The journal of pain : official journal of the American Pain Society
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Monitoring recovery during acute pain episodes is useful for identifying youth at risk for pain persisting. Subjective and objective measures can assess function postinjury, but associations among these different measures and pain patterns in the acute period are unknown. To fill this gap, we examined associations among self-reported activity limitations, objectively measured physical activity, and pain intensity in 176 youth (age 11-17, 46% male) seeking health care for acute musculoskeletal pain. ⋯ Future work should examine how physical activity and activity limitations change longitudinally and predict pain persistence. PERSPECTIVE: This study examined daily associations between pain intensity, self-reported activity limitations, and objectively assessed physical activity in youth during the acute recovery period following a musculoskeletal injury. Self-reported activity limitations and objective physical activity represent 2 distinct, yet related, aspects of physical functioning that are associated with pain.
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The count of locations with chronic pain is widely used in research and clinical practice. However, this approach might be too simplistic to fully capture the complexity of chronic pain experiences. This study identified prevalent patterns of chronic pain locations and evaluated their associations with incident dementia among middle-aged and older adults in the UK. ⋯ PERSPECTIVE: This article unveils chronic pain patterns and dementia risks in the UK Biobank. Chronic pain in back, neck, and knee presents frequently, either individually or in combinations associated with increased dementia rates. Chronic pain combos correlate with diverse dementia rates, guiding targeted prevention strategies through pain management.
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Pain is a hallmark symptom of knee osteoarthritis (KOA), yet intensity and severity vary widely among individuals. There is a knowledge gap in understanding key characteristics of high-impact chronic pain (HICP) within the context of KOA. Therefore, our first purpose was to examine the prevalence of HICP in a cohort of individuals with radiographic evidence of KOA, and our second purpose was to assess patient-level factors associated with HICP. ⋯ These findings could be used to develop intervention approaches specific to individuals with KOA and to inform future investigations of sociodemographic and clinical factors associated with HICP. PERSPECTIVE: These findings provide additional information on the characterization of HICP for individuals with KOA. There was consistency in psychosocial factors associated with HICP, while sociodemographic and clinical factors varied based on how HICP status was defined.
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This study examines the influence of body mass index (BMI) on the relationship between quantitative sensory testing measures and clinical characteristics in fibromyalgia syndrome (FMS). Utilizing BMI as a categorical covariate (≥25 or ≥30 kg/m²) in associations between quantitative sensory testing metrics (pain-60, conditioned pain modulation, and temporal summation of pain [TSP]) and FMS clinical features, we explored BMI's role as both a confounder (change-in-estimate criterion-change equal or higher than 10%) and effect modifier (interaction term). Significant interactions revealed overweight/obese BMI as a modifier in the relationship between conditioned pain modification and both depression and symptom impact, with a homeostatic relationship between better clinical profile and pain inhibitory response observed solely in the normal-weight group. ⋯ We discuss the mechanistic and therapeutic implications of targeting BMI in FMS clinical trials and the potential impact of this important relationship. PERSPECTIVE: This investigation highlights the disruptive influence of high BMI on pain inhibitory control in fibromyalgia, unbalancing clinical symptoms such as pain and depression. It underscores the necessity of integrating BMI considerations into therapeutic approaches to enhance pain management and patient outcomes.
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Randomized Controlled Trial
Studying the effect of expectations on high-frequency electrical stimulation-induced pain and pinprick hypersensitivity.
Negative expectations can increase pain, but can they promote the development of central sensitization? This study used an inert treatment and verbal suggestions to induce expectations of increased high-frequency electrical stimulation (HFS)-induced pain and assessed their effects on pain ratings during HFS and HFS-induced pinprick hypersensitivity. Fifty healthy volunteers were randomly allocated to either a control group (N = 25) or a nocebo group (N = 25). Participants in both groups received a patch containing water on the right forearm. ⋯ HFS increased pinprick sensitivity but no group differences were found. Because of the lack of differences in expected pain and pain intensity ratings for HFS between groups, no firm conclusions can be drawn regarding their effect on pinprick hypersensitivity. PERSPECTIVE: This study shows that sham treatment combined with verbal suggestions induces a nocebo effect but does not necessarily change expectations and experience of upcoming pain.