Pain medicine : the official journal of the American Academy of Pain Medicine
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Cannabinoids are being used by patients to help with chronic pain management and to address the two primary chronic pain comorbidities of anxiety and sleep disturbance. It is necessary to understand the biphasic effects of cannabinoids to improve treatment of this symptom triad. ⋯ This scoping review reports on biphasic effects of cannabinoids related to pain, sleep, and anxiety. Dose response relationships are present, but we found gaps in the current literature for biphasic effects of cannabinoids in humans. There is a lack of prospective research in humans exploring this specific relationship.
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Few studies have investigated specific associations between insomnia and orofacial pain (OFP). The aim of this cross-sectional study was to examine relationships of insomnia with pain, mental health, and physical health variables among treatment-seeking patients with chronic OFP. ⋯ Insomnia is associated with pain outcomes and should be appropriately managed when treating patients with chronic OFP.
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To identify common opioid tapering trajectories among patients commencing taper from long-term opioid therapy for chronic non-cancer pain, and examine patient-level characteristics associated with these different trajectories. ⋯ Those prescribed strong opioids and high doses appear less likely to complete taper. Further studies are needed to evaluate the clinical outcomes associated with the identified trajectories.
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Greater preoperative depression, anxiety, and pain catastrophizing are associated with more severe long-term pain following total knee arthroplasty (TKA). In a secondary analysis of previously reported data, we tested the hypothesis that these associations are mediated by oxidative stress (OS). ⋯ Results suggest that the adverse impact of depression, anxiety, and pain catastrophizing on post-TKA pain and functional outcomes are mediated in part by elevated OS.
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Orthopedic patients report pain as their main symptom complaint. Subjective pain experience is correlated with self-reported psychological state, such as distress. ⋯ We find statistical support to suggest that distress-particularly depressed mood and stress-mediates the association between mindful attention and pain intensity among orthopedic patients. A disposition of mindful attention might counter distress ailments that exacerbate subjective pain, and this has possible implications for mindfulness training interventions offered to orthopedic patients.