Scandinavian Journal of Pain最新文献

{"title":"Impact of respiration on abdominal pain thresholds in healthy subjects - A pilot study.","authors":"Jasmin Klick, Cui Yang, Armin Azimi, Christel Weiß, Christoph Reissfelder, Martin Schmelz, Erfan Ghanad","doi":"10.1515/sjpain-2025-0001","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0001","url":null,"abstract":"<p><strong>Objectives: </strong>Pressure algometry is a validated method for objectively quantifying pain sensitivity in musculoskeletal disorders, particularly useful for diagnosis and monitoring of treatment responses. However, its application to abdominal pain sensitivity remains insufficiently standardized, especially regarding the influence of physiological factors such as respiration. This study investigated the impact of respiratory phase (inhalation vs exhalation) on abdominal pressure pain thresholds (PT) to support the development of standardized assessment protocols.</p><p><strong>Methods: </strong>Thirty-one healthy medical students were recruited for the study. Each participant underwent three assessments of the abdominal PT with varying respiration phases. Furthermore, intraclass correlation coefficients (ICCs) were estimated to quantify the reliability of PT measurements.</p><p><strong>Results: </strong>The respiration phase has a significant impact on the PT, which was found to be significantly lower during exhalation than during inhalation (431 ± 177 vs 492 ± 186 kPa, <i>p</i> = 0.0003). The pressure application rate (PAR) for the expiratory measurements was significantly lower compared to the inspiratory PAR (112 ± 56 vs 130 ± 63 kPa/s, <i>p</i> = 0.0007). Both ICCs had similar magnitudes (close to 0.9). No significant difference in PT was found between sexes.</p><p><strong>Conclusions: </strong>Our study underscores the impact of respiration on pain perception, revealing increased abdominal PT during inhalation. A standardized approach is needed for abdominal PT assessment to guarantee its success in diagnostic and therapeutic evaluations.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When pain meets hope: Case report of a suspended assisted suicide trajectory in phantom limb pain and its broader biopsychosocial implications.","authors":"Robin Bekrater-Bodmann","doi":"10.1515/sjpain-2025-0044","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0044","url":null,"abstract":"","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stellate ganglion block for mental disorders - too good to be true?","authors":"Ulf E Kongsgaard, Mads U Werner","doi":"10.1515/sjpain-2025-0041","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0041","url":null,"abstract":"","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topically applied novel TRPV1 receptor antagonist, ACD440 Gel, reduces temperature-evoked pain in patients with peripheral neuropathic pain with sensory hypersensitivity, a randomized, double-blind, placebo-controlled, crossover study.","authors":"Adriana Miclescu, Rolf Karlsten, Ingrid Lönnstedt, Magnus M Halldin, Märta Segerdahl","doi":"10.1515/sjpain-2025-0011","DOIUrl":"10.1515/sjpain-2025-0011","url":null,"abstract":"<p><strong>Background: </strong>The transient receptor potential cation channel subfamily V1 (TRPV1) receptor is an important factor in pain transmission. The present Phase 2a study investigated the effect on evoked pain and safety of a topically administered TRPV1-antagonist (ACD440 Gel) in patients with chronic peripheral neuropathic pain (PNP).</p><p><strong>Methods: </strong>This was an exploratory, randomized, placebo-controlled double-blind crossover study in patients with probable or definite PNP demonstrating sensory hypersensitivity, assessed as evoked pain on suprathreshold sensory stimulation, i.e. hyperalgesia. The aetiologies included a mix of postherpetic neuralgia, postoperative neuropathic pains, and chemotherapy-induced pain. Patients administered ACD440 Gel twice daily onto the painful area(s) for 7 days. Primary endpoint was hyperalgesia to brush, cold, heat, and pinprick. Secondary endpoints included spontaneous pain and Neuropathic Pain Symptom Inventory Questionnaire (NPSI). Due to a significant period effect, a <i>post hoc</i> analysis was conducted, including only period 1 data, i.e. a parallel group comparison.</p><p><strong>Results: </strong>Fourteen patients were enrolled and completed the study. ACD440 Gel reduced pain intensity evoked by a 40°C thermoroller stimulus in heat hyperalgesic patients, by ACD440 from median 6 (IQR 4.75, 7.75) to 1.5 (IQR 0.75, 2.25), i.e. by -5.0 (95%CI -11.2, 1.2) vs placebo from median 4 (IQR 3.5, 5.0) to median 5.0 (IQR 4.5, 6.5), i.e. by 1.3 (95%CI -1.5, 4.2), <i>p</i> = 0.029. There were no adverse events induced by study treatment. Evoked mechanical hyperalgesia and brush allodynia were not significantly affected, <i>p</i> = 0.07.</p><p><strong>Conclusion: </strong>ACD440 Gel demonstrated a significant analgesic effect on thermally evoked pain, especially in suprathreshold heat pain. This is congruent with an attenuation of thermal hyperalgesia in chronic neuropathic pain patients with C-fibre mediated pain, while there was no effect on evoked pain related to Aβ and Aδ stimuli. The results support further clinical development in patients with thermally induced C-fibre mediated pain.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of registry data to assess clinical hunches: An example from the Swedish quality registry for pain rehabilitation.","authors":"Emmanuel Bäckryd","doi":"10.1515/sjpain-2025-0015","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0015","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to assess the clinical impression of health professionals at the Pain and Rehabilitation Centre, Linköping University Hospital, Sweden, according to whom patients have gradually become more complex and \"difficult\" over time.</p><p><strong>Methods: </strong>This is a repeated cross-sectional study. Over 8,000 patients assessed between 2009 and 2022 answered questionnaires from the Swedish quality registry for pain rehabilitation. Patient-reported outcome measures were analysed with multivariate data analysis such as principal component analysis.</p><p><strong>Results: </strong>During 2009-2022, the first principal component did not change statistically over time (<i>p</i> = 0.177), and it did not correlate to the year (rho = -0.014; <i>p</i> = 0.21). Patients were divided into three groups (2009-2012, 2013-2016, and 2017-2022), and a partial least squares-discriminant analysis model with group belonging as the <i>Y</i>-variable did not reveal any relevant differences (<i>R</i> ² = 0.048; <i>Q</i> ² = 0.045). For the period 2016-2022, additional data were available, enabling the comparison of pre- vs post-pandemic data by discriminant analysis. No clinically relevant difference was found.</p><p><strong>Conclusions: </strong>It was not possible to confirm the clinical impression of health care personnel. While it is important to listen to \"clinical hunches\" emitted by experienced clinicians, it is also essential not to be too quick to equate such impressions with a true state of affairs.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid use at admittance increases need for intrahospital specialized pain service: Evidence from a registry-based study in four Norwegian university hospitals.","authors":"Torbjørn Nordrik, Elisabeth Ørskov Rotevatn, Janne Mannseth, Audun Stubhaug, Lars Jørgen Rygh","doi":"10.1515/sjpain-2025-0008","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0008","url":null,"abstract":"<p><strong>Objectives: </strong>Acute Pain Services (APS) have significantly evolved since their establishment in the 1990s, emphasizing multimodal analgesia, which is a pivotal component of enhanced recovery after surgery, to enhance postoperative recovery. Despite improvements, variability in pain trajectories among patients necessitated the development of transitional pain units to address individual needs and ensure safe opioid tapering. The Norwegian National Registry for Advanced Acute Pain Services (AAPS), known as SmerteReg, was established to further enhance understanding of pain treatment in these patients. In this study, we aimed to analyze opioid use patterns and characteristics of opioid users referred to AAPS compared to non-opioid users.</p><p><strong>Methods: </strong>Data from SmerteReg (2016-2020) were analyzed, including patient demographics, diagnoses, pain treatment, and patient-reported outcome measures. Patient characteristics at admittance were compared between opioid users and non-opioid users. Multivariate logistic regression was used to explore factors associated with opioid use.</p><p><strong>Results: </strong>Of 1,068 patient tracks, 64% were opioid users at admittance. Opioid users were older and more frequently female, reporting higher levels of anxiety, depression, catastrophizing, and sleep problems before admission. Sleep problems before admittance was reported three times more frequent by patients using opioids compared to patients not using an opioid at admittance.</p><p><strong>Conclusion: </strong>Pre-admittance opioid use was prevalent among patients referred to AAPS, emphasizing the need for tailored pain management strategies. Women, older patients, and those reporting sleep problems before admittance were more likely to use opioids. The finding that sleep problems before admittance were strongly associated with opioid use, suggests the importance of addressing sleep disturbances in pain management protocols. This study contributes to understanding opioid use patterns and factors influencing pain management in hospitalized patients.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adding information on multisite and widespread pain to the STarT back screening tool when identifying low back pain patients at risk of worse prognosis.","authors":"Katarina Aili, Stefan Bergman, Emma Haglund","doi":"10.1515/sjpain-2024-0077","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0077","url":null,"abstract":"<p><strong>Objectives: </strong>The STarT Back screening Tool (SBT) captures patients with low back pain (LBP) at risk of worse prognosis. However, the SBT does not include assessment of multisite and chronic widespread pain (MS-CWP). The aim was to study the differences in prognostic factors in patients with LBP classified according to SBT or SBT in combination with MS-CWP, and the 1-year outcome regarding visits to physiotherapist and sickness absence, in relation to risk scorings.</p><p><strong>Methods: </strong>In this 1-year prospective study, adults (18-67 years) seeking care for LBP in primary care were classified into three prognostic risk groups (low, medium, high), using SBT only and using a combined screening tool (SBT and MS-CWP). Differences in prognostic factors at baseline, and outcome in terms of number of physiotherapist visits and sickness absence the year after inclusion were compared for risk groups derived by the two methods.</p><p><strong>Results: </strong>Eighty-four patients (61% women) were included in the study. According to SBT alone, 19 were classified as low risk, 48 as medium risk, and 17 as high risk. When using the combined screening tool, additionally seven patients from the medium risk group were classified as high risk. Patients classified as high risk by SBT only or by the combined screening tool showed similar statistically significant worse mental health, health status, kinesiophobia, physical function, and sleep, as compared to the low-risk group. There were no differences in visits to physiotherapist and sickness absence between the risk groups for neither of the tools.</p><p><strong>Conclusion: </strong>The combined screening tool resulted in more patients being classified as high risk than with SBT alone. The three risk groups identified either by SBT alone or by the combined screening tool differed significantly on all investigated prognostic factors, suggesting that including MS-CWP to the SBT captures more patients at risk.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regaining the intention to live after relief of intractable phantom limb pain: A case study.","authors":"Maria Munoz-Novoa, Joanna Ewf van Veldhoven, Sietke G Postema, Morten B Kristoffersen, Els Keesom, Eva Lendaro, Kajsa Lidstrom-Holmqvist, Max Ortiz-Catalan, Corry K van der Sluis","doi":"10.1515/sjpain-2025-0006","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0006","url":null,"abstract":"<p><strong>Objectives: </strong>Phantom limb pain (PLP) is common after limb amputation and can lead to chronic pain and psychosocial risks, potentially leading to suicide or euthanasia. This study aimed to explore the consequences of intractable PLP on a person's life before, during, and after receiving phantom motor imagery (PMI) treatment, focusing on the person's experiences with PMI and how it influenced his life and decision regarding euthanasia.</p><p><strong>Methods: </strong>This case study focused on a single participant from the PMI treatment group of a PLP randomized clinical trial (RCT). The participant, who joined the RCT as a last resort before euthanasia, experienced decreased PLP during the trial, but the pain returned 1 month post-treatment. Subsequently, the participant initiated self-administered PMI training at home. A mixed quantitative-qualitative method approach was used to analyze this case study.</p><p><strong>Results: </strong>Understanding and living with PLP was challenging for the participant, making him lose interest in life. Despite starting with low expectations, the participant enjoyed PMI, particularly home training. PLP disappeared during the RCT, returned after therapy cessation, and vanished again during PMI home training. PMI returned his motivation to live, leading him to discontinue his plans for euthanasia.</p><p><strong>Conclusions: </strong>This case illustrates the severity of chronic PLP, highlighting also the complex interaction of biopsychosocial factors in pain, which can lead a person to consider euthanasia. Representing the first use of PMI in a home setting, this study, along with previous studies in clinical setting, indicates PMI to be a promising and feasible innovative intervention for decreasing PLP, encouraging further research. This study also emphasizes the need to enhance PLP education among clinicians and people with amputations.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain intensity in anatomical regions in relation to psychological factors in hypermobile Ehlers-Danlos syndrome.","authors":"Tage Orenius, Karin von Smitten-Stubb, Hannu Kautiainen, Liisa Montin, Antonio Bulbena, Karl-August Lindgren","doi":"10.1515/sjpain-2024-0055","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0055","url":null,"abstract":"<p><strong>Objectives: </strong>Hypermobile Ehlers-Danlos syndrome (hEDS) is a multisystemic disorder in which pain and psychological symptoms appear to be highly interrelated. We investigate the relationships between pain intensity, pain location, and psychological distress in patients with hEDS.</p><p><strong>Methods: </strong>The study sample in this cross-sectional study comprised patients with diagnosed hEDS (<i>n</i> = 81) aged 18-67 years, with a mean age of 39.5. Sociodemographic information was collected using a questionnaire. Pain intensity was measured using the numeric rating scale, depressive symptoms with the Beck Depression Inventory, and pain-related anxiety with the Pain Anxiety Symptoms Scale. The interrelations between pain intensity and psychological factors were analysed for each of the following anatomical regions: head, neck, upper extremities, chest, back, abdomen, and lower extremities.</p><p><strong>Results: </strong>The results show that pain was intense and occurring in multiple anatomical regions. Pain intensity was related to depressive symptoms and pain anxiety, with the strength of the relationship varying across different anatomical regions. Specific findings were that strongest associations of depressive symptoms and pain intensity were in the abdomen and lower extremities. In contrast, pain in the upper extremities did not relate to depressive symptoms or pain anxiety.</p><p><strong>Conclusion: </strong>This is the first study on patients with hEDS that elucidates the multisite pain symptoms and their interrelation to psychological symptoms. The total burden of pain can be considered a strong contributing element to the results found in our study. These factors should be considered when treating patients with hEDS.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroinflammation in chronic pain: Myth or reality?","authors":"Stephen H Butler","doi":"10.1515/sjpain-2024-0065","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0065","url":null,"abstract":"<p><p>The term \"neuroinflammation\" (NI) is currently popular, and the meaning is a long way from the original description restricted to findings after stroke, central nervous system (CNS) trauma, or CNS infection. NI has been implied in association with diseases of the CNS, such as Alzheimer's, Parkinson's, and Multiple Sclerosis. In addition, it has also been associated with psychiatric/psychological diagnoses, chronic pain diagnoses, stress, many functional disorders, and \"central sensitization.\" Findings proposed to be evidence for NI have been found not only in the brain but also in the spinal cord, dorsal root ganglia, and peripheral nerves. Worrisome is the mistaken confusion that leads \"association\" to be \"proof of cause,\" where there is much dispute over whether findings are really evidence for inflammation. This article is a short review of the literature and a critique of the concept of NI.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}