Scandinavian Journal of Pain最新文献

{"title":"Measuring pain intensity in categories through a novel electronic device during experimental cold-induced pain.","authors":"Elisabeth Ørskov Rotevatn, Mette Engan, Emilie Stensaker, Karl Ove Hufthammer, Lars Jørgen Rygh","doi":"10.1515/sjpain-2025-0018","DOIUrl":"10.1515/sjpain-2025-0018","url":null,"abstract":"<p><strong>Objectives: </strong>Pain assessment is challenging given its subjective nature, and existing assessment tools have limitations, especially for patients having problems with verbal communication. A prior study evaluated the Grasp, a handheld device for assessing pain intensity through squeezing, showing a moderate association with the numeric rating scale (NRS). This study examined an improved version of the Grasp with instant visual feedback through color-coded categories and compared it to NRS.</p><p><strong>Methods: </strong>Healthy adults underwent two consecutive cold pressor tests (CPTs), reporting pain intensity via NRS or Grasp with colour-coded feedback. Two additional CPTs assessed the association of repeated measurements with both instruments. The Grasp was calibrated to individual strength before CPTs.</p><p><strong>Results: </strong>Forty-six subjects completed all tests. Pain intensity association between Grasp and NRS was moderate with a mean Kendall's <i>τ</i>-<i>b</i> coefficient (<i>τ</i>-<i>b</i>) of 0.45, 95% confidence interval (CI) 0.35-0.56. Repeated Grasp measurements showed a moderate association (<i>τ</i>-<i>b</i> = 0.37, 95% CI 0.27-0.48), while repeated NRS measurements had a stronger association (<i>τ</i>-<i>b</i> = 0.71, 95% CI 0.64-0.78). After adjusting Grasp to individual squeeze strength (resulting in a 0.0-1.0 scale), a simple equation relating NRS value and mean Grasp value was identified: Grasp = 0.091 × NRS. Grouping reports into mild, moderate, and severe pain resulted in agreement proportions across two CPTs of 69% for Grasp and 79% for NRS.</p><p><strong>Conclusions: </strong>The moderately high agreement proportions for pain intensity categories suggest that the Grasp method with colour-coded feedback may be useful for categorical pain intensity assessment, especially in settings where conventional tools (i.e., NRS) are inconvenient or not feasible.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973991","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 and health-related quality of life among women of childbearing age in Iceland: ICEPAIN, a nationwide survey.","authors":"Sigfridur Inga Karlsdottir, Eva Halapi, Gudmundur Kristjan Oskarsson, Hafdis Skuladottir, Thorbjorg Jonsdottir","doi":"10.1515/sjpain-2024-0073","DOIUrl":"10.1515/sjpain-2024-0073","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of the study was to assess the prevalence of both non-chronic and chronic pain among women of childbearing age and describe the impact that pain has on their health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>This is a cross-sectional cohort study, and the data were collected as part of the ICEPAIN nationwide study. Participants were recruited from a randomised sample, stratified by age and residence to secure a proportional sample, by email invitation. Women between 18 and 45 years of age participated, and data were collected through a web-based platform with questionnaires that measured sociodemographic characteristics, lifestyle factors, sleep quality, pain severity, characteristics of pain, pain interference (Brief Pain Inventory), and HRQoL (SF-12-v2). Spearman correlation was used when assessing relationships between demographic and lifestyle factors, and HRQoL and pain. Chi-square, Mann-Whitney <i>U</i>, ANOVA, and multivariate general linear model were used to assess group differences.</p><p><strong>Results: </strong>In total, 969 women of childbearing age (18-45 years) participated in the study, and the response rate was 34.8%. The average age was 36.1 ± 6.3 years, and the majority (82.5%) were married, cohabiting, or in a steady relationship. Altogether, 45.9% of the sample reported having pain during the past week (<i>n</i> = 445); the vast majority, 80.4% (<i>n</i> = 366), had chronic pain. The majority of the participants, 57.3%, had moderate or severe pain. Chronic pain was significantly correlated with higher age, higher BMI, experiencing pain during the period, and poorer sleep quality. In contrast, no significant correlation was found between chronic pain and parity, residence, education, physical exercise, smoking, or alcohol drinking. Both non-chronic and chronic pain interfered with mood, sleep, general activities, and other aspects of daily life, and the effect of pain was significantly greater among women with chronic pain. Among these, pain severity was strongly correlated with the level of pain interference (0.79). A negative correlation between pain interference and HRQoL (physical component score, -0.64, and mental component score, -0.34) was observed among women with chronic pain.</p><p><strong>Conclusions: </strong>Both non-chronic and chronic pain are common among women of childbearing age in Iceland. It interferes with daily life and affects their HRQoL.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974009","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":"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":"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":"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":1.9,"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":"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":1.9,"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":"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":1.9,"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":"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":1.9,"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}