European journal of pain : EJP
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Low back pain (LBP) and neck pain (NP) are common among the adult population but relatively few reports exist on the associations between these. We examined cross-sectional and prospective relationships of LBP with NP in an employee cohort studied repeatedly over 28 years. Locally perceived pain was studied separately from pain with a radiating component. ⋯ In conclusion, the study showed a clear association of LBP with NP that persisted on a similar level irrespective of the aging of the cohort. Particularly, radiating LBP was associated with radiating NP. The prospective associations of LBP at baseline with new reports of radiating NP decreased as the length of follow-up increased.
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Various risk factors associated with disability pensioning have been reported. This study investigated the relationship between the number of pain sites and risk of receiving a disability pension. We hypothesised that risk of work disability would increase as the number of pain sites increased, even after controlling for potential confounders. ⋯ However, a model controlling for all significant confounders showed that general health and sick leave previous year captured almost all the predictive power of the number of pain sites on work disability. Since these variables could be seen as intermediate variables and not confounders, they were excluded in a new model which gave a strong "dose-response" relationship between number of pain sites and disability with a 10-fold increase from 0 to 9-10 pain sites. The predictive validity of the number of pain sites in determining future disability renders this simple measurement useful for future research on musculoskeletal pain and functioning.
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A task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) was convened to produce some up-to-date, evidence-based, practical, clinical guidelines on the management of cancer-related breakthrough pain in adults. On the basis of a review of the literature, the task group was unable to make recommendations about any individual interventions, but was able to make a series of 12 recommendations about certain generic strategies. However, most of the aforementioned recommendations are based on limited evidence (i.e., case series, expert opinion). The task group also proposed a definition of breakthrough pain, and some diagnostic criteria for breakthrough pain.
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The neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) play a pivotal role in the generation and maintenance of hyperalgesia. In the present study we analyzed NGF and BDNF levels in human skin of the upper arm and axilla skin sites by dermal microdialysis and multiplexed assay. Skin sensitization and inflammatory responses were evoked experimentally by repetitive shaving of one axilla provoking local erythema and reduced heat pain thresholds. ⋯ On average, NGF levels were analyzed at 14.6 fg/microg/ml and BDNF values at 202 fg/microg/ml. These data demonstrate enhanced level of neurotrophin release in inflamed human skin in vivo which might well contribute to peripheral sensitization. Analyses of neurotrophic factors by dermal microdialysis are useful endogenous markers to further explore their role in neuronal sensitization processes in human.
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Emerging evidence indicates that meanings attributed to pain contribute to tolerance and coping among affected individuals. However, links between pain appraisals and coping responses have received little attention within a broader interpersonal context. In this experiment, effects of appraisal on pain tolerance and coping were examined in adult dyads. ⋯ Pain language was also most prominent in transactions of threatened dyads. Finally, use of attention diversion by observers contributed to pain tolerance, independent of participant factors (reported pain, appraisal condition, reported coping) and pain language in conversations during immersions. The study highlights how appraisal contributes not only to pain tolerance and coping in the affected individual but also to care-giving efforts of others in their social environment.