The Clinical journal of pain
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There is clinical experimental evidence that extracranial arterial vasodilation, extracranial neurogenic inflammation, and decreased inhibition of central pain transmission are involved in the pathogenesis of the migraine headache. The migraine aura is likely caused by a neurophysiologic phenomenon akin to Leão's cortical spreading depression, a wave of short-lasting neuronal excitation that travels over the cerebral cortex, followed by prolonged depression of cortical neuronal activity. ⋯ The process driving the pathogenesis of the migraine attack and susceptible to the migraine trigger factors may be located in the brain stem.
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To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people. ⋯ The mood disturbance related to spousal bereavement aggravates pain in older people. This lends support to the biopsychosocial model of pain.
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Comparative Study Clinical Trial Controlled Clinical Trial
Spousal responses are differentially associated with clinical variables in women and men with chronic pain.
Spousal responses have been related to clinical variables in patients with chronic pain. For example, solicitous responses from spouses have been associated with greater levels of pain and disability among patients with chronic pain. However, few investigators have determined whether spousal solicitousness produces different effects in women versus men with chronic pain. The present study examined pain reports, medication use, psychosocial factors, functional measures, and pain tolerance in patients with chronic pain. ⋯ These results extend previous findings demonstrating a relationship between spousal responses and patients' adjustment to pain; however, the pattern of these effects appears to be moderated by the sex of the patient. Implications for assessment and treatment of chronic pain are discussed.
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Clinical Trial Controlled Clinical Trial
Differential relationships between anxiety and treatment-associated pain reduction among male and female chronic pain patients.
Clinical, epidemiological, and laboratory-based studies have all suggested that female sex and elevated anxiety are associated with greater experience of pain. However, several recent reports have also indicated that sex may moderate the relationship between anxiety and responses to noxious stimuli, with anxiety more strongly related to pain among males. The present study examined whether anxiety differentially impacts outcomes for pain treatment among males and females. ⋯ These findings suggest differential relationships between anxiety and pain relief as a function of sex. While we are unable to identify a mechanism for this effect, higher anxiety may have predicted more pain relief among males and less pain relief among females due to sex differences in coping strategies or placebo effects.
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Myofascial pain syndrome (MPS) is defined as acute or chronic pain with sensory or motor autonomic symptoms, referred from active myofascial triggering points with associated dysfunction. Previous studies have suggested the usefulness of botulinum toxin A (BTX-A) in the treatment of MPS since it is capable of controlling muscular spasms, as well as other alternative mechanisms of action. ⋯ The results of this study are consistent with other studies showing the efficacy of BTX-A for treating pain in MPS. The evaluation of the psychologic dimension of this disorder and its associated disability can provide valuable information for the adequate management of these patients and for assessing treatment outcome.