The journal of pain : official journal of the American Pain Society
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Errors in language are common in pain medicine, but the extent of such errors has not been systematically measured. This pre-registered umbrella review explored Embase, PubMed, Medline and CINAHL and seeks to quantify the prevalence of errors in language in review articles since the last IASP definition revision. To be eligible, studies must have met the following criteria: 1) Primary aim was stated as to provide neurophysiological explanations of nociception and/or pain in humans in context of a pathology/condition; 2) Any type of review article; 3) Written in English; 4) Published in a peer-reviewed journal. ⋯ Our findings underscore the imperative for prompt action in regulating pain medicine terminology. PRE-REGISTRATION: This umbrella review was pre-registered on OSF registries (https://doi.org/10.17605/osf.io/kau8m). ONLINE MATERIAL: https://osf.io/kdweg/.
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Minimum clinically important differences (MCIDs) in acute pain intensity have not been well established. Conventional approaches for estimating MCIDs require an independent reference scale, with a threshold that must be presumed to accurately classify meaningful change in pain for all study participants, to serve as an anchor. The double stopwatch technique is the gold standard for measuring the time to meaningful relief, where participants actively press the second stopwatch when they experience pain relief that is meaningful to them. ⋯ The advantages of the stopwatch-based MCID methodology are illustrated relative to a conventional approach using data from a randomized trial in third molar extraction. PERSPECTIVE: This article describes a methodology for determining MCIDs using the double stopwatch technique, the gold standard for assessing meaningful changes in acute pain. This methodology can be used to establish MCIDs in different acute pain settings, providing a useful basis to evaluate the meaningfulness of clinical trial results.
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Multi-site pain is common in people aged 60 years and over and is associated with a high risk of falls. To prevent and treat pain-related disabilities, it is crucial to identify the mechanisms underlying these associations. There is some evidence that pain leads to changes in walking, such as slower gait speed and shorter walking distance, which impair mobility and may increase the risk of falls. ⋯ These findings suggest that pain impacts walking speed in older people, highlighting the importance of addressing this association to manage mobility deficits and fall risk. PERSPECTIVE: This systematic review and meta-analysis show that pain is associated with reduced gait speed in older people. Recognising and addressing the impact of pain on walking may be important for preventing mobility-related disorders and falls in this population.
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We used a scoping review design to map the available evidence describing the use of reassurance in clinical practice, interventions to increase the delivery of reassurance, and reassurance-related outcome measures. We searched CINAHL, MEDLINE, EMBASE and Cochrane Central from inception to October 2024. Publications were included if they described the use of reassurance or reassurance-related outcome measures in patients with non-specific low back pain (LBP) presenting to primary care. ⋯ PERSPECTIVE: This review maps the available evidence describing how patient reassurance is used and assessed in the management of low back pain. There is limited assessment of the effectiveness of reassurance interventions. Reassurance is rarely the primary component of interventions and there are no validated measures to directly assess patient reassurance.
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Randomized Controlled Trial
Comparable conditioned pain modulation and painful-exercise-induced hypoalgesia in healthy young adults: A randomised crossover trial.
Conditioned pain modulation and exercise-induced hypoalgesia reflect inhibitory pain controls emanating from the brain. The aim of this study was to compare the extent of pain inhibition from exercise-induced hypoalgesia (isometric wall squat), conditioned pain modulation (cold-water immersion), and their combination (wall squat followed by cold water in fixed order) in healthy pain-free adults. Sixty-one participants (median age 21 years) completed 3 sessions (wall-squat, cold-water, and combined) in random order. ⋯ Pressure pain in body regions remote from the exercised or conditioned sites may be weakly modulated. PERSPECTIVE: The current findings suggest that pain-inhibitory effects induced by painful wall squat and by cold-water immersion may overlap. The magnitude of pain inhibition in the forehead remote from the exercised thigh or the conditioned foot appears smaller, which could be examined further in future research.