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dc.contributor.authorMole, Tom B
dc.contributor.authorMackeith, Pieter
dc.date.accessioned2018-07-24T11:08:32Z
dc.date.available2018-07-24T11:08:32Z
dc.date.issued2018-02-12
dc.identifier.issn1757-790X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/278421
dc.description.abstractPostoperative neuropathic pain exacerbated by movement is poorly understood and difficult to treat but a relatively common complication of surgical procedures such as endoscopic thoracic sympathectomy. Here, we describe a case of unexpected, immediate, complete and sustained remission of postoperative intercostal neuralgia after the patient engaged in an open-water swim in markedly cold conditions. Though an incidental chance association is possible, the clear temporal proximity linking the swim with pain remission makes a causal relationship possible. We discuss plausible mechanisms that may underlie the relationship and discuss the potential implications for postoperative pain management and patient-centred mobilisation. We recommend further evaluation of cold forced open-water swimming as a mobility-pain provocation challenge to see if the observed unexpectedly positive outcome can be replicated. With the poor response to traditional management, there is a need for novel, curative interventions for postoperative neuropathic pain and associated impaired mobility.
dc.format.mediumElectronic
dc.languageeng
dc.publisherBMJ
dc.subjectHumans
dc.subjectNeuralgia
dc.subjectPain, Postoperative
dc.subjectTreatment Outcome
dc.subjectSympathectomy
dc.subjectThoracic Surgical Procedures
dc.subjectSwimming
dc.subjectAdult
dc.subjectMale
dc.subjectCold Temperature
dc.titleCold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?
dc.typeArticle
prism.publicationDate2018
prism.publicationNameBMJ Case Rep
prism.volume2018
dc.identifier.doi10.17863/CAM.20341
dcterms.dateAccepted2017-12-05
rioxxterms.versionofrecord10.1136/bcr-2017-222236
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-02-12
dc.contributor.orcidMole, Tom B [0000-0001-8732-8188]
dc.identifier.eissn1757-790X
dc.publisher.urlhttp://casereports.bmj.com/content/2018/bcr-2017-222236
rioxxterms.typeJournal Article/Review
cam.issuedOnline2018-02-12
rioxxterms.freetoread.startdate2018-08-12


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