Pain medicine : the official journal of the American Academy of Pain Medicine
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Veterans with chronic noncancer pain (CNCP) are a vulnerable population whose care remains a challenge for clinicians, policy-makers, and researchers. As a result of military experience, veterans are exposed to high rates of musculoskeletal injuries, trauma, psychological stressors (e.g., post-traumatic stress disorder, depression, anxiety, substance abuse), and social factors (e.g., homelessness, social isolation, disability, decreased access to medical care) that contribute to the magnitude and impact of CNCP. In the veteran population, sound theoretical models are needed to understand the specific physiological, psychological, and social factors that influence this unique experience. ⋯ The adaption of the biopsychosocial model of CNCP for veterans provides a useful and relevant conceptual framework that can be used to guide future research and improve clinical care in this vulnerable population.
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This study aims to evaluate the presence of myofascial trigger points (TrPs), widespread pressure pain sensitivity, and mechanosensitivity of neural tissue in women with chronic pelvic pain. ⋯ Patients with chronic pelvic pain presented a high percentage of TrPs that reproduce their symptoms. Patients also showed a widespread pressure pain hyperalgesia and more mechanosensitive neural tissue due to a decrease on the range of motion related to neurodynamics.
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Analyzing medication data for research purposes is complex, and methods are rarely described in the literature. Our objective was to describe methods of quantifying opioid and nonopioid analgesics and to compare the utility of five different analgesic coding methods when analyzing relationships between pain, analgesic use, and clinical outcomes. In this study, we used physical function as the outcome variable for its clinical relevance and its relationship to pain in older adults. ⋯ Analgesic medications are important variables to consider in community-based studies of older adults. We illustrate several methods of quantifying analgesic medications for research purposes. In this community-based sample, we found no advantage of complex equianalgesic coding methods over simple counts in predicting physical functioning. The results may differ depending on the research question or clinical outcome studied. Thus, methods of analyzing analgesic drug data warrant further research.
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Physically active individuals show greater conditioned pain modulation (CPM) compared with less active individuals. Understanding the effects of acute exercise on CPM may allow for a more targeted use of exercise in the management of pain. This study investigated the effects of acute isometric exercise on CPM. In addition, the between-session and within-session reliability of CPM was investigated. ⋯ Isometric exercise decreased CPM in individuals who reported systemic EIH, suggesting activation of shared mechanisms between CPM and systemic EIH responses. These results may improve the understanding of increased pain after exercise in patients with chronic pain and potentially attenuated CPM.