Pain Reports最新文献

{"title":"Virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) reduces daily pain intensity in patients with lumbosacral radiculopathy: a randomized controlled trial.","authors":"Ryan S Wexler, Devon J Fox, Danielle ZuZero, Melissa Bollen, Anand Parikshak, Hannah Edmond, Johnny Lemau, Diane Montenegro, Jillian Ramirez, Sophia Kwin, Austin R Thompson, Hans L Carlson, Lynn M Marshall, Thomas Kern, Scott D Mist, Ryan Bradley, Douglas A Hanes, Heather Zwickey, Courtney K Pickworth","doi":"10.1097/PR9.0000000000001132","DOIUrl":"10.1097/PR9.0000000000001132","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbosacral radiculopathy (LR), also known as sciatica, is a common type of radiating neurologic pain involving burning, tingling, and numbness in the lower extremities. It has an estimated lifetime prevalence as high as 43%.</p><p><strong>Objectives: </strong>The objective of this randomized controlled trial was to evaluate the impact of virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) on patients with LR during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Potentially eligible patients were identified using electronic health record queries and phone screenings. Participants were then randomized to MORE or treatment-as-usual (TAU) for 8 weeks, with pain intensity assessed daily. At baseline and follow-up visits, participants completed questionnaires assessing the primary outcome, disability, as well as quality of life, depression, mindful reinterpretation of pain, and trait mindfulness.</p><p><strong>Results: </strong>In our study, patients undergoing virtual delivery of MORE had greater improvements in daily pain intensity (<i>P</i> = 0.002) but not in disability (<i>P</i> = 0.09), depression (<i>P</i> = 0.26), or quality of life (<i>P</i> = 0.99 and <i>P</i> = 0.89, SF-12 physical and mental component scores, respectively), relative to TAU patients. In addition, patients in MORE experienced significantly greater increases in mindful reinterpretation of pain (<i>P</i> = 0.029) and trait mindfulness (<i>P</i> = 0.035).</p><p><strong>Conclusion: </strong>Among patients with lumbar radiculopathy, MORE significantly reduced daily pain intensity but did not decrease disability or depression symptoms. Given the long duration of symptoms in our sample, we hypothesize the discrepancy between changes in daily pain intensity and disability is due to fear avoidance behaviors common in patients with chronic pain. As the first trial of a mindfulness intervention in patients with LR, these findings should inform future integrative approaches to LR treatment, particularly when considering the increasing use of virtual interventions throughout the COVID-19 pandemic.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of randomized controlled head-to-head trials of recommended drugs for neuropathic pain.","authors":"Ayda Asadizadeh Sadegh, Nina Lykkegaard Gehr, Nanna Brix Finnerup","doi":"10.1097/PR9.0000000000001138","DOIUrl":"10.1097/PR9.0000000000001138","url":null,"abstract":"<p><p>Neuropathic pain is a challenging chronic pain condition. Limited knowledge exists regarding the relative effectiveness of pharmacological treatments, and differences in trial design and impact of the placebo response preclude indirect comparisons of efficacy between drug classes. The purpose of this systematic review and meta-analysis of head-to-head trials was to compare the efficacy and tolerability of drugs recommended for neuropathic pain. We conducted a systematic review and meta-analysis of direct-comparison double-blind randomized trials. Primary outcomes were mean change in pain intensity and number of responders with a 50% reduction in pain intensity. Secondary outcomes encompassed quality of life, sleep, emotional functioning, and number of dropouts because of adverse events. We included 30 trials (4087 patients), comprising 16 crossover and 14 parallel-group design studies. All studies were conducted in adults, and the majority were investigator-initiated trials. We found moderate-quality evidence for equivalence (no clinically relevant difference) between tricyclic antidepressants (TCA) and gabapentin/pregabalin with a combined mean difference in pain score of 0.10 (95% CI -0.13 to 0.32). We could not document differences between TCA and serotonin-noradrenaline reuptake inhibitors (SNRI), between SNRI and gabapentin/pregabalin, or between opioids and TCA (low quality of evidence). We found more dropouts because of adverse events with SNRI and opioids compared with TCA (low quality of evidence). We did not identify any studies that included topical treatments. This systematic review of direct-comparison studies found evidence for equivalence between TCA and gabapentin/pregabalin and fewer dropouts with TCA than SNRI and opioids.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Night time heart rate predicts next-day pain in fibromyalgia and primary back pain.","authors":"Veronica Dudarev, Oswald Barral, Mariia Radaeva, Guy Davis, James T Enns","doi":"10.1097/PR9.0000000000001119","DOIUrl":"10.1097/PR9.0000000000001119","url":null,"abstract":"<p><strong>Introduction: </strong>Primary chronic pain is pain that persists for over 3 months without associated measurable tissue damage. One of the most consistent findings in primary chronic pain is its association with autonomic hyperactivation. Yet whether the autonomic hyperactivation causes the pain or results from it is still unclear. It is also unclear to what extent autonomic hyperactivation is related to experienced pain intensity in different subtypes or primary chronic pain.</p><p><strong>Objectives: </strong>Our first aim was to test lagged relationships between the markers of autonomic activation (heart rate) and pain intensity to determine its directionality. The main question here was whether autonomic biomarkers predict pain intensity or whether pain intensity predicts autonomic biomarkers. The second aim was to test whether this relationship is different between people with primary back pain and people with fibromyalgia.</p><p><strong>Methods: </strong>Sixty-six patients with chronic pain were observed over an average of 81 days. Sleep heart rate and heart rate variability were measured with a wearable sensor, and pain intensity was assessed from daily subjective reports.</p><p><strong>Results: </strong>The results showed a predictive relationship between sleep heart rate and next-day pain intensity (<i>P</i> < 0.05), but not between daily pain intensity and next night heart rate. There was no interaction with the type of chronic pain.</p><p><strong>Conclusions: </strong>These findings suggest that autonomic hyperactivation, whether stress-driven or arising from other causes, <i>precedes</i> increases in primary chronic pain. Moreover, the present results suggest that autonomic hyperactivation is a common mechanism underlying the pain experience in fibromyalgia and chronic back pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowered Relief, cognitive behavioral therapy, and health education for people with chronic pain: a comparison of outcomes at 6-month Follow-up for a randomized controlled trial.","authors":"Beth D Darnall, John W Burns, Juliette Hong, Anuradha Roy, Kristin Slater, Heather Poupore-King, Maisa S Ziadni, Dokyoung S You, Corinne Jung, Karon F Cook, Kate Lorig, Lu Tian, Sean C Mackey","doi":"10.1097/PR9.0000000000001116","DOIUrl":"10.1097/PR9.0000000000001116","url":null,"abstract":"<p><strong>Introduction: </strong>We previously conducted a 3-arm randomized trial (263 adults with chronic low back pain) which compared group-based (1) single-session pain relief skills intervention (Empowered Relief; ER); (2) 8-session cognitive behavioral therapy (CBT) for chronic back pain; and (3) single-session health and back pain education class (HE). Results suggested non-inferiority of ER vs. CBT at 3 months post-treatment on an array of outcomes.</p><p><strong>Methods: </strong>Here, we tested the durability of treatment effects at 6 months post-treatment. We examined group differences in primary and secondary outcomes at 6 months and the degree to which outcomes eroded or improved from 3-month to 6-month within each treatment group.</p><p><strong>Results: </strong>Empowered Relief remained non-inferior to CBT on most outcomes, whereas both ER and CBT remained superior to HE on most outcomes. Outcome improvements within ER did not decrease significantly from 3-month to 6-month, and indeed ER showed additional 3- to 6-month improvements on pain catastrophizing, pain bothersomeness, and anxiety. Effects of ER at 6 months post-treatment (moderate term outcomes) kept pace with effects reported by participants who underwent 8-session CBT.</p><p><strong>Conclusions: </strong>The maintenance of these absolute levels implies strong stability of ER effects. Results extend to 6 months post-treatment previous findings documenting that ER and CBT exhibit similarly potent effects on outcomes.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary analysis: heat and self-report pain sensitivity associate with biological sex and racialized sociocultural group but may not be mediated by anxiety or pain catastrophizing.","authors":"Timothy J Meeker, Hee Jun Kim, Ingrid K Tulloch, Michael L Keaser, David A Seminowicz, Susan G Dorsey","doi":"10.1097/PR9.0000000000001133","DOIUrl":"10.1097/PR9.0000000000001133","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have demonstrated associations between sex and racialized group on pain sensitivity and tolerance. We analyzed the association of sex and racialized group on heat pain sensitivity, sensibility to painful suprathreshold mechanical pain (STMP), and pain sensitivity questionnaire (PSQ). We hypothesized that anxiety and pain catastrophizing reported by racialized minority groups and women would mediate enhanced pain sensitivity. Our secondary aim was to evaluate validity of the PSQ in a diverse population.</p><p><strong>Methods: </strong>Using quantitative sensory testing for painful heat, STMP (forces: 64, 128, 256, and 512 mN), and PSQ, we evaluated pain sensitivity in 134 healthy participants [34 (18 women) Asian, 25 (13 women) Black, and 75 (41 women) White]. We used general linear and linear mixed models to analyze outcomes. We assessed mediation of state and trait anxiety and pain catastrophizing on pain sensitivity.</p><p><strong>Results: </strong>Racialized minority status was associated with greater heat pain sensitivity (F = 7.63; <i>P</i> = 0.00074) and PSQ scores (F = 15.45; <i>P</i> = 9.84 × 10^-7) but not associated with STMP (F = 1.50; <i>P</i> = 0.23). Female sex was associated with greater heat pain sensitivity (F = 4.9; <i>P</i> = 0.029) and lower PSQ (F = 9.50; <i>P</i> = 0.0025) but not associated with STMP (F = 0.0018; <i>P</i> = 0.97). Neither anxiety nor pain catastrophizing mediated associations between sex or racialized group with heat pain threshold or PSQ. Differential experience of individual items (F = 19.87; <i>P</i> = 3.28 × 10^-8) limited PSQ face validity in racialized minorities.</p><p><strong>Conclusion: </strong>Consistent with previous research, sensitivity to painful heat was associated with racialized minority status and female sex. By contrast, there was no significant effect of racialized minority status or female sex on STMP. Some PSQ items are inapplicable to participants from racialized minority groups.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10811695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing fibromyalgia syndrome from small fiber neuropathy: a clinical guide.","authors":"Sarah Jänsch, Dimitar Evdokimov, Nadine Egenolf, Caren Meyer Zu Altenschildesche, Luisa Kreß, Nurcan Üçeyler","doi":"10.1097/PR9.0000000000001136","DOIUrl":"10.1097/PR9.0000000000001136","url":null,"abstract":"<p><strong>Introduction: </strong>Fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) are distinct pain conditions that share commonalities and may be challenging as for differential diagnosis.</p><p><strong>Objective: </strong>To comprehensively investigate clinical characteristics of women with FMS and SFN to determine clinically applicable parameters for differentiation.</p><p><strong>Methods: </strong>We retrospectively analyzed medical records of 158 women with FMS and 53 with SFN focusing on pain-specific medical and family history, accompanying symptoms, additional diseases, and treatment. We investigated data obtained using standardized pain, depression, and anxiety questionnaires. We further analyzed test results and findings obtained in standardized small fiber tests.</p><p><strong>Results: </strong>FMS patients were on average ten years younger at symptom onset, described higher pain intensities requiring frequent change of pharmaceutics, and reported generalized pain compared to SFN. Pain in FMS was accompanied by irritable bowel or sleep disturbances, and in SFN by paresthesias, numbness, and impaired glucose metabolism (<i>P</i> < 0.01 each). Family history was informative for chronic pain and affective disorders in FMS (<i>P</i> < 0.001) and for neurological disorders in SFN patients (<i>P</i> < 0.001). Small fiber pathology in terms of skin denervation and/or thermal sensory threshold elevation was present in 110/158 (69.7 %) FMS patients and 39/53 (73.6 %) SFN patients. FMS patients mainly showed proximally reduced skin innervation and higher corneal nerve branch densities (p<0.001) whereas SFN patients were characterized by reduced cold detection and prolonged electrical A-delta conduction latencies (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Our data show that FMS and SFN differ substantially. Detailed pain, drug and family history, investigating blood glucose metabolism, and applying differential small fiber tests may help to improve diagnostic differentiation and targeted therapy.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10811691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology of knee osteoarthritis pain: contribution of joint structural changes and pain sensitization to movement-evoked pain in knee osteoarthritis.","authors":"Takafumi Hattori, Satoshi Ohga, Kazuhiro Shimo, Takako Matsubara","doi":"10.1097/PR9.0000000000001124","DOIUrl":"10.1097/PR9.0000000000001124","url":null,"abstract":"<p><strong>Introduction: </strong>Movement-evoked pain (MEP) is the primary symptom in patients with knee osteoarthritis (KOA).</p><p><strong>Objectives: </strong>This study aimed to investigate the contribution of joint structural changes and pain sensitization to the mechanisms of MEP in patients with KOA.</p><p><strong>Methods: </strong>A total of 86 patients were assessed for demographic characteristics, osteoarthritis severity, Whole-Organ Magnetic Resonance Imaging Score-Hoffa synovitis and bone marrow lesions, pressure pain threshold and temporal summation of pain at the knee and forearm, Central Sensitization Inventory-9, and MEP. In measure of MEP, knee pain was scored using a numerical rating scale (NRS, 0-10) before and every minute during a 6-minute walking test (6MWT), and the MEP index was defined as the change in NRS pain score from baseline to the sixth minute of walking.</p><p><strong>Result: </strong>On average, pain during 6MWT increased by 1.4 ± 1.5 points on the NRS relative to baseline, with 30.2% of patients showing an increase of 2 points or more. The hierarchical linear regression analysis revealed that Hoffa synovitis, pressure pain threshold at the forearm, and temporal summation of pain at the knee were associated with the MEP index.</p><p><strong>Conclusion: </strong>The findings of this study suggest that both synovitis and neural mechanisms, such as pain sensitization, play a role in the development of MEP in KOA.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining sensitization could be a sensitive issue.","authors":"Roger B Fillingim","doi":"10.1097/PR9.0000000000001126","DOIUrl":"10.1097/PR9.0000000000001126","url":null,"abstract":"<p><p><b>Commentary on:</b> van den Broeke EN, Crombez G, Vlaeyen JWS. Reconceptualizing sensitization in pain: back to basics. PAIN Reports 2024;9:e1125.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10796134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconceptualizing sensitization in pain: back to basics.","authors":"Emanuel N van den Broeke, Geert Crombez, Johan W S Vlaeyen","doi":"10.1097/PR9.0000000000001125","DOIUrl":"10.1097/PR9.0000000000001125","url":null,"abstract":"<p><p>Fillingim RB. Redefining sensitization could be a sensitive issue. PAIN Rep 2024;9:e1126.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10796139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to PAIN Reports reviewers!","authors":"","doi":"10.1097/pr9.0000000000001127","DOIUrl":"https://doi.org/10.1097/pr9.0000000000001127","url":null,"abstract":"","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139633427","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}