Association of Intermittent and Constant Knee Pain Patterns With Knee Pain Severity, Radiographic Knee Osteoarthritis Duration and Severity

The objective of this study was to examine the relation of knee pain patterns to pain severity, and to radiographic osteoarthritis (OA) severity and duration. 

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A Comprehensive Review of Over-The-Counter Treatment for Chronic Migraine Headaches

Migraine headaches are a neurologic disorder characterized by attacks of moderate to severe throbbing headache that are typically unilateral, exacerbated by physical activity, and associated with phonophobia, photophobia...
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Perioperative Point of Care Ultrasound (POCUS) for Anesthesiologists: An Overview

Point of care ultrasound (POCUS) has played a role across almost every medical specialty. Although anesthesiologists have been using bedside ultrasound for nerve blocks and vascular access for many years now, there has b...
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Surgery Versus Conservative Care for Persistent Sciatica Lasting 4 to 12 Months

The treatment of chronic sciatica caused by herniation of a lumbar disk has not been well studied in comparison with acute disk herniation. Data are needed on whether diskectomy or a conservative approach is better for s...
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Acupuncture for Pediatric Sickle Cell Pain Management: A Promising Non-Opioid Therapy

The objective of this study is to describe the use of acupuncture for pain management in children with sickle cell disease. 

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IL-4 Induces M2 Macrophages to Produce Sustained Analgesia Via Opioids

IL-4 is a pleiotropic antiinflammatory cytokine, which can be neuroprotective after nervous system injury. The beneficial actions of IL-4 are thought to result from the blunting of action of inflammatory mediators, such ...
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Association of Opioid Use with Pain and Satisfaction After Dental Extraction

Dentists commonly prescribe opioids to relieve pain after tooth extraction. Understanding the differences in patient-reported outcomes between opioid users and nonusers could encourage the adoption of more conservative a...
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Smartphone Use and Primary Headache

The objective of this study is to determine the association of smartphone use with occurrence of new-onset headache and/or increased severity of headaches in patients with primary headache.  Read the abstract . ...
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Behavioral Activation and Behavioral Inhibition: An Examination of Function in Chronic Pain

The objective of the study was to examine the BIS-BAS model of chronic pain. This model posits that 2 neurophysiological systems-the behavioral inhibition system (BIS) sensitized to and activated by punishment cues and t...
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Depression and Functional Outcomes in Patients Presenting to the Emergency Department With Low Back Pain

Low back pain (LBP) is a common reason for patients to present to Emergency Departments (EDs). Our objective was to describe the associations between depressive symptoms, pain severity, and functional impairment up to 3 ...
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Improving Osteoarthritis Care by Digital Means - Effects of a Digital Self-Management Program after 24- or 48-Weeks of Treatment.

Osteoarthritis (OA) is highly prevalent in older adults and a growing cause of disability. Easily accessible first-line treatment of OA is increasingly important. Digital self-management programs have in recent years bec...
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Associations Between Stopping Prescriptions for Opioids, Length of Opioid Treatment, and Overdose or Suicide Deaths in US Veterans: Observational Evaluation

The objective of this study is to examine the associations between stopping treatment with opioids, length of treatment, and death from overdose or suicide in the Veterans Health Administration.  Read the abstract ....
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Can Pain Management be Safely Optimized in Older Adults?

Managing chronic pain is a challenging task. Older adults (OAs) (>65 years) are the fastest growing segment of our population, and are substantially affected by chronic pain of various etiologies. Read the abstract .&...
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3D Printed Opioid Medicines with Alcohol-Resistant and Abuse-Deterrent Properties

In the past decade, prescriptions for opioid medicines have been exponentially increasing, instigating opioid abuse as a global health crisis associated with high morbidity and mortality. Read the abstract . 
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Let It Be: Mindful Acceptance Down-Regulates Pain and Negative Emotion

Mindfulness training ameliorates clinical and self-report measures of depression and chronic pain, but its use as an emotion regulation strategy—in individuals who do not meditate—remains understudied. Read the abstract ...
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Quality Improvement in Dementia Care

The Dementia Management Quality Measurement Set was first developed and released in 2013 by the PCPI Foundation. Developed by an appointed multistakeholder technical expert panel (TEP), the 2013 Measurement Set was suppo...
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Association of Tramadol Use with Risk of Hip Fracture

Several professional organizations have recommended tramadol as one of the first-line or second-line therapies for patients with chronic noncancer pain and its prescription has been increasing rapidly worldwide; however, the safety profile of tramadol, such as risk of fracture, remains unclear.

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T'ai Chi for Chronic Low Back Pain in Older Adults: A Feasibility Trial

T'ai chi (TC) has been found effective for improving chronic low back pain. However, such studies did not include adults over 65 years of age. This study was designed to evaluate the feasibility and acceptability of TC in this population compared with Health Education and with Usual Care.

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Efficacy, Safety, and Acceptability of Pharmacologic Treatments for Pediatric Migraine Prophylaxis: A Systematic Review and Network Meta-Analysis

 What are the most effective, safe, and accepted pharmacologic treatments for migraine prophylaxis in children and adolescents?

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Does Vitamin D Status Influence Lumbar Disc Degeneration and Low Back Pain in Postmenopausal Women? A Retrospective Single-Center Study

The objective of this study was to investigate the relationship between serum vitamin D concentration and lumbar disc degeneration (LDD) in postmenopausal women and the epidemiologic factors affecting low back pain (LBP). 

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Cost-Effectiveness Model Shows Superiority of Wireless Spinal Cord Stimulation Implantation Without a Separate Trial

The authors in this study evaluated the cost-effectiveness of wireless spinal cord stimulation (Wireless SCS) with single stage "direct to permanent" implantation vs. screening with temporary electrodes and an external pulse generator followed by implantation of a system for long-term use (IPG SCS). 

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Cutaneous Nerve Fields of the Anteromedial Lower Limb-Determination With Selective Ultrasound-Guided Nerve Blockade

This study aimed to determine the peripheral cutaneous nerve fields (CNF), their variability, and potential overlap by selectively blocking the intermediate (IFCN) and medial (MFCN) femoral cutaneous nerves and the infrapatellar branch of the saphenous nerve (IPBSN) in healthy volunteers.

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Magnetic Resonance Imaging of Neuroinflammation in Chronic Pain: A Role for Astrogliosis?

Non-invasive measures of neuroinflammatory processes in humans could substantially aid diagnosis and therapeutic development for many disorders, including chronic pain. Several proton Magnetic Resonance Spectroscopy (H-M...
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A Systematic Review of the Evidence for the Efficacy of Opioids for Chronic Non-Cancer Pain in Community-Dwelling Older Adults

The ageing global population and concomitant increase in the use of opioid analgesia have highlighted the need to evaluate the effectiveness of opioids for chronic pain in older people.

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Perturbing the Activity of the Superior Temporal Gyrus During Pain Encoding Prevents the Exaggeration of Pain Memories: A Virtual Lesion Study Using Single-Pulse Transcranial Magnetic Stimulation

Past studies have shown that pain memories are often inaccurate, a phenomenon known as mnemonic pain bias. Pain memories are thought to play an important role on how future pain is felt. Recent evidence from our laborato...
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Does Experimentally Induced Pain-Related Fear Influence Central and Peripheral Movement Preparation in Healthy People and Low Back Pain Patients?

Non-specific chronic low back pain (CLBP) is a multifactorial disorder. Pain-related fear and altered movement preparation are considered to be key factors in the chronification process. Interactions between both have be...
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Evaluation and Treatment Patterns of New Low Back Pain Episodes for Elderly Adults in the United States, 2011–2014

New low back pain (LBP) is a common outpatient complaint. Little is known about how care is delivered over the course of a year to patients who develop new LBP and whether such care patterns are guideline-concordant.

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Preemptive Pain Management Program Is Associated with Reduction of Opioid Prescriptions After Benign Minimally Invasive Foregut Surgery

The opioid crisis is partly due to opioids prescribed after elective surgery. This study sought to determine if a preemptive pain-management program would be associated with opioid-free discharge after benign foregut surgery.

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Neural and Sociocultural Mediators of Ethnic Differences in Pain

Understanding ethnic differences in pain is important for addressing disparities in pain care. A common belief is that African Americans are hyposensitive to pain compared to Whites, but African Americans show increased ...
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Call for Late-Breaking Poster Abstracts Live through January 6, 12 pm CT

Submit late-breaking scientific poster abstracts for possible publication Pain Medicine and presentation at the AAPM 36th Annual Meeting, February 27-March 1, 2020, in National Harbor, MD. 

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Trends in Prescription Analgesic Use Among Adults With Musculoskeletal Conditions in the United States, 1999-2016

Monitoring trends in prescription analgesic use among adults with musculoskeletal conditions provides insight into how changing prescribing practices, guidelines, and policy measures may affect those who need pain management. 

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The Association of Early Life Stressors with Pain Sensitivity and Pain Experience at 22 Years

Early life stress (ELS) can significantly influence biological pathways associated with nociception, increasing vulnerability to future heightened pain sensitivity and subsequent risk of pain events. However, very little...
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Neurostimulation Methods in the Treatment of Chronic Pain

Abstract:  The goal of this narrative review was to give an up-to-date overview of the peripheral and central neurostimulation methods that can be used to treat chronic pain. Special focus has been given to three pa...
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Treatment Patterns and Medication Use in Patients with Postherpetic Neuralgia

Postherpetic neuralgia (PHN) is a chronic, painful condition characterized by persistent pain following resolution of a herpes zoster (HZ) infection. Epidemiologic data demonstrate that the risks for HZ infections and the development of PHN increase with age.

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Are Perioperative Interventions Effective in Preventing Chronic Pain After Primary Total Knee Replacement? A Systematic Review

For many people with advanced osteoarthritis, total knee replacement (TKR) is an effective treatment for relieving pain and improving function. Features of perioperative care may be associated with the adverse event of c...
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Tonic Suppression of the Mesolimbic Dopaminergic System by Enhanced Corticotropin-Releasing Factor Signaling Within the Bed Nucleus of the Stria Terminalis in Chronic Pain Model Rats

Although dysfunction of the mesolimbic dopaminergic system has been implicated in chronic pain, the underlying mechanisms remain to be elucidated. We hypothesized that increased inhibitory inputs to the neuronal pathway ...
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Spinal Cord Stimulation Failure: Evaluation of Factors Underlying Hardware Explantation

Spinal cord stimulation has been shown to improve pain relief and reduce narcotic analgesic use in cases of complex refractory pain syndromes. However, a subset of patients ultimately undergoes removal of the spinal cord...
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Self-Motion Perception Is Sensitized in Vestibular Migraine: Pathophysiologic and Clinical Implications

Vestibular migraine (VM) is the most common cause of spontaneous vertigo but remains poorly understood. We investigated the hypothesis that central vestibular pathways are sensitized in VM by measuring self-motion percep...
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Headache in Petrous Apicitis: A Case Report of Chronic Migraine-like Headache Due to Peripheral Pathology

 AbstractObjective: To report a case of petrous apicitis that manifested as chronic migraine without aura and to discuss the pathophysiological mechanisms behind this presentation. Background:Petrous apicitis is a r...
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An Evolutionary Medicine Perspective on Pain and Its Disorders

Abstract: Enormous progress in understanding the mechanisms that mediate pain can be augmented by an evolutionary medicine perspective on how the capacity for pain gives selective advantages, the trade-offs that shaped t...
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Euphorbia Bicolor (Euphorbiaceae) Latex Phytochemicals Induce Long-Lasting Non-Opioid Peripheral Analgesia in a Rat Model of Inflammatory Pain

The negative side effects of opioid-based narcotics underscore the search for alternative non-opioid bioactive compounds that act on the peripheral nervous system to avoid central nervous system-mediated side effects. Th...
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Rethinking Opioid Dose Tapering, Prescription Opioid Dependence, and Indications for Buprenorphine

The expanded use of opioids for chronic pain has created a population of patients prescribed long-term opioid therapy lasting years or decades. Doses are often above the thresholds suggested in the 2016 Centers for Disea...
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The Fear Reduction Exercised Early (FREE) Approach to Management of Low Back Pain in General Practice: A Pragmatic Cluster-Randomized Controlled Trial

Effective and cost-effective primary care treatments for low back pain (LBP) are required to reduce the burden of the world's most disabling condition. This study aimed to compare the clinical effectiveness and cost-effectiveness of the Fear Reduction Exercised Early (FREE) approach to LBP (intervention) with usual general practitioner (GP) care (control).

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A Cell-Penetrating Scorpion Toxin Enables Mode-Specific Modulation of TRPA1 and Pain

TRPA1 is a chemosensory ion channel that functions as a sentinel for structurally diverse electrophilic irritants. Channel activation occurs through an unusual mechanism involving covalent modification of cysteine residu...
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Mortality After Discontinuation of Primary Care–Based Chronic Opioid Therapy for Pain: A Retrospective Cohort Study

 Despite known risks of using chronic opioid therapy (COT) for pain, the risks of discontinuation of COT are largely uncharacterized. The objective of this study was to evaluate mortality, prescription opioid use, and primary care utilization of patients discontinued from COT, compared with patients maintained on opioids.

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Facial Presentations of Migraine, TACs, and Other Paroxysmal Facial Pain Syndromes

The objective of this study was to assess the prevalence of facial pain (V2 and/or V3) presentations among nearly 3,000 patients with headache treated in a university tertiary care center.

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Prospective Cohort Study of Caffeinated Beverage Intake as a Potential Trigger of Headaches Among Migraineurs

 The purpose of the study was to evaluate the role of caffeinated beverage intake as a potential trigger of migraine headaches on that day or on the following day.

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Ketamine Infusion for Pain Control in Elderly Patients with Multiple Rib Fractures: Results of a Randomized Controlled Trial

Abstract: INTRODUCTION: Rib fractures are associated with increased mortality, particularly in the elderly. While opiate-based pain regimens remain the cornerstone of rib fracture management, issues related to opioids ha...
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Pain Neurology

Abstract: Pain is often the initial complaint for which patients seek medical care presenting both a diagnostic and therapeutic challenge to the primary care provider. The appreciation of pain is not merely the result of...
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Remote Surveillance Technologies: Realizing the Aim of Right Patient, Right Data, Right Time

Abstract: The convergence of multiple recent developments in health care information technology and monitoring devices has made possible the creation of remote patient surveillance systems that increase the timeliness and quality of patient care. More convenient, less invasive monitoring devices, including patches, wearables, and biosensors, now allow for continuous physiological data to be gleaned from patients in a variety of care settings across the perioperative experience. These data can be bound into a single data repository, creating so-called data lakes. The high volume and diversity of data in these repositories must be processed into standard formats that can be queried in real time. These data can then be used by sophisticated prediction algorithms currently under development, enabling the early recognition of patterns of clinical deterioration otherwise undetectable to humans.

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