European journal of pain : EJP
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Randomized Controlled Trial
Topical capsaicin modulates the two-point discrimination threshold-Modulation depends on stimulation modality and intensity.
Spatial acuity concerns the ability to localize and discriminate sensory input and is often tested using the two-point discrimination threshold (2PDT). Sensitization of the pain system can affect the spatial acuity, but it is unclear how 2PDTs of different testing modalities are affected. The aim was to investigate if the 2PDTs for mechanical and heat stimulation at different intensities were modulated by topical capsaicin sensitization. ⋯ This study investigated how the two-point discrimination threshold (2PDT) can be modulated by topical capsaicin. The 2PDT was assessed for two different modalities (thermal and mechanical) and for two different intensities (innocuous and noxious) before and after capsaicin. The results showed that the 2PDT was generally impaired following capsaicin, but this was only significant for mechanical innocuous stimuli. Furthermore, it was shown that mechanical innocuous stimuli assessed the 2PDT with lower variability than other combinations.
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Randomized Controlled Trial
Sudden gains in depression and anxiety during an online pain management programme for chronic pain.
Chronic pain is associated with depression and anxiety symptoms. Pain management programms, delivered face-to-face or via the internet, can effectively help adults manage the impacts of chronic pain. Sudden gains are defined as substantial, rapid, and lasting symptom reductions that occur between consecutive treatment sessions and have been associated with better treatment outcomes in non-pain samples. This study examined whether adults with chronic pain report sudden gains in depression or anxiety symptoms during an 8-week online pain management programme, and whether sudden gains were associated with better treatment outcomes for depression or anxiety. Dominant theories of sudden gains argue that therapists are required for sudden gains to be maintained and improve treatment outcomes. ⋯ Sudden gains in depression and anxiety symptoms were not associated with improved treatment outcomes for adults with chronic pain who participated in an online pain management programme, regardless of the level of therapist guidance provided. These findings suggest possible differences in symptom change in chronic pain samples compared to general population samples.
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Randomized Controlled Trial
A sham-controlled, randomized trial of spinal cord stimulation for the treatment of pain in chronic pancreatitis.
Spinal cord stimulation (SCS) has emerged as a treatment option for patients with chronic pancreatitis (CP) who experience pain that does not respond to standard interventions. However, there is a lack of sham-controlled trials to support its efficacy. ⋯ In this first sham-controlled trial to apply high-frequency (1000 Hz) spinal cord stimulation in patients with visceral pain due to chronic pancreatitis, we did not find evidence for clinically relevant pain relief. Taken together with potential procedure-related complications, adverse effects and costs associated with spinal cord stimulation, our findings question its use for management of visceral pain.
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Randomized Controlled Trial
Short all-out isokinetic cycling exercises of 90 and 15 s unlock exercise-induced hypoalgesia.
Acute physical activity leads to exercise-induced hypoalgesia (EIH). However, to what degree it can be induced by very short but highly intensive exercise is largely unknown. This study aims to investigate the effects of two different short all-out isokinetic exercise sessions on EIH. ⋯ This study investigates the potential for brief, highly intensive exercise sessions to induce exercise-induced hypoalgesia (EIH). The research demonstrates that EIH can indeed be triggered by such short workouts, with greater effects observed during a 90 s session compared to a 15 s one, most likely due to higher subjective and objective exertion. These findings offer insights into the potential for extremely brief but intense exercises to alleviate pain, impacting exercise recommendations and pain management strategies.
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Randomized Controlled Trial
Guided internet-based acceptance and commitment therapy for provoked vestibulodynia: A randomized controlled trial.
Provoked vestibulodynia (PVD) causes suffering in many women's lives due to its impact on relationships, sexual functioning and functioning in other key domains. ⋯ In summary, a relatively brief, guided, online version of ACT appears to produce benefits for women with PVD and related impacts on daily functioning. 50% to 60% of the women who participated in the treatment reliably improved in sexual functioning and distress.