European journal of pain : EJP
-
Randomized Controlled Trial
A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work-related activities.
Pain-related fear is related to disability in persistent pain conditions. Exposure treatment has been reported to be of great benefit in replicated single case experiments. ⋯ Compared to a group receiving usual treatment and waiting for exposure, the exposure in vivo group demonstrated a significantly larger improvement on function. Overall exposure had moderate effects on function, fear and pain intensity. We conclude that exposure may be important in treatment, but is not recommended as a "stand alone" adjunct to usual treatment.
-
This study analyses the relationships between patients' cognitive appraisals concerning their pain and the coping strategies they use. In addition, the way the coping strategy influences the intensity of perceived pain and impairment in these patients was studied. ⋯ By analysing the cognitive appraisals made by chronic pain patients, clinicians could make better predictions regarding the way they cope and adjust.
-
Mice lacking the serotonin-transporter (5-HTT-/- mice) develop reduced thermal hyperalgesia after nerve injury, concomitant with reduced serotonin (5-HT) levels in nervous tissue. Here we investigated pain behaviour in 5-HTT-/- mice compared to their wild type littermates after hind paw inflammation induced by complete Freund's adjuvant (CFA). We used standard tests for pain behaviour, high performance liquid chromatography for measurement of 5-HT, and immunohistochemistry of hind paw skin tissue and L5 dorsal root ganglia (DRG) to measure local inflammation and nerve injury. ⋯ Accordingly, a higher number of injured DRG neurons was identified by activating transcription factor 3 (ATF3) staining in 5-HTT-/- mice after CFA. We conclude that the phenotype of 5-HTT-/- mice leads to reduced inflammatory pain due to reduced tissue 5-HT levels and to greater peripheral nerve injury after inflammation. Human variants of the 5-HTT genotypes might be part of the factors determining the extent of nerve injury and hyperalgesia in inflammation.
-
The objective of this paper was to analyse opioid consumption in a number European countries using different sources of data. ⋯ Caution is required when interpreting the data on opioid consumption between countries because of differences in the collection and reporting of data. Better recording of opioid consumption is needed for meaningful analysis of opioid consumption and its possible effect on pain management in different countries. Data on opioids consumed for cancer-related pain in comparison with chronic non-malignant pain are needed. A uniform method of collection of data on analgesic consumption should be established for all European countries.
-
Comparative Study
A comparison of the relationship between depression, perceived disability, and physical performance in persons with chronic pain.
This study examined the relationships between self-report of depressive symptoms, perceived disability, and physical performance among 267 persons with chronic pain. Prior research has reported a relationship between depression and disability using self-report measures. However, self-report instruments may be prone to biases associated with depression as depressed persons with pain may have an exaggerated negative view of their level of function. ⋯ The magnitude of the relationships between depression and self-report and functional activity were similar, suggesting that a self-report bias associated with depression is not responsible for an observed relationship between depression and disability. Physiologic effort partially mediated the relationship between depression and physical performance. The findings further highlight the importance of depression in the experience of chronic pain.