The Clinical journal of pain
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Alexithymia has been shown to be associated with key pain-related variables in persons with chronic pain from western countries, but the generalizability of these findings across cultures has not been examined adequately. Also, there remain questions regarding the importance of alexithymia to patient functioning over and above the effects of the general negative affectivity. ⋯ The findings support the cross-cultural generalizability of significant associations between alexithymia and both pain interference and catastrophizing. However, whether (1) alexithymia influences patient functioning indirectly by its effects on negative affect or (2) the univariate associations found between alexithymia and measures of patient functioning are a byproduct of both being influenced by negative affect needs to be tested using longitudinal and experimental research.
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To evaluate the influence of myofascial pain on the Pressure Pain Threshold (PPT) of masticatory muscles in women with migraine. ⋯ Migraine, especially when accompanied by myofascial pain, reduces the PPT of masticatory muscles, suggesting the importance of masticatory muscle palpation during examination of patients with migraine.
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Randomized Controlled Trial
Psychobiological correlates of improved mental health in patients with musculoskeletal pain after a mindfulness-based pain management program.
Mindfulness-based pain management programs (MBPMs) aim to improve mental and physical health in individuals with chronic pain. In this study, we investigated whether improvement in mental health might require (1) reduction in the sensory pain experience and brain correlates of that experience, and/or (2) improved perceptions of the controllability of pain and corresponding brain activity related to cognitive control and emotional regulation. ⋯ Increased activity in cognitive control regions of the brain during pain anticipation related to improved mental health and perceived control over pain, but not to decreased pain experience. Greater perceived control may therefore result from improved regulation of the emotional response to pain.
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Comparative Study
Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI.
After cessation of a low-back pain (LBP) episode, alterations in trunk muscle behavior, despite recovery from pain, have been hypothesized to play a pathogenic role in the recurrence of LBP. This study aimed to identify the presence of lumbar muscle dysfunction during the remission of recurrent LBP, while performing a low-load trunk-extension movement. ⋯ Lower T2-rest values have been suggested to correlate with a conversion of the multifidus' fiber typing toward the glycolytic muscle spectrum. Elevated T2 shifts correspond with increased levels of metabolic activity in the multifidus in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide evidence of concurrent alterations in the multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain free and functionally recovered.
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Graded motor imagery (GMI) shows promising results for patients with complex regional pain syndrome (CRPS). ⋯ Our case report develops a design capable of differentiating cerebral changes associated with behavioral therapy of CRPS type I study.