The Clinical journal of pain
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The relationship of personality variables and patient recruitment to pain coping strategies and psychological distress was assessed in a Dutch sample of 111 chronic tension headache patients. Using the Coping Strategy Questionnaire (CSQ), high scores on the factor of helplessness proved to be associated with psychological distress. ⋯ Patients who reported shorter daily pain periods indicated a lower level of active coping with pain. It is concluded that future research must be more attentive to the complex interactions between personality variables, environmental factors, and the coping demands posed by the nature of the pain problem.
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The following discussion demonstrates a clinical need for a physical education service in a multidisciplinary pain center. Weight loss, and physical and aerobic conditioning are essential aspects of managing pain. By improving patient care and increasing one's pain center attraction, physical education and aerobic research centers can also increase departmental revenues.
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Pain related to fibromyalgia may consist of a complex interaction of nociceptive, neuropathic, dysregulatory central nervous system and psychosomatic mechanisms. Nociceptor pain is based on the excitation of nervous sensors specialized to signal potentially harmful stimuli, i.e., the nociceptors. Metabolic deficiencies in muscle and neurogenic inflammation induced by the release of substance P and other neuropeptides from the peripheral nerve endings may result in chemical sensitization of nociceptors and an ensuing hyperalgesia particularly present in tender points. ⋯ Persistent abnormal spinal reflex transmission due to, e.g., peripheral trauma or inappropriate postural habits may result in a vicious circle between muscle hypertension and pain. Similarly, a defective sympathetic control may result in disturbed microcirculation and nociceptor excitation (e.g., in sympathetic algodystrophy). Many symptoms of pain in fibromyalgia (trigger points, pain referral, pain associated with muscle spasm or neurogenic joint immobilization) can be attributed to abnormal control mechanisms in a complex cybernetic system.(ABSTRACT TRUNCATED AT 250 WORDS)