Pain practice : the official journal of World Institute of Pain
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Musculoskeletal pain has major public health implications, but the theoretical framework remains unclear. It is hypothesized that sensorimotor incongruence (SMI) might be a cause of long-lasting pain sensations in people with chronic musculoskeletal pain. Research data about experimental SMI triggering pain has been equivocal, making the relation between SMI and pain elusive. The aim of this study was to systematically review the studies on experimental SMI in people with musculoskeletal pain and healthy individuals. ⋯ Based on the current evidence and despite some methodological issues, there is no evidence that experimental SMI triggers pain in healthy individuals and in people with chronic musculoskeletal pain. However, people with chronic musculoskeletal pain report more sensory disturbances and pain during the experimental conditions, indicating that visual manipulation influences pain outcomes in this population.
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Clinical Trial
Focal Mechanical Vibration Does not Change Laser-Pain Perception and Laser-Evoked Potentials: A Pilot Study.
Nonpainful tactile and electrical stimulation of the large myelinated fibers reduces spontaneous pain and the amplitude of laser-evoked potentials (LEPs), which represent the most reliable technique to assess the nociceptive pathway function. Focal mechanical vibration stimulates the Aβ afferents selectively; thus, it is conceivable its action on nociceptive pathways. ⋯ We conclude that a vibratory stimulus is ineffective in reducing the laser-evoked potentials and laser-pain perception.
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Parental behavior plays a significant role in children's pain response. Prior research has found generally no differences between mothers' and fathers' verbal behavior during child pain. This study compared mothers' and fathers' nonverbal behavior during child pain. ⋯ However, children of mothers who engaged in more physical comfort/reassurance reported higher levels of pain intensity, and children of mothers who engaged in more procedure-related attending behaviors had lower pain tolerance. Further, both mothers and fathers who engaged in higher levels of verbal nonattending behaviors also engaged in lower levels of nonverbal procedure-related attending behaviors. These findings further support the importance of considering the influence of mothers and fathers in children's pain, and provide novel insights into the role of nonverbal behavior.
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Psychological inflexibility-the inability to take value-based actions in the presence of unwanted thoughts, feelings, or bodily symptoms-is associated with negative health outcomes including depression and anxiety. ⋯ Psychological inflexibility plays an important role in understanding the increased pain and decreased upper extremity physical function in patients with musculoskeletal pain. It also suggests that the cognitive error of pain catastrophizing is one of the mechanisms through which the general construct of psychological inflexibility may influence pain intensity and upper extremity physical function. Psychological treatments aimed at decreasing pain and increasing upper extremity physical function should target both pain catastrophizing and psychological inflexibility.
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Postmastectomy pain syndrome is common after surgical treatment for breast cancer and may be challenging to manage. Currently, there are a wide variety of approaches to treat this type of pain, including medications, physical therapy, and interventional procedures. ⋯ We present a case series of 8 patients who were successfully treated with serratus plane block for pain after treatment for breast cancer. We feel that this particular application for the serratus plane block deserves further investigation, as it is relatively easy to perform and has good clinical utility for this type of pain.