The Clinical journal of pain
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Comparative Study
Comparing pain modulation and autonomic responses in fibromyalgia and irritable bowel syndrome patients.
Past studies confirm that patients with fibromyalgia (FM) and irritable bowel syndrome (IBS) show similar pain processing dysfunctions, such as reduced pain inhibition and aberrant autonomic nervous system (ANS) responses. However, patients with FM and IBS have rarely been investigated in the same study. The aim of the present study, therefore, was to compare descending pain inhibition, pain sensitivity, and ANS reactivity to pain in FM, IBS, and healthy controls (HC). ⋯ Our results confirm the presence of graded levels of somatic hyperalgesia across patients with IBS and FM. A similar pattern of result was observed for pain inhibitory dysfunctions. These pain processing changes were accompanied by abnormal autonomic responses, which maintained patients (principally patients with FM) in a state of sympathetic hyperactivity. Results suggest that patients with IBS and FM may present common, but graded, pain processing and autonomic dysfunctions.
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Case Reports
A case of potential treatment of remote pain after sacral nerve stimulation for chronic urinary retention.
A case is presented in which a 58-year-old man developed a potential unintended and durable treatment of pain at remote sites (cervical region and low back) after sacral nerve stimulation for chronic urinary retention. ⋯ The current case presents a potential example of neurological crosstalk and highlights the inherent complexity in human neural physiology. Further research may reveal novel treatment strategies for patients with voiding dysfunction and chronic pain syndromes.
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This study examined the relationship between pain and mental health outcomes of depression and affect among survivors of breast cancer. The mediating role of physical activity was also tested. ⋯ Participation in physical activity is one pathway through which pain influences mental health. Efforts are needed to help survivors of breast cancer manage pain symptoms and increase their level of physical activity to help improve mental health.
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The Minimum Clinical Important Difference (MCID) was initially intended to provide outcome measures that would be more clinically meaningful than measurements based simply on mean improvement in some outcomes. Indeed, a basic concept behind the MCID was that statistically significant differences in measures did not necessarily reflect clinically meaningful benefits. ⋯ A call is made for a more comprehensive approach to synthesize a nearly decade's worth of clinical research that has still not yielded consensus concerning the best MCID approach to objectively document lumbar spine fusion patients' outcomes.
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Isolated proximal-without-distal (buttock but not calf) exercise-related lower-limb ischemia (IPI) might develop in the presence of arterial lesions impairing the blood flow supply toward the hypogastric vascular bed. In IPI, lower-limb sensory nerve dysfunction might occur from the sacral nerve plexus becoming ischemic during exercise. The purpose of this study was to compare patients with IPI with healthy controls for the presence of sensory nerve dysfunction, as assessed using somatosensory testing (SST). ⋯ The SST data suggest that patients with IPI have abnormal functioning of Aβ-fiber and C-fiber inputs in their affected limb(s). These sensory abnormalities might contribute to the exercise-induced ischemic symptoms experienced by these patients.