Latest & greatest articles for chronic pain

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Top results for chronic pain

901. A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy

A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy Timm K E Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Prevention of chronic low back pain (CLBP) following an L5 laminectomy with passive treatments (physical agents, and joint manipulation); and active treatments (low-tech exercise and high-tech exercise). Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Patients employed in an industrial setting

1994 NHS Economic Evaluation Database.

902. Subcutaneous sterile water injections for chronic neck and shoulder pain following whiplash injuries. (PubMed)

Subcutaneous sterile water injections for chronic neck and shoulder pain following whiplash injuries. In many cases of whiplash injury symptoms persist and do not respond to treatment. There is uncontrolled evidence to suggest that intracutaneous injections of sterile water might help. Since that route may be unacceptable to patients the subcutaneous route is used in the randomised trial reported here. 40 patients with whiplash syndrome, mean age 46 years (24-73) were given subcutaneous (...) injections of 0.3-0.5 ml sterile water or saline over tender and trigger points in the neck and shoulder. A maximum of three treatments were given during the first two months of the study and the patients were followed up for 8 months. The accidents had occurred 4-6 years previously. X-ray examinations revealed no traumatic spinal lesions. Neck mobility and pain levels were evaluated by a physiotherapist immediately before and after the first treatment and after 1, 3, and 8 months. After 3 months

1993 Lancet

903. Morphine responsiveness of chronic pain: double-blind randomised crossover study with patient-controlled analgesia. (PubMed)

Morphine responsiveness of chronic pain: double-blind randomised crossover study with patient-controlled analgesia. There is controversy about whether the lack of response of some chronic pain to opioid treatment is absolute or relative. It is widely believed that nociceptive pain is responsive to opioids whereas neuropathic pain tends not to be. We have used a method of patient-controlled analgesia (PCA) with simultaneous nurse-observer measurement of analgesia, mood, and adverse effects (...) to address these issues. Ten patients with chronic pain were given morphine at two concentrations (10 and 30 mg/ml) by PCA in two separate sessions in a double-blind randomised crossover study. Before the study a clinical judgment was made as to whether each pain was nociceptive or neuropathic. Seven patients showed good analgesic responses (more than 70 mm pain relief on a visual-analogue scale) of pain at rest, two patients poor responses (less than 30 mm pain relief), and one a moderate response

1992 Lancet

904. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. (PubMed)

A controlled trial of corticosteroid injections into facet joints for chronic low back pain. Chronic low back pain is a common problem with many treatments, few of which have been rigorously evaluated. This randomized, placebo-controlled trial was designed to evaluate the efficacy of injections of corticosteroid into facet joints to treat chronic low back pain.Patients with chronic low back pain who reported immediate relief of their pain after injections of local anesthetic into the facet (...) in the treatment of patients with chronic low back pain.

1991 NEJM

905. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. (PubMed)

A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. A number of treatments are widely prescribed for chronic back pain, but few have been rigorously evaluated. We examined the effectiveness of transcutaneous electrical nerve stimulation (TENS), a program of stretching exercises, or a combination of both for low back pain. Patients with chronic low back pain (median duration, 4.1 years) were randomly assigned to receive daily treatment (...) , however, most patients had discontinued the exercises, and the initial improvements were gone. We conclude that for patients with chronic low back pain, treatment with TENS is no more effective than treatment with a placebo, and TENS adds no apparent benefit to that of exercise alone.

1990 NEJM

906. Clinical trial of intensive muscle training for chronic low back pain. (PubMed)

Clinical trial of intensive muscle training for chronic low back pain. 105 patients who had chronic low back pain without clinical signs of lumbar nerve root compression or radiological evidence of spondylolysis or osteomalacia were randomised to three treatments: 30 sessions of intensive dynamic back extensor exercises over three months; a similar programme at one-fifth the exercise intensity; or one month of thermotherapy, massage, and mild exercises. The results consistently favoured

1989 Lancet

907. Mexiletine for treatment of chronic painful diabetic neuropathy. (PubMed)

Mexiletine for treatment of chronic painful diabetic neuropathy. Sixteen of nineteen patients completed a randomised double-blind crossover trial to assess the effect of oral mexiletine (10 mg/kg bodyweight daily) on the symptoms and signs of chronic painful diabetic neuropathy. The median age of the sixteen patients was 50 years (range 30-64). Assessment with a five-item clinical symptom scale showed significant improvement during the mexiletine phase compared with the placebo phase. Pain

1988 Lancet

908. A new approach to the treatment of chronic low back pain. (PubMed)

A new approach to the treatment of chronic low back pain. 81 patients with chronic low back pain (average duration 10 years) were randomised to two treatment groups. 40 received an empirically devised regimen of forceful spinal manipulation and injections of a dextrose-glycerine-phenol ("proliferant") solution into soft-tissue structures, as part of a programme to decrease pain and disability. The other 41 patients received parallel treatment in which the main differences were less extensive (...) and the numbers free from disability were 15 and 4, respectively (p less than 0.003). Visual analogue pain scores and pain diagrams likewise showed significant advantages for the experimental regimen.

1987 Lancet

909. Auriculotherapy fails to relieve chronic pain. A controlled crossover study. (PubMed)

Auriculotherapy fails to relieve chronic pain. A controlled crossover study. Enthusiastic reports of the effectiveness of electrical stimulation of the outer ear for the relief of pain ("auriculotherapy") have led to increasing use of the procedure. In the present study, auriculotherapy was evaluated in 36 patients suffering from chronic pain, using a controlled crossover design. The first experiment compared the effects of stimulation of designated auriculotherapy points, and of control points (...) unrelated to the painful area. A second experiment compared stimulation of designated points with a no-stimulation placebo control. Pain-relief scores obtained with the McGill Pain Questionnaire failed to show any differences in either experiment. It is concluded that auriculotherapy is not an effective therapeutic procedure for chronic pain.

1984 JAMA