European journal of pain : EJP
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Cervical dystonia is the most common form of focal idiopathic dystonia and is frequently associated with pain. Headaches are not considered to be more prevalent among patients presenting with cervical dystonia, and headaches attributed to craniocervical dystonia are considered to be a rare disorder, despite the lack of studies and clinical information regarding the subject. ⋯ We found that headaches are more frequent among patients with cervical dystonia than previously thought, and that they contribute towards an overall increase in pain in these patients. Headaches attributed to craniocervical dystonia are associated with greater disability among patients with cervical dystonia. These headaches improve after botulinum toxin injections, in parallel with the improvement of cervical dystonia symptoms.
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Pain is common and refractory in spinal cord injury (SCI). Currently, most studies evaluated pain in male-predominant traumatic-SCI. Also, concomitant secondary pain syndromes and its temporal evolution were seldom reported. ⋯ In this longitudinal study with NMO-related SCI, pain affected almost three-quarters of patients with NMO. Over 70% have more than one pain syndrome and at-level neuropathic pain is the most common type of pain syndrome. Patients without pain were significantly younger but had the same burden of inflammatory lesions than those with pain. During follow-up, up to one fifth of patients presented with changes in the main pain syndromes, which can occur even in the absence of clinical activity of the inflammatory disease. In this cohort, Pain affected quality of life as much as disability or motor strength.
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Fibromyalgia has been associated with various physical and mental disorders. However, these comorbidities need to be quantified in a population-based study. ⋯ We showed here a strong association of self-reported fibromyalgia with both mental and physical comorbidities. We showed that among participants with self-reported fibromyalgia, more than 8 out of 10 had at least three other physical comorbidities, and almost half had at least three mental comorbidities. This is a cross-sectional study using a representative sample of the US population with highly reliable psychiatric diagnosis that makes our results generalizable. Practitioners managing fibromyalgia should search and treat these comorbidities.
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Fibromyalgia (FM) is a syndrome characterized by altered pain processing at central and peripheral level, whose pathophysiologic mechanisms remain obscure. We aimed at exploring the structural changes of peripheral nociceptor measured by skin biopsy, the functional changes of central nociceptive pathway assessed by laser-evoked potentials (LEP), and their correlation with clinical features and comorbidities. ⋯ Central impairment of pain processing likely underlies FM, which in most patients is associated with mild proximal small fibre pathology.
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Review Meta Analysis
Effects of neurofeedback in the management of chronic pain: A systematic review and meta-analysis of clinical trials.
Neurofeedback (NFB) provides real-time feedback about neurophysiological signals to patients, thereby encouraging modulation of pain-associated brain activity. This review aims to evaluate the effectiveness and safety of NFB in alleviating pain and pain-associated symptoms in chronic pain patients. ⋯ Neurofeedback is a novel neuromodulatory approach which can be used to reduce the severity of pain and pain-associated symptoms such as sleep disturbances, mood disturbances, fatigue and anxiety in a number of chronic pain conditions. It has a potential to provide integrative non-pharmacological management for chronic pain patients with pain refractory to pharmacological agents with high side-effect profiles. Further high-quality double-blinded randomized sham-controlled trials are needed in order to fully explore the potential of this therapy.