Pain Research & Management最新文献

Objectives: To develop effective, individualized pain science education for people with chronic (primary) pain, underlying pain concepts, defined as the understanding of what pain is, what function it serves, and what processes are thought to underpin it, are essential. Pain concepts and misconcepts of chronic pain can influence its development and maintenance. This study explores whether profiles of healthy adults' biopsychosocial pain concepts can be identified using a newly developed tool, the biopsychosocial pain concept matrix (BiPS matrix), and if adults assigned to the profiles differ regarding sociodemographic and pain-related variables. Methods: N = 229 healthy adults (75% female, M = 22.66 years, SD = 3.61) participated in an online survey. The BiPS matrix assesses biopsychosocial pain concepts through 40 items on the biological, psychological, and social domains combined with the five content dimensions of the common-sense model of self-regulation. Results: A latent profile analysis (LPA) revealed a five-profile solution with distinct patterns of biopsychosocial pain concepts. Participants assigned to Profile 1 demonstrated strongly developed biopsychosocial pain concepts, Profile 2 showed weakly developed concepts, and Profiles 3 to 5 showed different levels of pain concepts. General and neurophysiological pain knowledge differed between profiles, with higher scores being associated with Profile 1 and lower scores with Profile 5. There were no differences in sociodemographic variables in adults assigned to the different profiles. Discussion: Results provide preliminary evidence for distinct profiles of biopsychosocial pain concepts among healthy adults. Further research should replicate these findings in clinical samples to better understand biopsychosocial pain concepts and their use for individualized pain science education.

Objectives: To observe the clinical efficacy of Tiaokou acupoint-penetrating Chengshan combined with conventional therapy for C5 nerve root palsy after posterior cervical decompression surgery. Methods: A total of 52 patients undergoing posterior cervical decompression surgery at Tianjin Union Medical Center from March 2020 to March 2023 were grouped using computer-generated random numbers. Group A (n = 26) received the treatment of acupuncture combined with conventional therapy. Group B (n = 26) received only conventional therapy. Results: The VAS scores of the two groups after treatment were significantly lower than scores before treatment (p < 0.01). The JOA scores, Lovett muscle strength grade, and shoulder ROM of the two groups after treatment were significantly higher than those before treatment (p < 0.01). After treatment, the VAS scores of Group A were significantly lower than those in Group B (p < 0.01) while the JOA scores, Lovett muscle strength grade, and shoulder ROM were significantly higher than those in Group B (p < 0.01). There were significant differences in VAS difference (p < 0.01) and JOA difference (p < 0.01) after 2 weeks of intervention treatment in Group A compared to Group B. There was a significant difference in the improvement of shoulder ROM in Group A after 2 weeks of intervention compared to Group B. Conclusions: The acupuncture method of Tiaokou acupoint-penetrating Chengshan combined with conventional nutritional support therapy was more effective in patients with C5 nerve root palsy after posterior cervical decompression surgery compared to conventional nutritional support therapy. Trial Registration: Clinical Trial Registry identifier: ChiCTR2300073583.

Purpose: Acute postoperative pain is a typical complaint following cesarean delivery (CD). The current standard for postcesarean pain management is the use of a multimodal analgesia regimen which is beneficial for many but may be inadequate for some patients. This study aimed to determine if combining patients' response to a pain rating questionnaire, their pain score during local anesthetic infiltration (LAI) preceding spinal anesthesia for CD, and an anesthesiologist's prediction of postcesarean pain severity can predict the intensity of postcesarean pain. Methods: This was a prospective study of ninety women undergoing scheduled CD under spinal anesthesia. Patients completed a pain rating questionnaire preoperatively and rated pain on LAI before spinal injection, and an anesthesiologist predicted the severity of postcesarean pain. Postoperative pain scores were assessed at rest and with movement at 6, 24, and 48 h after surgery. Results: The patient's expected postoperative pain (β = 0.39, p=0.0011), perceived analgesic requirements (β = 0.34, p=0.0002), pain on LAI (β = 0.22, p=0.004), and anesthesiologist's predicted postoperative pain severity (β = 0.22, p=0.01) were associated with mean postoperative pain after CD. The multivariate model analysis found that the pain rating questionnaire and the an anesthesiologist's prediction of postcesarean pain severity contributed to postoperative pain modeling (R ² = 0.27). Conclusion: Combining a preoperative pain rating questionnaire with an anesthesiologist's prediction of postcesarean pain severity accounted for 27% of the variance in mean postoperative pain with movement and may be a useful tool in predicting postcesarean pain. Implications: This study highlights the potential of a combined preoperative pain rating questionnaire and anesthesiologist's predictions to improve postcesarean pain management. By accounting for 27% of the variance in mean postcesarean pain with movement, this approach could enhance pain management outcomes for CD patients.

Objectives: Resilience to pain is a protective factor against aversive pain outcomes, such as suicide. Religiosity as a cornerstone of resilience has been found to be associated with reduced risk of suicidality in chronic pain. However, affiliations to different religions have displayed differences in suicide risk. This study focuses on the roles of pain resilience and Dao religion in mitigating suicidal experience in individuals with chronic pain. Methods: This study adopted a mixed-method approach. A preliminary investigation was conducted regarding the internal consistency and construct validity of the translated version of the pain resilience scale (PRS). Qualitative data were collected through interviews with individuals experiencing chronic pain. Levels of PRS and gender were included in the logistic regression on the probability of suicide attempts. The role of Dao practice was qualitatively analyzed through narrative analysis. Results: Among the 24 participants, 14 were affiliated with the Dao religion; therefore, the transcripts of these 14 interviews were analyzed. Individuals with moderate scores on the PRS were 11.60 times less likely to have attempted suicide than those with low PRS scores. The likelihood further decreased by 38.7 times in those with high PRS scores. Four themes emerged from the qualitative interviews. The participants experienced a burden from pain, made efforts to please the deities in exchange for better pain control, continuously adjusted to pain, and ultimately developed a new perspective on the relationship between their religion and pain. Many individuals have engaged in Dao rituals to try to alleviate their physical and psychological pain. Most participants tended to offer a religious interpretation of enlightening moments after surviving a suicide attempt. Discussion: This study illustrates how pain resilience and Dao religious practices mitigate suicidality in chronic pain. Trial Registration: ClinicalTrials.gov identifier: NCT05148364.

Background: Persistent spinal pain syndrome type-2 (PSPS-II) is a chronic condition that is characterized by severe pain and results in disability and a significant reduction in quality of life. Despite the wide range of interventional pain treatments that are applied, depending on the complexity of the etiology, epidural pulsed radiofrequency (EPRF) application has emerged as an approach that has gained popularity in recent years. Objective: The objective of this study is to examine the efficacy of EPRF in patients diagnosed with PSPS-II. Methodology: In this prospectively designed study, patients with PSPS-II who had not responded to conservative treatments and epidural steroid injections were subjected to fluoroscopy-guided EPRF. Patients were evaluated with the Numeric Rating Scale (NRS) for pain severity and the Douleur Neuropathique-4 (DN-4) questionnaire for presence of neuropathic pain before the procedure and at one and three months after. Although the change in NRS score was established as the primary outcome measure, the change in the number of patients with neuropathic pain according to the DN-4 was determined as the secondary outcome measure. Result: In the final analysis, data from 42 patients were evaluated. The analysis of the time-dependent change in NRS revealed a statistically significant reduction in the scores for the first and third months, in comparison with the initial measurement. A significant decrease was observed in the number of patients diagnosed with neuropathic pain according to the DN-4 questionnaire in the first month, in comparison with the baseline. However, no significant change was noted in the third month. Conclusion: The utilization of EPRF for the treatment of chronic radicular pain in the setting of PSPS-II appears to be effective in the short term. Further studies are required to ascertain its long-term effects. Trial Registration: ClinicalTrials.gov identifier: NCT06239857.

Objective: To investigate the effects of experimental pain and visual feedback on the accuracy and precision of knee joint position sense following a period of motor training. Methods: Forty healthy young subjects (age: 24.5 ± 3.6 years old) underwent an 8 day motor training. After the training, they were instructed to perform a knee reposition task before and after receiving an injection of either hypertonic (pain group) or isotonic (control group) saline into the infrapatellar fat pad of the left knee. The Visual Analog Scale (VAS) was recorded for both groups. In each condition, participants were instructed to extend their knee to three predetermined target positions (30°, 45°, and 60°) for 10 repetitions, both with visual feedback (VF) and without visual feedback (NVF). The accuracy and precision of the knee reposition task were measured before and after the injection. Accuracy was determined by calculating the mean difference between the target angle and the actual angle achieved, while precision was determined by calculating the standard deviation of all actual angles. Data were analyzed using two-way ANOVAs and independent-samples t-tests to compare the pain and control groups. Results: The VAS were 4.14 ± 2.48 for the pain group and 0.83 ± 0.89 for the control group. There was a significant decrease in knee accuracy after the injection of hypertonic saline compared to movements before the injection during VF (p=0.009). The pain group showed significantly worse knee accuracy compared to the control group in the relative change of performance during VF (p=0.015). Conclusions: This study demonstrates that experimental knee pain impairs the accuracy of joint position sense, even after a period of motor training. This could serve as a helpful cue for individuals with knee pain to pursue timely treatment, thereby reducing the risk of additional injury. Trial Registration: ClinicalTrials.gov identifier: NCT04146311.

Objective: Chronic postsurgical pain (CPSP) is a significant yet often underrecognized complication following surgical procedures, impacting patients' quality of life. Surgical nurses play a crucial role in postoperative care and pain management, making their knowledge of CPSP essential for improving patient outcomes. The aim of the study was to assess CPSP knowledge among surgical nurses in a Turkish University Hospital. Methods: This descriptive cross-sectional study included a total of 175 nurses. Data were collected from nurses employed in the surgical units of İnönü University hospital between May 15 and June 15, 2023. Personal information and knowledge-level forms created by the researchers were used for data collection. IBM SPSS Statistics v.25 was used for the statistical analysis. Results: The mean CPSP knowledge score of the nurses working in surgical clinics was 9.26 ± 1.40 (min. = 0, max. = 12) and 75.4% of them had sufficient knowledge. Surgical nurses' knowledge level of CPSP was influenced by their education level (p ≤ 0.001) and total duration of employment in the surgical department (p=0.002). Conclusions: Although most surgical nurses had sufficient CPSP knowledge, gaps remained, particularly among those with lower education levels and less experience. Targeted training programs and continuous professional development initiatives are recommended to enhance CPSP awareness and improve postoperative pain management practices.

Introduction: Few studies compare differences in the use of nonpharmacologic interventions (NPIs) between those with high-impact chronic pain (HICP) and low-impact chronic pain (LICP) or describe differences in the use of NPIs by locations of bothersome pain. Objectives: To describe the use of NPIs in HICP and LICP subgroups and to examine the association between locations of bothersome pain and use of NPIs among those with HICP. Methods: We used data from the 2019 National Health Interview Survey. After identifying respondents who reported having chronic pain, we then created high and low pain impact subgroups. Additional variables in our analyses included sociodemographic data, health characteristics, and pain management characteristics. Our analysis included descriptive statistics, Chi-squared tests, and adjusted survey-weighted logistic regression models. Results: The estimated prevalence of chronic pain in US adults was 19.9% (95% CI: 19.5-20.0), with 36.4% (95% CI: 35.1-38.0) of that group having HICP. Of those with HICP, 69.7% (95% CI: 67.6-71.9) reported using ≥ 1 NPIs in the past 3 months, compared to 62.9% (95% CI: 61.1-64.6) with LICP. The most frequently used NPI was physical, rehabilitative, or occupational therapy (25.9%, 95% CI: 24.0-27.9), and the least used was a peer support group (2.7%, 95% CI: 2.0-3.6). Among those with HICP, bothersome back pain (OR = 1.52, 95% CI: 1.19-1.95) and upper extremity pain (OR = 1.26, 95% CI: 1.003-1.59) are associated with the greater use of any NPIs compared to those without bothersome pain at these sites, respectively. Conclusion: Our findings highlight that most US adults with HICP have recently used NPIs to manage their pain, but the use of specific NPIs varied considerably. The odds of using NPIs were different depending on the locations of bothersome pain. Future work should examine barriers for access to specific NPIs or the use of NPIs by locations of bothersome pain.

Background: Dezocine is a leading analgesic in China used for relieving moderate to severe pain. Previous studies have characterized its pharmacological properties, demonstrating its role as a partial agonist at both the κ-opioid receptor (KOR) and the μ-opioid receptor (MOR), thereby producing potent antinociceptive effects in acute pain models. However, its efficacy and mechanisms in chronic pain management remained unclear. Methods: Chronic pain models, including chronic neuropathic pain and cancer pain, were employed using chronic constriction injury (CCI) of the sciatic nerve and bone cancer pain (BCP) methodologies, respectively. The assessment of the mechanical allodynia was conducted using a von Frey filament. Results: Dezocine, administered via the intraperitoneal route, alleviated both neuropathic pain and cancer pain in a dose-dependent manner, with ED₅₀ of 1.3 mg/kg and 1.6 mg/kg, respectively. In the CCI model, the analgesic effect of dezocine was significantly inhibited by pretreating with KOR antagonist nor-BNI, MOR antagonist β-FNA, α2-adrenoceptor antagonist yohimbine, and 5-HT2A receptor antagonist altanserin. In the BCP model, dezocine-induced analgesia was markedly suppressed by nor-BNI, β-FNA, and yohimbine but not altanserin. Conclusion: These results suggest that, in neuropathic pain, the analgesic effects of dezocine are mediated through KOR and MOR activation, together with norepinephrine reuptake inhibition (NRI) and serotonin reuptake inhibition. In contrast, in cancer pain, KOR and MOR activation and NRI are involved in mediating the analgesic effect of dezocine. This study, along with previous data, enhances our understanding of the potential clinical utility of dezocine and elucidates its mechanisms of action in chronic pain management.