No abstract

Background Fear and anxiety are important considerations in both acute and chronic pain. Effectively and efficiently measuring fear and anxiety associated with pain in healthcare settings is critical for identifying vulnerable patients. The length and administration time of current measures of pain‐related fear and anxiety inhibit their routine use, as screening tools and otherwise, suggesting the need for a shorter, more efficient instrument. Methods A 9‐item shortened version of the Fear of Pain Questionnaire – III ( FPQ ‐ III ), the Fear of Pain Questionnaire‐9 ( FPQ ‐9), was developed based upon statistical analyses of archival data from 275 outpatients with chronic pain and 275 undergraduates. Additionally, new data were collected from 100 outpatients with chronic pain and 190 undergraduates to directly compare the standard and short forms. Exploratory and confirmatory factor analyses, and other psychometric analyses, were conducted to examine and establish the FPQ ‐9 as a reliable and valid instrument. Results The original three‐factor structure of the FPQ ‐ III was retained in the shortened version; a confirmatory factor analysis produced good model fit ( RMSEA = 0.00, CFI = 1.00, TLI = 1.00, SRMR = 0.03). Results suggested a high degree of correlation between the original FPQ ‐ III and the new FPQ ‐9 ( r = 0.77, p < 0.001). Measures of internal consistency for FPQ ‐9 subscales were high; correlations with other pain and anxiety instruments suggested concurrent, convergent and divergent validity. Conclusions The FPQ ‐9 is a psychometrically sound alternative to longer instruments assessing fear and anxiety associated with pain, for use in both clinical and research situations that only allow brief screening. Significance The FPQ ‐9 has considerable potential for dissemination and utility for routine, brief screening, given its length (completion time ~2 min; scoring time ~1 min), reading level and psychometric properties.

No abstract

Background: Spinal cord stimulation (SCS) is an established treatment option for chronic pain. Prior to permanent implantation, temporary trials are performed to evaluate the SCS treatment. Currently there are multiple manufacturers with varying fundamental differences in delivery and resultant paresthesias. However, trials are typically limited to one manufacturer for the patient to evaluate. Objective: To evaluate the role of the Observational Mechanical Gateway (OMG) Connector for patients undergoing SCS trials. Study Design: Retrospective cohort design study. Patients undergoing SCS trials were offered at the end of the 7 day trial to experience stimulation using the OMG Connector. Setting: Academic university-based pain management center. Method: Participants were trialed using the OMG Connector at the end of the 7 day spinal cord stimulation trial. Data based on participants’ preference were collected. Results: The average pain score at baseline was 7.3 on a 10-point scale overall, with improvement during the SCS trial to 2.9 overall; 3.5 in Medtronic (MT); and 2.4 in St. Jude (SJ) SCS trials (P = 0.04). The average pain score with OMG was 2.6 overall; 2.8 in MT; and 2.4 in SJ (P = 0.28). In terms of overall coverage of pain distribution, paresthesia and overall satisfaction, the P values were 0.24, 0.21 and 0.33 respectively. Overall, 12 of 16 participants underwent permanent implantation. One of the 4 failed trials was successfully retrialed with the OMG Connector. Limitations: Small sample of participants and the duration of the OMG Connector trial. Conclusions: The OMG Connector offers patients another opportunity to better access the available treatment options during the SCS trial period. Key words: Spinal cord stimulation, OMG Connector, paresthesia, neurostimulation, constant current, constant voltage, chronic pain, dorsal column

Lower Back Pain is one of the leading causes of disability globally. Its degradation to patients’ standing stability has been reported in the past. The goal of the current study was to evaluate the influence of immediate pain relief enabled by a lumbar facet joint anesthetic injection on patients’ standing stability. A total of 91 chronic LBP patients were recruited, each patient performed standing balance tests both before and after a lumbar facet nerve block treatment while their dynamic center of pressure data were recorded and compared. Results of our study showed that after the injection, participants showed 10% smaller total excursion and up to 30% smaller sway area. These results suggested patients’ balance might be used as an objective measurement to evaluate pain reduction among LBP patients.