European journal of pain : EJP
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We hypothesized that prepulse modulation (PPM) would be altered in trigeminal neuralgia (TN) if suprasegmental inhibitory network involvement was present and tested our hypothesis in a group of patients with classical TN. ⋯ There is a bilateral prepulse inhibition deficit in TN, even on the asymptomatic side. Our findings provide electrophysiological evidence for suprasegmental changes and loss of filtering activity at the brainstem in level TN.
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Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. ⋯ Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age.
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While data from USA and Canada demonstrate an opioid overdose epidemic, very little nation-wide European studies have been published on this topical subject. ⋯ In 2004-2017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a nontrivial increase in opioid-related morbidity-mortality. Although giving no indication for an 'opioid epidemic,' these findings call for proper monitoring of opioid use.
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Case Reports
A case report of sustained resolution of cancer pain by continuous perineural infusion of local anaesthetic.
Opioids are currently offered as first-line treatment for chronic pain from cancer. Continuous regional analgesia could be an alternative to opioids. However, the required duration of catheterization and the sustained analgesic effects of this technique after catheter removal have yet to be clarified. ⋯ This case report provides new insights into the treatment of cancer pain. The most interesting finding is that the pain did remained absent after 45 days of continuous infusion of local anaesthetics through an interscalene catheter. We postulated that local anaesthetic drugs have an impact on pain memory.
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The assessment of pressure pain has become an integral part in pain research. The distribution of pressure under a plunger can be uneven. However, measurements based on conventional devices show the applied force or mean pressure, failing to take local pressure peaks into account. Our main question was whether peak pressures under the probe are responsible for pain onset. ⋯ This study adds some important considerations for the use of pressure algometers. It was found that during pressure pain thresholds readings distinct peak pressure profiles could arise, which may influence the perception of pain. Peak pressure could be another contributing factor, which may explain some of the high variability in pressure pain readings.