European journal of pain : EJP
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Chronic neuropathic pain is often associated with conditions such as depression and anxiety and strongly affects daily functioning and overall quality of life. It is argued, therefore, that psychosocial interventions should be added to traditional biomedical interventions. This systematic review evaluates the effectiveness of cognitive and behavioral interventions for the management of chronic neuropathic pain. ⋯ This is the first systematic review that has evaluated the effectiveness of cognitive and behavioral techniques for the management of chronic neuropathic pain. Given the limited methodological quality, no informative conclusions can be drawn with respect to the study objective. However, this review does provide insight into the difficulties of this specific area, the need for a clear and widely accepted definition of neuropathic pain and the need for standardized multidimensional measurement instruments.
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Recurrent pain not only has an impact on disability, but on the long term it may become a threat to one's sense of self. This paper presents a cross-sectional study of patients with work-related upper extremity pain and focuses on: (1) the role of self-discrepancies in this group, (2) the associations between self-discrepancies, pain, emotions and (3) the interaction between self-discrepancies and flexible-goal adjustment. Eighty-nine participants completed standardized self-report measures of pain intensity, pain duration, anxiety, depression and flexible-goal adjustment. ⋯ Furthermore, significant interactions were found between actual-ought other self-discrepancies and flexibility, indicating that less flexible participants with large self-discrepancies score higher on depression. This study showed that self-discrepancies are related to negative emotions and that flexible-goal adjustment served as a moderator in this relationship. The view of self in pain and flexible-goal adjustment should be considered as important variables in the process of chronic pain.
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Little is known about the relationships of clinical findings in the low back with low back pain (LBP) in the normal working population. We studied whether physiotherapist's findings in the low back were associated with local and radiating LBP among a cohort (n=902) of employees in the engineering industry. A systematic non-proportional sample was drawn in strata by age, gender, and occupational class. ⋯ No associations between limited forward flexion and new cases of LBP were observed. Thus, membership in clusters with different levels of findings in simple clinical measurements predicted new reports of radiating LBP, in particular, among employees. The generalizability of the results may be limited due to the characteristics of the sampling.
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Eccentric jaw exercises has been known to cause muscle soreness but no studies have so far examined to what extent temporal summation mechanisms within the exercised muscles are changed. The purpose of the present study was to investigate the effects of an eccentric biting exercise on the temporal summation, mechanical pressure sensitivity and jaw muscle activity. A total of 15 healthy men participated in a two-session-experiment: In one session, they performed 30 min controlled eccentric jaw exercise and the other session served as a no-exercise control. ⋯ The summation ratio was significantly decreased at 1-day-after in both sessions. The present findings demonstrate that eccentric jaw exercise does not induce detectable changes in temporal summation. However, the summation ratio may have clinical utility to differentiate the location of sensitization.
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This study aimed at investigating in details the spatial characteristics of muscular hyperalgesia after development of delayed onset muscle soreness (DOMS) in the trapezius muscle. High density pressure pain mapping consisting of 36 pain pressure threshold (PPT) recording points were assessed over the trapezius muscle from 20 subjects. PPT were recorded before, immediately after and 24h after eccentric exercise/rest for the exercise group (N=10) and the control group (N=10). ⋯ The hyperalgesia was also mostly developed in the muscle belly sites (P<0.001), further enhancing its position as the most sensitive part of the muscle. The present results showed the topographical distribution of pressure pain sensitivity over the trapezius muscle and also that hyperalgesia developed in a heterogeneous manner over the trapezius muscle in response to eccentric exercise underlining sensory partitioning of the muscle. The technique of high density pressure pain topographical mappings can be helpful in characterizing muscle hyperalgesia and its heterogeneity.