Opioid Use in the Management of Diabetic Peripheral Neuropathy (DPN) in a Large Commercially Insured Population
Conclusions: Opioids were the most frequently prescribed first-line agents for DPN. More than 50% of DPN patients remained untreated with pharmacologic agents 1 year after a DPN diagnosis. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - April 9, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Mediators and Moderators of Chronic Pain Outcomes in an Online Self-Management Program
This study supports the effectiveness of online interventions when CBT and self-management targets pain levels, emotional factors, and wellness-focused coping. The importance of stress as a mediator of pain severity is discussed. The absence of moderators may indicate that the intervention is effective for a wide variety of patients with chronic pain. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - April 9, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Test-retest Agreement and Reliability of Quantitative Sensory Testing 1 Year After Breast Cancer Surgery
Discussion: The QST protocol reliability allows for group-to-group comparison of sensory function, but less so for individual follow-up after breast cancer surgery. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - April 9, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Effect of Spinal Cord Stimulation on Sensory Characteristics: A Randomized, Blinded Crossover Study
Discussion: The results support existing evidence suggesting that SCS does not change sensory characteristics, which is important information for both patients and clinicians. Changes in pain intensity after deactivation of SCS may be different in short-term and long-term SCS treatment. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - April 9, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

The Influence of Anxiety Reduction on Clinical Response to Pediatric Chronic Pain Rehabilitation
This study investigates the relationship between anxiety reduction and functional outcomes in children and adolescents receiving intensive interdisciplinary rehabilitation services for chronic pain (CP). Specifically, we evaluated whether: (1) anxiety changes over the course of treatment; (2) anxiety covaries with functional outcomes to rehabilitation; and (3) change in anxiety predicts change in functional outcomes from rehabilitation for CP. Using 3 separate measures assessing anxiety-related constructs, we hypothesized that anxiety would be associated with functioning, both before and following intensive rehabilitation ...
Source: The Clinical Journal of Pain - April 9, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

The Shared Neuroanatomy and Neurobiology of Comorbid Chronic Pain and PTSD: Therapeutic Implications
This article focuses on neurobiological factors that may contribute to the coprevalence and synergistic interactions of chronic pain and PTSD. First, we outline how circuits that mediate emotional distress and physiological threat, including pain, converge. Secondly, we discuss specific neurobiological mediators and modulators of these circuits that may contribute to chronic pain and PTSD symptoms. For example, neuropeptide Y, and the neuroactive steroids allopregnanolone and pregnanolone (together termed ALLO) have antistress and antinociceptive properties. Reduced levels of neuropeptide Y and ALLO have been implicated in...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Review Articles Source Type: research

Neonatal Pain and Developmental Outcomes in Children Born Preterm: A Systematic Review
Conclusions: For infants born preterm, neonatal pain-related stress was associated with alterations in both early and in later developmental outcomes. Few longitudinal studies examined the impact of neonatal pain in the long-term development of children born preterm. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Review Articles Source Type: research

Pain Catastrophizing Differs Between and Within West Haven-Yale Multidimensonal Pain Inventory (MPI) Pain Adjustment Classifications: Theoretical and Clinical Implications From Preliminary Data
We examined how catastrophizing, and the underlying components of magnification, rumination, and helplessness, may relate to MPI classifications and differentially relate to pain outcomes across classification groups to inform clinical treatment planning. Materials and Methods: Sixty-nine adults (70% women) diagnosed with musculoskeletal pain were recruited from 2 pain clinics and completed self-report measures of pain severity, the MPI, Pain Catastrophizing Scale, and the Mood and Anxiety Symptom Questionnaire. Results: Patients in the DYS and ID groups reported the greatest levels of rumination, helplessness, and overall...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

The Pain Quality Response Profile of a Corticosteroid Injections and Heated Lidocaine/Tetracaine Patch in the Treatment of Shoulder Impingement Syndrome
This study presents pain quality data from a randomized open-label study comparing the effects of an injection of triamcinolone and up to twice daily application of a heated lidocaine/tetracaine (Trilexis) patch in individuals with SIS. Study participants completed a measure of pain quality at baseline and again on study days 14, 28, and 42 following initiation of 2 treatments for SIS. Baseline and posttreatment pain quality scores were graphed to provide a visual representation of treatment-associated changes. Analyses of variance were used to examine the differences between treatment conditions in changes in pain quality...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

A Prospective 2-Year Examination of Cognitive and Behavioral Correlates of Provoked Vestibulodynia Outcomes
Discussion: Changes in both cognitive and behavioral variables were significantly associated with improved pain and sexual satisfaction outcomes. However, it was the positive changes in SE that better predicted changes in avoidance behavior, pain, and sexual satisfaction. Cognitive-behavior therapy is often focused on changing negative pain-related cognitions to reduce avoidance and pain, but the present results demonstrate the potential importance of bolstering positive self-beliefs as well. Indeed, before engaging in exposure therapies, SE beliefs should be assessed and potentially targeted to improve adherence to exposu...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Ability of the Central Sensitization Inventory to Identify Central Sensitivity Syndromes in an Outpatient Chronic Pain Sample
Conclusions: The CSI is a useful and valid instrument for screening patients for the possibility of a CSS, although the chances of false positives are relatively high when evaluating patients with complex pain and psychophysiological disorders. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Mechanical Hyperalgesia and Reduced Quality of Life Occur in People With Mild Knee Osteoarthritis Pain
This study determined whether individuals with mild knee pain due to osteoarthritis (OA) experience hyperalgesia and central sensitivity by comparing them with age-matched and sex-matched control participants and determined whether these levels are associated with pain intensity. This study also determined whether these individuals experience significantly poorer quality of life than age-matched and sex-matched controls and whether pain and function predict quality of life. Methods: Quantitative sensory tests (QSTs), including punctate pain intensity (PPI), pressure pain threshold (PPT), and heat pain threshold, tolerance,...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Nociceptive Processing in Women With Premenstrual Dysphoric Disorder (PMDD): The Role of Menstrual Phase and Sex Hormones
This study was designed to address this gap in the literature. Materials and Methods: Healthy, regularly cycling participants (14 PMDD, 14 non-PMDD) attended pain testing sessions during the mid-follicular, ovulatory, and late-luteal phases of the menstrual cycle (order counterbalanced) and salivary estradiol, progesterone, and testosterone were assessed at each testing session. Pain sensitivity was measured from electrocutaneous threshold/tolerance, ischemic threshold/tolerance, sensory and affective ratings of electrocutaneous and ischemic stimuli, and the nociceptive flexion reflex threshold (NFR, a measure of spinal no...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

The Effect of Neck-specific Exercise With, or Without a Behavioral Approach, on Pain, Disability, and Self-Efficacy in Chronic Whiplash-associated Disorders: A Randomized Clinical Trial
Objectives: The aim of this study was to compare the effect on self-rated pain, disability, and self-efficacy of 3 interventions for the management of chronic whiplash-associated disorders: physiotherapist-led neck-specific exercise (NSE), physiotherapist-led NSE with the addition of a behavioral approach, or Prescription of Physical Activity (PPA). Materials and Methods: A total of 216 volunteers with chronic whiplash-associated disorders participated in this randomized, assessor blinded, clinical trial of 3 exercise interventions. Self-rated pain/pain bothersomeness (Visual Analogue Scale), disability (Neck Disability In...
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

A Randomized, Placebo-controlled Trial of the Analgesic Efficacy and Safety of the p38 MAP Kinase Inhibitor, Losmapimod, in Patients With Neuropathic Pain From Lumbosacral Radiculopathy
Discussion: Losmapimod could not be differentiated from placebo in terms of analgesia. The lack of response could reflect insufficient losmapimod levels in the spinal cord or differences between lumbosacral radiculopathy and animal models of neuropathic pain. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - March 10, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Focus Article Report of the NIH Task Force on Research Standards for Chronic Low Back Pain: Erratum
No abstract available (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Erratum Source Type: research

Traumatic Functional Pathology of the Masticatory System as Being Responsible for Headaches: An Odontologic Standpoint
No abstract available (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Letter to the Editor Source Type: research

Modeling the Predictive Value of Pain Intensity on Costs and Resources Utilization in Patients With Peripheral Neuropathic Pain
Objective: The aim of the present analysis was to model the association and predictive value of pain intensity on cost and resource utilization in patients with chronic peripheral neuropathic pain (PNP) treated in routine clinical practice settings in Spain. Methods: We performed a secondary economic analysis based on data from a multicenter, observational, and prospective cost-of-illness study in patients with chronic PNP that is refractory to prior treatment. Pain intensity was measured using the Short-Form McGill Pain Questionnaire. Univariate and multivariate linear regression models were fitted to identify independent...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Review Article Source Type: research

Trigger Points and Pressure Pain Hypersensitivity in People With Postmeniscectomy Pain
The objectives of this study are (1) to assess the presence of myofascial trigger points (TrPs) and widespread pressure hyperalgesia; and (2) to assess the relationship between the presence of active TrPs, pain intensity, and widespread pressure hypersensitivity in individuals with postmeniscectomy pain. Methods: Thirty-three patients with postmeniscectomy pain, 46 to 60 years of age, and 33 matched controls participated. TrPs were explored bilaterally within the tensor fasciae latae, rectus femoris, vastus lateralis, vastus medialis, adductor magnus, adductor longus, semitendinosus, biceps femoris, and gastrocnemius muscl...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Psychological Covariates of Longitudinal Changes in Back-related Disability in Patients Undergoing Acupuncture
Objectives: To identify psychological covariates of longitudinal changes in back-related disability in patients undergoing acupuncture. Materials and Methods: A longitudinal postal questionnaire study was conducted with data collection at baseline (pretreatment), 2 weeks, 3, and 6 months later. A total of 485 patients were recruited from 83 acupuncturists before commencing acupuncture for back pain. Questionnaires measured variables from 4 theories (fear-avoidance model, common-sense model, expectancy theory, social-cognitive theory), clinical and sociodemographic characteristics, and disability. Longitudinal multilevel mo...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Are Prevalent Self-reported Cardiovascular Disorders Associated With Delayed Recovery From Whiplash-associated Disorders: A Population-based Cohort Study
This study was based on the Saskatchewan Government Insurance cohort, including individuals over 18 years of age, who made a traffic-injury claim or received health care after a traffic injury, between 1997 and 1999. Participants completed a baseline questionnaire and were followed up by telephone interviews at 6 weeks, 3 months, 6 months, 9 months, and 12 months after injury. Our sample includes a subcohort of 6011 participants who reported WAD (defined as answering “yes” to the question “Did the accident cause neck or shoulder pain”) at baseline. The outcome, self-perceived recovery, was measured ...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Maternal Satisfaction as an Outcome Criterion in Research on Labor Analgesia: Data Analysis from the Recent Literature
Objectives: To investigate whether maternal satisfaction (MS) is taken into consideration as an outcome criterion in clinical research on analgesia for labor. Methods: A systematic review of articles reporting analgesia for labor from a panel of 17 influential journals was undertaken. A total of 116 articles were analyzed, including 282 within-study groups. The scope of MS, the type of outcome measure used, and the time of measurement were noted. Each available observation was assigned an ordinal value of MS (ordMS), according to data distribution. The factors influencing ordMS were identified by multivariable analysis. Re...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Agreement Between Verbal and Electronic Versions of the Numerical Rating Scale (NRS-11) when Used to Assess Pain Intensity in Adolescents
Discussion: Pain intensity ratings on the vNRS-11 and eNRS-11 seem to be comparable, at least for the 80% CI. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

An Investigation of the Associations Between Measures of Mindfulness and Pain Catastrophizing
Objective: Mindfulness and pain catastrophizing are important constructs in pain research, and there are theoretical reasons for suspecting that measures of the 2 constructs should be related in predictable ways. The present study investigated the association of pain catastrophizing (Pain Catastrophizing Scale) with mindfulness (Five Facet Mindfulness Questionnaire). The Penn State Worry Questionnaire was included to control for confounding of worry; the influence of demographics was explored. Methods: The participants were 214 undergraduates, who were administered questionnaires via the Internet. Analyses assessed relatio...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Italian Oncological Pain Survey (IOPS): A Multicentre Italian Study of Breakthrough Pain Performed in Different Settings
Conclusion: This survey performed by an Italian observatory expert review group, has confirmed that the BTP represents a clinically relevant condition with a negative impact on the patient’s quality of life. BTP was detected in all settings involved. A number of factors are associated with the BTP. Also factors regarding the course of disease and setting of care have been assessed. This information may help in stratifying patients or predicting the risk of development of BTP with specific characteristics. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Organ-specific Microcirculatory Mass Transport of Oxycodone in Humans: Clinical Implications for Therapeutic Use
Discussion: Organ-specific OC mass transport kinetics provide new information for OC dosing in pain management. The model promotes patient safety in opioid prescribing because it allows predictions to be made about the relative contribution that OC recycling makes to circulating OC levels. The model indicates that pharmacologic modulation of the microcirculation may give way to site-specific delivery of opioids in the future. Our study demonstrates that translation of bench in silico research data into clinical practice, although still challenging, is feasible and can assist in OC dose regimen design for patient safety. (S...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Opioid-related Adverse Drug Events: Do Parents Recognize the Signals?
This study examined parents’ recognition and response to pain and ADE signals using both dynamic hypothetical scenarios and real at-home opioid decisions. Materials and Methods: A total of 514 parents whose children required prescription opioids after discharge were surveyed. Parents made analgesic decisions for 4 hypothetical scenarios wherein the child’s pain level and ADE symptoms were altered. After discharge, parents recorded their child’s real pain levels, ADEs, and their analgesic decisions. Mixed-effects logistic regression examined the influence of pain and ADE signals on parents’ opioid de...
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Pain Assessment in Children: Validity of Facial Expression Items in Observational Pain Scales
Discussion: The facial items varied considerably in coder judgment reliability as well as criterion (empirical and convergent), content, and face validity. Observational scales should provide behavioral cues that correspond to empirical descriptions of the facial expression of pain. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - February 6, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

The Role of Positive Affect in Pain and Its Treatment
Discussion: We offer an “upward spiral” model of PA, resilience and pain self-management, which makes specific predictions that PA will buffer maladaptive cognitive and affective responses to pain, and promote active engagement in valued goals that enhance CP self-management. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Review Articles Source Type: research

Outcome Measures in Randomized-controlled Trials of Neuropathic Pain Conditions: A Systematic Review of Systematic Reviews and Recommendations for Practice
Discussion: These results demonstrate that measures of pain are predominantly used in trials of NeP conditions and highlight the scant usage of functional outcome measures. The lack of standardization for the diagnostic criteria in NeP trials is also an issue that needs to be considered for future research and guideline development. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Review Articles Source Type: research

Myofascial Trigger Point-focused Head and Neck Massage for Recurrent Tension-type Headache: A Randomized, Placebo-controlled Clinical Trial
Objective: Myofascial trigger points (MTrPs) are focal disruptions in the skeletal muscle that can refer pain to the head and reproduce the pain patterns of tension-type HA (TTH). The present study applied massage focused on MTrPs of patients with TTH in a placebo-controlled, clinical trial to assess efficacy on reducing headache (HA) pain. Methods: Fifty-six patients with TTH were randomized to receive 12 massage or placebo (detuned ultrasound) sessions over 6 weeks, or to wait-list. Trigger point release massage focused on MTrPs in cervical musculature. HA pain (frequency, intensity, and duration) was recorded in a daily...
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Attachment and Adjustment in Adolescents and Young Adults With a History of Pediatric Functional Abdominal Pain
This study tested predictions of the Attachment-Diathesis Model (ADM) of Chronic Pain in a cross-sectional sample of adolescents and young adults with a history of childhood functional abdominal pain (FAP). ADM posits that attachment anxiety is a diathesis for poor adjustment (physical health, mental health, and functioning) in the context of chronic pain and that pain self-efficacy, pain threat appraisal, and passive coping mediate this effect. Methods: Participants (N=261) were recruited from a database of consecutive new patients evaluated for abdominal pain at a pediatric gastroenterology clinic. Participants’ me...
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Barriers to Change in Depressive Symptoms After Multidisciplinary Rehabilitation for Whiplash: The Role of Perceived Injustice
Conclusions: The results suggest that the identification of patients with high levels of perceived injustice and implementation of targeted interventions for these patients might contribute to greater improvements in their depressive symptomatology. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Pain Self-efficacy Mediates the Relationship Between Depressive Symptoms and Pain Severity
We examined the relationships between depressive symptoms, pain severity, and pain self-efficacy (PSE) in patients with chronic low back pain (CLBP). We hypothesized that change in depressive symptoms would significantly influence change in pain severity, and that PSE indirectly affects this relationship. Materials and Methods: Participants were 109 CLBP patients in a 4-week multidisciplinary rehabilitation program for CLBP. They completed measures of PSE, depression, and pain severity at admission and discharge. Structural equation modeling was used to test the significant direct and indirect effects from pretreatment to ...
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Original Articles Source Type: research

Effective Reassurance in Primary Care of Low Back Pain: What Messages From Clinicians are Most Beneficial at Early Stages?
Discussion: Reassurance of patients in early phases of persistent back pain might improve from affective and cognitive parts of communication and individually tailored information. Subgroup differences with respect to different prognosis, associated patterns of adaptive or maladaptive pain coping, and levels of health-promoting versus harmful physical activity should be considered more carefully. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Special Topic Series Source Type: research

Subgrouping of Low Back Pain Patients for Targeting Treatments: Evidence from Genetic, Psychological, and Activity-related Behavioral Approaches
Conclusions: For future research and treatment it might be challenging to develop theoretical frameworks combining different subgrouping classifications. On the basis of this framework, tailoring treatments more specifically to the patient needs may result in improvements in treatment programs for patients with LBP. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Special Topic Series Source Type: research

A Self-Regulation Perspective on Avoidance and Persistence Behavior in Chronic Pain: New Theories, New Challenges?
Discussion: Several implications and challenges arising from this review are discussed. In particular, a self-regulation perspective does not consider avoidance and persistence behavior to be intrinsically adaptive or maladaptive, but argues that their effects on disability and well-being rather depend on the goals underlying these behaviors. Such view would require a shift in how avoidance and persistence behavior are assessed and approached in clinical interventions. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Special Topic Series Source Type: research

Exercise, Not to Exercise, or How to Exercise in Patients With Chronic Pain? Applying Science to Practice
Conclusion: Exercise therapy has found to be beneficial in CP, but it should be appropriately and individually tailored with emphasis on prevention of symptom flares and applying adequate recovery strategies. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Special Topic Series Source Type: research

Interaction Between Pain, Movement, and Physical Activity: Short-term Benefits, Long-term Consequences, and Targets for Treatment
Movement is changed in pain. This presents across a spectrum from subtle changes in the manner in which a task is completed to complete avoidance of a function and could be both a cause and effect of pain/nociceptive input and/or injury. Movement, in a variety of forms, is also recommended as a component of treatment to aid the recovery in many pain syndromes. Some argue it may not be sufficient to simply increase activity, whereas others defend a necessity to consider how a person moves. There is unlikely to be a simple relationship between pain and movement, as both too little and too much movement could be suboptimal fo...
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Special Topic Series Source Type: research

Pain, Mind, and Movement in Musculoskeletal Pain: Is Physical Activity Always Health-promoting or Are There Detrimental Aspects?
No abstract available (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - January 8, 2015 Category: Anesthesiology Tags: Editorial Source Type: research

Single-dose Systemic Acetaminophen to Prevent Postoperative Pain: A Meta-analysis of Randomized Controlled Trials
The objective of the current investigation was to evaluate the effect of a single preventive dose of systemic acetaminophen on postoperative pain outcomes. Materials and Methods:A wide search was performed to identify randomized controlled trials that evaluated the effects of a single dose of systemic acetaminophen on pain outcomes in a large variety of surgical procedures. Meta-analysis was performed using a random-effect model. Results:Eleven randomized clinical trials evaluating 740 patients were included in the analysis. The weighted mean difference (95% confidence interval [CI]) of the combined effects favored acetami...
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Review Article Source Type: research

Persistence of Noncancer-related Musculoskeletal Chronic Pain Among Community-dwelling Older People: A Population-based Longitudinal Study in Finland
Conclusions:Chronic musculoskeletal pain is a highly persistent condition among community-dwelling older persons and it is related to poor health and mobility difficulties. In addition, the use of daily analgesic is low despite the continuous nature of chronic pain. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Natural History of Comorbid Orofacial Pain Among Women With Vestibulodynia
Objectives:We evaluated the stability of the comorbidity between vulvodynia and orofacial pain (OFP) and its associated clinical characteristics over a 2-year follow-up period. Materials and Methods:In an earlier study of vestibulodynia patients, we administered questionnaires assessing demographic data, self-reported pain, anxiety, somatic awareness, and presence of signs and symptoms suggestive of clinical and subclinical OFP. The present study readministered the same surveys to a subset of the original cohort after a 2-year follow-up period. Results:Of the 138 women in the previous study, 71 (51%) agreed to participate ...
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Widespread Pressure Pain Hypersensitivity in Patients With Multiple Sclerosis With and Without Pain as Sign of Central Sensitization
Objective:To determine the presence of widespread pressure hyperalgesia in multiple sclerosis (MS) patients with and without pain and its association with pain and fatigue. Methods:A total of 108 individuals with definite MS, 49 men and 59 women (mean age, 44±8 y) and 108 age-matched and sex-matched pain-free controls (mean age, 44±9 y) were included. Fifty patients (n=58, 54%) reported pain and 50 (46%) did not. Pressure pain threshold (PPT) was bilaterally assessed over supraorbital, infraorbital, mental, median, radial and ulnar nerve trunks, C5-C6 joint, second metacarpal, and tibialis anterior muscle by ...
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Real-world Experience With Once-daily Gabapentin for the Treatment of Postherpetic Neuralgia (PHN)
Discussion:In real-world clinical practice, G-GR seems to be an effective, well-tolerated treatment option for patients with postherpetic neuralgia, regardless of age. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Molecular Analysis of Cluster Headache
Conclusions:Our data (although obtained on a small number of cases) confirm the genetic heterogeneity of CH, suggesting that mutations in the ADH4 gene and a novel rearrangement involving NRXN3 gene might be related to CH in a subset of cases. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Association of Pain and Depression in Those With Chronic Low Back Pain: The Mediation Effect of Patient Sexual Functioning
This study sought to test this hypothesis by considering the mediating effect of sexual functioning on the association between pain intensity and depressive symptoms in sexually active patients with chronic low back pain. Materials and Methods:This was a cross-sectional study on consecutive patients attending a chronic pain management clinic in Iran. All measures (pain intensity, depressive symptoms, sex-specific sexual function) were obtained by a self-report questionnaire, completed by patients while attending the clinic. Sobel testing, including bias-corrected bootstrapping, was used to produce 95% confidence intervals ...
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

MiR-203 Involves in Neuropathic Pain Development and Represses Rap1a Expression in Nerve Growth Factor Differentiated Neuronal PC12 Cells
This study revealed substantially (∼10-fold) decreased miR-203 expression in the spinal dorsal horns but not the dorsal root ganglions, hippocampus, or anterior cingulate cortexes of bCCI rats. Rap1a protein expression was upregulated in bCCI rat spinal dorsal horns. We further verified that miR-203 directly targeted the 3′-untranslated region of the rap1a gene, thereby decreasing rap1a protein expression in neuron-like cells. Discussion:Rap1a has diverse neuronal functions and their perturbation is responsible for several mental disorders. For example, Rap1a/MEK/ERK is involved in peripheral sensitization. These...
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Cold Hyperalgesia Associated With Poorer Prognosis in Lateral Epicondylalgia: A 1-Year Prognostic Study of Physical and Psychological Factors
Background:Predictors of outcome in lateral epicondylalgia, which is mainly characterized as a mechanical hyperalgesia, are largely limited to sociodemographic and symptomatic factors. Quantitative sensory testing is used to study altered pain processing in various chronic pain conditions and may be of prognostic relevance. Methods:The predictive capacity of early measures of physical and psychological impairment on pain and disability and mechanical hyperalgesia, were examined using data from 41 patients assigned to placebo in a prospective randomized controlled trial of unilateral lateral epicondylalgia. Quantitative sen...
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research

Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury
Conclusions:Genotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury. (Source: The Clinical Journal of Pain)
Source: The Clinical Journal of Pain - December 6, 2014 Category: Anesthesiology Tags: Original Articles Source Type: research