Neurophysiological changes and chronic pain in cleft patients

Publication date: Available online 18 October 2019Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Amely Hartmann, Claudia Welte-Jzyk, Bilal Al-Nawas, Monika DaubländerSummaryThe aim of this study was to evaluate if patients after orofacial cleft repair experience neurophysiological changes with consecutive chronic pain states after surgery.Patients (n=48) with a repaired orofacial cleft (CLP) recruited in a support group took part in a survey including five questionnaires. They revealed pain states, described cleft situation and history, and epidemiological data. Patients’ quality of life and psychological comorbidity after the surgical procedures were assessed with the Oral Health Impact Profile (OHIP), the Giessen Subjective Complaints List (GSCL) and the Hospital Anxiety and Depression Scale (HADS). Furthermore, psychosocial impairment was documented.39 out of 48 subjects with CLP reported to have experienced pain during the last 6 months. Pain was proven to be already chronic for 36 persons. Locations of pain were the orofacial region, back and limbs. Neurophysiological perception to cold, warmth, pressure and touch were found to be inhomogeneous.Local disturbances of subjective sensitivity in hard and soft tissues in the operated region are suspicious for neuropathic disorders and peripheral and central sensitization. 16 participants also reported that during dental interventions higher doses of local analgesia were necessary to achieve a pain free c...
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research

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Chronic back pain (CBP) is a major global health problem, while its treatment is hampered by a lack of efficacy and restricted safety profile of common frontline therapies. The present trial aims to determine whether a 3-week open-label placebo treatment reduces pain intensity and subjective and objective functional disability in patients with CBP. This randomized controlled trial, following a pretest–posttest design, enrolled 127 patients with CBP (pain duration>12 weeks) from the Back Pain Center, Neurology, University Hospital Essen, Germany. Patients randomized to the open-label placebo group received a 3-week...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Conclusions: Similar to previous studies, our results suggest that patients suffering from CLBP differ with regard to the magnitude of mental burden and the presence of physical impairment. These differences ascertain the need for precise targeting of treatment for CLBP. Inpatient pain centers therefore should offer different multimodal therapy pathways and integrate a meaningful triage, taking into account the multifaceted nature of CLBP based on sophisticated knowledge about forms, differences, and relationships among the biopsychosocial components of CLBP. PMID: 31728134 [PubMed - in process]
Source: GMS German Medical Science - Category: General Medicine Tags: Ger Med Sci Source Type: research
ConclusionsA history of MST is common among older women veterans and associated with a range of medical and mental health diagnoses. These findings call attention to the need for additional research in this understudied population, and the importance of trauma-informed care approaches for women across the lifespan.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Rebound headaches, also known as medication overuse headaches, are caused by the frequent or excessive use of pain-relieving and/or antimigraine drugs to treat headache attacks that are already in progress. (Note that these are not the same as oral prophylactic or preventive medicines, which should be taken daily.) In other words, the same medications that initially relieve headache pain can themselves trigger subsequent headaches if they are used too often. Medication overuse headaches can be disabling, forcing people with this condition to take sick leave and to be less productive at work and home. To be diagnosed with m...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Drugs and Supplements Headache Health Source Type: blogs
Conclusions: Turkish version of Back Beliefs Questionnaire is a valid and reliable questionnaire that can be used to evaluate beliefs about pain in patients with chronic low back pain. IMPLICATIONS FOR REHABILITATION Negative attitudes and beliefs about low back pain cause patients to avoid engaging in physical activities and consequently lead to disability. The Back Belief Questionnaire can be used to evaluate these negative attitudes and beliefs to determine whether the patient will suffer from a disability in the future. Informations obtained with the Back Belief Questionnaire can be used to train the susceptible patien...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Conclusion: The European Portuguese version of the FDI has very good internal consistency, good test-retest reliability, and construct validity when used in a sample of community adolescents with chronic pain. Implications for rehabilitation One of the most widely instruments used to assess functional disability is the Functional Disability Inventory (FDI), which in its original version has good psychometric properties and is recommended by the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials; However, the FDI has not been translated yet into European Portuguese language and its psychome...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Background: Our knowledge of central sensitization (CS) in chronic low back pain (CLBP) is limited. 2011 fibromyalgia criteria and severity scales (2011 FM survey) have been used to determine FM positive as a surrogate of CS. The major features of CS including widespread hyperalgesia and dysfunction of the descending inhibitory pathways can be identified by pressure pain threshold (PPT) and conditioned pain modulation (CPM) tests. The purpose of the study was to examine neurophysiological characteristics and psychosocial symptoms in a subgroup of FM-positive CLBP compared with FM-negative CLBP patients. Methods: A tot...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
Are you so happy that you can’t understand depression? Not us! While Gabe and Jackie can’t relate to that level of positivity, there are lots of people in the world who simply can’t fathom what depression feels like. Despite their best efforts, naturally happy people can have a hard time understanding depression and in Episode 2, we discuss how to explain depression to happy people, including both of our spouses who are, to be honest, annoyingly peppy. We give tips on how to approach the topic and share our own personal experiences of having this hard-to-understand conversation. SUBSCRIBE &REVIEW ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Bipolar Depression Family Not Crazy Podcast Source Type: blogs
Once you begin to dip your toes into psychological therapies, it doesn’t take long before you begin to see TLAs all over the place. So today I’m going to post on two things: some of the TLAs, and why or how we might consider using these approaches in pain rehabilitation. The first one is CBT, or cognitive behavioural therapy. CBT grew out of two movements: behaviour therapy (Skinner and the pigeons, rats and all that behaviour modification stuff), and cognitive therapy (Ellis and Beck and the “cognitive triad” – more on this later). When the two approaches to therapy are combined, we have c...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: ACT - Acceptance & Commitment Therapy Clinical reasoning Cognitive behavioral therapy Coping strategies Interdisciplinary teams Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice Source Type: blogs
CONCLUSIONS: The authors' findings provide insight regarding the mechanisms of spinal cord stimulation failure that resulted in total removal of the implanted system. The relationship between spinal cord stimulation failure and certain psychiatric disorders, such as PTSD, depression, and anxiety, is highlighted. Ultimately, this work may shed light on potential avenues to reduce morbidity and improve patient outcomes. PMID: 31585414 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
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