The journal of pain : official journal of the American Pain Society
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Chronic pain patients frequently report memory and concentration difficulties. Objective testing in this population points to poor performance on memory and cognitive tests, and increased comorbid anxiety and depression. Recent evidence has suggested convergence between chronic pain and memory deficits onto the hippocampus. ⋯ We propose that hippocampal atrophy in TN is pain-driven and successful treatment normalizes such abnormalities. PERSPECTIVE: Chronic pain patients have structural abnormalities in the hippocampus and its subfields. Pain relief normalizes these structural abnormalities and impacts patients in a sex-dependent manner.
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Review Meta Analysis
A Systematic Review and Meta-Analysis of the Effects of Biopsychosocial Pain Education upon Health Care Professional Pain Attitudes, Knowledge, Behaviour and Patient Outcomes.
Pain is a significant health burden globally and its management frequently fails to comply with evidence based, biopsychosocial guidelines. This may be partly attributable to inadequate biopsychosocial focussed pain education for students and clinicians. We aimed to undertake a systematic review, using Cochrane methodology, of randomized controlled trials with meta-analysis to quantify the effects of biopsychosocial education strategies in changing student/qualified health care professionals (HCPs) pain related attitudes, knowledge, clinical behaviour or patient outcomes. ⋯ PROSPERO systematic review record number, CRD42018082251. PERSPECTIVE: We outline the effectiveness of biopsychosocial pain education for health care professionals and students in improving pain knowledge, attitudes, and evidence-based behaviors. These improvements should enhance clinical outcomes in patients with pain but further evidence is needed to confirm this.
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Randomized Controlled Trial
Widespread pressure delivered by a weighted blanket reduces chronic pain: A randomized controlled trial.
Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. ⋯ The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). PERSPECTIVE: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.
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Clinical Trial Observational Study
Pediatric pain screening tool: A simple 9-item questionnaire predicts functional and chronic postsurgical pain outcomes after major musculoskeletal surgeries.
Reliable, clinic-friendly screening for Chronic postsurgical pain (CPSP) risk is unavailable. Within a prospective, observational study, we evaluated Pediatric Pain Screening Tool (PPST), a concise 9-item questionnaire, as a preoperative screening tool to identify those at higher risk for CPSP (Numerical Rating Scale > 3/10 beyond 3 months post-surgery) and poor function (disability/Functional Disability Inventory [FDI]/quality of life/ Pediatric Quality of Life) after spine fusion and Nuss procedures. Incidence of CPSP was 34.86% (38/109). ⋯ PERSPECTIVE: The article supports Pediatric Pain Screening Tool, a simple 9-item questionnaire, as a preoperative screening tool for CPSP and function 6-12 months after spine/pectus surgeries. PPST measures correlate with known risk factors for CPSP. Risk stratification and targeted preventive interventions in high-risk subjects are proposed.
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Many people with fibromyalgia use cannabidiol (CBD) products despite limited rigorous evidence of benefit. In the current study, we conducted a secondary analysis of a cross-sectional survey of N = 878 people with fibromyalgia to investigate naturalistic decision making around CBD product choices, use patterns, and dosing. We subgrouped participants based on use of high-THC cannabis (HTC) in the past year (yes/no) as previous studies have shown that HTC use influences CBD use patterns. ⋯ PERSPECTIVE: This article shows that past-year HTC use strongly influences how people with fibromyalgia choose and use CBD products. Participants typically used <50 mg/d of CBD, and there was no relationship between higher CBD dose and reported therapeutic benefit. Future clinical trials should investigate therapeutic benefits of low dose CBD.