European journal of pain : EJP
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Randomized Controlled Trial
Expectations of recovery: A prognostic factor in patients with neck pain undergoing manual therapy treatment.
Expectations have been investigated in populations seeking care for neck pain, however not considering potential confounding factors. The aim of this study was to investigate if pretreatment expectations of recovery is a prognostic factor for recovery from neck pain at 7 weeks follow-up in patients seeking manual therapy treatment. ⋯ Our results suggest that expectations of recovery is a prognostic factor for recovery in patients with neck pain seeking manual therapy treatment. WHAT DOES THIS STUDY ADD?: We found that high expectations of recovery yielded a higher probability of recovery compared to having low expectations, also when considering potential confounding factors. Expectations seemed to have a more distinct influence on recovery among men.
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Preclinical drug discovery for the treatment of chronic pain is at present challenged by the difficulty to study behaviours comparable to the complex human pain experience in animals. Several reports have demonstrated a frequent association of chronic pain in humans with affective disorders, such as anxiety and depression, and impaired cognitive functions, including memory and decision making, and motivation for goal-directed behaviours. In this study, we validated different behavioural outcomes to measure the emotional and cognitive manifestations of neuropathic pain induced in mice by partial sciatic nerve ligation. ⋯ These results indicate that some emotional manifestations of chronic pain do not necessarily resolve when pain is relieved and underline the relevance to evaluate multiple behavioural responses associated with chronic pain, including the affective-motivational and cognitive behaviours, to increase the predictive value of preclinical drug discovery. WHAT DOES THIS STUDY ADD?: In this study, we have validated different behavioural outcomes allowing a reliable measurement of the emotional and cognitive manifestations of neuropathic pain induced in mice by partial sciatic nerve ligation. These results underline the relevance to evaluate these multiple pain-related alterations to improve the predictive value of preclinical drug discovery.
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Randomized Controlled Trial
Differential psychophysiological effects of operant and cognitive behavioural treatments in women with fibromyalgia.
Determination of psychophysiological effects of operant behavioural (OBT) and cognitive behavioural treatment (CBT) for fibromyalgia patients. ⋯ Increased diastolic blood pressure and decreased pain after OBT suggest a reactivation of baroreflex-mechanisms in fibromyalgia and a normalization of the blood pressure and pain functional relationship. Reduced SCL following CBT may indicate reduced general arousal levels. Increased muscle tension after CBT and OBT suggest a normalization of physical parameters. The reduction in pain seems to be mediated by different psychophysiological processes, providing support for mechanism-based treatments might be indicated for CBT and OBT. WHAT DOES THIS STUDY ADD?: Differential physiological stress responses followed different psychological interventions. While OBT influenced blood pressure by restoring blood pressure-pain interaction, CBT reduced stress-related sudomotor activity. These results implicate specific mediating mechanisms in fibromyalgia suggesting a basis for matching based on specific patient psychophysiological features.
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Observational Study
Perceived pain extent is associated with disability, depression and self-efficacy in individuals with whiplash-associated disorders.
Completion of a pain drawing is a familiar task in those presenting with whiplash-associated disorders (WAD). Some people report pain almost over their entire body. Yet the reasons for larger pain extent have not been fully explored. ⋯ By utilizing a novel method for pain extent quantification, this study shows that widespread pain is associated with a number of factors including perceived disability, depression and self-efficacy in individuals with chronic WAD. Widespread pain should alert the clinician to consider more specific psychological screening, particularly for depression and self-efficacy, in patients with WAD. WHAT DOES THIS STUDY ADD?: Women with chronic WAD, those with unsettled insurance claims and those with poorer financial status perceive more widespread pain. When controlling for these factors, larger pain areas remain associated with perceived pain and disability, depression and self-efficacy. The pain drawing is useful to support psychological screening in people with chronic WAD.
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Cardiac surgery (CS) ranks among the most frequently performed interventions worldwide and persistent postoperative pain (PPP) has been recognized as a relevant clinical outcome in this context. We aimed to evaluate its incidence, characteristics, associated factors and patient's quality of life (QoL). ⋯ This is the first study comprehensively describing PPP after CS and identifying NP in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower QoL, which deserves the attention of health care professionals in order to improve prevention, assessment and treatment of these patients. WHAT DOES THIS STUDY ADD?: This study comprehensively describes persistent postoperative pain (PPP) after cardiac surgery (CS) and identifies neuropathic pain (NP) in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower quality of life.