Scandinavian journal of pain
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Background and aims In 2008, the International Association for the Study of Pain Special Interest Group on Neuropathic Pain (NeuPSIG) proposed a clinical grading system to help identify patients with neuropathic pain (NeP). We previously applied this classification system, along with two NeP screening tools, the painDETECT (PD-Q) and Leeds Assessment of Neuropathic Symptoms and Signs pain scale (LANSS), to identify NeP in patients with neck/upper limb pain. Both screening tools failed to identify a large proportion of patients with clinically classified NeP, however a limitation of our study was the use of a single clinician performing the NeP classification. ⋯ Implications Our observations suggest that in view of the heterogeneity in patients with neck/upper limb pain, a considerable amount of expertise is required to interpret the revised grading system. While the application was feasible in our clinical setting, it is unclear if this will be feasible to apply in primary health care settings where early recognition and timely intervention is often most needed. The use of LANSS and PD-Q in the identification of NeP in patients with neck/upper limb pain remains questionable.
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Background and aims Several pain conditions have been shown to reduce the discriminative abilities of external stimuli. The aim of this study was to investigate how cutaneous sensitization affects the tempo-spatial discrimination for both painful laser stimulation and mechanical stimulation. Methods Fifteen healthy subjects were presented with two different stimulation paradigms, a continuous line stimulation and a 2-point stimulation. ⋯ Conclusions The findings show how cutaneous sensitization appears to affect directional discrimination to a larger extent than the 2-point discrimination. Implications This study is the first to investigate how directional discrimination is altered during sensitization. If such measures can be optimized they may provide a new method to probe the neural mechanisms in pain patients.
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Background and aims The medical use of opioids in different countries is often subject to public concern and debate, frequently based on rough figures from prescription databases made for registration of consumption. However, public access to some of these databases allow for further exploration of the prescription data, which can be processed to increase knowledge and insight into national opioid prescribing-behavior. Denmark, Sweden and Norway are considered closely related with regard to health care and culture. ⋯ The amounts of dispensed opioids, opioid prescribing habits and changes were compared between the countries, and significant differences appeared. Within each country, the overall picture of opioid consumption appeared rather stable. Implications Studies like this can contribute to qualify the ongoing debates of use of opioids in different nations and to monitor effects of initiatives taken by health-care authorities and health-care policy-makers.
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Background and aims Opioid consumption has increased dramatically in patients with chronic non-cancer pain (CNCP), but long-term consequences are still unclear. The aim of this study is to investigate the effects of long-term opioid treatment on pain, cognition, mood, sleep and quality of life in CNCP patients. Methods In this cross-sectional pilot study, two groups of patients with CNCP treated in a multidisciplinary pain center were selected: (1) opioid group: ≥30 mg morphine equivalent/day for >4 weeks, and (2) control group: no opioid consumption for >4 weeks. ⋯ Interestingly, the patients assessed, regardless of taking opioids or not, could be classified with moderate pain intensity, anxiety and low quality of sleep and life compared to norm standards. Implications The findings of this pilot study suggested that long-term opioid treatment may influence pain and quality of life among CNCP patients. A larger cohort is needed to verify these findings.
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Background and aims This study aimed to determine, from the perspective of individuals living with the condition, what decreases their low back pain (LBP). LBP affects most people at some point during their life. The condition has a meaningful effect on people's lives including pain, reduced physical and social function, mood fluctuations, and a reduced ability to work. ⋯ From one perspective, there is the implication that public education about efficacious treatments may need to be enhanced as there is a discrepancy between research findings and the perspectives of individuals living with LBP. On the other hand, these findings also suggest that it is timely to re-examine the focus of LBP research to consider outcomes that are valuable to people living with the condition, which this study implies should include short term or temporary effects. The findings may also help clinicians tailor management to suit the individual patients by increasing the awareness that patient and research perspectives may at times diverge.