The Clinical journal of pain
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Chronic pain and posttraumatic stress symptoms (PTSS) co-occur in youth at high rates. Current conceptual models of mutual maintenance do not identify specific youth resilience factors, such as benefit finding in this co-occurrence. Benefit finding is the process of perceiving positive benefits as the results of experiencing adversity. It has been viewed as a potential mitigator for illness symptoms; however, only minimal cross-sectional research has been conducted and none has longitudinally examined the possible buffering effect of benefit finding in the co-occurrence of chronic pain and PTSS in youth. This longitudinal investigation examined whether benefit finding changes over time, influences pain outcomes and moderates the relationship between PTSS and chronic pain in a clinical sample of youth with chronic pain. ⋯ These findings replicate previous research that found positive cross-sectional associations between PTSS and chronic pain, and between benefit finding and worse pain intensity and interference. Further research on resilience in pediatric chronic pain is needed.
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To develop individual and effective treatment plans for patients with chronic pain, we aimed to replicate Grolimund and colleagues' empirical categorization of chronic pain patients on a new and larger sample. Moreover, this work aimed to extend previous knowledge by considering various treatment outcomes and exploratorily analyzing which coping skills might be particularly relevant for treatment success in each subtype. ⋯ Our findings highlight the importance of identifying and characterizing subtypes of chronic primary pain patients and that these subtypes should be considered for individualized and effective treatment.
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Randomized Controlled Trial
Mindfulness Combined with Exercise Online (MOVE) Compared with a Self-Management Guide for Adults with Chronic Pain: A Feasibility Randomised Controlled Trial.
Limited studies exist combining mindfulness-based stress reduction (MBSR) and exercise in a pain management programme (PMP), with none thus far delivering a combined intervention as an online PMP. This study aimed to explore the acceptability and feasibility of a combined MBSR and exercise online PMP for adults with chronic pain and to examine the feasibility of conducting a randomized controlled trial (RCT) comparing MBSR and exercise delivered online with an online self-management guide. ⋯ The findings suggest both interventions explored are acceptable and feasible. A fully powered RCT examining the effectiveness of MBSR combined with exercise, delivered live online is warranted.
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To evaluate subsequent shifts to patient access to tertiary pain management care following shelter-in-place (SIP) and increased telehealth during the COVID-19 pandemic. ⋯ Overall, accessibility to pediatric pain management through telehealth during SIP was maintained despite significant declines in overall access to health care, with some trends in increased accessibility for patients with government insurance.
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Adaptations in somatosensory function characterize several chronic pain conditions, including nonspecific neck pain (NNP). Early signs of central sensitization (CS) contribute to pain chronification and poor treatment responses after conditions such as whiplash injury and low back pain. Despite this well-established association, the prevalence of CS in patients with acute NNP, and accordingly, the potential impact of this association, is still unclear. Therefore, this study aimed to investigate whether changes in somatosensory function occur during the acute phase of NNP. ⋯ Changes in somatosensory function occur already in acute NNP. Local mechanical hyperalgesia demonstrated peripheral sensitization, while enhanced pain facilitation, impaired conditioned pain modulation, and self-reported symptoms of CS suggest adaptations in pain processing already early in the stage of NNP.