European Journal of Pain最新文献

{"title":"Are Stabilisation Exercises Effective After Epidural Steroid Injection in Patients With Cervical Radiculopathy? A Prospective Randomised Controlled Trial","authors":"Umut Islam Tayboga,&nbsp;Yucel Olgun,&nbsp;Osman Hakan Gunduz,&nbsp;Savas Sencan","doi":"10.1002/ejp.4777","DOIUrl":"10.1002/ejp.4777","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cervical radiculopathy is caused by dysfunction of nerve roots in the cervical spine. While many studies have assessed the effectiveness of interlaminar epidural steroid injection (ILESI) and stabilisation exercises separately for this condition, our study aims to evaluate the impact of different stabilisation exercise programmes following ILESI on treatment outcomes in radiculopathy patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-two patients with cervical radiculopathy were randomised into three groups: cervical ILESI-only (CO), neck stabilisation group (NSG) and scapular stabilisation group (SSG). The CO group received only ILESI, while NSG and SSG underwent stabilisation exercises following ILESI. Outcomes were assessed using the Numerical Rating Scale (NRS) for neck and arm pain, the Neck Disability Index (NDI) for functionality and the Short Form-12 (SF-12) for quality of life at baseline, 1 and 3 months posttreatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>When NRS, NDI and SF-12 parameters were analysed in all groups, a statistically significant improvement was observed in the 1st and 3rd months compared to the pretreatment period. While the improvement in SF-12 physical parameters was significant in SSG and NSG in the 1st month compared to the pretreatment period, no significant difference was found in the CO group in the posttreatment periods. When the 1st and 3rd month results were analysed in NSG, a greater improvement was observed in terms of NRS_NECK parameter in both evaluations compared to the other groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stabilisation exercise programme, especially neck stabilisation, should be included after ILESI treatment due to positive effects on treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>To the best of our knowledge, our study is the first to investigate the effect of a stabilisation exercise programme after ILESI on treatment outcomes in patients with radiculopathy due to cervical disc herniation. It is a valuable study in terms of its prospective design, its specific and homogeneous patient population and its results. Our study will help clinicians when prescribing exercise programmes for these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>NCT05307211</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive and Efficient Assessment of Psychological Flexibility in the Context of Chronic Pain","authors":"Amani Lavefjord,&nbsp;Felicia T. A. Sundström,&nbsp;Dane Chia,&nbsp;Fara Tabrizi,&nbsp;Monica Buhrman,&nbsp;Lance M. McCracken","doi":"10.1002/ejp.4781","DOIUrl":"10.1002/ejp.4781","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Multidimensional Psychological Flexibility Inventory (MPFI) is a measure of all facets of psychological flexibility and inflexibility, potentially important processes of change in psychological treatment for chronic pain. In some contexts, it can be considered too long. The aim of this study was, therefore, to validate a short form MPFI (MPFI-24P) in a chronic pain sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults with chronic pain were recruited online (<i>N</i> = 404) for a cross-sectional survey study. They first completed pain background questions and the MPFI. For examining convergent construct validity and explained variance in pain-related outcomes, participants also completed the Brief Pain Inventory (BPI) Pain Interference Scale, the Work and Social Adjustment Scale (WSAS) and the Patient Health Questionnaire (PHQ-9), a depression measure. Data were collected on two occasions, 2 weeks apart. Item response theory (IRT) and confirmatory factor analysis (CFA) were used for selecting the best-performing items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>IRT parameters were overall adequate, and hierarchical CFA demonstrated a good model fit. Network analysis of the MPFI items indicated that, in general, items intended to measure the same facets were substantially interconnected, more so for the inflexibility items. Temporal stability was adequate, and internal consistency was good. The MPFI-24P correlated with pain interference, work and social adjustment and depression, with the inflexibility scale better predicting these outcomes. The MPFI-24P correlated strongly with the full-length MPFI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MPFI-24P for chronic pain is generally valid and reliable, especially the inflexibility scale. It performs similarly to the full-length MPFI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This paper contributes with a measure that is both feasible to use in clinical practice and research, while being able to measure all facets of psychological flexibility and inflexibility—psychological processes of change that are important to evaluate in psychological treatment of chronic pain in order to better individualize treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Feasibility Study of a Triage Tool for Early Referral to Spinal Cord Stimulation for Patients With Chronic Low Back and Leg Pain","authors":"Ferdinand Bastiaens,&nbsp;Miranda L. van Hooff,&nbsp;Ivar J. Bruaset,&nbsp;Els van den Eede,&nbsp;Natasja J. G. Maandag,&nbsp;Erkan Kurt,&nbsp;Monique C. M. Schel-Huisman,&nbsp;Jessica T. Wegener,&nbsp;Kris C. P. Vissers","doi":"10.1002/ejp.4780","DOIUrl":"10.1002/ejp.4780","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with chronic back and leg pain.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To develop, implement, and evaluate the feasibility of a triage tool for patients with chronic back and/or leg pain to identify those eligible for referral to spinal cord stimulation (SCS) consultation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A triage tool was developed, based on Dutch SCS guidelines, literature review and expert panel consultation. The triage process was detected and implemented in collaboration with a multidisciplinary team, prior to first orthopaedic consultation. Feasibility, reliability and predictive accuracy were analysed as part of the evaluation of the triage tool.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The triage indicators included: Pain location (leg/mixed), DN4 &gt; 3, pain duration ≥ 3 months, leg pain ≥ back pain and NPRS leg pain ≥ 5. The triage tool was applied on patients on the orthopaedic waiting list, followed by a full orthopaedic review if they were not excluded. A total of 1025 orthopaedic patients with chronic back and leg pain were assessed with the triage tool. The triage tool was evaluated as feasible (mean System Usability Score 74.2 [SD 11.5]), reliable (inter-rater reliability [Fleiss' Kappa 0.79], intra-rater reliability [Cohen's Kappa 0.89]) and accurate (sensitivity [100%], specificity [98.8%], positive predictive value [40%] and negative predictive value [100%]).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Early triage of potential SCS candidates potentially supports rapid and appropriate care allocation, shortens waiting list time and improves clinical outcomes. Future research should explore strategies to optimise the tool's performance in identifying patients most likely to benefit from SCS therapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A novel triage tool was developed to identify patients with chronic back and leg pain for an early referral to SCS. This tool, evaluated for feasibility, reliability, and predictive accuracy, shows promise in reducing waiting times and improving patient selection. It can be a prelude to the further development of decision support for SCS and an acceleration in the care process for SCS candidat","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain in Parkinson's disease is impacted by motor complications, anxiety and sleep disturbances","authors":"Katarina Rukavina,&nbsp;Juliet Staunton,&nbsp;Pavlos Zinzalias,&nbsp;Magdalena Krbot Skoric,&nbsp;Karolina Poplawska-Domaszewicz,&nbsp;Antonio Pisani,&nbsp;Kirsty Bannister,&nbsp;K Ray Chaudhuri","doi":"10.1002/ejp.4765","DOIUrl":"https://doi.org/10.1002/ejp.4765","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Parkinson's disease (PD) is the second most common neurodegenerative disease. Over two thirds of People with Parkinson's (PwP) live with chronic PD-related pain, but its successful management remains an unmet need. Unrevealing links between pain and other motor and non-motor symptoms (NMS) of PD may accelerate delivery of much needed precision pain medicine approaches for PwP.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;An exploratory, cross-sectional analysis of the prospective, observational, multicentre, international study ‘&lt;i&gt;The Non-motor International Longitudinal, Real-Life Study in PD - NILS&lt;/i&gt;’.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In 109 PwP (41.3% women, age 64.29 ± 9.80 years, disease duration 5.50 (2.44–10.89) years, H&amp;Y stage 2 (1–4), levodopa equivalent daily dose 575.00 (315.00–1004.00) mg), strong correlations were noted between the total burden of PD-related pain and the total NMS burden (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.641) and moderate with disturbances of sleep/fatigue (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.483), cognitive issues (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.445), motor complications (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.421), anxiety (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.441) and depression (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.451). In a multivariate linear regression analysis, motor complications (&lt;i&gt;B&lt;/i&gt; = 2.063, 95% CI for B 1.152–2.974, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), sleep disturbances/fatigue (&lt;i&gt;B&lt;/i&gt; = 0.392, 95% CI for &lt;i&gt;B&lt;/i&gt; 0.064–0.720, &lt;i&gt;p&lt;/i&gt; = 0.020) and anxiety (&lt;i&gt;B&lt;/i&gt; = 0.912, 95% CI for &lt;i&gt;B&lt;/i&gt; 0.165–1.659, &lt;i&gt;p&lt;/i&gt; = 0.017) significantly impacted the overall burden of pain.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In PwP, PD-related pain is significantly impacted by motor complications, anxiety and sleep disturbances. A personalized, tailored approach to management of pain in PwP need to accurately identify and tackle all its interrelated symptoms. Whether successful management of motor complications, anxiety and sleep disturbances may contribute to pain relief in PwP for specified cohorts needs to be a focus of future randomized controlled clinical trials.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This explorative analysis identifies the frequent overlap of chronic pain, motor complications, sleep disturbances and anxiety in Parkinson's disease and could help advance the development of precise and effective pain management strategies tailored to the needs of People with Parkinson's.&lt;/","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Chronic Non-Cancer Pain in Denmark Over Two Decades: Prevalence, Mental Health and Loneliness","authors":"Ola Ekholm,&nbsp;Suzanne Forsyth Herling,&nbsp;Camilla Lykke,&nbsp;Svetlana Skurtveit,&nbsp;Aleksi Hamina,&nbsp;Per Sjøgren,&nbsp;Geana Paula Kurita","doi":"10.1002/ejp.4776","DOIUrl":"10.1002/ejp.4776","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Epidemiological surveys have monitored chronic non-cancer pain (CNCP) and investigated associated factors in Denmark for more than 20 years. This study aimed to analyse CNCP prevalence in the Danish population from 2000 to 2023 and its associations with mental health status and loneliness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based surveys were conducted between 2000 and 2023. In all waves, residents aged ≥ 16 years were randomly selected to complete a self-administered questionnaire. Samples included 10,089 respondents in 2000, 5292 in 2005, 14,330 in 2010, 13,429 in 2013, 13,050 in 2017, 10,384 in 2021 and 9303 in 2023. CNCP was defined as pain lasting ≥ 6 months. Mental status was assessed by Mental Component Summary score of Short Form-12 and severe loneliness by the Three-Item Loneliness Scale. Calibration weighting was applied to reduce potential non-response bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of CNCP increased steadily by 9.4 percentage points from 2000 (19.5%) to 2023 (28.9%), but with a downward tick during the COVID-19 pandemic in 2021 (25.3%). Women aged 45 years or older had the highest prevalence in all waves. Results showed a worsening of mental health over time in both individuals with and without CNCP; however, the lowest scores were reported by individuals with CNCP. Severe loneliness seemed to be a substantial problem in individuals with CNCP (17.3% in 2021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In summary, CNCP was highly prevalent over the given period and associated with mental health status and severe loneliness in recent years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study demonstrated alarming trend on chronic non-cancer pain prevalence over time in Denmark. The high estimates of prevalence and related issues, such as mental health and severe loneliness deserve further investigation and prioritisation in the public health agenda.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of perioperative analgesia on postoperative chronic analgesic prescriptions in patients with lung cancer undergoing minimally invasive thoracic surgery: A retrospective observational study","authors":"Shizuha Yabuki,&nbsp;Yu Kaiho,&nbsp;Kunio Tarasawa,&nbsp;Saori Ikumi,&nbsp;Yudai Iwasaki,&nbsp;Takahiro Imaizumi,&nbsp;Kenji Fujimori,&nbsp;Kiyohide Fushimi,&nbsp;Masanori Yamauchi","doi":"10.1002/ejp.4774","DOIUrl":"10.1002/ejp.4774","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer surgery is associated with a high incidence of chronic postsurgical pain (CPSP), which necessitates long-term analgesic prescriptions. However, while essential for managing pain, these have shown various adverse effects. Current guidelines recommend using peripheral nerve blocks over epidural anaesthesia for perioperative analgesia in minimally invasive thoracic surgery (MITS). However, the impact of perioperative analgesia on chronic analgesic prescriptions remains unclear. Therefore, this study investigated chronic analgesic prescription patterns following MITS in patients with lung cancer who received either perioperative epidural anaesthesia or nerve block.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using data from the Japanese Diagnosis Procedure Combination database. Data were extracted from patients with primary lung cancer who underwent MITS between April 2018 and March 2022. Patients were divided into two groups based on the perioperative analgesia they received: the epidural anaesthesia group and the nerve block group. We compared the proportion of analgesic prescriptions 3–6 months postoperatively between both groups using multivariable logistic regression analysis. Inverse probability of treatment weighting was used to balance the covariates between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 38,719 eligible patients, 4513 (11.6%) were prescribed postoperative analgesics. We found no significant difference in the proportion of analgesic prescriptions between the epidural anaesthesia and nerve block groups (odds ratio, 1.00; 95% confidence interval, 0.99–1.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This nationwide retrospective study suggests that the choice between perioperative epidural anaesthesia or nerve block in patients with lung cancer undergoing MITS does not influence the proportion of postoperative chronic analgesic prescriptions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of antidepressant use in people with low back pain: A retrospective study using workers' compensation data","authors":"Giovanni E. Ferreira,&nbsp;Michael Di Donato,&nbsp;Christopher G. Maher,&nbsp;Christina Abdel Shaheed,&nbsp;Stephanie Mathieson,&nbsp;Alex Collie","doi":"10.1002/ejp.4773","DOIUrl":"10.1002/ejp.4773","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antidepressants are commonly used to treat low back pain (LBP), but little is known about patterns of antidepressant use in this population. This study aimed to identify patterns of antidepressant dispensing and switching in Australian workers with an accepted workers' compensation claim for LBP, and to investigate factors associated with dispensing and switching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included data from accepted workers' compensation time loss claims for LBP between 2010 and 2018 with a 2-year follow-up. We described the type of antidepressant dispensed, the time for the index antidepressant to be dispensed, and whether people in the study switched to a different antidepressant. Logistic regression models investigated factors associated with antidepressants being dispensed for the first time and for switching to a different antidepressant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Antidepressants were dispensed to 2476 people with LBP (14%) at least once after a median (IQR) of 28 (10.9–54.7) weeks. Amitriptyline was the most dispensed antidepressant at any one point (47.8%), and the most common index antidepressant (42.9%). Also, 32.7% of people switched to a different antidepressant at least once. Sex, age, having been dispensed opioids, gabapentinoids or diazepam prior to antidepressants being dispensed, having used psychological services, and socioeconomic disadvantage were associated with antidepressant dispensing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>One in seven people with LBP were dispensed an antidepressant, most commonly amitriptyline. Antidepressants were commonly used in combination with other pain medicines such as opioids, gabapentinoids and diazepam.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Antidepressants were dispensed to one in seven people with low back pain, most commonly amitriptyline followed by duloxetine. Antidepressants were typically dispensed after 6 months and after other medicines such as opioids, gabapentinoids and diazepam had been dispensed. Due to the administrative nature of the data, the study cannot infer whether antidepressants were dispensed to treat pain or other health problems, such as a mental health condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply to the comment by Zhu et al.","authors":"Morten Pallisgaard Støve,&nbsp;Line Ørum Hansen,&nbsp;Kristian Kloppenborg Elmbæk,&nbsp;Stig Peter Magnusson,&nbsp;Janus Laust Thomsen,&nbsp;Allan Riis","doi":"10.1002/ejp.4770","DOIUrl":"10.1002/ejp.4770","url":null,"abstract":"<p>We appreciate the comment on our article ‘The effect of stretching intensity on pain sensitivity: A randomized crossover study on healthy adults’ (Støve, Hansen, et al., <span>2024</span>) by Zhu et al. (Binbin, <span>2024</span>). We want to acknowledge the authors for initiating an important discussion on how stretching intensity and body position influence the stretching effects.</p><p>We agree that, for pain modulation, our findings indicate that gentler, lower-intensity stretching may be preferable to high-intensity stretching, particularly in clinical populations (Støve, Hansen, et al., <span>2024</span>). This could apply both to pain modulation and to exercise adherence. However, it is important to note that stretching exercises are employed in various clinical contexts and are not always primarily aimed at modulating pain. By way of illustration, current evidence shows a dose–response relationship between stretching intensity and flexibility, with higher-intensity stretching yielding greater acute flexibility gains (Thomas et al., <span>2018</span>).</p><p>In our study, we utilized a seated stretching position in the Biodex as it ensured good experimental control. However, this approach may have limited clinical applicability. Although the effect of different body positions during stretching on pain modulation was beyond the scope of the present study, current evidence indicates that comparable pain modulation effects from static stretching exercises can be achieved across various delivery methods, including home-based, therapist-guided and machine-assisted stretching approaches (Støve et al., <span>2021</span>; Støve, Hirata, &amp; Palsson, <span>2024</span>; Støve, Thomsen, et al., <span>2024</span>).</p><p>We agree that the clinical implications of our findings go beyond basic static stretching and may extend to various exercise modalities that incorporate stretching elements, such as yoga, proprioceptive neuromuscular facilitation (PNF) and Tai Chi. However, additional work is needed to explore the factors that determine the analgesic effect of stretching exercises in different populations to enable the adaptation of interventions for diverse patient populations. The present results invite the hypothesis that the sensory perception of the stretching stimuli (e.g. the sensation of stretch, stiffness, discomfort or tightness) and the stretch duration may be key factors in determining the magnitude of stretch-induced hypoalgesia.</p><p>MPS wrote the first draft, which AR, LØH, KKE, JLT and SPM critically revised. All authors have read and approved the final manuscript.</p><p>This project was funded by the Frimodt-Heinecke Foundation. The funding body had no role in the design, collection, analysis, interpretation of data or in writing the manuscript.</p><p>The authors declare that they have no competing interests.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4770","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the magnitude and precision of pain predictions shape pain experiences","authors":"Suzanne M. J. C. Derksen,&nbsp;Maria Konttinen,&nbsp;Anastasiia Myronenko,&nbsp;Ben Seymour,&nbsp;Kaya J. Peerdeman","doi":"10.1002/ejp.4769","DOIUrl":"10.1002/ejp.4769","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In Bayesian models including predictive processing, the magnitude and precision of pain expectancies are key determinants of perception. However, relatively few studies have directly tested whether this holds for pain, and results so far have been inconclusive. Here, we investigated expectancy effects on pain experiences and associated affective responses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In two studies, healthy participants (&lt;i&gt;n&lt;/i&gt; = 30 in each) received painful electrical stimuli preceded by explicit pain predictions. In study 1, the magnitude of pain predictions and administered pain intensities were varied. In study 2, the magnitude and precision of pain predictions were varied, while administered pain intensity was kept constant. Experienced pain intensity was the primary outcome in both studies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pain experiences assimilated towards both under- and overpredictions of pain. In study 1, however, effects were small, if present at all, for non-painful stimuli and effects were not necessarily larger with predictions of greater magnitude. In study 2, assimilation of pain experiences appeared regardless of precision level, while no significant effects on EMG eyeblink startle responses were observed. Moreover, under- and overpredictions caused disappointment and relief, respectively, with greater disappointment upon precise than imprecise predictions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The influence of pain predictions on pain might be more complex than assumed in simple instantiations of current theoretical frameworks, with no systematically stronger assimilation of pain experiences to larger and more precise predictions. Since overpredictions are associated with relief, but underpredictions with disappointment, these findings underline the importance of providing correct predictions when preparing for upcoming painful procedures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our work supports, challenges, and extends the application of Bayesian and predictive processing frameworks to the influence of pain predictions on pain. Under- and overpredictions of pain yielded assimilation of pain experiences, but assimilation was not systematically stronger with larger prediction errors or greater precision. Moreover, under- and overpredictions resulted in disappointment and relief, respectively. This research signifies the impo","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different ways to reach the same goal: Are the analgesic effects of different types of tactile stimuli similar?","authors":"Rachel B. Zauberman,&nbsp;Simone Shamay-Tsoory,&nbsp;Irit Weissman-Fogel","doi":"10.1002/ejp.4772","DOIUrl":"10.1002/ejp.4772","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tactile-induced analgesia (TIA) is a phenomenon in which different types of tactile stimulation alleviate pain via different mechanisms including empathy. As TIA plays an essential role in therapeutic situations and clinical conditions, it is crucial to determine whether specific tactile stimulations confer distinct benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-two subjects (31 females; 21–47 years) were exposed to four distinct experimental conditions involving three types of touch provided within a simulated supportive therapeutic setting. First, a contact heat (70 s) at a pain intensity of 60/100 Numerical Pain Scale (NPS) was applied to the forearm. The pain stimulus was then given simultaneously with vibration, gentle stroking, or handholding in random order. Pain ratings were reported at 5 and 65 s of each stimulation. Given the role of empathy in TIA, we also assessed the levels of empathy experienced by the subjects and the experimenter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Handholding and vibration conditions were associated with a more rapid decrease in pain ratings compared to pain-alone (B values: handholding = −150.94 vs. pain-alone = −99.38, <i>p</i> = 0.01; vibration = −163.54 vs. pain-alone = −99.38, <i>p</i> &lt; 0.001). Higher levels of the experimenter's empathy toward the subjects were associated with greater pain alleviation during vibration vs. pain-alone condition (B values: vibration = −56.42 vs. B pain-alone = −9.57, <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vibration's potent analgesic effects may be attributed to its multi-channel analgesic mechanisms, including the therapist's empathy toward the participant. On the other hand, for handholding establishing an empathic interaction should be considered in a therapeutic setting to enhance its analgesic efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This article explores the effectiveness of touch-based pain relief methods and their association with empathetic therapeutic interactions. The study emphasizes the significance of positive therapeutic interactions in facilitating tactile-induced analgesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}