European journal of pain : EJP
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Chronic hip pain after total hip arthroplasty (THA) is a significant problem, but the aetiology remains unclear. ⋯ We found signs of hypersensitivity on the operated side, which was more prominent in patients with pain. Pain referred from the back or deeper structures in the hip seems to play a role for the pain in subgroups of patients. In addition, chronic hip pain was associated with mental vulnerability.
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Recent research indicated wide variability regarding pain-related cognitive/affective and behavioral responses to pain, showing that fear-avoidance responses (FAR) and endurance-responses (ER) play a prominent role in the maintenance of low back pain (LBP). Until now, there is a lack of reliable and valid instruments covering FAR and ER. ⋯ The AEQ has shown as a reliable and valid measure to assess pattern of fear-avoidance and endurance-related responses to pain. Both aspects seem to play a role in the maintenance of LBP.
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Normalization of activities in daily living is an important goal in rehabilitation treatment of chronic lower back pain (CLBP) patients. Clinicians indicate that CLBP patients often show deconditioning but also CLBP patients who seem to be too active are seen. The objective of the present cross-sectional study was to gain more insight into the daily activity pattern of CLBP patients compared to controls, using accelerometry. ⋯ Overall activity levels do not differ significantly between CLBP patients and controls, but the distribution of activities over the day differs significantly.
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The present study is the first demonstration of prolonged nociceptive behavior in the trigeminal region following compression of the trigeminal ganglion in rats. Experiments were carried out on male Sprague-Dawley rats mounted onto a stereotaxic frame under pentobarbital sodium anesthesia. For compression of the trigeminal ganglion, a 4% agar solution (8microl) was injected into the trigeminal ganglion through a stainless steel injector (24 gauge), which extended 2mm beyond the end of a guide cannula (21 gauge). ⋯ Although mechanical allodynia and hyperalgesia appeared bilaterally, the ipsilateral side was significantly more sensitive. Intraperitoneal treatment with carbamazepine significantly blocked mechanical allodynia produced by compression of the trigeminal ganglion. These findings suggest that prolonged nociceptive behavior following compression of the trigeminal ganglion may mimic trigeminal neuralgia in this animal model.
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Chronic pain patients often suffer from widespread and long lasting pain. The integrative effect of combined spatial and temporal summation on pain intensity has not been quantitatively tested. The present study was designed to investigate: (1) if the size of the stimulation area would facilitate the temporal summation of pain to repetitive pressure stimulation, and (2) if temporal summation is effective when stimulating separated sites, repetitively. ⋯ There was no temporal summation of pain to stimuli with ISI 5 and 30s when stimulating the separated sites. The current study indicated that spatial summation facilitated the temporal summation of pain for stimuli given at 5s and 30s ISI. The combination of temporal and spatial integration of nociceptive input facilitates the pain intensity, suggesting that temporal summation is clinically relevant in conditions with widespread pain.