The journal of pain : official journal of the American Pain Society
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People with chronic pain engage in various strategies, such as pain catastrophizing and pain acceptance, to regulate the difficult emotional aspects of living with pain. Engagement in these strategies is known to influence pain severity and pain interference. However, less research has examined the extent to which general emotion regulation, the ability to identify emotions and engage in strategies to alter emotions, relates to pain-related outcomes. ⋯ These findings highlight the value of considering the role of general emotion regulation (particularly identifying and describing emotions), in addition to pain-specific experiences, in understanding risk for poor pain-related outcomes. PERSPECTIVE: In addition to pain catastrophizing and pain acceptance, difficulties regulating emotions in general (particularly elevated alexithymia) relates to pain outcomes three months later. These findings shed light on risk for poor pain outcomes and point to general emotion regulation as a potentially important target of chronic pain intervention.
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Orofacial pain patients often report that the painful facial area is "swollen" without clinical signs - known as perceptual distortion (PD). The neuromodulatory effect of facilitatory repetitive transcranial magnetic stimulation (rTMS) on PD in healthy individuals was investigated, to provide further support that the primary somatosensory cortex (SI) is involved in facial PD. Participants were allocated to active (n = 26) or sham (n = 26) rTMS group in this case-control study. ⋯ The PD was significantly higher immediately after iTBS compared to 6 min after LA (P = .004) in the active rTMS group, but not in the sham rTMS group (P = .054). iTBS applied to a somatotopic-relevant cortical region appears to facilitate facial PD further supporting the involvement of SI in the processing of one´s own face and PD. PERSPECTIVE: This study provides information on neural substrate responsible for processing of perceptual distortion of the face which is speculated to contribute to the chronification of orofacial pain. The findings of this study may aid in mechanism-based management of the condition in orofacial pain disorders and possibly other chronic pain states.
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We examined the influence of negative psychological factors (catastrophizing, distress and kinesiophobia) on delayed onset muscle soreness (DOMS) intensity, cervical function (strength and range of motion) and on daily activities (ADL), and the suitability of an exercise protocol designed to induce DOMS within the cervical region. Psychological factors and cervical function were assessed in 86 healthy participants at baseline before applying a DOMS provocation protocol in the cervical flexor muscles. After 24hour, cervical function was reassessed. ⋯ Psychological distress (anxiety and depression), but not kinesiophobia and catastrophism, predicted a loss of cervical strength (explained 43% of the variance) and range of motion (explained 22% of the variance) after induction of DOMS. In addition, participants' anxiety level predicted DOMS intensity at 24hour (explained 19% of the variance). PERSPECTIVE: The present findings highlight the relevance of evaluating psychological distress as a preventive/therapeutic measure, given that high levels of distress could lead to more intense and disabling pain in acute injuries, and all these aspects are considered risk factors for the chronification of symptoms.
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Low back pain (LBP) is complex. This study aimed to use collaborative modeling to evaluate conceptual models that individuals with LBP have of their condition, and to compare these models with those of researchers/clinicians. Twenty-eight individuals with LBP were facilitated to generate mental models, using "fuzzy cognitive maps," that represented conceptualization of their own LBP and LBP "in general." "Components" (ie, causes, outcomes and treatments) related to pain, disability and quality of life were proposed, along with the weighted "Connections" between Components. ⋯ Findings highlight challenges for changing public perception of LBP, and provide a method with potential utility to understand how individuals conceptualize their condition. PERSPECTIVE: Collaborative modeling was used to understand how individuals with low back pain conceptualize their own condition, the condition in general, and compare this with models of expert researchers/clinicians. Data revealed issues in how individuals with back pain conceptualize their condition, and the method's potential utility for clinical evaluation of patients.