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Chronic central pain

Gustavo Plaza-Manzano, Marta Ríos-León, Patricia Martín-Casas, Lars Arendt-Nielsen, César Fernández-de-Las-Peñas, Ricardo Ortega-Santiago
Our aim was to investigate the differences in pressure sensitivity over musculoskeletal and nerve symptomatic and distant areas between individuals with plantar heel pain and healthy subjects, and to determine the relationship between sensitivity to pressure pain, foot pain, and fascia thickness. Thirty-five patients with unilateral chronic plantar heel pain and 35 matched healthy controls participated. Pressure pain thresholds (PPTs) were bilaterally assessed over several nerve trunks (median, radial, ulnar, common peroneal, tibial and sural nerve trunks) and musculoskeletal structures (calcaneus, medial gastrocnemius, tibialis anterior, second metacarpal) by an assessor blinded to the subject's condition...
August 16, 2018: Journal of Pain: Official Journal of the American Pain Society
M M Wertli, J Steurer
Low back pain is common. In the acute (duration <6 weeks) and subacute pain phases (6-12 weeks) the main goal of pharmacological pain treatment is to enable patients to move and to stay as active as possible. In the chronic phase, pain medications can support non-pharmacological measures and improve physical function. Although almost every person will experience low back pain at least once in a lifetime, for many pain medications no clinical studies on their efficacy exist. Most data are available on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in acute and chronic low back pain; however, potential adverse effects and contraindications for NSAIDs need to be taken into account when the medication is prescribed...
August 16, 2018: Der Internist
Thomas F Kallman, Bijar Ghafouri, Emmanuel Bäckryd
Objective: The pathophysiology of chronic pain is complex, with most of our knowledge being derived from preclinical studies. The search for biomarkers mirroring the pathophysiology of chronic pain is ongoing, and there is an increasing interest in saliva as a diagnostic tool. Given what is known about salivary substance P and salivary gland innervation, we hypothesized that salivary substance P and/or beta-endorphin might reflect the basal activity of these neuropeptides in the central nervous system, thereby perhaps mirroring a general propensity to chronic pain...
August 2018: Heliyon
S M Walker, A Melbourne, H O'Reilly, J Beckmann, Z Eaton-Rosen, S Ourselin, N Marlow
BACKGROUND: Surgery or multiple procedural interventions in extremely preterm neonates influence neurodevelopmental outcome and may be associated with long-term changes in somatosensory function or pain response. METHODS: This observational study recruited extremely preterm (EP, <26 weeks' gestation; n=102, 60% female) and term-born controls (TC; n=48) aged 18-20 yr from the UK EPICure cohort. Thirty EP but no TC participants had neonatal surgery. Evaluation included: quantitative sensory testing (thenar eminence, chest wall); clinical pain history; questionnaires (intelligence quotient; pain catastrophising; anxiety); and structural brain imaging...
September 2018: British Journal of Anaesthesia
T Tuna, L Van Obbergh, N Van Cutsem, E Engelman
BACKGROUND: Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS: We compared three populations: healthy (HS, n=280), with acute pain (AP=110 patients), and chronic pain (CP=280 patients) by assessing their pain behaviour with the pain sensitivity questionnaire (PSQ-total and PSQ-minor)...
September 2018: British Journal of Anaesthesia
Marc Martí-Pastor, Angels Pont, Mónica Ávila, Olatz Garin, Gemma Vilagut, Carlos G Forero, Yolanda Pardo, Ricard Tresserras, Antonia Medina-Bustos, Oriol Garcia-Codina, Juan Cabasés, Luis Rajmil, Jordi Alonso, Montse Ferrer
BACKGROUND: The EQ-5D has been frequently used in national health surveys. This study is a head-to-head comparison to assess how expanding the number of levels from three (EQ-5D-3L) to five in the new EQ-5D-5L version has improved its distribution, discriminatory power, and validity in the general population. METHODS: A representative sample (N = 7554) from the Catalan Health Interview Survey 2011-2012, aged ≥18, answered both EQ-5D versions, and we evaluated the response redistribution and inconsistencies between them...
August 16, 2018: Population Health Metrics
Emmanuel Bäckryd, Sofia Edström, Björn Gerdle, Bijar Ghafouri
BACKGROUND: Post-translational modifications (PTMs) generate a tremendous protein diversity from the ~ 20,000 protein-coding genes of the human genome. In chronic pain conditions, exposure to pathological processes in the central nervous system could lead to disease-specific PTMs detectable in the cerebrospinal fluid (CSF). In a previous hypothesis-generating study, we reported that seven out of 260 CSF proteins highly discriminated between neuropathic pain patients and healthy controls: one isoform of angiotensinogen (AG), two isoforms of alpha-1-antitrypsin (AT), three isoforms of haptoglobin (HG), and one isoform of pigment epithelium-derived factor (PEDF)...
August 16, 2018: BMC Neurology
Longhe Xu, Yaobo Liu, Yuhui Sun, Hao Li, Weidong Mi, Yuge Jiang
OBJECTIVE: Chronic neuropathic pain (CNP) is attributed to a lesion or disease of the somatosensory system, may be derived from the peripheral and central system. Recent study revealed that spinal cord stimulation attenuated CNP by inhibiting TLR4/NF-κB signaling pathway. The present study focuses on the potential analgesic effects of TLR4/NF-κB signaling pathway on CNP in a rat model of chronic constriction injury (CCI). METHODS: We successfully established the rat model of CCI by Bennett method, and then inhibited the TLR4/NF-κB signaling pathway in rat models...
August 13, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
D Yap, M Ng, N Mbakada
Small bowel obstruction is the most common surgical emergency after a patient has had abdominal surgery. However, Boerhaave syndrome secondary to an ileostomy obstruction has not been reported in current literature. We present a rare case of two concurrent surgical emergencies in a patient with Boerhaave syndrome and small bowel obstruction. A 38-year-old woman presented with sudden onset severe central chest pain associated with breathlessness. She had a history of Crohn's disease, which had been treated with pancolectomy and ileostomy...
August 16, 2018: Annals of the Royal College of Surgeons of England
Hiran Thabrew, Karolina Stasiak, Sarah E Hetrick, Stephen Wong, Jessica H Huss, Sally N Merry
BACKGROUND: Long-term physical conditions affect 10% to 12% of children and adolescents worldwide; these individuals are at greater risk of developing psychological problems, particularly anxiety and depression. Access to face-to-face treatment for such problems is often limited, and available interventions usually have not been tested with this population. As technology improves, e-health interventions (delivered via digital means, such as computers and smart phones and ranging from simple text-based programmes through to multimedia and interactive programmes, serious games, virtual reality and biofeedback programmes) offer a potential solution to address the psychological needs of this group of young people...
August 16, 2018: Cochrane Database of Systematic Reviews
Xu-Hui Li, Hui-Hui Miao, Min Zhuo
Since the discovery of NMDA receptor (NMDAR) dependent long-term potentiation (LTP) in the hippocampus, many studies have demonstrated that NMDAR dependent LTP exists throughout central synapses, including those involved in sensory transmission and perception. NMDAR LTP has been reported in spinal cord dorsal horn synapses, anterior cingulate cortex and insular cortex. Behavioral, genetic and pharmacological studies show that inhibiting or reducing NMDAR LTP produced analgesic effects in animal models of chronic pain...
August 14, 2018: Neurochemical Research
Amir Awwad, Renan E Ibrahem Adam, Chandni Patel, James D Thomas
Introduction: Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing's syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Surgical decompression is known to improve symptomatic cases and prevent further deterioration. Case presentation: An elderly male patient with background history of high-risk metastatic prostate cancer and long-term treatment with steroids and hormonal therapy presented with acute on chronic back pain and neurological symptoms...
2018: Spinal Cord Series and Cases
Bérengère Houzé, Héjar El-Khatib, Caroline Arbour
BACKGROUND: Complementary and alternative medicine (CAM) therapies may be used as a non-pharmacological approach to chronic pain management. While hundreds of trials about individual CAM modality have been conducted, a comprehensive overview of their results is currently lacking for pain clinicians and researchers. AIM: This umbrella review synthesized the quality of meta-analytic evidence supporting the efficacy, tolerability and safety of CAM therapies for the management of chronic pain...
August 11, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
Timothy W Churchill, Supriya Krishnan, Marc Weisskopf, Brandon Yates, Frank E Speizer, Jonathan H Kim, Lee E Nadler, Alvaro Pascual-Leone, Ross Zafonte, Aaron L Baggish
BACKGROUND: Professional American-style football players are among the largest athletes across contemporary sporting disciplines, and weight gain during the years of football participation is common. At present, the health implications of this early-life weight gain remain incompletely understood. We sought to define weight trajectories of former professional American-style football athletes and to establish their relationship with 5 health afflictions common in this population (cardiovascular disease, cardiometabolic disease, neurocognitive impairment, sleep apnea, and chronic pain)...
August 10, 2018: American Journal of Medicine
Xiu Hong Yang, Bao Long Zhang, Yan Hong Gu, Xiao Li Zhan, Li Li Guo, Hui Min Jin
OBJECTIVE: Sleep disorders, chronic pain, and fatigue have been long-standing torments in most patients with chronic kidney disease (CKD). In this review, we attempted to explore whether these nontraditional cardiovascular risk factors are associated with increased mortality in patients with CKD. METHOD: Electronic searches were performed in MEDLINE (PubMed, 1966-2018), EMBASE (1974-2018),, and the Cochrane Central Register of Controlled Trials databases...
August 9, 2018: Sleep Medicine
Bettina Böttcher, Elke R Gizewski, Christian Siedentopf, Ruth Steiger, Michael Verius, David Riedl, Anja Ischebeck, Julia Schmid, Ludwig Wildt, Sigrid Elsenbruch
BACKGROUND: Chronic pelvic pain, in particular dysmenorrhea, is a significant yet unresolved healthcare problem in gynecology. As interoceptive sensitivity and underlying neural mechanisms remain incompletely understood, this functional magnetic resonance imaging (fMRI) study assessed behavioral and neural responses to visceral stimuli in primary dysmenorrhea (PMD). METHODS: Women with PMD (N=19) without psychological comorbidity and healthy women (N=20) were compared with respect to visceral sensory and pain thresholds, and to neural responses to individually-calibrated mildly-painful and painful rectal distensions implemented during scanning...
August 11, 2018: European Journal of Pain: EJP
Leidiane Mazzardo-Martins, Daiana Cristina Salm, Elisa C Winkelmann-Duarte, Júlia Koerich Ferreira, Daniela Dero Lüdtke, Kamilla Pamplona Frech, Luiz Augusto Oliveira Belmonte, Verônica Vargas Horewicz, Anna Paula Piovezan, Francisco José Cidra-Filho, Ari Ojeda Ocampo Moré, Daniel Fernandes Martins
Complex regional pain syndrome (CRPS) is a disorder that involves abnormal inflammation and nerve dysfunction frequently resistant to a broad range of treatments. Peripheral nerve stimulation with electroacupuncture (EA) has been widely used in different clinical conditions to control pain and inflammation; however, the use of EA in the treatment of CRPS is under investigation. In this study, we explore the effects of EA on hyperalgesia and edema induced in an animal model of chronic post-ischemia pain (CPIP model) and the possible involvement of endothelin receptor type B (ETB ) in this effect...
August 10, 2018: Pflügers Archiv: European Journal of Physiology
Mohammed Zacky Ariffin, Khairunisa Mohamad Ibrahim, Andy Thiam-Huat Lee, Rui Zhi Lee, Shou Yu Poon, Hwai Kit Thong, Eugene Hern Choon Liu, Chian-Ming Low, Sanjay Khanna
The present study explored the role of the medial septal region (MS) in experimental neuropathic pain. For the first time, we found that the MS sustains nociceptive behaviors in rodent models of neuropathic pain, especially in the chronic constriction injury (CCI) model and the paclitaxel model of chemotherapy-induced neuropathic pain. For example, inactivation of the MS with intraseptal muscimol (2 μg/μl, 0.5 μl), a GABA mimetic, reversed peripheral hypersensitivity (PH) in the CCI model and induced place preference in a conditioned place preference task, a surrogate measure of spontaneous nociception...
August 8, 2018: Scientific Reports
K White, M Targett, J Harris
Specific primary afferent fibres termed nociceptors are responsible for transmitting nociceptive information. Centrally the axonal terminals of these fibres synapse with secondary projection neurones in the spinal dorsal horn to transmit nociceptive information to the higher centres in the brain. Irrespective of the presence or absence of nociceptive inflow the activity of dorsal horn neurones is modulated by, amongst other things, local interneurones and descending midbrain and brainstem networks which can inhibit or facilitate dorsal horn transmission...
July 2018: Veterinary Journal
Nuria García-Magro, Yasmina B Martin, Pilar Negredo, Carlos Avendaño
The neuromodulation of the greater occipital nerve (GON) has proved effective to treat chronic refractory neurovascular headaches, in particular migraine and cluster headache. Moreover, animal studies have shown convergence of cervical and trigeminal afferents on the same territories of the upper cervical and lower medullary dorsal horn (DH), the so-called trigeminocervical complex (TCC), and recent studies in rat models of migraine and craniofacial neuropathy have shown that GON block or stimulation alter nociceptive processing in TCC...
August 6, 2018: Journal of Comparative Neurology
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