European journal of pain : EJP
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Pain has consistently been viewed as containing two dimensions, a sensory (intensity) and an emotional (unpleasantness). It has been suggested that pain involves higher order cognitive processes that go beyond unpleasantness. We therefore aimed at extending the assessment of pain by introducing an additional dimension of pain-related suffering and identifying noxious stimulation protocols that are most adequate for its psychophysical and psychophysiological characterization. ⋯ These results suggest that in acute pain, suffering is a constitutive dimension that might even be more crucial in clinical states of pain.
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The spinal cord is a prime site of action for analgesia. Here we characterize the effects of established analgesics on segmental spinal reflexes. The aim of the study was to look for the pattern of action or signature of analgesic effects on these reflexes. ⋯ morphine and duloxetine had general depressant effects on spinal reflexes, whereas the effects of clonidine, pregabalin and S1RA appeared to be restricted to signals originated by strong repetitive activation of C-fibres. Results are discussed in the context of reported behavioural effects of the compounds studied.
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Randomized Controlled Trial
Does the addition of visceral manipulation alter outcomes for patients with low back pain? A randomized placebo controlled trial.
This study aimed to investigate whether the addition of visceral manipulation, to a standard physiotherapy algorithm, improved outcomes in patients with low back pain. ⋯ Our study suggests that visceral manipulation in addition to standard care is not effective in changing short-term outcomes but may produce clinically worthwhile improvements in pain at 1 year.
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An influential idea is that attentional bias to information related to pain or pain-related negative affect underlies persistent pain problems. Such information is however often ambiguous. If ambiguous input is perceived as pain or threat related, attention to this stimulus would be enhanced compared with stimuli with no (dominant) pain-/threat-related meaning. Attentional bias to ambiguous stimuli related to somatic/health threat was expected to be more pronounced with higher levels of pain catastrophizing. ⋯ Low catastrophizers demonstrated attentional bias to threat content. Participants reporting higher catastrophizing showed overall enhanced attentional orienting. There was no evidence for differences in (biased) attention to unambiguous and ambiguous words. Further research is needed to determine attentional bias for ambiguous pain-/threat-related stimuli in the context of consistent attentional bias for unambiguous pain-/threat-related stimuli.
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Increased apoptotic changes in the spinal cord may be responsible for the development of chronic constriction injury (CCI)-induced neuropathic pain. We previously reported the beneficial effect of hyperbaric oxygen (HBO) in the treatment of CCI-induced neuropathic pain. In this study, we tested our hypotheses that HBO may achieve its beneficial effect by inhibiting CCI-induced proapoptosis gene expression and apoptosis in the spinal cord. ⋯ Overly expressed proapoptosis genes, and subsequent increase in spinal apoptotic cells, seem to contribute to the development of CCI-induced neuropathic pain. The inhibitory role of HBO on spinal proapoptosis genes and apoptotic changes may contribute to its beneficial effect on CCI-induced neuropathic pain.