European journal of pain : EJP
-
Review Comparative Study
Overview review: Comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions.
Ibuprofen and paracetamol have long been used as analgesics in a range of acute, intermittent and chronic pain conditions. Paracetamol is often the first line analgesic recommended, without consensus about which is the better analgesic. ⋯ At standard doses in different painful conditions, ibuprofen was usually superior producing more patients with the degree of pain relief that patients feel worthwhile. Neither of the drugs will be effective for everyone, and both are needed. This overview questions the practice of routinely using paracetamol as a first line analgesic because there is no good evidence for efficacy of paracetamol in many pain conditions.
-
Activation of noradrenergic α2 receptor in spinal dorsal horn effectively alleviates the pathological pain. However, the precise mechanisms underlying noradrenergic pain suppression are not fully understood. Convincing evidence has indicated that extracellular signal-regulated kinases 1 and 2 (ERK1/2) play a key role in spinal sensitization. The present study investigated the potential influence of noradrenergic α2 receptor agonist clonidine on ERK1/2 activity. ⋯ The analgesic action produced by noradrenergic α2 receptor agonist clonidine involved the reversal of ERK1/2 hyperactivity in spinal dorsal horn of inflamed mice.
-
The aim of this study was to investigate the associations between sickness absence due to back pain or depressive episode with future all-cause and diagnosis-specific disability pension, while adjusting for comorbidity and socio-demographics, for all and stratifying for sex. ⋯ Results indicate that sickness absence due to a depressive episode or back pain is a strong risk factor for a future disability pension due to mental, musculoskeletal or other somatic diagnoses.
-
Review Meta Analysis
Local and distant acupuncture points stimulation for chronic musculoskeletal pain: A systematic review on the comparative effects.
One in four people suffers from chronic musculoskeletal pain (CMP). Acupuncture points stimulation is increasingly used for pain relief for CMP. Commonly, a combination of local and distant points is used. ⋯ Local and distant point stimulation induces similar degree of acupuncture analgesia. The benefit of combining local and distant point stimulation is unknown. However, subgroup analyses suggested that local tender points could be important in the treatment of CMP for short-term pain relief.
-
The ability to accurately recognize facial expressions of pain is known to affect clinical decision making and delivery of care. Although recognition accuracy for facial expressions of pain is well above chance level, substantial shortcomings have also been reported which stress the need to look for methods to improve recognition accuracy. Based on findings that pain is encoded in different facial activity patterns, we wanted to investigate whether training observers to recognize these various faces of pain might improve their ability to accurately recognize pain. ⋯ Raising awareness in observers that different combinations of facial movements (different faces of pain) are equivalent signals of pain through a brief training procedure can improve recognition accuracy for pain substantially.