European journal of pain : EJP
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Randomized Controlled Trial
Naloxone inhibits not only stress-induced analgesia but also sympathetic activation and baroreceptor-reflex sensitivity.
Interactions between the sympathetic nervous system and pain are manifold and still have not been sufficiently characterized. Accordingly, several possible neuronal pathways have been described as being involved in mental stress-induced analgesia. We studied the role of the endogenous opioidergic system in stress-induced analgesia in 14 healthy participants in a double-blind cross-over trial. ⋯ Thus, the opioidergic system not only modulates nociceptive input but also the interplay with vegetative responses. We conclude that acute stress, sympathetic activation and analgesia might be linked via vagal reflexes, which are disturbed when opioid receptors are blocked. This mechanism might underlie increased perception of noxious stimuli in patients with chronic pain or mood disorders.
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Randomized Controlled Trial
Are there gender differences in coping with neck pain following acute whiplash trauma? A 12-month follow-up study.
Little is known about gender differences in coping after whiplash, and to date possible interaction of gender and coping on recovery has not been investigated. ⋯ No interaction between coping and gender on neck pain was found, thus different coping strategies 3 months post-collision did not explain the different prognosis observed in men and women. Clinically relevant influence of 'catastrophizing' and 'praying and hoping' to prognosis was found, therefore we should identify patients predominantly using these strategies.