European journal of pain : EJP
-
Observational Study
Acute pain Factors predictive of post-operative pain and opioid requirement in multimodal analgesia following knee replacement.
Despite the development of multimodal analgesia for postoperative pain management, opioids are still required for effective pain relief after knee arthroplasty. We aimed to identify the determinants of post-operative pain intensity and post-operative opioid requirement in this context. ⋯ Our findings suggest that clinicians could use the pre-operative pain profile, in terms of anxiety levels, neuropathic pain symptoms, and chronic pre-operative pain intensity, to improve the efficacy of pain management after knee surgery.
-
Randomized Controlled Trial
Effects of insular stimulation on thermal nociception.
Electrical stimulation used for brain mapping in the postero-superior insula can evoke pain. The effects of prolonged high frequency insular stimulation on pain thresholds are unknown. ⋯ High frequency inhibitory postero-superior insular stimulation may have the potential to decrease thermal nociception. Together with previous studies, our data support the notion that the integrity of this brain region is necessary for thermal but not pressure nociceptive processing.
-
The spatial precision of expectancy effects on pain is unclear. We hypothesized that expecting nociceptive stimuli at particular skin sites would have an analgesic effect on nociceptive stimuli presented between them (middle zone). ⋯ Expecting a painful stimulus in non-adjacent skin sites has spatially specific effects on pain modulation, but this reflects an interaction between the expected location of stimulation and the actual location. This suggests a more complex connection between somatotopic maps and nociceptive modulation than previously thought; several distinct mechanisms likely contribute.
-
Kinesiophobia is an excessive, irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury. The Tampa Scale for kinesiophobia (TSK) is a patient-reported outcome (PRO) measure designed to help identify kinesiophobia. The original version of the TSK had 17 items. A 13-item version was later found to have better psychometric properties and was used in the present study. Although the TSK-13 has been widely studied, one shortcoming is the lack of clinically meaningful score categories. The objective of the present study was to develop severity levels to help aid clinical interpretation of TSK-13 scores. ⋯ TSK-13 severity levels were strongly associated with objective lifting performance variables and psychosocial PRO measures, providing support for these severity levels as a guideline for healthcare providers and researchers in interpreting TSK-13 scores.
-
Cognitive processes like attentional and interpretation biases have been suggested to play a vital role in the onset and exacerbation of chronic pain. Research consistently supports the occurrence of interpretation bias (IB) in pain patients and healthy individuals high in pain anxiety. Nevertheless, studies on the indirect assessment of IB or the relation between IB and responses to pain are limited. The present studies examined the association between indirect assessed IB and pain anxiety, while Study 2 additionally examined IB as a mediator in the relation between pain anxiety and pain responses. ⋯ Current findings underscore the importance of interpretational processes in the context of physical health threat. Furthermore, the ambiguous word priming task is proposed as a suitable paradigm for further research on the indirect assessment of IB. Nevertheless, further research is warranted to deepen our understanding of IB and its contribution to the experience of (chronic) pain.