The Clinical journal of pain
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This study investigated the bidirectional relationship between the intensity of low back pain (LBP) and sleep disturbance. Further, the study aimed to determine whether any relationship is dependent on pain duration, symptoms of depression and anxiety, and the method of sleep assessment (subjective vs. objective). ⋯ The findings demonstrate that there is a bidirectional relationship between sleep and pain intensity in patients with LBP. The relationship is independent of pain duration and baseline symptoms of depression and anxiety and somewhat dependent on the method of sleep measurement (sleep diary or Armband). Future research is needed to determine whether targeting sleep improvement in patients with LBP contributes to pain reduction.
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Comparative Study
Preferences, Experience, and Attitudes in the Management of Chronic Pain and Depression: A Comparison of Physicians and Medical Students.
The current study investigated clinicians' treatment preferences for chronic pain and depression and the extent to which these preferences were related to clinicians' experience and attitudes. ⋯ Physicians and medical students shared a general preference for "low-risk," self-management approaches for chronic pain and depression; however, they differed in their recommendations for some specific treatments. Participants' attitudes toward patients with pain and depression were associated with their preferences and accounted for the differences in their treatment decisions. These results suggest a need for early and continuing education to reduce clinicians' negative attitudes toward and improve the management of patients with chronic pain and depression.
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Measures of central pain processing like conditioned pain modulation and suprathreshold heat pain response (SHPR) have been described to assess different components of central pain modulatory mechanisms. Central pain processing potentially plays a role in the development of postsurgical pain, however, the role of conditioned pain modulation and SHPR in explaining postoperative clinical pain and disability is still unclear. ⋯ The present study suggests that baseline measures of central pain processing were not predictive of 6-month postoperative pain outcome. Instead, the 3-month change in SHPR might be a relevant factor in the transition to an elevated 6-month postoperative pain and disability outcomes. In patients with shoulder pain, the 3-month change in a measure of central pain processing might be a relevant factor in the transition to elevated 6-month postoperative pain and disability scores.
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Comparative Study
Comparison of location, depth, quality, and intensity of experimentally induced pain in 6 low back muscles.
The pattern of pain originating from experimentally induced low back pain appears diffuse. This may be because sensory information from low back muscles converges, sensory innervation extends over multiple vertebral levels, or people have difficulty accurately representing the painful location on standardized pain maps. ⋯ Depth and lateral position may be the most critical descriptors to determine the source of acute lumbar muscular pain. Overlapping regions of pain may be explained by convergence of receptive fields, innervation of multifidus fascicles at multiple lumbar segments, and convergence of sensory input from different muscles to the same sensory cell bodies as demonstrated in the lumbar spine of animal preparations.
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Treatment for childhood leukemia requires frequent lumbar punctures (LP) and bone marrow aspirations (BMA), often described by children and parents as more distressing than the disease itself. Findings in schoolchildren and chronic pain samples indicate that increased parental distress may increase parental protective, pain-attending behavior, which is associated with more child pain and distress. However, in the context of invasive medical procedures, it is unknown which parents are likely to become most distressed and engage in pain-attending behavior, and how this impacts the children's experiences. The present study investigated the impact of parental catastrophic thoughts upon parental distress and pain-attending behavior (verbal and nonverbal). Furthermore, the association between parental responses and the children's pain behavior, pain, and distress was examined. ⋯ The findings demonstrate the importance of parental catastrophic thinking in understanding their caregiving responses and preparing parents and children for painful invasive medical procedures.