Scandinavian journal of pain
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This study examined the altered patterns of functional connectivity in task-positive resting state networks in failed back surgery syndrome (FBSS) patients compared to healthy controls using functional magnetic resonance imaging (fMRI). This work stems from a previous study in which alterations in the task-negative default mode network were investigated. ⋯ These data suggest that a chronic pain condition-FBSS-is associated with disruptions to networks of functional connectivity in brain areas that are involved in numerous functions, including pain processing, sensation, and movement. It is possible that the alterations in these networks may contribute to other common chronic pain comorbidities, such as disrupted cognitions or anxiety. Previous research shows that during experimentally-induced pain, these networks can return to initial levels of functioning, indicating that these functional alterations are likely not permanent.
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Observational Study
The association between pain characteristics, pain catastrophizing and health care use - Baseline results from the SWEPAIN cohort.
Pain is common and adds to the global burden of disease. However, individuals suffering from pain are a heterogeneous group in terms of pain spreading, intensity and duration. While pain influences overall health care consultation not everyone with pain consult health care. To be able to provide health care matching the patients' needs increased knowledge about what factors determines the decision to consult health care is essential. The aim of this study was to explore the combined importance of pain spreading, intensity, duration and pain catastrophizing for consulting health care. ⋯ Treatment and rehabilitation strategies should incorporate this finding in order to meet the individual's needs focusing on the biopsychosocial model within health care focusing not only on actual pain reliefs but also on for example acceptance and behavioural changes.
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Clinicians treating paediatric chronic pain conditions understand that persistent pain, functional ability, and symptoms of depression often co-exist, yet these relationships have only been described to a limited extent by research. This paper more closely examines the relationship between symptoms of depression and subtypes of functional disability. ⋯ We argue that prior research has measured physical functional limitations in paediatric pain sufferers in a way that is heavily influenced by psychosocial factors, in particular by the symptoms of clinical depression. In contrast, using a measure of physical functioning (PODCI) less influenced by psychosocial factors suggests that the relationship between physical functioning during activities of daily living (e.g., use of upper limbs, basic gross and fine motor skills, basic mobility) and depression is weaker, despite both being heightened in this sample. Unlike other functional disability measures, the Pediatric Outcomes Data Collection Instrument (PODCI) may allow researchers to assess functional limitations somewhat independently of depression symptoms. This conclusion requires replication in further studies, but if confirmed, then the PODCI could be advocated as a useful measure to obtain a more 'pure' measure of functional difficulties due to pain, relatively independent of depression.
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Knowledge, attitudes and beliefs towards low back pain (LBP) can significantly impact a health care provider's clinical decision making. Several studies have investigated interventions designed to change practitioner attitudes and beliefs towards LBP, however no such studies involving medical students have been identified. ⋯ Medical doctors are at the forefront of managing low back pain in the community, however there is a need to strengthen musculoskeletal education in medical training programmes. The results from this research suggest educational interventions on back pain do not need to be extensive in order to have favourable outcomes on medical students' knowledge, attitudes and beliefs towards back pain. The translational effects of these changes into clinical practice are not known.