European journal of pain : EJP
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Recent evidence suggests that chronic low back pain is associated with plastic changes in the brain that can be modified by neuromodulation strategies. This study investigated the efficacy of transcranial direct current stimulation (tDCS) combined simultaneously with peripheral electrical stimulation (PES) for pain relief, disability and global perception in patients with chronic low back pain (CLBP). ⋯ Transcranial direct current stimulation combined simultaneously with PES leads to a significant and clinical pain relief that can last up to three months in chronic low back pain patients. For this article, a commentary is available at the Wiley Online Library.
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Visual cue conditioning is a valuable experimental paradigm to investigate placebo and nocebo effects in pain. However, little attention has been paid to the cues themselves and potential variability of effects (their quantity and quality) stemming from the choice of stimuli. Yet, this seemingly methodological question has important implications for the interpretation of experimental findings in terms of their significance for clinical practice. ⋯ We compared different types of neutral cues commonly used in conditioning paradigms and found that faces elicited a stronger, more robust nonconscious effect than abstract images or pseudo-words.
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Emerging evidence suggests that perceived injustice is a risk factor for work disability in individuals with whiplash injury. At present, however, little is known about the processes by which perceived injustice impacts on return to work. The purpose of this study was to examine whether expectancies mediated the relationship between perceived injustice and return to work in patients with whiplash injury. ⋯ The study confirms that expectancies are the mechanism through which perceived injustice impacts return to work following whiplash injury. The findings suggest that interventions designed to specifically target return-to-work expectancies might improve rehabilitation outcomes in patients with whiplash injury.
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Chronic postsurgical pain (CPSP) affects half a million children annually in the United States, with dire socioeconomic consequences, including long-term disability into adulthood. The few studies of CPSP in children are limited by sample size, follow-up duration, non-homogeneity of surgical procedure and factors evaluated. ⋯ In a homogeneous cohort of adolescents undergoing spine fusion, we report a high incidence of persistent postsurgical pain (41.8%) predicted by child anxiety, perioperative pain, and surgical duration. Our results stress timely preventive and therapeutic strategies.
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This study examined the effects of rumination on attentional processes in relation to an acute experimental pain task. In keeping with recent theory and research, it was hypothesized that we would identify a pattern of attentional bias characterized by enhanced initial vigilance followed by avoidance of pain-related stimuli. ⋯ The rumination manipulation led to increased worry about pain and induced to an attentional pattern of vigilance-avoidance for affective pain words. The induction also led to more distress and pain. Rumination and worry appear to increase unhelpful patterns of attention and could be an appropriate focus of intervention.