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Chronic Pain

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35 papers 0 to 25 followers
Bradford W Fenton, Elim Shih, Jessica Zolton
Pain is a significant national burden in terms of patient suffering, expenditure and lost productivity. Understanding pain is fundamental to improving evaluation, treatment and innovation in the management of acute and persistent pain syndromes. Pain perception begins in the periphery, and then ascends in several tracts, relaying at different levels. Pain signals arrive in the thalamus and midbrain structures which form the pain neuromatrix, a constantly shifting set of networks and connections that determine conscious perception...
2015: Pain Management
Roy Freeman, Birol Emir, Bruce Parsons
BACKGROUND: Greater understanding of factors associated with the high placebo-response rates noted in recent neuropathic pain trials may improve trial design. This study investigated placebo response and its predictors in pregabalin trials in patients with diabetic peripheral neuropathy (DPN) or postherpetic neuralgia. PATIENTS AND METHODS: Individual patient data from 16 randomized, placebo-controlled, double-blind trials of pregabalin in 3,053 patients with DPN and 1,460 patients with postherpetic neuralgia were pooled (by condition and all together) in order to investigate the placebo response and its predictors...
2015: Journal of Pain Research
Christopher E Ramsden, Daisy Zamora, Alexandros Makriyannis, JodiAnne T Wood, J Douglas Mann, Keturah R Faurot, Beth A MacIntosh, Sharon F Majchrzak-Hong, Jacklyn R Gross, Amber B Courville, John M Davis, Joseph R Hibbeln
UNLABELLED: Omega-3 and omega-6 fatty acids are biosynthetic precursors of endocannabinoids with antinociceptive, anxiolytic, and neurogenic properties. We recently reported that targeted dietary manipulation-increasing omega-3 fatty acids while reducing omega-6 linoleic acid (the H3-L6 intervention)-reduced headache pain and psychological distress among chronic headache patients. It is not yet known whether these clinical improvements were due to changes in endocannabinoids and related mediators derived from omega-3 and omega-6 fatty acids...
August 2015: Journal of Pain: Official Journal of the American Pain Society
Peter Courtney, Anthony Espinet, Bruce Mitchell, Marc Russo, Andrew Muir, Paul Verrills, Kristina Davis
OBJECTIVES: Conventional spinal cord stimulation (SCS) delivers a tonic waveform with consistent stream of pulses; burst delivers groups of pulses separated by short pulse-free periods. The current study compared the short-term safety and efficacy of burst with tonic stimulation in subjects already receiving SCS. MATERIALS AND METHODS: At 4 IRB-approved sites, 22 subjects previously implanted with an SCS device for intractable, chronic pain gave informed consent and received burst stimulation for 14 days...
July 2015: Neuromodulation: Journal of the International Neuromodulation Society
Hili Giladi, Manon Choinière, Mary-Ann Fitzcharles, Mark A Ware, Xianming Tan, Yoram Shir
BACKGROUND: Pregabalin is frequently prescribed for chronic non-cancer pain. No previous study has examined its off-label use. OBJECTIVES: Our primary aim was to assess the proportion of patients taking pregabalin for conditions approved by Health Canada ('on-label') and compare their perspectives on its use to those who use pregabalin for other conditions ('off-label'). METHODS: Patients who have used pregabalin within the past year were recruited from two registries of chronic non-cancer pain patients treated in tertiary care clinics: the Quebec Pain Registry and the Fibromyalgia Patients Registry...
2015: Current Medical Research and Opinion
Gregory J Boyle, Bård H Boerresen, Deannah M Jang
The McGill Pain Questionnaire (MPQ) aims to measure sensory, affective, and evaluative dimensions of pain. However, the structural dimensionality of the MPQ remains somewhat uncertain. Exploratory (EFA) factor analyses were used to investigate the structure of the MPQ based on the responses of a diverse sample of 448 pain patients (M age = 43.1 yr., SD = 19.3). The EFA employed a methodologically sound iterative maximum-likelihood procedure, together with direct oblimin oblique simple structure rotation. Perusal of the 3-, 4-, and 5-factor solutions suggested that the MPQ measures two separate sensory dimensions of pain, while affective and evaluative dimensions were not sharply delineated, suggesting that the MPQ structure requires some revision...
June 2015: Psychological Reports
Andrea Burri, Soshiro Ogata, Jelle Vehof, Frances Williams
Recent studies have provided consistent evidence for a genetic influence on chronic widespread pain (CWP). The aim of this study was to investigate (1) the etiological structure underlying CWP by examining the covariation between CWP and psychological comorbidities and psychoaffective correlates and (2) the decomposition of the covariation into genetic and environmental components. A total of 3266 female twins (mean age 56.6 years) were subject to multivariate analyses. Using validated questionnaires to classify twins as having CWP, the prevalence of CWP was 20...
August 2015: Pain
Ian Gilron, Ralf Baron, Troels Jensen
Neuropathic pain is caused by disease or injury of the nervous system and includes various chronic conditions that, together, affect up to 8% of the population. A substantial body of neuropathic pain research points to several important contributory mechanisms including aberrant ectopic activity in nociceptive nerves, peripheral and central sensitization, impaired inhibitory modulation, and pathological activation of microglia. Clinical evaluation of neuropathic pain requires a thorough history and physical examination to identify characteristic signs and symptoms...
April 2015: Mayo Clinic Proceedings
Stephan A Schug, Catherine Goddard
This review focuses on newer medications for the treatment of pain as well as on new guidelines and indications for the use of established medications. With regard to classical analgesics, the use of non-opioids and opioids is reviewed. Here are relevant new data on the use of the old substance acetaminophen as well as on non-selective non-steroidal anti-inflammatory drugs (NSAIDs) and the newer COX-2 selective agents, which continue to be misunderstood. Amongst the opioids the new compound tapentadol with a new mechanism of action is presented as well as a number of new opioid preparations aiming to increase speed of onset of effect and to reduce abuse and diversion...
October 2014: Annals of Palliative Medicine
Emily L Zale, Joseph W Ditre
Chronic pain is a significant public health concern that imposes substantial burdens on individuals and healthcare systems, and factors that contribute to the development and maintenance of pain-related disability are of increasing empirical and clinical interest. Consistent with the fear-avoidance model of chronic pain, greater pain-related fear has consistently been associated with more severe disability and may predict the progression of disability over time. Recent evidence indicates that treatments designed to reduce pain-related fear are efficacious for improving disability outcomes, and several clinical trials are currently underway to test tailored intervention content and methods of dissemination...
October 1, 2015: Current Opinion in Psychology
Stephen G Woodhams, Devi Rani Sagar, James J Burston, Victoria Chapman
Preparations of the Cannabis sativa plant have been used to analgesic effect for millenia, but only in recent decades has the endogenous system responsible for these effects been described. The endocannabinoid (EC) system is now known to be one of the key endogenous systems regulating pain sensation, with modulatory actions at all stages of pain processing pathways. The EC system is composed of two main cannabinoid receptors (CB1 and CB2) and two main classes of endogenous ligands or endocannabinoids (ECs)...
2015: Handbook of Experimental Pharmacology
James L Oschman, Gaétan Chevalier, Richard Brown
Multi-disciplinary research has revealed that electrically conductive contact of the human body with the surface of the Earth (grounding or earthing) produces intriguing effects on physiology and health. Such effects relate to inflammation, immune responses, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. The purpose of this report is two-fold: to 1) inform researchers about what appears to be a new perspective to the study of inflammation, and 2) alert researchers that the length of time and degree (resistance to ground) of grounding of experimental animals is an important but usually overlooked factor that can influence outcomes of studies of inflammation, wound healing, and tumorigenesis...
2015: Journal of Inflammation Research
Johan W S Vlaeyen
Pain is a biologically relevant signal and response to bodily threat, associated with the urge to restore the integrity of the body. Immediate protective responses include increased arousal, selective attention, escape, and facial expressions, followed by recuperative avoidance and safety-seeking behaviors. To facilitate early and effective protection against future bodily threat or injury, learning takes place rapidly. Learning is the observable change in behavior due to events in the internal and external environmental and includes nonassociative (habituation and sensitization) and associative learning (Pavlovian and operant conditioning)...
April 2015: Pain
Dinu-Stefan Teodorescu, Trond Heir, Johan Siqveland, Edvard Hauff, Tore Wentzel-Larsen, Lars Lien
BACKGROUND: Traumatized refugees often report significant levels of chronic pain in addition to posttraumatic stress disorder symptoms, and more information is needed to understand pain in refugees exposed to traumatic events. This study aimed to assess the frequency of chronic pain among refugee psychiatric outpatients, and to compare outpatients with and without chronic pain on trauma exposure, psychiatric morbidity, and psychiatric symptom severity. METHODS: We conducted a cross-sectional study of sixty-one psychiatric outpatients with a refugee background using structured clinical diagnostic interviews to assess for traumatic events [Life Events Checklist (LEC)], PTSD (Posttraumatic Stress Disorder) and complex PTSD [Structured Clinical Interview for DSM-IV PTSD Module (SCID-PTSD) and Structured Interview for Disorders of Extreme Stress (SIDES)], chronic pain (SIDES Scale VI) and psychiatric symptoms [M...
2015: BMC Psychology
Lisa Doan, Toby Manders, Jing Wang
Acute pain induces depressed mood, and chronic pain is known to cause depression. Depression, meanwhile, can also adversely affect pain behaviors ranging from symptomology to treatment response. Pain and depression independently induce long-term plasticity in the central nervous system (CNS). Comorbid conditions, however, have distinct patterns of neural activation. We performed a review of the changes in neural circuitry and molecular signaling pathways that may underlie this complex relationship between pain and depression...
2015: Neural Plasticity
Samantha D Outcalt, Kurt Kroenke, Erin E Krebs, Neale R Chumbler, Jingwei Wu, Zhangsheng Yu, Matthew J Bair
Both posttraumatic stress disorder (PTSD) and depression are highly comorbid with chronic pain and have deleterious effects on pain and treatment outcomes, but the nature of the relationships among chronic pain, PTSD, and depression has not been fully elucidated. This study examined 250 Veterans Affairs primary care patients with moderate to severe chronic musculoskeletal pain who participated in a randomized controlled pain treatment trial. Baseline data were analyzed to examine the independent associations of PTSD and major depression with multiple domains of pain, psychological status, quality of life, and disability...
June 2015: Journal of Behavioral Medicine
Anne L J Burke, Jane L Mathias, Linley A Denson
OBJECTIVES: Chronic pain (CP; >3 months) is a common condition that is associated with significant psychological problems. Many people with CP do not fit into discrete diagnostic categories, limiting the applicability of research that is specific to a particular pain diagnosis. This meta-analysis synthesized the large extant literature from a general CP, rather than diagnosis-specific, perspective to systematically identify and compare the psychological problems most commonly associated with CP...
September 2015: British Journal of Clinical Psychology
Barbara L Nye, Vijay M Thadani
Migraine and epilepsy are disorders that are common, paroxysmal, and chronic. In many ways they are clearly different diseases, yet there are some pathophysiological overlaps, and overlaps in clinical symptomatology, particularly with regard to visual and other sensory disturbances, pain, and alterations of consciousness. Epidemiological studies have revealed that the two diseases are comorbid in a number of individuals. Both are now recognized as originating from electrical disturbances in the brain, although their wider manifestations involve the recruitment of multiple pathogenic mechanisms...
March 2015: Headache
Elizabeth R Duval, Arash Javanbakht, Israel Liberzon
Anxiety and stress disorders are among the most prevalent neuropsychiatric disorders. In recent years, multiple studies have examined brain regions and networks involved in anxiety symptomatology in an effort to better understand the mechanisms involved and to develop more effective treatments. However, much remains unknown regarding the specific abnormalities and interactions between networks of regions underlying anxiety disorder presentations. We examined recent neuroimaging literature that aims to identify neural mechanisms underlying anxiety, searching for patterns of neural dysfunction that might be specific to different anxiety disorder categories...
2015: Therapeutics and Clinical Risk Management
Emery R Eaves, Karen J Sherman, Cheryl Ritenbaugh, Clarissa Hsu, Mark Nichter, Judith A Turner, Daniel C Cherkin
BACKGROUND: The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we examined how participants' expectations of treatment changed over the course of a therapy. METHODS: We conducted semi-structured qualitative interviews with 64 participants initiating one of four CAM therapies (yoga, chiropractic, acupuncture, massage) for chronic low back pain...
2015: BMC Complementary and Alternative Medicine
2015-04-03 00:07:19
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