The journal of pain : official journal of the American Pain Society
-
Relatively recently, in 2009, experimental studies were undertaken to determine the role of social observational learning in forming hypoalgesic, analgesic and hyperalgesic responses to a placebo. The research findings obtained in studies published before 2018 were integrated and formed the basis of the theoretical model of social learning of placebo effects in pain proposed by Bajcar and Bąbel. This model considered the involvement of different types of modeling (ie, behavioral modeling, symbolic modeling, and verbal modeling) in shaping placebo hypoalgesia/analgesia and nocebo hyperalgesia. ⋯ Notably, the extended version of the model considers the contribution of the characteristics of the observed person to the magnitude of placebo effects induced by social learning. PERSPECTIVE: The paper proposes a comprehensive theoretical approach to explaining the role of observational learning in shaping placebo effects in pain. The proposed model emphasizes the potential of this form of learning in shaping placebo responses and indicates factors that can modify the effectiveness of observational learning.
-
Randomized Controlled Trial
Treatment effect modifiers for return-to-work in patients with musculoskeletal disorders.
Investigating how individual characteristics modify treatment effects can improve understanding, interpretation, and translation of trial findings. The purpose of this secondary analysis was to identify treatment effect modifiers of the MI-NAV trial, a 3 arm, parallel randomized controlled trial which compared motivational interviewing and stratified vocational advice intervention in addition to usual case management (UC), to UC alone. This study included (n = 514) participants with musculoskeletal disorders on sick leave for at least 50% of their contracted work hours for at least 7 consecutive weeks with the Norwegian Labour and Welfare Administration. ⋯ For stratified vocational advice intervention versus UC, analgesic medication use (MD -26.2, 95% CI -45.7 to -6.7; P = .009) was identified as a treatment effect modifier (P ≤ .05). These findings may assist in more targeted treatment adaptation and translation as well as the planning of future clinical trials. PERSPECTIVE: This secondary analysis of the MI-NAV trial found that analgesic medication use, age, and self-perceived health may modify the effect of 2 vocational interventions on reducing sickness absence in people with musculoskeletal disorders.
-
Randomized Controlled Trial
Bystander Acknowledgment Mitigates the Psychological and Physiological Pain of Racial Discrimination for Black Young Adults: A Randomized Controlled Trial.
Racism increases pain sensitization and contributes to racialized pain inequities; however, research has not tested interventions targeting racism to reduce pain. In this study, we examined whether White bystanders can act to mitigate racism's pain-sensitizing effects. To simulate racial exclusion in the laboratory, Black young adults (age 18-30; N = 92) were randomly assigned to be included or excluded by White players in a ball-tossing game (Cyberball). ⋯ We demonstrate that acute exposure to mild racism increases acute pain sensitization. Results suggest that a bystander acknowledging witnessed racism can buffer the acute sensitizing effects of racism on pain, pointing to the potential of interpersonal interventions targeting racism. TRIAL REGISTRATION: Clinicaltrials.gov NCT06113926.
-
Randomized Controlled Trial
Fecal Microbiota Transplantation Improves Clinical Symptoms of Fibromyalgia: An open-label, Randomized, Nonplacebo-Controlled Study.
Fibromyalgia (FM) is a complex and poorly understood disorder characterized by chronic and widespread musculoskeletal pain, of which the etiology remains unknown. Now, the disorder of the gut microbiome is considered as one of the main causes of FM. This study aimed to investigate the potential benefits of fecal microbiota transplantation (FMT) in patients with FM. ⋯ PERSPECTIVE: FMT is a novel therapy that aims to restore the gut microbial balance and modulate the gut-brain axis. It is valuable to further explore the therapeutic effect of FMT on FM. Furthermore, certain neurotransmitters may become a diagnostic marker or a new therapeutic target for FM patients.
-
Randomized Controlled Trial
The Role of Pain Expectations in the Development of Secondary Pinprick Hypersensitivity: Behavioral-Neurophysiological Evidence and the Role of Pain-Related Fear.
Secondary mechanical hypersensitivity, a common symptom of neuropathic pain, reflects increased responsiveness of nociceptive pathways and can be induced temporarily in healthy volunteers using high-frequency electrical stimulation of the skin. Expectations modulate acute pain perception and fear of pain has been shown to attenuate and amplify the placebo and nocebo effects, respectively. However, the role of expectations and fear in the development of mechanical secondary hypersensitivity remains unclear. ⋯ We provide preliminary evidence that both expectations and fear impact the development of mechanical secondary hypersensitivity. PERSPECTIVE: Expectations of pain may influence the development of secondary mechanical hypersensitivity. This effect is moderated by dispositional fear of pain and partially mediated by situational fear of pain.