Chronic pain disrupts ability to work by interfering with social function: A cross-sectional study
Conclusions In the development of effective solutions to address the economic and societal burden of chronic pain, this paper highlights the role of social function as an important, yet frequently overlooked, contributor to chronic pain's effect on the ability to work. Our findings underscore the importance of an integrated biopsychosocial approach to managing chronic pain, especially when addressing ability to work. From a clinical standpoint, assessing and managing pain intensity is necessary but not sufficient in addressing the far-reaching negative consequences of chronic pain. Implications The development of interven...
Source: Scandinavian Journal of Pain - December 9, 2017 Category: Anesthesiology Source Type: research

Impact of analgesics on executive function and memory in the Alzheimer's Disease Neuroimaging Initiative Database
Conclusions NSAID use was associated with higher executive function, and memory scores in certain subjects and larger cortical volumes in particular regions. Limitations of the study include secondary analysis of existing data and the possibility of confounding. Implications These results suggest it is important to consider the secondary effects of medications when choosing a treatment regimen. Further prospective studies are needed to examine the role of analgesics on cognition and whether NSAIDs act through cortical dimension changes and how they are related to gender and cognitive diagnosis. (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - December 9, 2017 Category: Anesthesiology Source Type: research

Psychoneuroimmunological approach to gastrointestinal related pain
Conclusions (based on our findings) Rather than proceeding with established allopathic single-target central or peripheral treatments, by non-invasively modulating the brain–gut axis components such as the psychological and neuroendocrinological status, microbiota, enteric nervous system, or immune cells (e.g. glial or mast cells), a favourable clinical outcome in various chronic gastrointestinal related pain syndromes may be achieved. Clinical tools are readily available in forms of psychotherapy, prebiotics, probiotics, nutritional advice, and off-label drugs. An example of the latter is low-dose naltrexone, a compound...
Source: Scandinavian Journal of Pain - December 9, 2017 Category: Anesthesiology Source Type: research

Evaluation of external vibratory stimulation as a treatment for chronic scrotal pain in adult men: A single center open label pilot study
Conclusion External vibratory stimulation has been suggested as a promising non-invasive tool to alleviate chronic pain. As a proof-of-concept, we implemented EVS to treat men with idiopathic orchialgia. The majority of patients noted benefit in both severity and frequency of pain. Given its low risk profile, EVS deserves further evaluation and inclusion in treatment guidelines as a promising experimental therapy for a disease with few conservative treatment options available to providers. Implications In this longitudinal study, external vibratory stimulation was found to decrease chronic scrotal pain without any adverse...
Source: Scandinavian Journal of Pain - December 9, 2017 Category: Anesthesiology Source Type: research

Visualization of painful inflammation in patients with pain after traumatic ankle sprain using [11C]-D-deprenyl PET/CT
Conclusions and implications The data provide further support that [11C]-D-deprenyl PET can visualize, quantify and follow processes in peripheral tissue that may relate to soft tissue injuries, inflammation and associated nociceptive signaling. Such an objective correlate would represent a progress in pain research, as well as in clinical pain diagnostics and management. Graphical abstract (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - December 9, 2017 Category: Anesthesiology Source Type: research

Developing a model for measuring fear of pain in Norwegian samples: The Fear of Pain Questionnaire Norway
Conclusion A 6-factor model for explaining and measuring FOP in Norwegian samples was identified and termed the FPQ-NOR. This new model constituted six factors and 27 items, conceptualized as Minor, Severe, Injection, Fracture, Dental, and Cut Pain. The FPQ-NOR had the best fit overall and in male- and female subgroups, probably due to cross-cultural differences in FOP. Implications This study highlights the importance on exploratory analysis of FOP-instruments when applied to different countries or cultures. As the FPQ-III is widely used in both research and clinical settings, it is important to ensure that the models co...
Source: Scandinavian Journal of Pain - December 9, 2017 Category: Anesthesiology Source Type: research

Unpredictable pain timings lead to greater pain when people are highly intolerant of uncertainty
Conclusions Our results show that IU moderately correlates to the change in pain intensity provoked by unpredictable stimulation timings. High IU scores were associated with a worsening of the subjective pain experience, especially during long delays in an unpredictable situation. These observations suggest that IU could be considered as a psychological variable that is able to influence pain perception in certain situations. Implications Assessing and addressing IU could be an added value in pain-related therapy, especially in chronic pain. (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - October 14, 2017 Category: Anesthesiology Source Type: research

Identifying characteristics of the most severely impaired chronic pain patients treated at a specialized inpatient pain clinic
Conclusion This study describes what makes the subgroup of pain patients most affected by their pain special according to associated factors and comorbidity We found that they were distinguished by a high degree of psychiatric comorbidity, low physical functioning and extreme levels of symptom preoccupation/hypervigilance. Many severe symptoms additional to pain (e.g. depression/anxiety, tiredness, disturbed sleep, lack of concentration, constipation) were reported. The group seems hypervigilant, overwhelmed with a multitude of different symptoms on a high severity level. Implications When treating this complex group, the...
Source: Scandinavian Journal of Pain - October 13, 2017 Category: Anesthesiology Source Type: research

Implicit evaluations and physiological threat responses in people with persistent low back pain and fear of bending
Conclusions Contrary to our expectation, self-reported fear of bending was not related to physiological startle response or implicit measures. People with PLBP as a group (irrespective of fear levels) showed an implicit association between images of a round-back bending/lifting posture and danger, but did not display elevated physiological responses to these images. These results provide insight to the understanding of the relationship between pain and fear of movement. Implications The potential clinical implications of our findings are twofold. First, these results indicate that self-report measures do not always reflec...
Source: Scandinavian Journal of Pain - October 13, 2017 Category: Anesthesiology Source Type: research

A novel miniature, wireless neurostimulator in the management of chronic craniofacial pain: Preliminary results from a prospective pilot study
Conclusion Percutaneous placement of a wireless neurostimulation device directly adjacent to affected craniofacial nerve(s) is a minimally invasive and reversible method of pain control in patients with craniofacial pain refractory to conventional medical managements. Preliminary results are encouraging and further larger scale studies are required for improved applications. (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - October 12, 2017 Category: Anesthesiology Source Type: research

Towards a structured examination of contextual flexibility in persistent pain
Publication date: Available online 11 October 2017 Source:Scandinavian Journal of Pain Author(s): Henrik Børsting Jacobsen (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - October 12, 2017 Category: Anesthesiology Source Type: research

The cognitive impact of chronic low back pain: Positive effect of multidisciplinary pain therapy
Conclusions These findings show that patients with cLBP have slowed speeds of information processing and working memory, but no alteration in attention and recognition memory. There are clearly interactions of cognitive function with pain, depression, anxiety, and medication. MDPT may improve the impaired cognitive function of patients with cLBP. Implication Health professionals should contemplate the results from this study when planning therapy strategies especially when prescribing pain medications such opioids to patients with chronic low back pain. (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - October 8, 2017 Category: Anesthesiology Source Type: research

Broadening the fear-avoidance model of chronic pain?
Publication date: October 2017 Source:Scandinavian Journal of Pain, Volume 17 Author(s): Jantine J.L.M. Boselie, Johan W.S. Vlaeyen (Source: Scandinavian Journal of Pain)
Source: Scandinavian Journal of Pain - October 7, 2017 Category: Anesthesiology Source Type: research

Hospitalization due to acute exacerbation of chronic pain: An intervention study in a university hospital
Conclusions Despite our attending physician-led intervention, the frequency, duration and very substantial costs of hospitalization of the cohort were not significantly reduced, suggesting that other strategies need to be identified to help these complex and vulnerable patients. Implications Frequent hospitalization with acute exacerbation of chronic pain is a largely hidden problem that has very substantial implications for patients, their carers and healthcare providers. Chronic pain services tend to focus on outpatient management. Breaking the cycle of frequent and recurrent hospitalization using multidisciplinary chro...
Source: Scandinavian Journal of Pain - October 7, 2017 Category: Anesthesiology Source Type: research

Is acetaminophen safe in pregnancy?
Publication date: Available online 4 October 2017 Source:Scandinavian Journal of Pain Author(s): Katsuhiro Toda Acetaminophen is thought to be the safest analgesic and antipyretic medicine for pregnant women, and it is widely used all over the world. However, prenatal acetaminophen was reported to be associated with asthma, lower performance intelligence quotient (IQ), shorter male infant anogenital distance (predicting poor male reproductive potential), autism spectrum disorder, neurodevelopmental problems (gross motor development, communication), attention-deficit/hyperactivity disorder, poorer attention and executive...
Source: Scandinavian Journal of Pain - October 5, 2017 Category: Anesthesiology Source Type: research