The journal of pain : official journal of the American Pain Society
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Although evidence supports the importance of pain-related thoughts (ie, cognitive content, or what people think) as predictors of pain and pain-related function, evidence regarding the role of cognitive processes (ie, how people think about pain, eg, by accepting pain, not making judgments about pain, or being absorbed by the pain experience) in adjustment to chronic pain is in its early stages. Using baseline data from a clinical trial of individuals with chronic low back pain (N = 327), the study aimed to increase knowledge regarding the associations between cognitive processes, pain intensity, pain interference, and depression. The results indicate that a number of cognitive processes are significantly related to pain intensity when controlling for catastrophizing, although the pattern of associations found was opposite to those anticipated. ⋯ Longitudinal and experimental studies to evaluate the causal nature of the associations identified are warranted. PERSPECTIVE: The study findings highlight the potential importance of cognitive process variables (ie, how people think) in adjustment to chronic pain. Research to evaluate cognitive processes as potential mechanism variables in pain treatment is warranted.
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Prescription opioid tapering has increased significantly over the last decade. Evidence suggests that tapering too quickly or without appropriate support may unintentionally harm patients. The aim of this analysis was to understand patients' experiences with opioid tapering, including support received or not received for pain control or mental health. ⋯ Patient-centered approaches to tapering include reaching out to monitor how patients are doing, involving patients in decision-making, supporting mental health changes, and allowing for flexibility in the tapering pace. PERSPECTIVE: Patients tapering prescription opioids desire more provider-initiated communication including checking in about pain, setting expectations for withdrawal and mental health-related changes, and providing support for mental health. Patients preferred opportunities to share decisions about taper speed and to have flexibility with pausing the taper as needed.
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Previous studies have established a core outcome set for pediatric chronic pain clinical trials. The aim of this research was to establish which outcomes young people and parents considered important to measure during treatment for chronic musculoskeletal pain. To the best of our knowledge, this is the first study to explore which outcomes could be used to tailor interventions within a clinical setting. ⋯ Overall, the research highlighted the need for clinical guidance on which outcome domains to measure during the treatment course to gauge treatment effectiveness and optimally tailor interventions. PERSPECTIVE: This study established the range of outcomes that were important to young people and their parents during treatment for chronic musculoskeletal pain. The findings show how young people and parents have different outcome preferences and how their outcome focus changes during the treatment course.
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The measurement of withdrawal to experimenter-delivered mechanical stimuli (von Frey test) and to heat stimuli (radiant heat paw-withdrawal or Hargreaves' test) applied to the hind paws is ubiquitous in preclinical pain research, but no normative values for the most-common applications of these tests have ever been published. We analyzed a retrospective data set of withdrawal thresholds or latencies in 8,150 mice in which these measures were taken using replicate determinations, before and after injection of inflammatory substances or experimental nerve damage producing pain hypersensitivity, totaling 97,332 measurements. All mice were tested in the same physical laboratory over a 20-year period using similar equipment and procedures. ⋯ These factors are discussed, and we believe that these normative data will serve as a useful reference for expected values in preclinical pain testing. PERSPECTIVE: This article presents a retrospective analysis of a large data set of mouse von Frey and radiant heat paw-withdrawal (Hargreaves' test) measurements collected in a single laboratory over 20 years. In addition to serving as a normative guide, sources of variability are identified including genotype, tester, and sex.
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Review Meta Analysis
The Relationship Between Pain and Interoception: A Systematic Review and Meta-Analysis.
Interoception refers to the ability to sense internal bodily sensations. Research suggests that dysfunctions in interoception may be implicated in the transition to chronic pain, however, little work has examined interoceptive ability in pain states. Therefore, this systematic review aimed to assess whether interoception is altered in individuals experiencing pain. ⋯ This review was registered on the PROSPERO International Prospective Register of Systematic Reviews (Registration ID = CRD42022318843). PERSPECTIVE: This review considered the relationship between interoception and pain and found that an individual's ability to accurately sense internal signals is decreased in those with chronic pain, despite them reporting being more aware of internal sensations. However, there remains little research examining interoception in non-chronic pain states.