Scandinavian Journal of Pain最新文献

{"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":"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":1.9,"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":"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":1.9,"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}

{"title":"Pain trajectories and exercise-induced pain during 16 weeks of high-load or low-load shoulder exercise in patients with hypermobile shoulders: A secondary analysis of a randomized controlled trial.","authors":"Behnam Liaghat, Birgit Juul-Kristensen, Frederik Holsteen Christensen, Simon Enghuus Nissen, Søren T Skou, Karen Søgaard, Jens Søndergaard, Jonas Bloch Thorlund","doi":"10.1515/sjpain-2024-0072","DOIUrl":"10.1515/sjpain-2024-0072","url":null,"abstract":"<p><strong>Objectives: </strong>To compare pain trajectories and acute exercise-induced pain over a 16-week period in patients with hypermobility spectrum disorder (HSD) undergoing high-load (HEAVY) or low-load (LIGHT) shoulder exercise.</p><p><strong>Methods: </strong>In this secondary analysis using data from a randomized controlled trial, we included men and women aged 18-65 with HSD and shoulder complaints >3 months. Participants were randomly allocated (1:1 ratio) to 16 weeks of HEAVY or LIGHT shoulder exercise program, performed three times weekly. The HEAVY program consisted of progressive strengthening and full range of motion exercises, while the LIGHT program included low-load exercises performed in neutral to mid-range. Pain was assessed using the numeric rating scale (NRS) before and after each exercise session. Pain trajectories were assessed using pre-exercise pain scores at the final session each week. Exercise-induced pain was evaluated as the change in pain before and after exercise, using the mean of the three sessions each week. Both outcomes were analyzed using linear mixed models.</p><p><strong>Results: </strong>Data from 64 out of 100 patients (HEAVY 34, LIGHT 30) were analyzed (80% women, mean age 39.6, mean Beighton score of 5.8). Shoulder pain was reduced by 0.89 NRS in HEAVY (95% CI 0.4 to 1.4) and 0.33 NRS (95% CI -0.25 to 0.91) in LIGHT. The between-group difference in change in pain from baseline to week 16 was 0.56 (95% CI -0.20 to 1.33, <i>p</i> = 0.149). There was no between-group difference in pain trajectories (group × time interaction, <i>p</i> = 0.321). The mean exercise-induced pain over time was similar in both groups (group × time interaction, <i>p</i> = 0.614), with pain below 0.5 NRS throughout the 16 weeks.</p><p><strong>Conclusions: </strong>Pain trajectories over 16 weeks were similar in patients with HSD and persistent shoulder complaints performing high-load or low-load shoulder exercises. There was minor to no exercise-induced pain during high-load strengthening exercise, challenging previous beliefs.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217292","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":"Quantitative sensory testing - <i>Quo Vadis</i>?","authors":"Erik Nordh, Bo Johansson, Elisabeth Kjær Jensen, Christopher S Nielsen, Martin F Bjurström, Mads U Werner","doi":"10.1515/sjpain-2025-0036","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0036","url":null,"abstract":"","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183079","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":"An action plan: The Swedish healthcare pathway for adults with chronic pain.","authors":"Marcelo Rivano Fischer, Allan Abbott, Mathilda Björk, Gunilla Brodda Jansen, Gunilla Göran, Britt-Marie Stålnacke, Monika Löfgren","doi":"10.1515/sjpain-2024-0082","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0082","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain is a major global public-health issue. In Sweden, 20% adults report moderate to severe chronic pain, with 7% continuously seeking healthcare. Shortcomings in treatment, accessibility, and knowledge in healthcare for chronic pain have previously been reported. A generic treatment structure from primary to specialized care and rehabilitation was missing. This study aims to describe the development process for the creation of a person-centered and coherent care (P3C) pathway for adults with chronic pain in Sweden.</p><p><strong>Methods: </strong>A National Action Group with expertise in pain medicine, rehabilitation medicine, psychiatry, anesthesiology, neurosurgery, general medicine, nursing, psychology, physiotherapy, occupational therapy, and patient representation was commissioned to develop the pathway following a stepwise co-designed approach, which included mapping current situation, goals, measures and indicators of the pathway, assessment of consequences and anchoring the process.</p><p><strong>Results: </strong>Goals were based on challenges identified in the mapping, including improvements in patient's well-being, continuity during and between care contacts, timely self-management, communication between levels of care, and knowledge about pain. Points of pathway entrance and exit were described. Measures focused on areas such as early pain analysis, biopsychosocial approach to assessment and treatment, early rehabilitation plan, teamwork, dialogue and joint plans between levels of care, patient participation, and education on pain and its consequences. Process and outcome indicators, and a report on benefits and risks for patients, ethical aspects, costs, and impacts of the pathway on other areas of healthcare were included.</p><p><strong>Conclusions: </strong>The P3C pathway addressed the challenges described by patients and practitioners. By being person-centered and coherent, it can promote patient empowerment and equality in care, with emphasis on early and timely interventions, dialogue between patients and practitioners and between levels of care, self-management of pain instead of prolonged medical intervention, value-driven and coordinated care contacts, and increased knowledge about chronic pain, based on existing evidence and experience.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180431","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":"Abstracts presented at SASP 2025, Reykjavik, Iceland. From the Test Tube to the Clinic - Applying the Science.","authors":"Sigríður Gunnarsdóttir, Sigríður Zoëga, Mads U Werner","doi":"10.1515/sjpain-2025-0033","DOIUrl":"https://doi.org/10.1515/sjpain-2025-0033","url":null,"abstract":"","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120697","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":"Properties of pain catastrophizing scale amongst patients with carpal tunnel syndrome - Item response theory analysis.","authors":"Mikhail Saltychev, Annika Miikkulainen, Hanna-Stiina Taskinen","doi":"10.1515/sjpain-2024-0079","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0079","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the psychometric properties of pain catastrophizing scale (PCS) using item response theory (IRT) amongst people with carpal tunnel syndrome (CTS).</p><p><strong>Methods: </strong>Retrospective cross-sectional register-based study amongst 1,597 patients with CTS. Two-parameter IRT analysis with rating scale model.</p><p><strong>Results: </strong>The average age was 55.3 (16.3) years and 896 (56%) were women. The average PCS total score was 15.1 (11.6) points. For all 13 items, the estimates of difficulty parameter indicated a shift towards higher PCS scores. This was also seen in item characteristic curves and item information function. Respectively, the entire composite score showed the same shift towards higher PCS scores. The discrimination of PCS was excellent 1.98 (95% CI 1.89-2.07).</p><p><strong>Conclusions: </strong>Overall, the psychometric properties of the PCS were found to be sufficiently good to recommend this scale for clinical use in CTS. The PCS is well able to distinguish between people with different levels of pain catastrophizing, even if performing better in elevated levels of catastrophizing. Also, the respondents may have a slight tendency to underestimate the severity of their catastrophizing when responding to the PCS. The results may be of interest to both clinicians and researchers in planning and implementing conservative or operative treatment for CTS, setting rehabilitation goals, and evaluating treatment or rehabilitation outcomes.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081388","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":"Completion of the PainData questionnaire - A qualitative study of patients' experiences.","authors":"Rannvá Apolonia Egholm, Ann Merete Møller, Thordis Thomsen","doi":"10.1515/sjpain-2024-0048","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0048","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore barriers experienced by patients with chronic pain to completing the PainData questionnaire (PDq) at the Interdisciplinary Pain Centre, Herlev and Gentofte Hospital (HGH). The PDq collects patient-reported data relevant for treatment decisions and research. However, at HGH the response rate prior to treatment initiation is only 67% despite a national response rate of over 80%.</p><p><strong>Methods: </strong>This qualitative study used individual, semi-structured interviews with patients from HGH. Content analysis was performed, and the study adhered to the COREQ guideline.</p><p><strong>Results: </strong>Fifteen participants (4 men, 11 women; median age 57) were interviewed. Four major categories were identified: (1) challenges originating from pain deterioration and stress hindering questionnaire completion, (2) lack of opportunity for nuanced responses, (3) inadequate patient understanding of the questionnaire's purpose, and (4) appreciation among participants of PainData's recognition of the long-term consequences of chronic pain.</p><p><strong>Conclusion: </strong>This study highlighted key barriers to completing the PDq, including challenges related to its design and patients' resources. To address these issues, administrators could simplify the questionnaire. Individual clinics could enhance response rates by improving communication about the importance of patient-reported data, refining invitation strategies, and providing additional practical support. Despite these challenges, completion of the PDq encouraged participants to reflect on critical aspects of chronic pain, including its physical and mental health impacts. While the study provided valuable insights, the limited duration of interviews, due to participant fragility, was a notable limitation.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991458","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":"Experiences of cross-sectoral collaboration between social security service and healthcare service for patients with chronic pain - a qualitative study.","authors":"Maryam Haghshenas, Aslak Steinsbekk, Karen Walseth Hara","doi":"10.1515/sjpain-2024-0057","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0057","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with chronic pain need healthcare services for pain management. Many also require social security services due to potential negative influence of chronic pain on social and work-related issues. The aim of this study was therefore to investigate the experiences of taking part in cross-sectoral collaborative meetings between social security service and healthcare service for chronic pain patients.</p><p><strong>Methods: </strong>A qualitative study using semi-structured individual interviews with 15 informants, including healthcare providers, patients, and social security supervisors who had taken part in 8 different meetings, was conducted. The focus of the interviews was how the informants experienced cross-sectoral collaborative meetings. The data were analyzed following the systematic text condensation method, including the steps of total impression, identifying meaning units, condensation, and synthesizing.</p><p><strong>Results: </strong>The findings were categorized into four themes: \"Joining the meeting with preconceptions,\" which showed how some informants experienced that negative preconceptions toward the social security service were addressed in the cross-sectoral collaborative meetings and solved in some cases. \"Get to know each other,\" which highlighted that the meetings provided opportunities for participants to increase their knowledge about the involved actors. \"Access to detailed health information?\" indicated that although concerns about whether sensitive health information should be shared with social security supervisors were raised by healthcare providers, the supervisors found this issue to be less concerning. Finally, \"Who has the final word?\", which showed that unclarity over decision-making processes during the meetings was experienced to create disagreement between participants.</p><p><strong>Conclusions: </strong>The informants experienced that cross-sectoral collaborative meetings between patients, social security supervisors, and healthcare providers, while challenging, can play a significant role in managing the needs of patients with chronic pain. The study highlights the need for clarification over the roles of the actors and a jointly agreed-upon agenda for the meetings to ensure effective collaboration.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039442","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":"Neural networks involved in painful diabetic neuropathy: A systematic review.","authors":"Johanne Lundager Axelsen, Ulrich Kirk, Søren Bo Andersen, Juliana Janeiro Schmidt, Maria Beck Gaarde, Christopher Lund Franck, Eelco van Duinkerken, François Pouwer","doi":"10.1515/sjpain-2024-0069","DOIUrl":"10.1515/sjpain-2024-0069","url":null,"abstract":"<p><strong>Objectives: </strong>Diabetic distal symmetric polyneuropathy, affecting up to 50% of adults with diabetes, often leads to painful symptoms; yet current treatments are largely ineffective with standard therapies providing limited relief. The aim of this systematic review is to address the knowledge gap in understanding the neural networks associated with painful diabetic polyneuropathy (P-DPN). By synthesizing evidence from neuroimaging studies, it seeks to identify potential targets for neuromodulation-based treatments, ultimately guiding clinicians and researchers in developing novel, more effective therapeutic interventions for P-DPN.</p><p><strong>Content: </strong>A comprehensive search following the preferred reporting items for systematic reviews and meta-analysis was conducted across Embase, PsycINFO, and MEDLINE databases to identify relevant neuroimaging studies from 2010 to May 2024. The search focused on studies involving P-DPN and excluded animal research. After the removal of duplicates and irrelevant studies, 18 studies were included and critically appraised for their contributions to understanding the neural correlates of P-DPN.</p><p><strong>Summary: </strong>The review highlights that P-DPN is associated with alterations in brain networks involved in pain perception, particularly in the primary somatosensory cortex highlighting its role in sensory and pain perception. Regions such as the anterior cingulate cortex and thalamus exhibit altered functional connectivity, with the former showing responses to pain treatment. The review also identified increased connectivity between the cingulate cortex, medial prefrontal cortex, medial temporal region, and insula in individuals with P-DPN, pointing to the involvement of these regions in the emotional and cognitive aspects of pain processing.</p><p><strong>Outlook: </strong>This review provides a foundational understanding of the neural networks involved in P-DPN, offering potential targets for future neuromodulation therapies. Further research is required to deepen the understanding of these brain alterations and to explore how they can be leveraged for more effective P-DPN treatments.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804473","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}