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  • 1
    Online Resource
    Online Resource
    An Interventional Response Phenotyping Study in Chronic Low Back Pain: Protocol for a Mechanistic Randomized Controlled Trial
    Oxford University Press (OUP) ; 2023
    In:  Pain Medicine Vol. 24, No. Supplement_1 ( 2023-08-04), p. S126-S138
    Details
    In: Pain Medicine, Oxford University Press (OUP), Vol. 24, No. Supplement_1 ( 2023-08-04), p. S126-S138
    Abstract: Evidence-based treatments for chronic low back pain (cLBP) typically work well in only a fraction of patients, and at present there is little guidance regarding what treatment should be used in which patients. Our central hypothesis is that an interventional response phenotyping study can identify individuals with different underlying mechanisms for their pain who thus respond differentially to evidence-based treatments for cLBP. Thus, we will conduct a randomized controlled Sequential, Multiple Assessment, Randomized Trial (SMART) design study in cLBP with the following three aims. Aim 1: Perform an interventional response phenotyping study in a cohort of cLBP patients (n = 400), who will receive a sequence of interventions known to be effective in cLBP. For 4 weeks, all cLBP participants will receive a web-based pain self-management program as part of a run-in period, then individuals who report no or minimal improvement will be randomized to: a) mindfulness-based stress reduction, b) physical therapy and exercise, c) acupressure self-management, and d) duloxetine. After 8 weeks, individuals who remain symptomatic will be re-randomized to a different treatment for an additional 8 weeks. Using those data, we will identify the subsets of participants that respond to each treatment. In Aim 2, we will show that currently available, clinically derived measures, can predict differential responsiveness to the treatments. In Aim 3, a subset of participants will receive deeper phenotyping (n = 160), to identify new experimental measures that predict differential responsiveness to the treatments, as well as to infer mechanisms of action. Deep phenotyping will include functional neuroimaging, quantitative sensory testing, measures of inflammation, and measures of autonomic tone.
    Type of Medium: Online Resource
    ISSN: 1526-2375 , 1526-4637
    URL: Article
    DOI: 10.1093/pm/pnad005
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2023869-1
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  • 2
    Online Resource
    Online Resource
    Clinical predictors of the medical interventions provided to patients with low back pain in the emergency department
    IOS Press ; 2018
    In:  Journal of Back and Musculoskeletal Rehabilitation Vol. 31, No. 1 ( 2018-02-06), p. 197-204
    Details
    In: Journal of Back and Musculoskeletal Rehabilitation, IOS Press, Vol. 31, No. 1 ( 2018-02-06), p. 197-204
    Type of Medium: Online Resource
    ISSN: 1878-6324 , 1053-8127
    URL: Article
    DOI: 10.3233/BMR-170806
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2018
    detail.hit.zdb_id: 2029336-7
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  • 3
    Online Resource
    Online Resource
    Osteopathic Approach to Sacroiliac Dysfunction in a Patient With Steroid Myopathy: Case Report and Literature Review
    Walter de Gruyter GmbH ; 2014
    In:  Journal of Osteopathic Medicine Vol. 114, No. 6 ( 2014-06-01), p. 498-504
    Details
    In: Journal of Osteopathic Medicine, Walter de Gruyter GmbH, Vol. 114, No. 6 ( 2014-06-01), p. 498-504
    Abstract: Long-term steroid use has a well-documented risk of myopathy that imposes functional limitations for patients and challenges for health care providers. Proximal weakness from steroid myopathy affects support structures around the pelvic girdle and likely predisposes patients to somatic dysfunction. To the authors' knowledge, there are no prior reports in the literature that describe an osteopathic manipulative medicine (OMM) approach for patients with steroid myopathy. In the present case report, a 59-year-old woman with acute myeloid leukemia received a blood stem cell transplantation and developed gastrointestinal graft-versus-host disease. High-dose steroids were prescribed, and she developed proximal weakness from steroid myopathy. The patient's acute inpatient rehabilitation was impacted by new onset left sacroiliac dysfunction. A patient-focused OMM approach was used to assist the patient in maximizing her sacroiliac function. The proximal weakness seen with steroid myopathy necessitates special considerations for an OMM approach to address somatic dysfunction associated with this disease.
    Type of Medium: Online Resource
    ISSN: 2702-3648
    URL: Article
    DOI: 10.7556/jaoa.2014.100
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2014
    detail.hit.zdb_id: 3045278-8
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  • 4
    Online Resource
    Online Resource
    Case Report: A Manual Medicine Approach to Sacroiliac Dysfunction in a Patient with Steroid Myopathy
    Wiley ; 2013
    In:  PM&R Vol. 5, No. 9S ( 2013-09)
    Details
    In: PM&R, Wiley, Vol. 5, No. 9S ( 2013-09)
    Type of Medium: Online Resource
    ISSN: 1934-1482 , 1934-1563
    URL: Article
    DOI: 10.1016/j.pmrj.2013.08.362
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2480906-8
    SSG: 31
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  • 5
    Online Resource
    Online Resource
    The impact of nociplastic pain features on the response to physical therapy in patients with primary myofascial pain
    IOS Press ; 2022
    In:  Journal of Back and Musculoskeletal Rehabilitation Vol. 35, No. 5 ( 2022-09-02), p. 1143-1151
    Details
    In: Journal of Back and Musculoskeletal Rehabilitation, IOS Press, Vol. 35, No. 5 ( 2022-09-02), p. 1143-1151
    Abstract: BACKGROUND: Myofascial pain is a common, but poorly understood multifactorial condition. OBJECTIVE: This study analyzed how the degree of central sensitization (nociplastic pain) can impact the response to physical therapy for patients with myofascial pain. METHODS: This prospective, observational cohort study compared pain phenotyping and functional measures in 30 participants with non-acute neck/shoulder girdle primary myofascial pain following 3-months of physical therapy. The Fibromyalgia Survey Questionnaire Score served as a surrogate of central sensitization. RESULTS: All participants demonstrated some benefit from physical therapy; however, those with moderate levels of nociplastic pain features were less likely to have clinically significant improvements on the Neck Disability Index, PEG score, or pain catastrophizing measures. Those with higher levels of nociplastic pain had a similar chance of showing improvement as those with lower levels, except regarding catastrophizing. Significant improvements were independent of the type or amount of therapy received. CONCLUSION: The degree of nociplastic pain in patients with myofascial pain appears to be inversely related to improvements from a peripherally based treatment. This is not to say that individuals with moderate to higher levels of nociplastic pain do not benefit from physical therapy, but they proportionally benefit less.
    Type of Medium: Online Resource
    ISSN: 1878-6324 , 1053-8127
    URL: Article
    DOI: 10.3233/BMR-210244
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2022
    detail.hit.zdb_id: 2029336-7
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  • 6
    Online Resource
    Online Resource
    Initial validation of the electronic form of the Michigan Body Map
    BMJ ; 2020
    In:  Regional Anesthesia & Pain Medicine Vol. 45, No. 2 ( 2020-02), p. 145-150
    Details
    In: Regional Anesthesia & Pain Medicine, BMJ, Vol. 45, No. 2 ( 2020-02), p. 145-150
    Abstract: The Michigan Body Map (MBM) was developed to assess pain location in a reliable and valid manner; however, electronic formats have not been validated. This study had two aims: (1) initial validation of the electronic form of the MBM (eMBM) and (2) preliminary test of assessing pain severity within body zones. Methods For the first aim, 68 participants with chronic pain completed paper and electronic forms of the MBM, then underwent scripted interviews to assess preferences among body maps and verbal confirmation of pain locations. For the second aim, a subset of the participants (n=40) completed the Brief Pain Inventory (BPI) pain severity subscale, as well as the eMBM again and endorsed pain severity using additional screens showing body zones that contained areas in which pain was endorsed. Results There were few discrepancies between MBM, eMBM and verbal report (1.9% and 1.6%, respectively), and no difference between forms in perceived ability to indicate areas of pain or ease of completion. Patients accurately indicated their bodily pain on both maps, with 84% and 87% reporting one or no errors on MBM and eMBM, respectively. Participants also reported no preference for which version best-depicted areas of pain or best distinguished left from right. Lastly, the most preferred measure was eMBM with pain severity zones, followed by eMBM without zones, followed by the BPI pain severity subscale. Conclusions These data support the validity of the eMBM for patients with chronic pain. Further, an expanded form of the eMBM that assesses pain severity was preferred by most participants.
    Type of Medium: Online Resource
    ISSN: 1098-7339 , 1532-8651
    URL: Article
    DOI: 10.1136/rapm-2019-101084
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2028901-7
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  • 7
    Online Resource
    Online Resource
    Interventional Spine Considerations for Radiosensitivity in a Patient with Ligase IV Syndrome
    American Society of Interventional Pain Physicians ; 2020
    In:  Pain Management Case Reports
    Details
    In: Pain Management Case Reports, American Society of Interventional Pain Physicians
    Abstract: Background: Patient selection plays a critical role in any interventional pain practice. Rare conditions may not always have clearly established guidelines for interventional pain procedures. Ligase IV (LIG4) syndrome is a rare inherited condition with a wide variety of features, including radiosensitivity.. Case Report: A 36-year-old woman with a known history of LIG4 syndrome presented with an acute on chronic left L5 and S1 radiculopathy from a large L5-S1 central disc herniation. In an effort to minimize radiation exposure, an ultrasound (US)-guided caudal epidural steroid injection was used to help manage her radicular leg pain. Conclusion: Interventional spine providers should be aware of rare radiosensitive conditions and strive to offer appropriate treatment alternatives. While limitations do exist, emerging US-guide spine procedures hold a distinct advantage for patients with radiosensitivities. Key words: Epidural steroid injection, Ligase IV syndrome, radiculopathy, radiology, radiosensitivity, ultrasound
    Type of Medium: Online Resource
    ISSN: 2575-9841
    URL: Journal
    URL: Article
    DOI: 10.36076/pmcr
    DOI: 10.36076/pmcr.2020/4/135
    Language: English
    Publisher: American Society of Interventional Pain Physicians
    Publication Date: 2020
    detail.hit.zdb_id: 3018839-8
    detail.hit.zdb_id: 3018840-4
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  • 8
    Online Resource
    Online Resource
    Relationships Between Clinical Predictors and the Medical Interventions Provided to Patients with Low Back Pain in the Emergency Department
    Wiley ; 2013
    In:  PM&R Vol. 5, No. 9S ( 2013-09)
    Details
    In: PM&R, Wiley, Vol. 5, No. 9S ( 2013-09)
    Type of Medium: Online Resource
    ISSN: 1934-1482 , 1934-1563
    URL: Article
    DOI: 10.1016/j.pmrj.2013.08.511
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2480906-8
    SSG: 31
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  • 9
    Online Resource
    Online Resource
    The Effects of a Pain Psychology and Neuroscience Self-Evaluation Internet Intervention : A Randomized Controlled Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  The Clinical Journal of Pain Vol. 36, No. 9 ( 2020-09), p. 683-692
    Details
    In: The Clinical Journal of Pain, Ovid Technologies (Wolters Kluwer Health), Vol. 36, No. 9 ( 2020-09), p. 683-692
    Abstract: Many patients’ chronic musculoskeletal pain is strongly influenced by central nervous system processes such as sensitization or amplification. Education about pain neuroscience can change patients’ beliefs but has less consistent effects on pain outcomes. Patients may have greater clinical benefits if the educational intervention is personalized, and they evaluate various psychosocial risk factors with respect to their pain. We developed and tested a brief, internet-based Pain Psychology and Neuroscience (PPN) self-evaluation intervention. Materials and Methods: From a patient registry, 104 adults reporting chronic musculoskeletal pain were randomized to the PPN intervention or a matched, active, education control condition. At baseline and 1-month (primary endpoint) and 10-month follow-ups, participants reported pain severity (primary outcome) and multiple secondary outcomes. Primary analyses compared the 2 experimental conditions using analyses of covariances; post hoc exploratory analyses compared the effects of PPN in subgroups of patients who met criteria for fibromyalgia (FM; n=50) or who did not (n=54; primarily spinal pain). Results: At 1-month follow-up, compared with the control condition, PPN led to significantly lower pain severity (η p 2 =0.05) and interference (η p 2 =0.04), greater brain (η p 2 =0.07) and psychological (η p 2 =0.07) attributions for pain, and greater readiness for pain self-management (η p 2 =0.08). Effects on distress, pain catastrophizing, kinesiophobia, and life satisfaction were not significant. Exploratory analyses showed that the PPN intervention was especially beneficial for patients without FM but was of less benefit for those with FM. Most of the effects (except attributions) were lost at 10 months. Discussion: A brief PPN self-evaluation intervention, presented on-line, can yield short-term improvements in musculoskeletal pain severity and interference, especially for people with spinal/localized pain rather than FM, perhaps because the psychology/neuroscience perspective is more novel for such patients.
    Type of Medium: Online Resource
    ISSN: 0749-8047
    URL: Article
    DOI: 10.1097/AJP.0000000000000857
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1497640-7
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  • 10
    Online Resource
    Online Resource
    Interventional and Non-interventional Medical Rehabilitation Approaches to Axial Spine Pain in Vertebral Metastatic Disease
    Frontiers Media SA ; 2021
    In:  Frontiers in Pain Research Vol. 2 ( 2021-6-4)
    Details
    In: Frontiers in Pain Research, Frontiers Media SA, Vol. 2 ( 2021-6-4)
    Abstract: As targeted therapies help patients with advanced cancer live longer, interventions for management of axial spine pain will become more common. Unfortunately, the indications for and safety of these procedures have been relatively unexplored compared with non-cancer adults. This review focuses on the following aspects of axial spine pain management in patients with vertebral metastatic disease: (1) pathophysiology and symptoms of cancer- and non-cancer-related spine pain; (2) safety and efficacy of non-interventional rehabilitation approaches to treat this pain; (3) considerations for interventional pain approaches to acute and chronic pain in patients with vertebral metastatic disease. This review also summarizes gaps in the literature and describes specific cases in which the described interventions have been applied.
    Type of Medium: Online Resource
    ISSN: 2673-561X
    URL: Article
    DOI: 10.3389/fpain.2021.675787
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 3035397-X
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