Pain
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The relationship between anxiety and chronic pain has been poorly studied. The authors studied the occurrence of symptoms of anxiety in chronic low back pain patients. ⋯ Anxious mood, tension and general somatic symptoms of the sensory type were more common than any other type of anxiety symptoms. The authors discuss the potential role of anxiety in chronic pain patients.
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A novel form of subcutaneous nerve stimulation (SCNS) was recently introduced for the relief of chronic pain. We present a study using this form of SCNS applied over the radial, median and saphenous nerves in patients with clinically diagnosed osteoarthritis of the hip. ⋯ We suggest that these results may be explained by the ability of SCNS to evoke a placebo response. The efficacy of the placebo effect and the ethical implications of its use in clinical practice are discussed.
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The current study investigated the utility of the Back Pain Classification Scale with chronic, intractable low back pain and headache patients. Subjects consisted of 50 chronic low back pain and 50 chronic headache patients referred to a university based Pain Center for evaluation. Data indicated that subjects were a representative sample of severely intractable chronic pain patients typically referred for Pain Center evaluation and treatment. ⋯ It was concluded that the Back Pain Classification Scale was an empirically valid instrument to use with chronic low back pain patients, but not with chronic headache patients. This lack of utility with chronic headache patients was also viewed as support for the construct validity of the scale. Wider use of the scale with chronic low back pain patients was suggested.
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The relationship between labor pain and concomitant psychological state, in terms of prenatal anxiety levels and post-partum mood, has been studied. A consecutive series of primiparae (n = 129) was assessed at intervals over the course of their pregnancy and after delivery. State anxiety was measured at recruitment (10-14 weeks of pregnancy), 10 weeks, 32 weeks and at labor. ⋯ Anxiety scores at 32 weeks accounted for a further 5% of the variance and emerged as the best predictor of MPQ evaluative scores and visual analog ratings. A significant association was found between pain ratings and ratings of post-partum mood. Neither attendance at preparatory classes nor initial attitudes towards the neonate were related to pain scores.
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Stressors in the family and job environments have been proposed to play a role in the modulation of pain, yet direct empirical support for such a role is limited. The present study investigated the relationship between general stress, family and work environments (perceived social climate), psychological distress (anxiety, depression), and pain experience (sensory, affective, evaluative) in 33 ambulatory chronic low back pain (CLBP) subjects and 35 healthy controls matched for age, sex, socioeconomic status (SES), weight, and height. Results indicated that environmental stressors/social climate measures, including family conflict, family control, and general stress (Social Readjustment Rating Scale), were greater in the CLBP group. ⋯ Less peer cohesion, less physical comfort, and less job clarity were correlated with increased pain, but not distress. Work pressure was associated with decreased depression and less pain. These findings suggested the presence of both stress and operant mechanisms in the modulation of pain in the family, while operant and distraction mechanisms appear to characterize the relationship among work environment factors and pain.