Is central sensitisation really a thing?
It seems odd to me that there’s much argument about central sensitisation in pain circles. I thought the idea of central sensitisation was well-established based on research from some years ago – but apparently there are still arguments about its relevance, and lots of debate about how to identify it clinically. This post is based mainly on a presentation by Jo Nijs from Pain in Motion, at the recent NZ Pain Society meeting in Nelson. In this post I want to briefly review the material presented by Jo suggesting that central sensitisation is a thing. I’ll write more about assessment in a future blog, or this post will be the longest ever! Firstly, what is it and why should it matter? Researchers have long been aware that when a nerve is repeatedly stimulated, in future stimulation it will respond for longer and with more intensity – this is called long-term potentiation. Recently, the contribution of glial cells to this situation has been identified (remember glia? Those little cells whose purpose no-one really knew? Turns out they release gliotransmitters that circulate throughout the spinal cord and allow information to be transmitted widely, far from the original source of stimulation – see Kronschlager, Drdla-Schutting, Gassner, Honsek et al, (2016). Glial cells occur widely throughout the central nervous system, and while LTP is a process we’ve known about in the CNS for some time – we’ve known because this is how “mem...
Conclusion: Results concerning muscle dysfunction in smokers are divergent, since some studies have shown worse results in a variety of muscle strength variables in smokers compared with nonsmoking controls, whereas other studies have not. Moreover, there is rather preliminary evidence indicating worse muscle dysfunction and lower CSA in patients with mild COPD in comparison with healthy (or non-COPD) smokers.
Hi everyone. Long time lurker here. I'm aware I can search the forums and I have but some of the information is somewhat dated, in particular software. I am planning to open a new pain practice and would appreciate some advice if any of you who own or run a pain practice can provide some answers What EMR system are you using and what are they charging? Kareo, Athena? Others? Does it do it all? Scheduling, charting, billing? What do you like about it or not like about it? What do you use... new practice questions
Reactive arthritis, also known as Reiter syndrome, is a spondyloarthropathy that typically follows a urogenital or gastrointestinal infection, and is characterized by conjunctivitis, urethritis, and arthritis. The frequency of reactive arthritis in the United States is estimated at 3.5 to 5 patients per 100,000. Physician assistants (PAs) can manage the condition; therefore, they should be familiar with the disease's signs and symptoms, diagnostic criteria, and treatment regimens. Without proper management, reactive arthritis can progress to a chronic destructive arthritis. Prompt recognition of the condition is key to ear...
Abdominal wall endometriosis is ectopic endometrial tissue in the abdominal wall. Consider this condition in any woman presenting with chronic abdominal pain and a surgical history significant for exposure of the abdominal cavity to the endometrial canal. The diagnosis can be suspected with accurate history taking and a thorough physical examination. In patients with suspected abdominal wall endometriosis, MRI is the imaging study of choice and complete surgical resection is the treatment of choice.
UCLA has received a $10 million gift fromThe Eli and Edythe Broad Foundation to fund education, faculty recruitment and retention, and innovative research at the campus ’s stem cell research center. The foundation also announced $10 million gifts to the Broad family’s namesake stem cell research centers UC San Francisco and the University of Southern California, bringing its total support of stem cell research centers in California to $110 million since 2005. “We are proud to support California’s growing stem cell research and treatment infrastructure led by the talented sci...
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Conclusion. Our study identifies the various factors associated with a lower likelihood of RTW at 3 months after cervical spine surgery in the non-worker's compensation setting. This information provides expectations for the patient and employer when undergoing cervical spine surgery. Level of Evidence: 3
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