European journal of pain : EJP
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Review Meta Analysis
The effectiveness of self-management interventions in adults with chronic orofacial pain: A Systematic review, Meta-analysis and Meta-regression.
Psychosocial risk factors associated with chronic orofacial pain are amenable to self-management. However, current management involves invasive therapies which lack an evidence base and has the potential to cause iatrogenic harm. ⋯ This systematic review provides clear evidence for effectiveness of combined biomedical and psychological interventions (incorporating self-management approaches) on long-term outcomes in the management of chronic orofacial (principally TMD) pain. Self-management should be a priority for early intervention in primary care in preference to invasive, irreversible and costly therapies. Further research is needed firstly to clarify the relative effectiveness of specific components of self-management, both individually and in conjunction, and secondly on outcomes in other types of chronic orofacial pains.
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Pain models are commonly used in drug development to demonstrate analgesic activity in healthy subjects and should therefore not cause long-term adverse effects. The ultraviolet B (UVB) model is a model for inflammatory pain in which three times the minimal erythema dose (3MED) is typically applied to induce sensitization. Based on reports of long-lasting postinflammatory hyperpigmentation (PIH) associated with 3MED, it was decided to investigate the prevalence of PIH among subjects who were previously exposed to 3MED at our research centre. In addition, re-evaluation of the UVB inflammation model using a reduced exposure paradigm (2MED) was performed in healthy subjects. ⋯ Postinflammatory hyperpigmentation is an unwanted long-term side effect associated with the UVB inflammation model using the 3× minimal erythema dose (3MED) paradigm. In contrast, using a 2MED paradigm results in hyperalgesia that is stable for 36 hr and has a lower risk of inducing postinflammatory hyperpigmentation.
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Fibromyalgia represents a condition still controversial in its entity, pathophysiology, diagnosis and management (Figure ). In a world where everybody is connected, and everybody is sharing their own image, fibromyalgia (FM) represents the emblematic pathology of misconnection and lack of specific biomarker. ⋯ The concept of misconnection defines FM in a different and holistic view and proposes different views of assessment, management and representation: FM pathophysiology: the desynchronization of brain and body FM recognition: the broken link between patients and physicians FM assessment: merging the body and mind for an optimal diagnosis and management FM treatment: re-establishing the good connections at different levels We hope to reconnect FM patients with all healthcare providers, help FM patients reconnect with their painful body and integrate FM into regular medical practice. SIGNIFICANCE: The concept of misconnection defines FM in a different and holistic view, and propose different views of assessment, management and representation.
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Athletes who play contact sports are regularly exposed to pain, yet manage to perform complex tasks without significant decrement. Limited research has suggested that superior pain tolerance in contact athletes may be important in this context and this may be altered via experience of pain. Other psychological variables such as challenge states, pain bothersomeness and coping style may also influence skill execution during pain. ⋯ Athletes with even relatively small amounts of contact sport experience perform better during experimental pain than athletes who play non-contact sports. Experienced contact athletes had higher levels of direct coping and were more challenged and less threatened by pain than non-contact athletes.
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γ-Aminobutyric acid type A (GABAA ) receptors containing the α6 subunit are located in trigeminal ganglia, and their reduction by small interfering RNA increases inflammatory temporomandibular and myofascial pain in rats. We thus hypothesized that enhancing their activity may help in neuropathic syndromes originating from the trigeminal system. Here, we performed a detailed electrophysiological and pharmacokinetic analysis of two recently developed deuterated structurally similar pyrazoloquinolinone compounds. ⋯ Results obtained in two protocols of chronic constriction injury of the infraorbital nerve in rats dosed intraperitoneally with DK-I-56-1 during 14 days after surgery or with DK-I-56-1 or DK-I-87-1 during 14 days after trigeminal neuropathy were already established, demonstrated that DK-I-56-1 but not DK-I-87-1 significantly reduced the hypersensitivity response to von Frey filaments. SIGNIFICANCE: Neuropathic pain induced by trigeminal nerve damage is poorly controlled by current treatments. DK-I-56-1 that positively modulates α6 GABAA receptors is appropriate for repeated administration and thus may represent a novel treatment option against the development and maintenance of trigeminal neuropathic pain.