adults with self-reported low back pain recruited from outpatient Physical Therapy clinics and the community...

OBJECTIVE: Primary dysmenorrhea (PD), or painful menstruation, is a common gynaecological condition that can cause intense pain and functional disability in women of reproductive age. As a non-malignant condition, PD is relatively under-studied and poorly managed. The purpose of this study was to estimate the prevalence and impact of PD among third-level students in Ireland. DESIGN: Cross-sectional observational study. METHODS: Students (N = 892; age range = 18-45) completed an online survey on menstrual pain characteristics, pain management strategies, pain interference, and pain catastrophizing...

OBJECTIVE: The aim of this study was to assess whether anodal DCS applied to the suboccipital (SO) target area could potentiate antinociception assessed primarily with conditioned pain modulation of tonic thermal test stimuli. DESIGN: Randomised double-blinded control trial. SETTING: Rehabilitation hospital. SUBJECTS: Healthy participants. METHODS: Forty healthy participants were randomized to receive either SO-DCS or M1-DCS...

INTRODUCTION: Some claimants harbor perceptions of injustice about the way they have been treated. In particular, those with ongoing and disabling pain have been generally dissatisfied by the way they have been managed by the systems designed to offer them financial compensation. AIM: To explore possible factors that may contribute to their dissatisfaction. METHOD: We review the historical development of the various systems in which monetary compensation was awarded for personal injury...

OBJECTIVE: The need for measuring emotional functioning in chronic pain patients was recognized decades ago. The Initiative on Methods, Measures, and Pain Assessment in Clinical Trials (IMMPACT) proposed the Profile of Mood States (POMS) for this purpose. However, to date, its factor structure has not been confirmed in these patients. METHODS: We set out to use confirmatory factor analysis (CFA) to test the theoretical structure of seven factors: Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor-Activity, Fatigue-Inertia, Confusion-Bewilderment, and Friendliness...

BACKGROUND: Pre-outpatient interventions in chronic pain have the potential to improve patient self-management earlier in primary or secondary care, which may minimize pain chronicity and negative health outcomes. The literature for this is sparse, and there are no existing systematic reviews on this topic. METHODS: The purpose of this systematic review is to examine the evidence for pre-outpatient group interventions in chronic pain. RESULTS: We identified four studies that looked at this: two randomized control trials, one prospective observational study, and one descriptive study...

OBJECTIVE: African American older adults living in disadvantaged communities are disproportionately burdened by disabling pain. To address their needs, we tested the feasibility and potential effects of a cognitive-behavioral chronic pain self-management program delivered by community health workers. DESIGN: A single-group, pre-post evaluation of the STEPS-2 (Seniors using Technology to Engage in Pain Self-management) intervention, in which participants learned pain-management skills through web-based videos...

CONTEXT: Pain is a common complaint in maintenance hemodialysis (MHD) patients, and it is often inadequately assessed and inappropriately treated. OBJECTIVES: The study goal was to preliminarily evaluate pain management in MHD patients. METHODS: The study was a cross-sectional study conducted in 2013-2015. A sample of 277 MHD patients who reported pain within the last 24 hours from five hospital hemodialysis units in Israel were interviewed and evaluated...

No abstract text is available yet for this article.

OBJECTIVE: To examine associations of combined pain and fatigue severity with physical performance and quality of life in people with chronic knee pain. DESIGN: Cross-sectional. SETTING: General community. PARTICIPANTS: Adults (N = 193) aged ≥ 50 years with chronic knee pain. METHODS: Physical performance measures included Six-Minute Walk test, Timed Up and Go test, and 20-feet timed walk test...

OBJECTIVE: Compare the effectiveness of genicular nerve blockade (GNB) using classical anatomical targets (CT) versus revised targets (RT) in patients suffering from chronic knee osteoarthritis pain. DESIGN: Double-blinded randomized controlled trial. SETTING: Pain medicine center of a teaching hospital. METHODS: We randomly assigned 55 patients with chronic knee osteoarthritis pain to receive a GNB (using a fluid mixture of 2 mL: lidocaine 1% + 20 mg triamcinolone) with either classical targets (CT-group, n = 28) or revised targets (RT-group, n = 27)...