Articles: chronic-pain.
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For reasons unknown, temporomandibular disorder (TMD) can manifest as localized pain or in conjunction with widespread pain. We evaluated relationships between cytokines and TMD without or with widespread palpation tenderness (TMD-WPT or TMD+WPT, respectively) at protein, transcription factory activity, and gene levels. Additionally, we evaluated the relationship between cytokines and intermediate phenotypes characteristic of TMD and WPT. ⋯ Interactions were observed between TGFβ1 and IL-8 SNPs: an additional copy of the TGFβ1 rs2241719 minor T allele was associated with twice the odds of TMD+WPT among individuals homozygous for the IL-8 rs4073 major A allele, and half the odds of TMD+WPT among individuals heterozygous for rs4073. These results demonstrate how pro- and antiinflammatory cytokines contribute to the pathophysiology of TMD and WPT in genetically susceptible people. Furthermore, they identify MCP-1, IL-1ra, IL-8, and TGFβ1 as potential diagnostic markers and therapeutic targets for pain in patients with TMD.
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Chronic pain is often associated with hyperalgesia in cross-sectional studies. In the present study, a random cohort of 40-year-old individuals (n = 264) from the general population was assessed for low back pain (LBP) status and pressure pain threshold (PPT), with follow-up assessment 4 and 8 years later. ⋯ Of the participants without recent or long-lasting LBP, those with a low PPT at baseline (lower 10% percentile) had no increased risk of developing LBP (p > 0.05). The findings indicate that PPT decreases as a consequence of long-lasting pain, whereas a low PPT seems not to constitute a separate risk factor for the development of LBP.
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The aim of the present study was to investigate the 2-year outcome of a cognitive-behavioral training program for the management of depressive symptoms for patients with chronic low back pain (CLBP) and co-existing depressive symptoms compared with the standard rehabilitation. Therefore, a quasi-experimental 3 × 2 × 5 (treatment condition × gender × time) repeated measures design with five assessment points (pre-treatment, post-treatment, 6-, 12-, and 24-month follow-up) was employed among N = 153 patients with CLBP, aged 33-62 years. ⋯ Only short- or mid-term improvements were found in the CG(depr). In conclusion, the new cognitive-behavioral training program augmented the long-term rehabilitation success in this highly strained subgroup of patients with CLBP and depressive symptoms.
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In this study, the relationship between pain intensity, neuropsychological, and physical function in adult chronic pain patients was examined. ⋯ The results suggest that in chronic pain patients, mental processing speed mediates the relationship between pain and physical function.
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Persistent pain after resolution of clinically appreciable signs of arthritis poses a therapeutic challenge, and immunosuppressive therapies do not meet this medical need. To investigate this conversion to persistent pain, we utilized the K/BxN serum transfer arthritis model, which has persistent mechanical hypersensitivity despite the resolution of visible inflammation. Toll-like receptor (TLR) 4 has been implicated as a potential therapeutic target in neuropathic and other pain models. ⋯ WT arthritic mice had reduced spinal levels of the anti-inflammatory prostaglandin 15-deoxy-Δ(12,14)-PGJ(2) (15d-PGJ(2)) on day 6, compared to IT LPS-RS-treated mice. Direct IT application of 15d-PGJ(2) (0.5 μg) on day 6 improved mechanical hypersensitivity in arthritic mice within 15 min. Hence, TLR4 signaling altered spinal bioactive lipid profiles in the serum transfer model and played a critical role in the transition from acute to chronic postinflammatory mechanical hypersensitivity.