Effects of Electroacupuncture on Opioid Consumption in Patients with Chronic Musculoskeletal Pain: A Multicenter Randomized Controlled Trial.

Objectives: To evaluate the efficacy and safety of electroacupuncture in reducing opioid consumption in patients with chronic musculoskeletal pain.

Design: A randomized, participant-assessor-blinded, three-arm trial.

Setting: Participants from three pain clinics and from the public.

Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up.

Objectives. This study aimed to evaluate the efficacy and safety of manual acupuncture as a prophylaxis for frequent migraine. Methods.

Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial.

Background: Chronic musculoskeletal pain is common and has been increasingly managed by opioid medications, of which the long-term efficacy is unknown. Furthermore, there is evidence that long-term use of opioids is associated with reduced pain control, declining physical function and quality of life, and could hinder the goals of integrated pain management. Electroacupuncture (EA) has been shown to be effective in reducing postoperative opioid consumption.

Dyskinetic patients show rebound worsening of affect after an acute L-dopa challenge.

Background: Motor response complications that arise with repeated L-dopa administration for the treatment of Parkinson's disease are well understood but the relationship between motor response complications and affect are not. We proposed that patients with dyskinesias would report rebound worsening in affect during wearing-off of L-dopa effect.

Methods: Fifty Parkinson's disease patients with were assessed with the Purdue Pegboard test and rated Positive Affect and Negative Affect after overnight withdrawal of dopaminergic medications and half hourly for 6 h after a standard L-dopa challenge.

The effect of local anaesthetic on age-related capsaicin-induced mechanical hyperalgesia--a randomised, controlled study.

Adults over 65 years exhibit a prolonged punctate hyperalgesia induced by topical application of capsaicin. The aim of this study was to investigate the role of peripheral afferent input in the slowed resolution of punctate hyperalgesia in older people. Twenty young (25.

Do dyskinesia and pain share common pathophysiological mechanisms in Parkinson's disease?

Plastic changes within the striatum resulting from pulsatile dopaminergic stimulation are thought to lead to dyskinesia in patients with Parkinson's disease (PD). The basal ganglia play a role in processing pain. We hypothesized that the plastic changes that lead to dyskinesia may also mediate pain responses.

The prevention and management of herpes zoster.

The burden of illness from herpes zoster (HZ) and postherpetic neuralgia (PHN) in the Australian community is high. The incidence and severity of HZ and PHN increase with age in association with a progressive decline in cell-mediated immunity to varicella-zoster virus (VZV). Antiviral medications (valaciclovir, famciclovir, aciclovir) have been shown to be effective in reducing much but not all of the morbidity associated with HZ and PHN, but are consistently underprescribed in Australia.

The effect of electroacupuncture on opioid-like medication consumption by chronic pain patients: a pilot randomized controlled clinical trial.

Opioid-like medications (OLM) are commonly used by patients with various types of chronic pain, but their long-term benefit is questionable. Electroacupuncture (EA) has been previously shown beneficial in reducing post-operative acute OLM consumption. In this pilot randomized controlled trial, the effect of EA on OLM usage and associated side effects in chronic pain patients was evaluated.

The relationship between medical comorbidity and self-rated pain, mood disturbance, and function in older people with chronic pain.

Background: Aging is associated with greater risk for many illnesses and the prospect of multiple, concurrent disease states. Chronic pain is also very common in advanced age, and there is likely to be a relationship with comorbid burden, but few studies have examined this issue. This study tests the hypothesis that comorbid burden is associated with greater levels of self-reported pain and associated disturbance in mood and function.

Widowhood and other demographic associations of pain in independent older people.

Objectives: To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people.

Design: One thousand older people (65+) randomly selected from independent residents living in a major city were surveyed about their health status (Health Status of Older People Study). Demographic characteristics, including age, gender, education, income, living alone, widowhood, and childlessness, were analyzed by logistic regression for their association with pain report of differing severity.

Age-related differences in the endogenous analgesic response to repeated cold water immersion in human volunteers.

Recent animal studies using stress-induced analgesia have suggested a general age-related decline in endogenous pain inhibitory systems. The aim of the current study was to examine age-related differences in the magnitude of endogenous analgesia in human volunteers, using psychophysical measures of neuroselective electrical, and thermal CO(2) laser induced pain thresholds, before, immediately after and 1 h after repeated cold water immersion of the hand. Sensory detection thresholds did not differ between age groups indicating that the functional integrity of primary afferent sensory fibres appears to be intact in older people.

Cognitive factors and the experience of pain and suffering in older persons.

Cognitive factors are thought to play an important mediational role between pain and consequent levels of suffering, yet there has been little investigation of these issues in older chronic pain patients. The present study sought to examine the reliability and validity of the Pain Locus of Control (PLOC) scale when used with older patients, to explore age differences in PLOC orientation, and examine the relationship between cognitive beliefs and levels of pain and suffering. 169 older patients attending a pain management clinic completed a comprehensive psychometric battery prior to admission.

Free radicals contribute to the reduction in peripheral vascular responses and the maintenance of thermal hyperalgesia in rats with chronic constriction injury.

We previously reported that the time frame and the extent of the changes in the peripheral neurogenic inflammatory response in the skin area, innervated by an injured nerve, coincide with those of pain behaviours. We raised the possibility that common factors might operate to modulate neuropathic pain and peripheral neurogenic processes in rats with chronic constriction nerve injury (CCI). In the present study we examined the role of free radicals in modulating the neurogenic vascular response and thermal hyperalgesia in rats with CCI of the sciatic nerve.

The impact of dementia on the pain experience.

Advancing age is associated with an increased risk of illness. Investigating the influence of ageing on the experience of pain must take account of this association, as well as the impact of past experience of life. Dementia, which is almost exclusively restricted to older people, is an illness where the effects of past experience and future life anticipation are severely curtailed.

Capsaicin-induced flare and vasodilatation in patients with post-herpetic neuralgia.

The aim of the present study was to investigate the role of primary afferent fibres with polymodal nociceptors in the various pain symptoms and signs associated with post-herpetic neuralgia (PHN). Forty-four patients with PHN affecting thoracic dermatomes were examined clinically for evidence of sensory disturbance to touch and pinprick and compared to 14 normal subjects and 9 subjects with evidence of past herpes zoster infection but no pain. The patients were then divided into 3 groups on the basis of their clinical symptoms and signs-those with steady burning discomfort only (n = 12), those with burning discomfort, allodynia and hyperalgesia to pinprick (n = 17), and those with burning discomfort, allodynia and hypalgesia to pinprick (n = 15).

Skin vascular reactivity to the neuropeptide substance P in rats with peripheral mononeuropathy.

A compression neuropathy model that produces pain-related behaviour in rats was used to investigate changes in skin vascular reactivity in the innervated area. Neuropathy was produced by 4 ligatures tied loosely around the common sciatic nerve. Vascular reactivity was assessed via perfusion of the neuropeptide substance P (SP) over the base of a blister raised on the rat foot pad.

Cerebral event-related responses induced by CO2 laser stimulation in subjects suffering from cervico-brachial syndrome.

The present study was undertaken to examine possible changes in subjective appraisal and central nervous system processing, indexed by pain-related cerebral evoked potentials (N290, P400), of incoming noxious information in 20 pain-free control volunteers and 18 subjects suffering from right-side cervico-brachial pain (CBS). Detection threshold and cerebral evoked potentials were recorded in response to noxious CO2 laser stimulation of the right and left hands. The results indicate that when compared to controls, CBS subjects exhibit an elevation in detection threshold intensity and a reduction in the amplitude of the P400 peak following laser stimulation of the pain affected side.

The measurement of capsaicin-sensitive sensory nerve fiber function in elderly patients with pain.

The present study was undertaken to investigate the possible involvement of peripheral nociceptors in 3 diagnostic categories of elderly patients with chronic pain. The 3 diagnostic groups consisted of: chronic lower lumbar pain of degenerative musculoskeletal etiology (LLP), post-herpetic neuralgia (PHN) and pain of non-organic origin in a group with a predominantly psychiatric disorder (PPD). The last group had pain confined to the trunk.