Pain
-
Randomized Controlled Trial Comparative Study Clinical Trial
Reduction of pain-related fear in complex regional pain syndrome type I: the application of graded exposure in vivo.
Fear of (re)injury/movement has been identified as a potential predictor of chronic disability in complex regional pain syndrome type I (CRPS-I). In order to reduce pain-related fears and pain disability, graded exposure in vivo (GEXP) is likely to be an appropriate treatment. Indeed, there is evidence that in chronic pain patients reporting substantial fear of (re)injury/movement, GEXP is successful in reducing pain disability. ⋯ The current study supports a GEXP approach to chronic CRPS-I. The GEXP was successful in decreasing levels of self-reported pain-related fear, pain intensity, disability, and physiological signs and symptoms. These results support the hypothesis that the meaning people attach to a noxious stimulus influences its experienced painfulness, and that GEXP activates cortical networks and reconciles motor output and sensory feedback.
-
Comparative Study
Predictive validity of the Chronic Pain Coping Inventory in subacute low back pain.
The Chronic Pain Coping Inventory (CPCI) was developed to assess eight behavioral coping strategies hypothesized to be important for pain adaptation. But the predictive validity of the CPCI has yet to be tested in a longitudinal study. Here, 321 workers on sick leave after a work accident affecting the low back pain (LBP) region completed the CPCI during the subacute stage (T1) of LBP as well as the Catastrophizing scale of the Coping Strategies Questionnaire (CSQ). ⋯ Catastrophizing and Guarding were the most strongly associated with depressive mood at T1 but at T2, only depressive mood at T1 predicted this same variable. Results indicated also that the Guarding and Catastrophizing scales were able to predict future work status. The present study clearly reveals the usefulness of Guarding from the CPCI and Catastrophizing from the CSQ, when predicting different outcomes of adjustment to low back pain.
-
Comparative Study
The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population.
This study sought to better understand the relationship between religion/spirituality and physical health and mental health in 122 patients with chronic musculoskeletal pain. The current study conceptualized religion/spirituality as a multidimensional factor, and measured it with a new measure of religion/spirituality for research on health outcomes (Brief Multidimensional Measure of Religion/Spirituality). Pain patients' religious and spiritual beliefs appear different than the general population (e.g. pain patients feel less desire to reduce pain in the world and feel more abandoned by God). ⋯ Forgiveness, negative religious coping, daily spiritual experiences, religious support, and self-rankings of religious/spiritual intensity significantly predicted mental health status. Religion/spirituality was unrelated to pain intensity and life interference due to pain. This study establishes relationships between religion/spirituality and health in a chronic pain population, and emphasizes that religion/spirituality may have both costs and benefits for the health of those with chronic pain.
-
Multicenter Study Comparative Study
Towards a new taxonomy of idiopathic orofacial pain.
There is no current consensus on the taxonomy of the different forms of idiopathic orofacial pain (stomatodynia, atypical odontalgia, atypical facial pain, facial arthromyalgia), which are sometimes considered as separate entities and sometimes grouped together. In the present prospective multicentric study, we used a systematic approach to help to place these different painful syndromes in the general classification of chronic facial pain. This multicenter study was carried out on 245 consecutive patients presenting with chronic facial pain (>4 months duration). ⋯ Inside this large cluster, only stomatodynia (n=42) emerged as a distinct homogenous subgroup. In contrast, facial arthromyalgia (n=46) and an entity formed with atypical facial pain (n=25) and atypical odontalgia (n=13) could only be individualised by variables reflecting topographical characteristics. These data provide grounds for an evidence-based classification of idiopathic facial pain entities and indicate that the current sub-classification of these syndromes relies primarily on the topography of the symptoms.
-
Comparative Study Clinical Trial
Lack of sex differences in modulation of experimental intraoral pain by diffuse noxious inhibitory controls (DNIC).
The aims of this study were to investigate possible sex differences in (a) intraoral pain evoked by topical application of capsaicin to the gingiva, and (b) the modulation of this pain by diffuse noxious inhibitory controls (DNIC). Three groups with a total of fifty-four healthy volunteers (20 men, 20 women using oral contraceptives (W+OC), 14 women not using (W-OC)) completed the study. In two sessions, intraoral pain was evoked by topical application of 30microL 5% capsaicin to the gingiva. ⋯ The degree of modulation by DNIC did not differ between groups (P=0.636). In conclusion, for a superficial type of intraoral pain, only minor sex differences were found in pain intensity and no differences in the degree of endogenous modulation by DNIC. Female sex and the use of OC may not consistently be associated with higher sensitivity to pain.