Pain medicine : the official journal of the American Academy of Pain Medicine
-
Randomized Controlled Trial Multicenter Study
Development of the Chronic Pain Coding System (CPCS) for Characterizing Patient-Clinician Discussions About Chronic Pain and Opioids.
To describe the development and initial application of the Chronic Pain Coding System. ⋯ This coding system appears to be a reliable and valid tool for characterizing patient-clinician communication about opioids and chronic pain during clinic visits. Objective data on how patients and clinicians discuss chronic pain and opioids are necessary to identify communication patterns and strategies for improving the quality and productivity of discussions about chronic pain that may lead to more effective pain management and reduce inappropriate opioid prescribing.
-
Randomized Controlled Trial
Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect.
Opioids are frequently prescribed for chronic low back pain (CLBP), but there are broad individual differences in the benefits and risks of opioid therapy, including the development opioid-induced hyperalgesia. This study examined quantitative sensory testing (QST) data among a group of CLBP patients undergoing sustained oral opioid treatment. We investigated whether individual differences in psychological characteristics were related to opioid-induced changes in pain perception and pain modulation. ⋯ These results reveal that while the low NA group seemed to exhibit a generally adaptive, analgesic pattern of changes during opioid management, the high NA group showed a pattern more consistent with opioid-induced hyperalgesic processes. A greater susceptibility to hyperalgesia-promoting changes in pain modulation among patients with high levels of distress may contribute to a lower degree of benefit from opioid treatment in high NA patients.
-
In healthy individuals and people with chronic pain, an inverse association between physical activity level and pain has been reported. Associations between objectively measured fitness and pain have also been found in people with chronic pain, but it is not clear whether the same relations are apparent in healthy individuals. The purpose of the present study was to examine the relation between aerobic capacity and pain in healthy individuals. ⋯ Aerobic capacity is unrelated to pain in healthy young adults. For people with chronic pain, the negative relation between aerobic capacity and pain presumably arises from the underlying pathophysiology and/or associated behaviors of the disease process.