The Clinical journal of pain
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Multicenter Study
Clinical Investigation of Pain-related Fear and Pain Catastrophizing for Patients With Low Back Pain.
to investigate select psychometric properties of fear-avoidance model measures commonly used to assess pain-related fear and catastrophizing in clinical studies of low back pain. ⋯ these analyses suggest clinical assessment of the Fear-Avoidance Model of Musculoskeletal Pain likely captures 3 factors including PCS, beliefs about work, and beliefs about physical activity. The FABQ-PA and PCS can be recommended for clinical use because of their unique associations with pain intensity and disability. The FABQ-W may only be appropriate for those interested in assessing work specific beliefs.
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the underlying cause of pathophysiological mechanisms triggering multiple chemical sensitivity (MCS) remains disputed.Recently, alterations in the central nervous system, for example,central sensitization, similar to various chronic pain disorders, have been suggested. Capsaicin is used in experimental pain models to provoke peripheral and central sensitization. In patients with symptoms elicited by odorous chemicals capsaicin-induced secondary hyperalgesia and temporal summation were assessed as markers for abnormal central nociceptive processing together with neurogenic inflammation (flare). ⋯ this is the first study to show facilitated pain processing in MCS and EC patients with the most abnormal responses in MCS.
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single nucleotide polymorphisms (SNPs) in the genes for catecholamine-O-methyltransferase (COMT), μ-opioid receptor and GTP cyclohydrolase (GCH1) have been linked to acute and chronic pain states. COMT polymorphisms are associated with experimental pain sensitivity and a chronic pain state. No such association has been identified perioperatively. We carried out a prospective observational clinical trial to examine associations between these parameters and the development of postoperative pain in patients undergoing third molar (M3) extraction. ⋯ we report an early demonstration of a COMT SNP association with a clinically meaningful pain outcome after elective surgery.
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the objective of this case is to report an occurrence of a skin rash in a dermatomal distribution subsequent to a lumbar transforaminal epidural steroid injection. ⋯ this is the first described case of a focal dermatomal rash occurring following lumbar transforaminal epidural steroid injection and we wish to remind pain practitioner’s of the possibility of anaphylactic events.