The journal of pain : official journal of the American Pain Society
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Persistent pain conditions, including low back pain (LBP), are often accompanied by alterations in pronociceptive and antinociceptive mechanisms, as quantified by temporal summation of pain (TSP) and conditioned pain modulation (CPM). It remains unclear whether altered pain sensitivity, CPM, and/or TSP are a consequence of pain presence or determine the degree of pain development. Pressure pain sensitivity, TSP, and CPM were assessed across an episode of exercise-induced LBP maintained for several days. ⋯ The baseline TSP was associated with the peak pain intensity of the exercise-induced LBP (p < .003). Perspective: Pressure-pain sensitivity was impacted by the presence of exercise-induced LBP, whereas TSP seemed to be more stable and was instead associated with the intensity of pain developed. No significant pain-related changes or associations were observed for CPM, suggesting this measure may have less usefulness in mild musculoskeletal pain conditions.
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Randomized Controlled Trial
Does sensorimotor incongruence trigger pain and sensory disturbances in people with chronic low back pain? A randomised cross-over experiment.
Chronic low back pain (CLBP) has major public health implications, and underlying mechanisms are still unclear. Sensorimotor incongruence (SMI)-an ongoing mismatch between top-down motor output and predicted sensory feedback-may play a role in the course of chronic nonspecific low back pain. The hypothesis of this study was that the induction of SMI causes sensory disturbances and/or pain in people with CLBP and healthy volunteers. ⋯ Therefore, the research hypothesis was not supported. PERSPECTIVE: The results of this study show that sensorimotor incongruence does not cause additional symptoms and pain in people with chronic low back pain. The conceptual premise that sensorimotor incongruence is an underlying contributor in the course of pain in this population is not supported.
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Translational correlates to pain with activities after deep tissue injury have been rarely studied. We hypothesized that deep tissue incision causes greater activation of nociception-transmitting neurons evoked by muscle contraction. In vivo neuronal activity was recorded in 203 dorsal horn neurons (DHNs) from 97 rats after sham, skin-only, or skin + deep muscle incision. ⋯ PERSPECTIVE: Completion of various activities is an important milestone for recovery and hospital discharge after surgery. Skin + deep muscle incision caused greater activation of nociception-transmitting DHNs evoked by muscle contraction compared with skin-only incision. This result suggests an important contribution of deep muscle injury to activity-evoked hyperalgesia after surgery.
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Chronic pain during childhood is prevalent and costly, but the access to interdisciplinary pain care is limited. Studies investigating adults waiting for pain clinic evaluation found that symptoms and quality of life deteriorate over the waiting period, but little is known about the experience of adolescents. Therefore, we aimed to determine wait list times and the longitudinal trends of pain and physical, mental, and social health over a 12-week period. ⋯ Findings highlight the need to consider approaches to reduce wait times and provide early intervention for youths awaiting pain clinic evaluation. Perspective: This study extends the literature on the characteristics and symptom trajectories of adolescents during the wait period for interdisciplinary pain clinic evaluation, described previously only in adults with chronic pain. Findings demonstrated an average wait time of 6.5 months, during which youths' pain and physical and social health remained impaired.
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Self-distancing has been shown to alleviate emotional pain and to have potential efficacy for treating chronic pain and imagined acute pain, relative to self-immersing. This study examined the efficacy of self-distancing in relieving acute physical pain caused by a cold pressor task (CPT) in healthy adults. A total of 65 undergraduates were assigned pseudorandomly to 1 of 3 groups: 1) a self-distancing group, in which participants were instructed to "take a step back" to simulate their current painful experience as an observer, 2) a self-immersed group, in which participants' current painful experience was stimulated from the egocentric perspective, and 3) a control group, in which participants coped with pains in their spontaneous ways. ⋯ This result supports that self-distancing could relieve the acute pain induced by CPT. Perspective: This study presents a brief effective psychological intervention to manage acute pain. This result could potentially have clinical and everyday importance.