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Journal: Pain practice : the official journal of World Institute of Pain


Chronic non-malignant pain perceived in the pelvic region commonly presents as a diagnostic challenge and is often difficult to manage. Treatment options are delayed as well as limited. The prevalence in the United States and the United Kingdom has been estimated to range from 14.7 % to 24% respectively (1, 2). Common chronic pelvic pain syndromes include interstitial cystitis, chronic prostatitis, coccygodynia, vulvodynia, chronic proctalgia, and pudendal neuralgia. This article is protected by copyright. All rights reserved.

Concepts: United States, United Kingdom, Pain, English language, Radio, Interstitial cystitis, Copyright, Chronic pain syndromes


Results from a phase-3, prospective, randomized, double-blind, placebo-controlled trial evaluating sufentanil sublingual tablet 30 mcg (SST) for the management of pain after ambulatory abdominal surgery are presented.

Concepts: Opioid


The objective of this pilot study was to assess the acceptability and feasibility of using BrightHearts, a biofeedback-assisted relaxation application (app), in children undergoing painful procedures.

Concepts: Pain


Pain is still a burden for many patients with cancer. A recent trial showed superiority of methadone over fentanyl in neuropathic pain, and we expect that this could increase the amount of patients treated with methadone.

Concepts: Head and neck anatomy, Head and neck, Pain, Head and neck cancer, Fentanyl


To compare fibromyalgia (FM) characteristics among patients identified in a community-based chronic pain cohort based on traditional International Classification of Diagnoses Ninth Revision, ICD-9 diagnostic coding, with that of patients identified using a novel predictive model.

Concepts: Medical terms, Diagnosis, Greek loanwords, Chronic pain


Several studies have documented increased cardiovascular risk factors, particularly hypercholesterolemia, in the migraine population with respect to controls. However, no studies have investigated the possible relationship between headache severity parameters and lipid serum levels.

Concepts: Cholesterol, Myocardial infarction, Atherosclerosis, Cardiovascular disease, Intracranial pressure, Paracetamol


Objective:  The objective of this report is to raise awareness of the effect of strenuous yoga flexion exercises on osteopenic or osteoporotic spines. We previously described subjects with known osteoporosis in whom vertebral compression fractures (VCFs) developed after spinal flexion exercise (SFE) and recommended that SFEs not be prescribed in patients with spinal osteoporosis. Methods:  This report describes 3 healthy persons with low bone mass and yoga-induced pain or fracture. Results:  All 3 patients had osteopenia, were in good health and pain-free, and had started yoga exercises to improve their musculoskeletal health. New pain and fracture areas occurred after participation in yoga flexion exercises. Conclusions:  The development of pain and complications with some flexion yoga positions in the patients with osteopenia leads to concern that fracture risk would increase even further in osteoporosis. Although exercise has been shown to be effective for improving bone mineral density and decreasing fracture risk, our subjects had development of VCFs and neck and back pain with yoga exercises. This finding suggests that factors other than bone mass should be considered for exercise counseling in patients with bone loss. The increased torque pressure applied to vertebral bodies during SFEs may be a risk. Exercise is effective and important for treatment of osteopenia and osteoporosis and should be prescribed for patients with vertebral bone loss. Some yoga positions can contribute to extreme strain on spines with bone loss. Assessment of fracture risk in older persons performing SFEs and other high-impact exercises is an important clinical consideration.

Concepts: Osteoporosis, Bone fracture, Bone density, Dual energy X-ray absorptiometry, Exercise, Vertebral column, Compression fracture, Osteopenia


Total hip and knee replacements are common surgeries, and an optimal pain treatment is essential for early rehabilitation. Since data from randomized controlled trails on the use of regional anesthesia in joint replacements of the lower extremities are conflicting, we analyzed the international PAIN OUT registry for comparison of regional anesthesia vs. general anesthesia regarding pain and morphine consumption on the first postoperative day.



Impaired pain inhibitory and enhanced pain facilitatory mechanisms are repeatedly reported in patients with central sensitization pain. However, the exact effects of frequently prescribed opioids on central pain modulation are still unknown.

Concepts: Rheumatoid arthritis, Rheumatology, Opioid, Pain, Morphine, Heroin, Naloxone, Arthritis