Where has the ‘bio’ in bio-psycho-social gone?

Purpose of review Current definitions of pain do not necessitate tissue damage. This is important because it does justice to the pain patient in whom a nociceptive source is not detectable. However, in conjunction with exciting findings regarding supraspinal pain modulation and a (perceived) failure of identifying nociceptive sources in individual patients, this might have led to a devaluation of the role of nociception for chronic pain. In this review, the relative importance of nociception versus psychological factors for chronic pain is examined by scrutinizing the example of pain present several months following surgical joint replacement for severe osteoarthritis. Recent findings In most patients with chronic pain due to severe osteoarthritis, removal of the putative nociceptive source leads to pain elimination/reduction, indicating that their pain depended on nociceptive input. Furthermore, the influence of psychological factors on outcomes following joint replacement for severe osteoarthritis is limited: pain catastrophizing, which is the most consistently identified psychological factor influencing outcome, explains less than 10% of the variance of pain magnitude several months after knee replacement. The influence of psychological factors might be larger for pain disability than for pain magnitude, which could skew the perception of the importance of psychological factors. Summary It appears that the importance of nociception relative to psychological factors...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: NON-MALIGNANT DISEASES: Edited by Anthony H. Dickenson and Kirsty Bannister Source Type: research

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by Drew Rosielle (@drosielle)This is the second in a series of several posts about many aspects of my current thinking about opioids.The first post is here:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Over-prescribing fueled the current drug overdose epidemic, and many of us who thought we were stamping out needless suffering contributed to the epidemic.A lot of what I read and believed about opioids early on in my career was wrong.I ’m old enough to remember those heady days in which there was a pretty large and ‘successful’ movement in American medicine to gr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
Abstract Chronic musculoskeletal pain and disability dramatically reduce quality and quantity of life worldwide, disproportionately so in low- and middle-income countries. Complementary therapies not typically learned in conventional medical training have much to offer but are under-utilized. Prolotherapy is an injection-based complementary therapy supported by high-quality evidence for osteoarthritis, tendinopathy, and low back pain. Prolotherapy addresses causes of pain and disability at the tissue level, is straightforward to learn, and relies on common, inexpensive material, and requires no refrigeration. Not-...
Source: Health Physics - Category: Physics Authors: Tags: Phys Med Rehabil Clin N Am Source Type: research
CONCLUSION: In addition to standard rehabilitation, a rehabilitation programme for strengthening the gluteal muscles in DDH patients who underwent THR determined an increase in muscle strength that improved functional performance and patient satisfaction. PMID: 31544524 [PubMed - as supplied by publisher]
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
Chronic musculoskeletal pain and disability dramatically reduce quality and quantity of life worldwide, disproportionately so in low- and middle-income countries. Complementary therapies not typically learned in conventional medical training have much to offer but are under-utilized. Prolotherapy is an injection-based complementary therapy supported by high-quality evidence for osteoarthritis, tendinopathy, and low back pain. Prolotherapy addresses causes of pain and disability at the tissue level, is straightforward to learn, and relies on common, inexpensive material, and requires no refrigeration. Not-for-profit organiz...
Source: Physical Medicine and Rehabilitation Clinics of North America - Category: Rehabilitation Authors: Source Type: research
Conclusion: In this study, the coastal areas of South Korea carry a higher burden than the national population. Additionally, chronic diseases compose the majority of the health burden in coastal areas. Despite the limitation of data, YLD was the best tool available for evaluating the health outcomes in specific areas, and has the advantage of simplicity and timely analysis.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Ravalli S, Castrogiovanni P, Musumeci G Abstract Inactivity contributes to chronic diseases, including diabetes, hypertension, cardiovascular disorders, and obesity. Sedentary habits can shorten life expectancy. Exercise has been widely proposed as a valuable approach to prevention. Regular physical activity, as part of one's daily routine, may help to manage pathological conditions. This editorial especially addresses osteoarthritis (OA), a degenerative disease of the articular cartilage, which is one of the most common causes of disability worldwide. Standard treatments for this illness include surgical ...
Source: World Journal of Orthopaedics - Category: Orthopaedics Tags: World J Orthop Source Type: research
Osteoarthritis (OA) is a chronic musculoskeletal disease characterized by joint pain, tenderness, and limited movement, and can lead to disability and eventually a reduction in quality of life in adults [1]. The global prevalence of OA is considered to be high. In Japan, the Comprehensive Survey of Living Conditions 2016 [2] estimated the number of outpatients with OA to be approximately 2.6 million. Due to this high prevalence, Japan ’s national medical costs related to OA are high, reaching 550 billion yen (approximately 5 billion dollars) in 2016 [3].
Source: Maturitas - Category: Primary Care Authors: Source Type: research
AbstractOsteoarthritis (OA) is a common cause of chronic pain and disability. Regenerative therapies using mesenchymal stem cells (MSCs) provide an option for OA treatment as it could potentially regenerate the damaged cartilage. Bone marrow, adipose tissue and synovium are common MSC sources. The aim is to compare the therapeutic effect of MSCs from bone marrow, adipose tissue and synovium; combining its differentiation potential and accessibility, to decide the optimal source of MSCs for the treatment of knee OA. A comparison of preclinical and clinical studies using MSCs has been made with regard to treatment outcomes, ...
Source: Cell and Tissue Research - Category: Cytology Source Type: research
Authors: Khlopas H, Khlopas A, Samuel LT, Ohliger E, Sultan AA, Chughtai M, Mont MA Abstract Ankle osteoarthritis constitutes a large burden to society and is a leading cause of chronic disability in the United States. Most commonly, it is post-traumatic, occurs in younger individuals, and is associated with obesity. This entity presents similarly to osteoarthritis of the other joints, with the typical nonspecific symptoms of stiffness, swelling, and pain. Radiographic investigation includes four weight-bearing standard views: antero-posterior and lateral foot, mortise view of the ankle, and a specialized view of t...
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
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