European journal of pain : EJP
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Most common instruments used to assess the painfulness of nociceptive stimuli and the perception of such stimuli are ordinal. This property limits arithmetical operations and statistical procedures that can be applied on their numbers. The Rasch methodology provides mathematical procedures for transforming scores on an ordinal scale into measures on an interval scale. ⋯ The analysis provided linear measures of the painfulness for each intensity of stimulation, of the pain perception of each subject and of the painfulness of each successive block. All these measures are located on a single pain perception continuum. Advantages and disadvantages of this methodology will be discussed in terms of subsequent possible mathematical analyses, statistical tests and implications for experimental and clinical investigations.
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Randomized Controlled Trial Comparative Study
Effect of hypnotic suggestion on fibromyalgic pain: comparison between hypnosis and relaxation.
The main aims of this experimental study are: (1) to compare the relative effects of analgesia suggestions and relaxation suggestions on clinical pain, and (2) to compare the relative effect of relaxation suggestions when they are presented as "hypnosis" and as "relaxation training". Forty-five patients with fibromyalgia were randomly assigned to one of the following experimental conditions: (a) hypnosis with relaxation suggestions; (b) hypnosis with analgesia suggestions; (c) relaxation. ⋯ The results showed: (1) that hypnosis followed by analgesia suggestions has a greater effect on the intensity of pain and on the sensory dimension of pain than hypnosis followed by relaxation suggestions; (2) that the effect of hypnosis followed by relaxation suggestions is not greater than relaxation. We discuss the implications of the study on our understanding of the importance of suggestions used in hypnosis and of the differences and similarities between hypnotic relaxation and relaxation training.
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In 15 patients with painful peripheral neuropathy and dynamic mechanical allodynia, the influence of spontaneous ongoing neuropathic pain on pain sensitivity in a remote pain-free area was examined, as was the influence of ischemia-induced heterotopic noxious conditioning stimulation (HNCS) on the intensity of ongoing pain and brush-evoked allodynia. In addition, the modulating effect of HNCS on pain sensitivity in a pain-free area was investigated. Pain thresholds to pressure and heat as well as the sensitivity to suprathreshold pressure- and heat pain were assessed in the pain-free area. ⋯ In the pain-free area higher pressure pain thresholds were demonstrated during conditioning stimulation in patients and controls alike (p<0.01). In controls only, a significantly higher heat pain threshold was found during the HNCS-procedure (p<0.01). The main finding of the present study was that HNCS altered differentially spontaneous and brush-provoked pain in patients with painful peripheral neuropathy.
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In this study we investigated the role of endothelin-1 (ET-1) and its peripheral receptor (ET-A) in carcinoma-induced pain in a mouse cancer pain model. Tumors were induced in the hind paw of female mice by local injection of cells derived from a human oral squamous cell carcinoma (SCC). ⋯ Intra-tumor expression of both ET-1 mRNA and ET-1 protein were significantly upregulated compared to normal tissue, and local administration of the ET-A receptor selective antagonist, BQ-123 (100 microM) significantly elevated withdrawal thresholds, indicating the induction of an antinociceptive effect. These findings support the suggestion that ET-1 and ET-A receptors contribute to the severity of carcinoma-induced soft tissue cancer pain.
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Review
Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review.
In addition to debilitating fatigue the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. ⋯ The results from the systematic review highlight the clinical importance of chronic pain in CFS, but only few studies addressing the aetiology or treatment of chronic pain in CFS are currently available.