The journal of pain : official journal of the American Pain Society
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Randomized Controlled Trial
The role of the observers' perception of a model's self-confidence in observationally induced placebo analgesia.
The aim of this study was to investigate the effect of a model's self-confidence as well as the observer's self-esteem and self-efficacy on observationally acquired placebo analgesia. In addition, we aimed to verify the stability of the placebo effect induced by observational learning. Participants (n = 60) were randomly assigned to one of three groups: a self-confident model, an unself-confident model, and a control group. ⋯ PERSPECTIVE: The results of this study open the discussion on the role of model's features in the effectiveness of observational learning in the induction of placebo effects. The study provides the very first suggestion that the perceived self-confidence of the model may be related to the magnitude of the observationally induced placebo analgesia. It suggests that self-confidence of other patients and medical staff might affect individual pain experiences.
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Despite extensive research on the development and risk factors of chronic pain, the process of recovery from chronic pain in later life has been rarely studied. We estimated the recovery rate of moderate to severe chronic pain (chronic pain of moderate or severe severity or interfering with usual activities) among older adults and investigated predictors of recovery. Leveraging the longitudinal Health and Retirement Study 2006-2016 data (6 waves), we estimated the biennial national attrition-adjusted recovery rate of moderate to severe chronic pain among 6,132 US adults aged 65-75 at baseline. ⋯ Interventions that improve physical activity and sleep quality may be important avenues for reducing chronic pain burden among older adults. PERSPECTIVE: Our longitudinal findings suggested that recovery from moderate to severe chronic pain is common in later life and we further identified several key factors associated with this recovery process. Future research should consider the potential of interventions that improve physical activity and sleep quality to enhance recovery among older adults.
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Treatment outcomes for migraine and other chronic headache and pain conditions typically demonstrate modest results. A greater understanding of underlying pain mechanisms may better inform treatments and improve outcomes. Increased GABA+ has been identified in recent studies of migraine, however, it is unclear if this is present in other headache, and pain conditions. ⋯ PERSPECTIVE: This study provides insights into the underlying mechanisms of chronic pain. Higher levels of GABA+ in the PCG may reflect an underlying mechanism of chronic headache and pain conditions. This knowledge may help improve patient outcomes through developing treatments that specifically address this aberrant brain neurochemistry.
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Neuropathic pain is a common disability produced by enhanced neuronal excitability after nervous system injury. The pathophysiological changes that underlie the generation and maintenance of neuropathic pain require modifications of transcriptional programs. In particular, there is an induction of pro-inflammatory neuromodulators levels, and changes in the expression of ion channels and other factors intervening in the determination of the membrane potential in neuronal cells. ⋯ PERSPECTIVE: Neuropathic pain is a common disability produced by enhanced neuronal excitability after nervous system injury. The underlying pathophysiological changes require modifications of transcriptional programs. This study notes that inhibition of BET proteins is a promising therapy for reducing neuropathic pain after neural injury.