The journal of pain : official journal of the American Pain Society
-
Pain is a central feature in small fiber neuropathy (SFN), with only moderate effects of pharmacologic treatment. The evaluation of the efficacy of therapies on pain has been driven by static measures, and a circadian cycle has been suggested. The aim of this study is to evaluate the pain dynamics in SFN. ⋯ PERSPECTIVE: This article presents for the first time the pain dynamics of SFN. The effect of pharmacologic treatment in SFN is often disappointing, partly owing to insufficient trial designs. The results of this study have added value in the development of new proper clinical trials in SFN.
-
Review Meta Analysis
Racial-Ethnic Differences in Osteoarthritis Pain and Disability: A Meta-Analysis.
Osteoarthritis (OA), a leading cause of disability and pain, affects 32.5 million Americans, producing tremendous economic burden. Although some findings suggest that racial/ethnic minorities experience increased OA pain severity, other studies have shown conflicting results. This meta-analysis examined differences in clinical pain severity between African Americans (AAs) and non-Hispanic whites with OA. ⋯ Clinical pain severity and disability in OA is higher among AAs and future studies should explore the reasons for these differences to improve pain management. PERSPECTIVE: This meta-analysis shows that differences exist in clinical pain severity, functional limitations, and poor performance between AAs and non-Hispanic whites with OA. This research may lead to a better understanding of racial/ethnic differences in OA-related pain.
-
Fibromyalgia (FM) is a common chronic pain disorder that presents diagnostic challenges for clinicians. Several classification, diagnostic and screening criteria have been developed over the years, but there continues to be a need to develop criteria that reflect the current understanding of FM and are practical for use by clinicians and researchers. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the U. ⋯ PERSPECTIVE: The ACTTION-APS FM taxonomy provides an evidence-based diagnostic system for FM. The taxonomy includes diagnostic criteria, common features, comorbidities, consequences, and putative mechanisms. This approach might improve the recognition of FM in clinical practice.
-
Mindfulness-based training reduces pain in clinical and experimental settings. Evidence suggests that these beneficial effects are facilitated via an increased focus on the present moment and a reduced emotional enhancement of pain. Most of the existing literature has focused on mindfulness as a learned skill and on the neural mechanisms that underlie the acquisition of this skill. ⋯ PERSPECTIVE: Mindfulness research mostly focuses on mindfulness as a trained skill rather than a trait. Consistent with trained-mindfulness studies, we demonstrate that mindfulness is associated with variations in neural connectivity linked to sensory and evaluative processes. These findings indicate that trait mindfulness serves as a marker for individual differences in pain coping.