Poststroke pain - but multiple pain mechanisms.

A 42-year-old man presented with acute left hemiplegia due to a right frontotemporal hemorrhagic stroke and left-sided pain. While the initial presentation suggested central poststroke pain, subsequent investigations also implicated heterotopic ossification of the left hip and amplification of previous low back pain by the new central pain. While heterotopic ossification has been commonly associated with brain injury, spinal cord injury or osseous injury, it is only rarely associated with stroke.

Epidemiologic perspective on chronic pain treatment.

Objective: To review the epidemiologic literature concerning psychosocial mediators of outcome in chronic pain. These factors deserve attention in the assessment and treatment of chronic pain by mental health professionals.

Method: We reviewed literature dealing with epidemiologic perspectives on abuse, depression, addiction, employment, coping skills, and psychosocial problems.

Epidemiology of chronic pain with psychological comorbidity: prevalence, risk, course, and prognosis.

Objective: To review the relation between chronic pain and psychological comorbidities, and the influence on course and prognosis, based on epidemiologic and population studies.

Method: We present a narrative overview of studies dealing with the epidemiology of chronic pain associated with mental health and psychiatric factors. Studies were selected that were of good quality, preferably large studies, and those that dealt with prevalences, course and prognosis of chronic pain, risk factors predicting new pain and comorbid disorders, and factors that affect health outcomes.

Psychological approaches in the treatment of chronic pain patients--when pills, scalpels, and needles are not enough.

Background: Chronic pain is a prevalent and costly problem that eludes adequate treatment. Persistent pain affects all domains of people's lives and in the absence of cure, success will greatly depend on adaptation to symptoms and self-management.

Method: We reviewed the psychological models that have been used to conceptualize chronic pain-psychodynamic, behavioural (respondent and operant), and cognitive-behavioural.

Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects.

Background: Chronic noncancer pain (CNCP) is a major health problem, for which opioids provide one treatment option. However, evidence is needed about side effects, efficacy, and risk of misuse or addiction.

Methods: This meta-analysis was carried out with these objectives: to compare the efficacy of opioids for CNCP with other drugs and placebo; to identify types of CNCP that respond better to opioids; and to determine the most common side effects of opioids.

The effect of low-intensity pulsed ultrasound therapy on time to fracture healing: a meta-analysis.

Background: The effect of low-intensity ultrasonography on fracture healing is controversial, and current management of fractures does not generally involve the use of ultrasound therapy. We describe a systematic review and meta-analysis of randomized controlled trials of low-intensity pulsed ultrasound therapy for healing of fractures.

Methods: We searched 5 electronic databases (MEDLINE, EMBASE, Cochrane Database of Randomised Clinical Trials, HealthSTAR and CINAHL) for trials of ultrasonography and fracture healing, in any language, published from 1966 to December 2000.

The Meaning of Illness Questionnaire: further evidence for its reliability and validity.

Cognitive appraisal processes or the meaning a person gives a stressful event are believed to mediate an individual's reaction to an event and, as such, have been demonstrated to explain adjustment to illness. The purpose of this paper is to test this cognitive as well as other social and illness variables to explain the variance in a person's adjustment to chronic pain. Two hundred and twenty-two patients, who were randomly selected from an original sample of referrals to a chronic pain specialty clinic, completed a questionnaire by telephone interview or mail.

An epidemiological follow-up survey of persistent pain sufferers in a group family practice and specialty pain clinic.

The course and prognosis of persistent pain are largely unknown. In addition, follow-up studies of chronic pain sufferers have come from specialized pain clinics and have ignored the question of how representative this special group is to the general population who suffer persistent pain. Because health care planners are assumed to require these data for projection of health care needs, it is important to determine the course of persistent pain in those persistent pain sufferers in the general population as well as those referred to a specialty clinic.

Coping with persistent pain: a comparison of persistent pain sufferers in a specialty pain clinic and in a family practice clinic.

Coping has been defined as an effort to manage external and internal demands and conflicts that tax or exceed a person's resources. This paper examines the types of coping strategies used by two groups of persistent pain sufferers: one from a family practice clinic and the other from a specialty pain clinic. The relationship between the use of different types of coping strategies and adjustment was determined.

Tender points in fibromyalgia.

To establish inter-rater and test-retest reliability of use of a pressure algometer, 5 males and 5 females suffering from chronic fibromyalgia ('fibrositis'), and a normal group of 5 males and 5 females, were examined 2 times by each of 2 independent examiners, using 1 kg/sec rate of application, over 10 paired and typical 'tender points,' localized by skin marker. Tenderness thresholds of tender points were coded and analyzed using repeated measures ANOVA, for factors sex, normal/fibromyalgia, and side, rater, and time 1/time 2. There was significantly lower tenderness thresholds of tender points in fibromyalgia compared to normal subjects.