The journal of pain : official journal of the American Pain Society
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Existing data suggest placebo responses to treatments are small, but some people may be more likely to respond. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on interindividual variability in response to placebo interventions MEDLINE, EMBASE, CINAHL, Web of Science Core Collection, CENTRAL, and SPORTDiscus were searched from inception to September 2023. Trial registry searches, citation tracking, and searches for prior systematic reviews were completed. ⋯ PERSPECTIVE: This study systematically reviewed and analyzed RCTs to assess interindividual variability in placebo responses for musculoskeletal pain. Findings suggest minimal variability in placebo response, with no distinct subgroups more likely to respond. Wide prediction intervals indicate uncertainty, highlighting the need for future individual participant data meta-analyses to better elucidate potential responder subgroups.
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Fibromyalgia (FM) impacts patients' health status, functioning and quality of life. Accurate diagnosis and effective treatment planning require reliable, valid and responsive measures of these domains. This study aimed to assess the psychometric properties of performance based tests (PBTs) in FM and to quantify the availability of reliable, valid and responsive PBTs linked to key International Classification of Functioning, Disability and Health (ICF) categories related to functional impact. ⋯ PERSPECTIVE: This review confirms that the current understanding of the psychometric properties of PBTs for FM patients is limited, hindered by heterogeneous tests and insufficient evidence, complicating outcome comparisons across studies. This gap underscores the need for future research to enhance methodological quality and address missing ICF categories related to FM. REGISTERED PROTOCOL AT PROSPERO: Registration number: CRD42022380709.
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Musculoskeletal pain is a global public health problem. Social marketing aims to increase adoption of desired behaviours in target audiences and may uncover new strategies to improve uptake of helpful pain-related behaviours at the population-level. We systematically evaluated effects of contemporary mass media campaigns targeting musculoskeletal pain and used social marketing benchmarking to explore strategies associated with campaign success. ⋯ PERSPECTIVE: We systematically evaluated contemporary mass media campaigns targeting musculoskeletal pain. Promising improvements in population beliefs about pain supports continued investment into campaigns. Our review provides critical new information including social marketing strategies to ensure future campaign efforts shift population-level pain-related behaviours, towards reducing the societal burden of pain.
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The personal, social and economic burden of chronic pain is enormous. Tremendous research efforts are being directed toward understanding, preventing, and managing chronic pain. Yet patients with chronic pain, clinicians and the public are sometimes poorly served by an evidence architecture that contains multiple structural weaknesses. ⋯ We end with a call for collective action to address this critical issue. PERSPECTIVE: Multiple challenges can adversely impact the trustworthiness of pain research and health research more broadly. We present ENTRUST-PE, a novel, integrated framework for more trustworthy pain research with recommendations for all stakeholders in the research ecosystem, and make a call to action to the pain research community.
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A significant driver of pain in individuals with low back pain (LBP) is alterations to endogenous pain modulation (EPM). EPM can be measured using quantitative sensory testing (QST), however; there are inconsistencies in the way QST has been implemented across the low back pain literature. The objective of this scoping review was to summarize protocols used to assess EPM using QST (pain pressure threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM)) or exercise-induced hypoalgesia (EIH) in LBP. ⋯ PERSPECTIVE: This article presents a summary of measures used to assess EPM in LBP. The results show the wide variability of protocols used in the literature. Future research should focus on creating standardized protocols, reporting guidelines and providing more guidance for researchers in selecting appropriate tests for their research questions.