The Clinical journal of pain
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Comparative Study Clinical Trial Controlled Clinical Trial
Spousal responses are differentially associated with clinical variables in women and men with chronic pain.
Spousal responses have been related to clinical variables in patients with chronic pain. For example, solicitous responses from spouses have been associated with greater levels of pain and disability among patients with chronic pain. However, few investigators have determined whether spousal solicitousness produces different effects in women versus men with chronic pain. The present study examined pain reports, medication use, psychosocial factors, functional measures, and pain tolerance in patients with chronic pain. ⋯ These results extend previous findings demonstrating a relationship between spousal responses and patients' adjustment to pain; however, the pattern of these effects appears to be moderated by the sex of the patient. Implications for assessment and treatment of chronic pain are discussed.
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There is clinical experimental evidence that extracranial arterial vasodilation, extracranial neurogenic inflammation, and decreased inhibition of central pain transmission are involved in the pathogenesis of the migraine headache. The migraine aura is likely caused by a neurophysiologic phenomenon akin to Leão's cortical spreading depression, a wave of short-lasting neuronal excitation that travels over the cerebral cortex, followed by prolonged depression of cortical neuronal activity. ⋯ The process driving the pathogenesis of the migraine attack and susceptible to the migraine trigger factors may be located in the brain stem.
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Clinical Trial Controlled Clinical Trial
Differential relationships between anxiety and treatment-associated pain reduction among male and female chronic pain patients.
Clinical, epidemiological, and laboratory-based studies have all suggested that female sex and elevated anxiety are associated with greater experience of pain. However, several recent reports have also indicated that sex may moderate the relationship between anxiety and responses to noxious stimuli, with anxiety more strongly related to pain among males. The present study examined whether anxiety differentially impacts outcomes for pain treatment among males and females. ⋯ These findings suggest differential relationships between anxiety and pain relief as a function of sex. While we are unable to identify a mechanism for this effect, higher anxiety may have predicted more pain relief among males and less pain relief among females due to sex differences in coping strategies or placebo effects.
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To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people. ⋯ The mood disturbance related to spousal bereavement aggravates pain in older people. This lends support to the biopsychosocial model of pain.
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The role of serotonin in the modulation of nociceptive input has been widely studied, and a link between serum serotonin (S-5HT) and pain thresholds elicited in patients with chronic painful pathologies has been shown. In the light of contradictory concepts on pain message modulation by S-5HT, this study tries to define whether S-5HT displays a nociceptive or antinociceptive role in experimental pain evaluation in healthy volunteers. ⋯ Low pain detection thresholds may be explained by a peripheral nociceptive effect of serotonin. Pain tolerance does not, however, encompass a similar pattern of serotoninergic involvement in pain control and may include other components that remain to be elucidated. These results call for further studies on a larger population.