Uncertainty: perennial controversies in pain understanding

As I write this post today, yet again there are new theories being proposed for that most common of experiences: pain. Not only theoretical controversies, but even the definition of pain is being debated – is pain an “aversive” experience? An aversive sensory and emotional experience typically caused by, or resembling that caused by, actual or potential tissue injury. Some researchers have recently “found” a new nociceptive fibre (though they persist in calling it a “pain fibre” – once again perpetuating the idea that pain is one and the same with nociception). One of the conversations is whether pain is a sensation, or an emotion, or something else. When I went to University and studied psychology, sensation was defined as “information transmitted by sensory receptors” – in other words, activity in the sensory receptors prior to perception is classified as sensation. Emotions are also defined in psychology, and depending on the theory being followed might be defined as “a complex reaction pattern, involving experiential, behavioral, and physiological elements.” Perception involves recognising and interpreting sensory information, and invokes the idea of awareness as an essential feature. (This is a good place to begin searching for definition – click) The term aversive indicates “a physiological or emotional response indicating dislike for a stimulus. It is usually accompanied by ...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Pain conditions Research Resilience/Health Science in practice definition disability living well persistent pain Source Type: blogs

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DiscussionThis trial is the first patient-facing ED-based intervention aimed at helping older adults to better manage their MSP and reduce their risk of developing chronic pain. If effective, future studies will examine the effectiveness of implementation strategies.Trial registrationClinicalTrials.govNCT04118595. Registered on 8 October 2019.
Source: Trials - Category: Research Source Type: clinical trials
CONCLUSIONS: The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP. PMID: 32623724 ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
In this study, we assessed the therapeutic effects of TPL on interleukin-1-beta (IL-1β)-induced OA in rats. Histological and protein analyses revealed that TPL not only could inhibit interleukin-6 (IL-6) and cyclooxygenase-2 (COX2) protein expression in cells and disrupt inflammation, but it also reduced the expression of matrix metalloproteinase (MMP)-3 and 13. Our results also supported the ability of TPL to suppress the osteoprotegerin/receptor activator of nuclear factor kappa-beta (NF-κB)/receptor activator of NF-κB ligand (OPG/RANK/RANKL) and NF-κB signaling pathways induced by IL-1β. Toge...
Source: European Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Eur J Pharmacol Source Type: research
ConclusionsFindings imply that raised blood inflammatory markers are present in chronic neck pain, which may represent an ongoing inflammatory process in this population.
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: REVIEW ARTICLE Source Type: research
This study demonstrated a substantial and increasing inpatient burden of PG in the United States, with considerable disability and mortality risk, multiple comorbid health disorders, and costs.
Source: Archives of Dermatological Research - Category: Dermatology Source Type: research
ConclusionSurgical treatment of VO patients leads to significantly improved QoL. Nevertheless, QoL levels were below those of the general population. Our results underscore that spine disability questionnaires measuring QoL are mandatory to demonstrate comprehensively the severity of this entity. Our study confirms a high mortality and points out the role of VO as a potentially life-threatening condition.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
ConclusionsStable, long-term results demonstrated that 10  kHz SCS is a promising therapy option for intractable chronic upper limb and neck pain.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Abstract Purpose: The aim of this study is to systematically review and critically assess the methodological quality of literature regarding prevalence, characteristics and factors influencing pain, other than phantom limb pain (PLP) in persons with lower limb amputation (LLA).Materials and methods: A systematic review was performed (PROSPERO CRD42019138018). Literature was searched using PubMed, EMBASE, PsycINFO, and PEDro. Studies were included if describing pain other than PLP at least three months after amputation. For residual limb pain (RLP) and back pain, a meta-regression was performed.Results: Fifty-one s...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Abstract OBJECTIVE: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application. DESIGN: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG). SETTING: Governmental and private institutions. PARTICIPANTS: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months. INTERVENTIONS: The EG received full version of the applic...
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
DISCUSSION AND IMPLICATIONS: Focus group participants were enthusiastic about the proposed program skills. Current work includes open pilot testing, qualitative interviews, and a small randomized controlled trial to optimize the programs and methodology in preparation for efficacy testing against an educational control. PMID: 32601670 [PubMed - as supplied by publisher]
Source: The Gerontologist - Category: Geriatrics Authors: Tags: Gerontologist Source Type: research
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