Pain medicine : the official journal of the American Academy of Pain Medicine
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Psychosocial factors are related to pain and sex-related outcomes in provoked vulvodynia and possibly in mixed and spontaneous vulvodynia. However, a broader behavioral framework, such as the psychological flexibility model, has received limited attention in this context. Recently, additional psychosocial variables have also emerged that appear relevant to vulvodynia, including perceived injustice, body-exposure anxiety during intercourse, and unmitigated sexual communion. The present study applied network analysis to explore relations between psychological flexibility, newly emerging psychosocial variables relevant to vulvodynia, and their associations with vulvodynia outcomes. The study also explored potential differences across vulvodynia subtypes. ⋯ Among the included variables, perceived injustice, pain acceptance, depression, and psychological flexibility appear to be important in vulvodynia. As different factors are significant across subtypes, tailored treatment approaches are suggested.
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Meta Analysis
Implicit motor imagery of the foot and hand in people with Achilles tendinopathy: a left right judgement study.
To determine if impairment in motor imagery processes is present in Achilles tendinopathy (AT), as demonstrated by a reduced ability to quickly and accurately identify the laterality (left-right judgement) of a pictured limb. Additionally, this study aimed to use a novel data pooling approach to combine data collected at 3 different sites via meta-analytical techniques that allow exploration of heterogeneity. ⋯ Impairments in motor imagery performance for hands were not found in this study, and we found inconsistent results for foot accuracy. This contrasts to studies in persistent pain of limbs, face and knee osteoarthritis, and suggests that differences in pathoetiology or patient demographics may uniquely influence proprioceptive representation.
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Randomized Controlled Trial
Opioid use as a predictor of pain outcomes in Iraq and Afghanistan Veterans with chronic pain: Analysis of a randomized controlled trial.
Our objectives were to: 1) assess the relationship between self-reported opioid use and baseline demographics, clinical characteristics and pain outcomes; and 2) examine whether baseline opioid use moderated the intervention effect on outcomes at 9 months. ⋯ In a stepped-care trial for pain, patients reporting baseline opioid use had greater improvement in pain disability at 9 months compared to patients not reporting opioid use.
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There is no single prevailing theory of pain that explains its origin, qualities, and alleviation. Although many studies have investigated various molecular targets for pain management, few have attempted to examine the etiology or working mechanisms of pain through mathematical or computational model development. In this systematic review, we identified and classified mathematical and computational models for characterizing pain. ⋯ Although understudied, the development of mathematical models may augment the current understanding of pain by providing directions for testable hypotheses of its underlying mechanisms. Additional focus is needed on developing models that seek to understand the underlying mechanisms of pain, as this could potentially lead to major breakthroughs in its treatment.