The journal of pain : official journal of the American Pain Society
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Autistic adolescents are at greater risk of chronic pain, but it is unclear how autistic features may relate to individual aspects of chronic pain. As autism traits exist in the general population as well, it is important to know if autistic traits could impact how effective chronic pain management is for adolescents. Here we examined autistic traits in 112 patients (12-18yrs) recruited from a UK national specialist adolescent pain rehabilitation programme. ⋯ Autistic traits were not related to the magnitude of improvement following IIPT. Our data therefore suggests that autism should not be a barrier to IIPT. DATA AVAILABILITY: Data is held in the PAIRED Pain Rehabilitation Database: Bath and Bristol, individual data used in the current analyses are therefore not available.
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The risk of developing chronic pain is twice as high among people with a history of childhood maltreatment compared to those without these experiences. It is unclear, however, whether childhood maltreatment might lead to lower or higher perception of pain. In this paper, we investigate the association between childhood maltreatment and pain sensitivity. ⋯ Individuals reporting childhood sexual abuse, emotional abuse or neglect and physical neglect could on average withstand hot and cold pain of 1.03 °C [0.13, 1.84] to 3.20 °C [0.62, 5.97] more across different types of abuse compared to those with no emotional abuse or (physical) neglect history. Physical abuse was not associated with pain sensitivity. The current findings suggest that childhood maltreatment might lead to habituation to painful stimuli as opposed to increased pain sensitivity.
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Observational Study
Why is low educational attainment linked to worse pain and function in fibromyalgia?
Lower educational attainment has been linked to worse pain in individuals with chronic pain, but the mechanisms of this relationship are not fully elucidated. This observational study analyzed the relationship between educational attainment and pain in patients with fibromyalgia (FM) and the potential psychological mechanisms driving this relationship. We hypothesized that (1) lower educational attainment would be associated with greater pain intensity and interference, and that (2) concerns about pain (CAP), anxiety, and depression would mediate the relationship between educational attainment and pain. ⋯ This work has important implications in reducing pain disparities and provides direction for psychological treatment, suggesting that both depression and CAP may be critical targets especially for people with lower education attainment. PERSPECTIVES: This study examined the relationship between educational attainment, psychological variables, and pain. Results have implications for psychological intervention aimed at concerns about pain and depression, especially among individuals with low educational attainment.
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The concomitant epidemics of chronic pain and opioid misuse in the United States have led to a call for novel analgesics with limited abuse potential. Previously, we have shown that co-delivery of a novel combination targeting both μ- and δ-opioid receptors in the peripheral and central nervous systems can produce synergistic analgesia. Loperamide, a peripherally restricted μ-opioid agonist, and oxymorphindole, a δ-opioid receptor partial agonist, synergize in multiple mouse models of hyperalgesia. ⋯ From these data we conclude that the combination of oxymorphindole and loperamide or the combination of N-benzyl-oxymorphindole and loperamide reverse incisional hyperalgesia, likely by acting in the periphery, in a large animal model without adverse effects on respiration or heart rate. PERSPECTIVE: This article presents novel opioid combinations, the μ-opioid agonist loperamide with a δ-opioid agonist, either oxymorphindole (OMI) or N-benzyl-oxymorphindole (BOMI), that relieve pain in mice and pigs without adverse side effects. These therapies could help clinicians manage pain in patients while reducing overall opioid burden and limiting side effects.
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The study of orofacial neuropathic pain necessitates the use of innovative assessment techniques, such as the facial expression of pain, which mirrors the internal state of the animals and could be utilized to identify the neural correlations involved. The Anterior Cingulate Cortex (ACC) is a crucial center in the processing of sensory and affective components of acute and neuropathic pain. However, its role in the facial response to pain remains a mystery. ⋯ Our study underscores the significant role of ACC in the development of signs of orofacial neuropathic pain, such as exacerbated facial response to mechanical stimuli. PERSPECTIVE: This article presents evidence on the sensory coding of mechanical stimulation in a neuropathic pain model in the Anterior Cingulate Cortex, using facial expression as a manifestation of the internal painful state. This evaluation provides a novel approach to evaluating the well-being of animals with neuropathic pain.