European journal of pain : EJP
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Disturbed sleep and pain often co-exist and the relationship between the two conditions is complex and likely reciprocal. This 5-year prospective study examines whether disturbed sleep can predict the onset of multi-site pain, and whether non-disturbed sleep can predict the resolution of multi-site pain. ⋯ In conclusion, sleep could be relevant for predicting both the onset and the resolution of multi-site pain. It seems to be a significant factor to include in research on multi-site pain and when conducting or evaluating intervention programmes for pain.
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Randomized Controlled Trial Comparative Study
A randomized controlled trial and novel mathematical analysis of the analgesic effect of oxycodone versus paracetamol orodispersible tablets.
For effective treatment of acute pain, a rapid onset of action is important. Here we quantify the antinociceptive profile of an orodispersible oxycodone tablet (OOT) in a randomized, double-blind, active comparator (paracetamol orodispersible tablet, POT), crossover study design in a population of healthy volunteers. ⋯ The analgesic effect of orodispersible oxycodone was successfully quantified using a mathematical model of analgesia evolution. This method allows quantification of a variety of responses times from sparse data sets. Response times as defined by a 30% increase in response thresholds varied significantly among end points: EPTol 15 min, PPTh 18 min and EPTh 41 min.
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The underlying mechanisms of adaptations to pain are unclear. In order to explore whether central or peripheral mechanisms predominate, the effects of two centrally mediated phenomena - spatial summation of pain (SSP) and transcutaneous electrical nerve stimulation (TENS) - were examined. The effect of the degree of painfulness, rather than absolute stimulation intensity, was also examined. ⋯ The mathematical models and the lack of effect of SSP on adaptation suggest that its dominant component is peripheral. Whereas relative painfulness determines whether pain adaptation or intensification occurs (probably a defence mechanism), absolute stimulation intensities influence the magnitude of the effect. Pain intensification is differentially affected by probe size, depending upon the occurrence of initial adaptation.
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The 9-item STarT-Back screening tool was developed in primary care patients with low back pain (LBP) to identify those at greatest risk for chronic pain and requiring targeted treatment. We conducted a secondary data analysis study to examine the performance of comparable questionnaire items in a sample of primary care patients with well-defined acute LBP. ⋯ A risk classification schema using the recommended cut-off scores with items similar to the STarT-Back in a primary care population with strictly defined acute LBP had limited ability to identify persons who progressed to chronic pain. The results suggest caution when applying the STarT-Back in patients with acute LBP and a need to consider a modification of its cut-offs.
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Memory of chronic, acute and experimental pain may be inaccurate, but the research findings are inconsistent. The main aim of the study was to compare the memory of three types of pain and their associated affect. ⋯ The results of the current study suggest that memory of pain and affect is influenced by the meaning and affective value of the pain experience. This may help us to understand why the previous research on the memory of pain were so diverse.