European journal of pain : EJP
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Youth with chronic pain are at higher risk for obesity than the general population. In youth with chronic pain, obesity exacerbates pain-specific activity limitations, and in adults with chronic pain, obesity perpetuates a cycle of disability. The current study examined whether weight status predicts functional disability outcomes over time in youth with chronic pain. ⋯ This study shows that obesity impedes improvement in functioning for youth with chronic pain. On the basis of these findings, interventions should be tailored to the unique challenges of this population.
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Randomized Controlled Trial
Learned control over spinal nociception in patients with chronic back pain.
Descending pain inhibition suppresses spinal nociception, reducing nociceptive input to the brain. It is modulated by cognitive and emotional processes. In subjects with chronic pain, it is impaired, possibly contributing to pain persistence. A previously developed feedback method trains subjects to activate their descending inhibition. Participants are trained to use cognitive-emotional strategies to reduce their spinal nociception, as quantified by the nociceptive flexor reflex (RIII reflex), under visual feedback about their RIII reflex size. The aim of the present study was to test whether also subjects with chronic back pain can achieve a modulation of their descending pain inhibition under RIII feedback. ⋯ Subjects with chronic back pain can learn to control their spinal nociception, quantified by the RIII reflex, when they receive feedback about the RIII reflex.
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Randomized Controlled Trial
Conditioned pain modulation dampens the thermal grill illusion.
The thermal grill illusion (TGI) refers to the perception of burning heat and often pain that arises from simultaneous cutaneous application of innocuous warm and cool stimuli. This study utilized conditioned pain modulation (CPM) to help elucidate the TGI's underlying neural mechanisms, including the debated role of ascending nociceptive signals in generating the illusion. ⋯ Conditioned pain modulation reduces the perceived painfulness, unpleasantness and heat of the thermal grill illusion and noxious heat similarly. The results have important theoretical implications for both types of pain.
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Repetitive transcranial magnetic stimulation (rTMS) at M1/S1 cortex has been shown to alleviate neuropathic pain. ⋯ Neurobiological correlates of rTMS for the pain relief are unclear. rTMS on M1/S1 with 11 C-carfentanyl-PET activates endogenous opioids. Thermal and heat pain thresholds remain unchanged. rTMS induces top-down opioid-mediated inhibition but not change the sensory discrimination of painful stimuli.
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The purpose of the study is to evaluate the feasibility of a newly developed parent program for parents of children with non-specific chronic musculoskeletal pain. This program is part of the child's interdisciplinary outpatient pain rehabilitation treatment. The goal of the parent program is to change parent's thoughts/behaviour regarding pain with the ultimate intention to further improve their child's functioning. There were two main objectives in the study: First, to evaluate the feasibility of the parent program. Second, to evaluate changing in parental behavioral factors pre- and posttreatment. ⋯ A parent program, designed to change cognition and behaviour of parents of children with chronic musculoskeletal pain is feasible.