The journal of pain : official journal of the American Pain Society
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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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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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In chronic pain, pain-related fear seems to overgeneralize to safe stimuli, thus contributing to excessive fear and avoidance behavior. Evidence shows that pain-related fear can be acquired and generalized based on conceptual knowledge. Using a fear conditioning paradigm, we investigated whether this concept-based pain-related fear could also be extinguished. ⋯ This is the first study to demonstrate extinction of concept-based pain-related fear, thus providing evidence for the potential of extinction-based techniques in the treatment of conceptual pain-related fear. PERSPECTIVE: This study demonstrates the acquisition, generalization, and extinction of concept-based pain-related fear in healthy participants. These are the first results to show that concept-based pain-related fear can be extinguished, suggesting that conceptual relationships between fear-inducing stimuli may also be important to consider in clinical practice.
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The Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), and Pain Severity subscale of the Brief Pain Inventory (BPI-PS) are the most frequently used instruments to measure pain intensity in low back pain. However, their measurement properties in this population have not been reviewed systematically. The goal of this study was to provide such systematic evidence synthesis. ⋯ All VAS measurement properties were underpinned by no, low, or very low quality evidence; likewise, the other measurement properties of NRS and BPI-PS. PERSPECTIVES: Despite their broad use, there is no evidence clearly suggesting that one among VAS, NRS, and BPI-PS has superior measurement properties in low back pain. Future adequate quality head-to-head comparisons are needed and priority should be given to assessing content validity, test-retest reliability, measurement error, and responsiveness.
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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.