Active clinical trials for "Chronic Pain"

This pilot study consists in testing the efficacy of hypnosis as an adjuvant treatment for patients suffering from chronic lumbar pain and for whom a facet block is indicated by a doctor in the Centre d'antalgie of CHUV (Centre Hospitalier Universitaire Vaudois), where this study will take place. 5 to 8 patients will be included in this study. The goals of this study are : Assess the feasibility of such a protocol with more patients Measure the number of patients necessary to obtain a significant result Search for possible side effects of the combination of both treatments Every patient in this pilot study will undergo 4 hypnosis sessions within 2 weeks before the facet block. These sessions will be done with an hypnotherapist formed for this kind of treatment. Three times during this study, each patient will have a discussion with the co-investigator :¨ 1st discussion : just before the first hypnosis session 2nd discussion : after the 4 hypnosis sessions and just before the facet block, approximately 3 to 4 weeks after the 1st discussion 3rd discussion : 2 to 4 weeks after the facet block They will allow to obtain several data : Pain assessment : intensity, localization, variability, characteristics, effects on daily life activities Anxiety and depression assessment Expectations assessment : about both treatments and their combination Efficacy assessment : about both treatments for the patient Questions about the perceptions of the treatments (prejudice, ...) et possible side effects. These data will then be analysed (quantitative and qualitative analysis, depending on the question type) to fulfill the objectives of the study. will include 5 to 8 people suffering from chronic lumbar pain. The procedure consists in two steps : 4 hypnosis sessions as an adjuvant treatment for number 2 a facet block, which is the standard procedure in the Centre d'antalgie in CHUV. There will be no control group, so every patient will participate to the hypnosis sessions and undergo the facet block. All the procedure of the facet block (including contraindications and side effects) are not considered to be part of this study because all patients in this study would have had a facet block if they would not participate in it. The only data that will be collected are questionnaires about several items (pain, anxiety, depression, ...). These questionnaires are filled with the patient at the beginning of the study (day 0), before the facet block (between day 14 and day 21) and 2-4 weeks after it (between day 28 and day 49). There are quantitative and qualitative questions.

This observational study is designed to evaluate the integration of a model-informed, clinically individualized pharmacokinetics (PK) profile (precision dosing dashboard) into prescribing clinicians' existing workflows to improve safety and efficacy of morphine dosing for neonates. The investigators will use user-centered participatory design methods and real-time analysis to inform the refinement of the recently developed Electronic Health Record (EHR) model-based decision support tool and test it during the pre-and post-implementation stages.

This is a one group study using a hybrid implementation design.

Transcranial direct current stimulation (tDCS) is an investigational device that has not been approved for the treatment of any medical condition by the FDA but is allowed to be used for research purposes. In clinical trials tDCS has been associated with pain relief by decreasing the intensity and duration of chronic pain. tDCS potentially works by stimulating the brain by delivering an extremely low-level electrical current to areas below the forehead - areas associated with chronic pain. It is anticipated that this current will increase brain activity or the likelihood of brain activity in these areas, affecting individual's ability to regulate pain. The purpose of this study is to compare eligible participants in the Pain Management Program at The Menninger Clinic receiving adjunctive real transcranial Direct Current Stimulation (tDCS) versus those receiving sham tDCS in the resolution of chronic pain. The primary objectives are: (1) improving pain tolerance and (2) improving subjective pain experience. Secondary objectives are: (1) improving subjective experience of sleep quality and (2) increasing physical activity.

The aim of the project is to do a fase two trial, where the effect of a local anesthetic lozenge will be tested in regard to oral pain, dryness of the mouth, irregularity of taste as well as investigate a potential antiinflammatory effect in patients with burning mouth syndrome, Sjögrens syndrome and lichen planus.

The first purpose of this study is to compare the effectiveness of the stellate ganglion block realized with two different approaches (blind and ultrasound-guided) in patients with a diagnosis of complex regional pain syndrome. The second purpose of this study is to determine the safest approach and to compare the safety profiles of the two approaches.

The investigators are conducting this study to find out if intravenous (injected through the vein) infusion of lidocaine and ketamine administered with general anesthesia is as effective as a paravertebral block in lessening pain after surgery and that both of these techniques are superior to general anesthesia alone in reducing pain immediately after surgery and in the long-term.

The primary purpose of the study is to evaluate the impact of treatment with fentanyl buccal tablets on the anxiety symptoms commonly associated with chronic pain in patients with breakthrough pain (BTP). Other purposes are to assess the management of BTP, to evaluate patient functioning, and to determine any influences on the successful dose achieved.

Pain is defined as "An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." In particular, chronic pain has significant impact on health care cost and socio-economic aspects of the society. It is clear that the development of effective chronic pain management is paramount in reducing the significant socio-economic burden of this common healthcare problem. One of the difficulties in measuring outcomes in chronic pain patients is the subjective nature of pain. The McGill Pain Questionnaire (MPQ) was developed in 1975 with the aim of quantifying the subjective pain experiences of patients. Since then it has become one of the major assessment tools in evaluation of chronic pain patients during the course of treatments. The Short Form McGill Pain Questionnaire (SF-MPQ) developed in 1987 has further refined pain descriptors into "sensory" and "affective" domains, and incorporating the Visual Analog Scale (VAS) for easier administration in hospitals and clinics. The validity and reliability of both the original English and translated versions of MPQ and SF-MPQ have been well demonstrated. The latest version of Short Form McGill Pain Questionnaire (SF-MPQ-2) included descriptive terms for neuropathic pain which expanded the scope of coverage on chronic neuropathic pain patients. It has also been evaluated in cancer pain patients. Translated versions of SF-MPQ-2 showed good reliability and validity. Therefore the investigators devised this study to (1) translate SF-MPQ-2 into Traditional Chinese-Cantonese (C-SF-MPQ-2) suitable for use in Hong Kong patients, (2) examine the validity, reliability and psychometric properties of this translated version in Hong Kong patients.

Musculoskeletal pain represents the leading cause of disability worldwide. It has been traditionally attributed to peripheral mechanisms, but peripheral damage, inflammation, and psychological factors have failed to significantly account for the presence, absence, or severity of chronic musculoskeletal pain (CMP). Recent studies show that individuals with CMP exhibit dysfunctional pain modulation supporting a significant central nervous system (CNS) contribution. However, the CNS mechanisms underlying these changes in pain modulation are not currently known, nor is their relation to clinical pain progression. The proposed pilot examines brain circuits recently described in predicting the transition from acute to chronic pain, in predicting clinical and experimental pain changes as well as physical performance and mobility changes in older persons with musculoskeletal pain over a one year period. The findings will provide novel and important information regarding the mechanisms underlying aberrant pain processing and its functional consequences in older adults with musculoskeletal pain. The information learned can be subsequently used to target treatment and prevention strategies in future studies of older adults. The central hypothesis is that increased functional and structural connectivity of cortico-striatal regions will be significantly associated with baseline clinical and experimental pain and decreased physical function in persons with CMP and will account for more rapid clinical pain and disability progression over time.