Articles: pain-measurement.
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Randomized Controlled Trial
Predictors of subacute postoperative pain after total knee arthroplasty: A secondary analysis of two randomized trials.
Methods for identifying high-pain responders undergoing total knee arthroplasty remain important to improve individualized pain management. This study aimed at evaluating pre- and perioperative predictors of pain on Days 2-7 after total knee arthroplasty. ⋯ This study investigated factors associated with pain after total knee arthroplasty beyond the immediate postoperative period. The analysis revealed significant associations between preoperative pain levels and, particularly, pain 24 h postoperatively, with subsequent subacute pain the following week. These findings can assist in identifying patients who would benefit from enhanced, individualized analgesic interventions to facilitate postoperative recovery.
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The concept "nociplastic pain" has been developed for patients with features of nociceptive system sensitization that are not explained as nociceptive or neuropathic. Here, we tested how well the recently published grading system differentiates between chronic primary and secondary pain conditions. We recruited patients with fibromyalgia (FMS, n = 41), complex regional pain syndrome (CRPS, n = 11), osteoarthritis (OA, n = 21), or peripheral nerve injury (PNI, n = 8). ⋯ Based on these data, specificity remained excellent (93%), but sensitivity dropped substantially (60%) due to lacking evidence for pain hypersensitivity in many patients with FMS. This low sensitivity suggests that the published grading system is not suitable for screening purposes. We suggest structural and content modifications to improve sensitivity, including placement of patient history before clinical examination and addition of a high tender point count as evidence for widespread pain hypersensitivity.
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To investigate the relationship between offset analgesia magnitude and the responsiveness to conditioned pain modulation (CPM), temporal summation of (second) pain (TSP), and clinical pain severity in people with knee osteoarthritis (KOA). ⋯ Offset analgesia was not associated with CPM, TSP, or KOOS PAIN in people with KOA. Despite the lack of case-control studies comparing offset analgesia between people with KOA and healthy controls, these findings suggest that offset analgesia may provide information about endogenous pain modulation beyond CPM and TSP, though its clinical translation remains uncertain.
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Tactile-induced analgesia (TIA) is a phenomenon in which different types of tactile stimulation alleviate pain via different mechanisms including empathy. As TIA plays an essential role in therapeutic situations and clinical conditions, it is crucial to determine whether specific tactile stimulations confer distinct benefits. ⋯ This article explores the effectiveness of touch-based pain relief methods and their association with empathetic therapeutic interactions. The study emphasizes the significance of positive therapeutic interactions in facilitating tactile-induced analgesia.
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Background: The current research aims to elucidate the interplay between the anatomical distribution of spinal metastases, MRI features, and the intensity of bone pain in patients with breast cancer. Methods: A retrospective analysis was used on a cohort of 45 breast cancer patients with verified spinal metastases, examining the relationship between metastatic locations, MRI-derived metrics, and bone pain scores. The Visual Analogue Scale (VAS) was conducted to measure the severity of bone pain. ⋯ Conclusions: The study's outcomes indicate that distinct MRI profiles, including the number and location of spinal metastases, can serve as prognostic indicators of bone pain intensity in breast cancer patients. Our data highlighted the need for personalized pain management strategies and targeted interventions tailored to specific imaging characteristics. Ultimately, this research underscores the dual role of MRI in both detecting spinal metastases and informing symptom management, with the potential to augment the overall well-being of breast cancer patients with spinal involvement.