The Clinical journal of pain
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Comparative Study
Quantitative sensory testing profiles in chronic back pain are distinct from those in fibromyalgia.
Alterations in the central nervous system leading to higher pain sensitivity have been shown in both chronic back pain (CBP) and fibromyalgia syndrome (FMS). The aim of this study was to disclose commonalities and differences in the pathophysiology of FMS and CBP. ⋯ FMS patients showed increased sensitivity for different pain modalities at all measured body areas, suggesting central disinhibition as a potential mechanism. CBP participants in contrast, showed localized alterations within the affected segment possibly due to peripheral sensitization.
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Multicenter Study
The Discriminative validity of "nociceptive," "peripheral neuropathic," and "central sensitization" as mechanisms-based classifications of musculoskeletal pain.
Empirical evidence of discriminative validity is required to justify the use of mechanisms-based classifications of musculoskeletal pain in clinical practice. The purpose of this study was to evaluate the discriminative validity of mechanisms-based classifications of pain by identifying discriminatory clusters of clinical criteria predictive of "nociceptive," "peripheral neuropathic," and "central sensitization" pain in patients with low back (± leg) pain disorders. ⋯ By identifying a discriminatory cluster of symptoms and signs predictive of "nociceptive," "peripheral neuropathic," and "central" pain, this study provides some preliminary discriminative validity evidence for mechanisms-based classifications of musculoskeletal pain. Classification system validation requires the accumulation of validity evidence before their use in clinical practice can be recommended. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.
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Phantom limb perception is common following amputation, and is sometimes characterised by pain that resembles the characteristics, intensity or location of past pain. We tested Flor's model that phantom pain results from memory for long-lasting znoxious input. ⋯ We propose that somatosensory pain memories likely relate to the generation and maintenance of limb representations upon which intense or emotionally powerful past experiences have been imprinted.
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Randomized Controlled Trial
A randomized, controlled study to investigate the analgesic efficacy of single doses of the cannabinoid receptor-2 agonist GW842166, ibuprofen or placebo in patients with acute pain following third molar tooth extraction.
To evaluate the postoperative analgesic efficacy of GW842166, a noncannabinoid CB2 agonist, in patients undergoing third molar tooth extraction. ⋯ In comparison to ibuprofen, single doses of GW842166 (100 and 800 mg) failed to demonstrate clinically meaningful analgesia in the setting of acute dental pain.
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The link between chronic back pain and disability is well established. Despite this, the literature also reflects an inconsistency in methods of assessing disability, as studies interchangeably use self-report measures, clinical tests, and electronic monitoring. The purpose of this study was to conduct a multimethod comparison of disability measures to identify similarities and differences in the constructs measured by each. ⋯ The results indicate substantial differences in the types of variables that predict disability when measured through 3 different methods. This is suggestive of differences in the constructs measured by each type of disability assessment. The implications for researchers who assess predictors of disability and clinicians who use disability measures in their assessment of patients are that the measures of disability they select should be carefully matched to the proposed purposes. Strong theoretical and practical considerations support using electronic ambulatory monitoring in future research and clinical service.