Pain
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Despite the prominence of fear-avoidance models of chronic pain, there is a paucity of research regarding the origins of pain-related fear. Based on the premise that insecure attachment could be a developmentally based origin of elevated fear of pain, associations between adult attachment dimensions and constructs included in fear-avoidance models of chronic pain were investigated. Consistent with Bartholomew and Horowitz's [Bartholomew K, Horowitz LM. ⋯ The model of self dimension had significant positive associations with each of the fear-avoidance constructs. The model of others dimension had a significant positive association with pain catastrophizing, but was not significantly associated with fear of pain and pain hypervigilance. Future research directions and potential clinical implications are discussed.
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The theory of chemical radiculitis had been put forward about 30 years ago, but as yet it has not been proved by clinical studies. The aim of the current studies was to determine whether the annular tear of a painful disc proved by discography is the cause of radiating leg pain (radiculopathy) in patients with discogenic low back pain. Forty-two patients with discogenic low back pain at single disc level with concomitant radiating leg pain were studied in order to analyse the relationship between site of annular tear and side of radiating leg pain. ⋯ The current studies found that there was a significant positive correlation between the site of annular tear and the side of radiation pain. Abnormalities of electromyogram and reduction of motor nerve conduction velocity were found on the side of radiating leg pain. The studies indicated that leakage of chemical mediators or inflammatory cytokines, which are produced in the painful disc, into epidural space through annular tear could lead to injury to adjacent nerve roots, and it might constitute the primary pathophysiologic mechanism of radiating leg pain in patients with discogenic low back pain but with no disc herniation.