Pain
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Randomized Controlled Trial
Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial.
Endometriosis-associated chronic pelvic pain (EACPP) presents with an intense inflammatory reaction. Melatonin has emerged as an important analgesic, antioxidant, and antiinflammatory agent. This trial investigates the effects of melatonin compared with a placebo on EACPP, brain-derived neurotrophic factor (BDNF) level, and sleep quality. ⋯ Melatonin improved sleep quality, reduced the risk of using an analgesic by 80%, and reduced BNDF levels independently of its effect on pain. This study provides additional evidence regarding the analgesic effects of melatonin on EACPP and melatonin's ability to improve sleep quality. Additionally, the study revealed that melatonin modulates the secretion of BDNF and pain through distinct mechanisms.
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The aim of this study was to investigate whether diagnostic tests for musculoskeletal pain in the orofacial region [temporomandibular disorder (TMD) pain] are influenced by the presence of comorbid conditions, and to determine whether this influence decreases when the presence of "familiar pain" is used as outcome measure. In total, 117 patients (35 men, 82 women; 75 TMD-pain patients, 42 pain-free patients; mean age ± SD = 42.94 ± 14.17 years) were examined with palpation tests and dynamic/static tests. After each test, they were asked whether any pain was provoked and whether this pain response was familiar or not. ⋯ Pain on dynamic/static tests was associated with the primary predictor (P < 0.001, OR = 11.08), but also with somatization (P = 0.037, OR = 4.5), whereas familiar pain on dynamic/static tests was only associated with the primary predictor (P < 0.001, OR = 32.37). In conclusion, diagnostic tests are negatively influenced by the presence of comorbidity. This influence decreases when the presence of familiar pain is used as outcome measure.
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The purpose of this systematic review was to summarize and critically appraise research developing or validating instruments to assess patient-reported safety, efficacy, and/or misuse in ongoing opioid therapy for chronic pain. Our search included the following datasets: OvidSP MEDLINE (1946-August 2012), OvidSP PsycINFO (1967-August 2012), Elsevier Scopus (1947-August 2012), OvidSP HaPI (1985-August 2012), and EBSCO CINAHL (1981-August 2012). Eligible studies were published in English and pertained to adult, nonsurgical/interventional populations. ⋯ The studies employed a wide variety of psychometric tests, with most demonstrating statistical significance, but several potential sources of bias and generalizability limitations were identified. Lack of testing in clinical practice limited assessment of feasibility. The dearth of safety and efficacy items and lack of testing in clinical practice demonstrates areas for further research.
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Perception of emotional stimuli alters the perception of pain. Although facial expressions are powerful emotional cues - the expression of pain especially plays a crucial role for the experience and communication of pain - research on their influence on pain perception is scarce. In addition, the opposite effect of pain on the processing of emotion has been elucidated even less. ⋯ Most important, painful thermal stimuli increased the arousal of simultaneously presented pain expressions, and in turn, pain expressions resulted in higher pain ratings compared to all other facial expressions. These findings demonstrate that the modulation of pain and emotion is bidirectional with pain faces being mostly prone to having mutual influences, and support the view of interconnections between pain and emotion. Furthermore, the special relevance of pain faces for the processing of pain was demonstrated.
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The present study investigated the role of observer pain catastrophizing and personal pain experience as possible moderators of attention to varying levels of facial pain expression in others. Eye movements were recorded as a direct and continuous index of attention allocation in a sample of 35 undergraduate students while viewing slides presenting picture pairs consisting of a neutral face combined with either a low, moderate, or high expressive pain face. Initial orienting of attention was measured as latency and duration of first fixation to 1 of 2 target images (i.e., neutral face vs pain face). ⋯ With respect to attentional maintenance, participants reporting high catastrophizing and pain intensity demonstrated significantly longer gaze duration for all face types (neutral and pain expression), relative to low catastrophizing counterparts. Finally, independent of catastrophizing, higher reported pain intensity contributed to decreased attentional maintenance to pain faces vs neutral faces. Theoretical implications and further research directions are discussed.