The Clinical journal of pain
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To evaluate whether orexin receptor antagonism with filorexant provides pain relief in patients with painful diabetic neuropathy (PDN). ⋯ These data do not provide evidence for the efficacy of nightly filorexant for the treatment of PDN.
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Posttraumatic stress disorder (PTSD) is common in chronic posttraumatic pain. Theoretical models suggest that attentional biases (AB) contribute to the development and maintenance of chronic pain and PTSD; however, the influence of AB on clinical and heat pain sensitivity in chronic posttraumatic pain patients is unknown. This study investigated AB for linguistic pain-related stimuli and trauma-related stimuli, and clinical and thermal sensitivity in patients with chronic posttraumatic pain with and without PTSD. ⋯ These results suggest that attentional avoidance is associated with increased chronic posttraumatic pain. The causal contribution of attentional avoidance to pain outcomes remains unclear.
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The involvement of inflammatory components in the pathophysiology of low back pain (LBP) is poorly understood. It has been suggested that spinal manipulative therapy (SMT) may exert anti-inflammatory effects. ⋯ The production of chemotactic cytokines is significantly and protractedly elevated in LBP patients. Changes in chemokine production levels, which might be related to SMT, differ in the acute and chronic LBP patient cohorts.
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Review Meta Analysis
Lumbar Tactile Acuity in Patients With Low Back Pain and Healthy Controls: Systematic Review and Meta-Analysis.
Diminished tactile acuity in chronic non-neuropathic pain syndromes has been attributed to central pain processing and cortical reorganization. The latter was recently targeted in clinical trials that demonstrated no clear advantages over traditional approaches for the reduction of nonspecific low back pain (LBP). The aim of this systematic review and meta-analysis was to summarize the current evidence on tactile acuity in LBP and pain-free controls. ⋯ A gap of knowledge regarding tactile acuity in populations with acute and chronic non-neuropathic LBP needs to be addressed in future research as this may significantly help the understanding of the causality of tactile acuity alterations.
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Multicenter Study Observational Study
Sensitivity of the DN4 in Screening for Neuropathic Pain Syndromes.
Several tools have been developed to screen for neuropathic pain. This study examined the sensitivity of the Douleur Neuropathique en 4 Questions (DN4) in screening for various neuropathic pain syndromes. ⋯ The DN4 performed well; however, sensitivity varied by syndrome and the lowest sensitivity was found for trigeminal neuralgia. A positive DN4 was associated with greater pain catastrophizing, disability and anxiety/depression, which may be because of disease severity, and/or these scales may reflect magnification of sensory symptoms and findings. Future research should examine how the DN4 could be refined to improve its sensitivity for specific neuropathic pain conditions.