European journal of pain : EJP
-
Patellofemoral pain (PFP) is defined biomechanically, but is characterized by features that fit poorly within nociceptive pain. Mechanisms associated with central sensitization may explain why, for some, symptoms appear nociplastic. This study compares psychological and somatosensory characteristics between those with persistent PFP and controls. ⋯ (a) Individuals with PFP have widespread reduced pain thresholds to pressure and thermal stimuli. (b) Mechanically induced pain is likely amplified in those with PFP. (c) Pain-related fear is highly prevalent and helps explain PFP-related disability.
-
Mechanisms underpinning ongoing symptoms in chronic whiplash associated-disorder (WAD) are not well understood. People with chronic WAD can exhibit sensory dysfunction consistent with small nerve fibre pathology, including thermal hypoaesthesia and hyperalgesia. This study investigated small fibre structure and function in chronic WAD. ⋯ Our study found decreased intraepidermal nerve fibre density, reduced dermal innervation, thermal hypoaesthesia and hypersensitivity in people with chronic WAD, suggestive of small fibre pathology. This observation of peripheral nervous system pathology in chronic whiplash provides novel insights on mechanisms underpinning symptoms and challenges commonly held beliefs regarding this condition.
-
An increasing trend in opioid consumption has been observed worldwide in last decades. However, data related to opioid utilization in hospital settings are scarce. The aim of this study was to determine the evolution of use of strong opioids and pain intensity in a tertiary hospital during 6 years. ⋯ This study shows a stable consumption of strong opioid analgesics in a hospital setting in contrast to what appears to be the extrahospitalary trend during last years. The association between consumption of opioids and pain intensity seems to indicate a good control of pain in the clinical setting, showing a significant correlation between the consumption of opioids and repeated and severe pain in medical departments.
-
The association between fear of pain (FOP) and pain intensity has remained unclear. This study aimed to examine whether highly pain-fearful participants showed pain perceptual biases to general painful stimulus or to specific threatening painful stimulus. ⋯ The findings highlight the modulatory influence of threat appraisal of pain in the positive association between pain-related fear and pain perceptual biases.
-
Clinical and experimental evidence advocates a structural and functional link between the vestibular and other sensory systems. For instance, visuo-vestibular and vestibular-somatosensory interactions have been widely reported. However, whether visual inputs carrying vestibular information can modulate pain is not yet clear. Recent evidence using natural vestibular stimulation or moving visual stimuli, points at an unspecific effect of distraction. ⋯ This study explored how the visualization of static environments in immersive virtual reality can lead to pain threshold modulation through the activation of the vestibular system. Immersion into rotated virtual environments led to the illusory sensation of body rotation, and this sensation was found to be related with a modulation of pain perception. Possible analgesic effects due to distraction could be ruled out. These results expand our current knowledge about how the visual, vestibular and somatosensory (pain) systems interact. These findings may influence future pain treatment strategies based on multisensory stimulation.