European journal of pain : EJP
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Within the Fear Avoidance Model of pain, quantitative neurophysiological factors provide additional conceptual benefit when integrated along with traditional psychologically aspects of the FAM.
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Fibromyalgia represents a condition still controversial in its entity, pathophysiology, diagnosis and management (Figure ). In a world where everybody is connected, and everybody is sharing their own image, fibromyalgia (FM) represents the emblematic pathology of misconnection and lack of specific biomarker. ⋯ The concept of misconnection defines FM in a different and holistic view and proposes different views of assessment, management and representation: FM pathophysiology: the desynchronization of brain and body FM recognition: the broken link between patients and physicians FM assessment: merging the body and mind for an optimal diagnosis and management FM treatment: re-establishing the good connections at different levels We hope to reconnect FM patients with all healthcare providers, help FM patients reconnect with their painful body and integrate FM into regular medical practice. SIGNIFICANCE: The concept of misconnection defines FM in a different and holistic view, and propose different views of assessment, management and representation.
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Estimation of a patient's pain may have a considerable impact on the level of care that patient receives. Many studies have shown that contextual factors may influence an observer's pain estimation. Here, we investigate the effect of an observer's impression of a person in pain and justification of his/her pain on the observer's pain estimation, tendency to help and perceived empathy. ⋯ Observers' estimation of pain, perceived empathy and tendency to help biases by their understanding of the characteristics of the person in pain. In clinical settings, these biases may influence the quality of care and well-being of patients. Understanding the underlying mechanisms of these biases can help us improve the quality of care and control the effect of prejudices on pain assessment.
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Observational Study
Spinal cord stimulation for chronic refractory pain: long-term effectiveness and safety data from a multicentre registry.
Spinal cord stimulation (SCS) is an established therapy for refractory neuropathic pain. To ascertain the balance between treatment benefits and risks, the French National Authority for Health requested a post-market registry for real-world evaluation of the long-term effectiveness and safety of the therapy. ⋯ This observational, prospective study in a real-life setting followed a large cohort of patients suffering from chronic pain and implanted with SCS devices in France. The study assessed the long-term effectiveness and safety of SCS therapy in a representative sample of implanting sites in France.
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Review Meta Analysis
The effectiveness of self-management interventions in adults with chronic orofacial pain: A Systematic review, Meta-analysis and Meta-regression.
Psychosocial risk factors associated with chronic orofacial pain are amenable to self-management. However, current management involves invasive therapies which lack an evidence base and has the potential to cause iatrogenic harm. ⋯ This systematic review provides clear evidence for effectiveness of combined biomedical and psychological interventions (incorporating self-management approaches) on long-term outcomes in the management of chronic orofacial (principally TMD) pain. Self-management should be a priority for early intervention in primary care in preference to invasive, irreversible and costly therapies. Further research is needed firstly to clarify the relative effectiveness of specific components of self-management, both individually and in conjunction, and secondly on outcomes in other types of chronic orofacial pains.