European journal of pain : EJP
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Verbascoside, a representative phenylethanoid glycoside, is widely distributed in plants and has various activities beneficial for human health. Although systemically administered verbascoside has an antinociceptive effect, little is known about the site and mechanism of its activity. The aim of the present study was to determine whether verbascoside attenuates neuropathic pain in the spinal cord and which pain regulatory systems are involved. ⋯ Currently available treatments for neuropathic pain have limited efficacy in most patients. Some natural products have favourable biological activities for long-term administration such as antioxidative and neuroprotective effects. Verbascoside inhibits spinal nociceptive transmission without serious side effects to the same degree as gabapentin, a first-line remedy for neuropathic pain. Natural products may be promising candidates for novel treatments of neuropathic pain.
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Bodily experience disturbances are frequent among chronic musculoskeletal pain patients and associated with important pain-related psychosocial outcomes (e.g., disability, quality of life). However, the relationship between bodily experience and the psychological dimensions of chronic pain (e.g., affective, cognitive) has only recently garnered attention. This scoping review aimed to identify trends and gaps in research on the nexus between body awareness, body image, and body schema, and psychological processes/outcomes in adults with chronic musculoskeletal pain to inform future directions for research and practice. ⋯ This scoping review identifies trends/gaps in current research on the relationship between body awareness/body image/body schema and pain-related psychological processes/outcomes in adults with musculoskeletal pain. Overall, findings suggest that better bodily experiences are associated to lower fear-avoidance beliefs, better self-regulation strategies and better chronic pain adjustment, being important targets in pain management interventions. Nonetheless, the results also emphasize the need to further investigate the causal relationships and other outcomes related to psychological resilience, as well as to develop gold standard treatments focused on bodily experience.
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Randomized Controlled Trial
Values-based Cognitive Behavioral Therapy for the Prevention of Chronic Whiplash Associated Disorders: A Randomized Controlled Trial.
Whiplash is a common traffic-related injury with up to 50% of those affected continuing to experience symptoms one-year post-injury. Unfortunately, treatments have not proven highly effective in preventing and treating chronic symptomatology. The overall aim of this study was to test the effectiveness of an early values-based cognitive-behavioural therapeutic intervention (V-CBT) delivered within 6 months post-injury in preventing chronic symptomatology compared to wait list controls. ⋯ An early Values-based Cognitive Behavioural Therapeutic intervention delivered within 6 months post-injury (mean days 117) was effective in reducing pain-related disability and psychological distress compared to the control group that received the intervention later after a three months wait-list period. The effects were sustained at 12 months follow-up. The early intervention was significantly more effective in reducing pain-related disability compared to the control group, indicating that an intervention window for early prevention of disability after whiplash injury may exist.
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To improve CRPS treatment, it is imperative to understand the nature, degree and relative importance of ongoing problems associated with CRPS. The objective of this systematic review was to summarize the published data concerning measures of function and impact including occupational parameters, of CRPS at 12 months from symptom onset and beyond. ⋯ This review provides first-time clarity in relation to outcomes of limb function and work status associated with an episode of CRPS, beyond 12 months from onset. Results demonstrate that the long-term impact of an episode of CRPS on these outcomes is much larger than previously described, and thus also illustrates how the wider health economic impact of CRPS is not yet fully understood. We additionally highlight the need for future research that identifies long-term predictors, and treatments that can foster good functional and occupational recovery.