Pub Date : 2022-06-06eCollection Date: 2022-07-01DOI: 10.1097/PR9.0000000000001009
Peter M Mullins, Robert J Yong, Neil Bhattacharyya
Introduction: Chronic pain affects more than 1 in 5 American adults, and its effects are not evenly distributed throughout the population.
Methods: Using the National Health Interview Survey (NHIS), a household-based annual survey of self-reported health status of U.S. adults, this cross-sectional study describes differences in the prevalence of chronic pain and its effects across socioeconomic groups.
Results: In univariate analyses, chronic pain was more prevalent among female respondents, persons with lower educational attainment, non-Hispanic White individuals, and those who were insured as well as those who were married. After accounting for all other demographic factors, age, female sex, and lower educational attainment were associated with higher odds of having chronic pain, whereas Hispanic and non-Hispanic Black race were associated with lower odds. Despite lower odds of having chronic pain, Hispanic and non-Hispanic Black race were associated with greater odds of reporting more severe pain than White race. There were no significant differences across race in the effects of pain on life, work, or family, although female sex and lower educational attainment were associated with greater effects of pain on these domains. Educational attainment was the only characteristic associated with greater odds of ineffective pain management after accounting for all other demographic factors.
Conclusions: Implications for reducing disparities in the treatment of chronic pain are discussed.
{"title":"Impact of demographic factors on chronic pain among adults in the United States.","authors":"Peter M Mullins, Robert J Yong, Neil Bhattacharyya","doi":"10.1097/PR9.0000000000001009","DOIUrl":"10.1097/PR9.0000000000001009","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain affects more than 1 in 5 American adults, and its effects are not evenly distributed throughout the population.</p><p><strong>Methods: </strong>Using the National Health Interview Survey (NHIS), a household-based annual survey of self-reported health status of U.S. adults, this cross-sectional study describes differences in the prevalence of chronic pain and its effects across socioeconomic groups.</p><p><strong>Results: </strong>In univariate analyses, chronic pain was more prevalent among female respondents, persons with lower educational attainment, non-Hispanic White individuals, and those who were insured as well as those who were married. After accounting for all other demographic factors, age, female sex, and lower educational attainment were associated with higher odds of having chronic pain, whereas Hispanic and non-Hispanic Black race were associated with lower odds. Despite lower odds of having chronic pain, Hispanic and non-Hispanic Black race were associated with greater odds of reporting more severe pain than White race. There were no significant differences across race in the effects of pain on life, work, or family, although female sex and lower educational attainment were associated with greater effects of pain on these domains. Educational attainment was the only characteristic associated with greater odds of ineffective pain management after accounting for all other demographic factors.</p><p><strong>Conclusions: </strong>Implications for reducing disparities in the treatment of chronic pain are discussed.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"7 1","pages":"e1009"},"PeriodicalIF":4.8,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10833639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45403250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-06eCollection Date: 2022-07-01DOI: 10.1097/PR9.0000000000001015
Salene M W Jones, Joseph M Unger
Introduction: Current methods of determining minimally important differences (MIDs) in patient-reported outcomes (PROs) do not incorporate individual patient values.
Objectives: This study tested the feasibility of having cancer patients define a personally meaningful change in pain intensity, a method we have termed Precision PROs.
Methods: Adults with cancer and pain (n = 231) completed an electronic questionnaire twice over 2 weeks. Participants were then given their pain intensity scores with an explanation of score meaning. Participants then defined their own MIDs for an increase and decrease in pain intensity. Participants also answered 3 questions testing their understanding of the MID concept.
Results: The majority of participants could define an individually meaningful increase (97% [n = 223]) and individually meaningful decrease (98% [n = 226]) in pain intensity. Seventy-two percent of participants (n = 166) answered all test questions correctly and 26% (n = 60) answered 2 of 3 correctly. Using the individual MID, 32% (95% CI: 25.3, 40.0) of the sample experienced a meaningful change between the 2 surveys, more than other methods (z-test: 14%, 95% CI: 9.4, 20.6; distribution-based method: 24%, 95% CI: 17.7, 31.1).
Conclusions: This study showed the feasibility of the Precision PRO individual MID, which could be used in clinical care or clinical trials. Further studies are needed to compare the individual MID to current methods.
{"title":"Feasibility of a patient-centered method to determine meaningful change in pain intensity on a survey of patients with a history of cancer.","authors":"Salene M W Jones, Joseph M Unger","doi":"10.1097/PR9.0000000000001015","DOIUrl":"10.1097/PR9.0000000000001015","url":null,"abstract":"<p><strong>Introduction: </strong>Current methods of determining minimally important differences (MIDs) in patient-reported outcomes (PROs) do not incorporate individual patient values.</p><p><strong>Objectives: </strong>This study tested the feasibility of having cancer patients define a personally meaningful change in pain intensity, a method we have termed Precision PROs.</p><p><strong>Methods: </strong>Adults with cancer and pain (n = 231) completed an electronic questionnaire twice over 2 weeks. Participants were then given their pain intensity scores with an explanation of score meaning. Participants then defined their own MIDs for an increase and decrease in pain intensity. Participants also answered 3 questions testing their understanding of the MID concept.</p><p><strong>Results: </strong>The majority of participants could define an individually meaningful increase (97% [n = 223]) and individually meaningful decrease (98% [n = 226]) in pain intensity. Seventy-two percent of participants (n = 166) answered all test questions correctly and 26% (n = 60) answered 2 of 3 correctly. Using the individual MID, 32% (95% CI: 25.3, 40.0) of the sample experienced a meaningful change between the 2 surveys, more than other methods (<i>z</i>-test: 14%, 95% CI: 9.4, 20.6; distribution-based method: 24%, 95% CI: 17.7, 31.1).</p><p><strong>Conclusions: </strong>This study showed the feasibility of the Precision PRO individual MID, which could be used in clinical care or clinical trials. Further studies are needed to compare the individual MID to current methods.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"7 1","pages":"e1015"},"PeriodicalIF":4.8,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10833635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42372436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-07eCollection Date: 2022-05-01DOI: 10.1097/PR9.0000000000000999
Richard Harrison, Wiebke Gandhi, Carien M van Reekum, Tim V Salomons
Introduction: Conditioned pain modulation (CPM) is a psychophysical assessment used to estimate the efficiency of an individual's endogenous modulatory mechanisms. Conditioned pain modulation has been used as a predictive assessment for the development of chronic pain and responses to pain interventions. Although much is known about the spinal cord mechanisms associated with descending pain modulation, less is known about the contribution of supraspinal and especially cortical regions.
Objectives: We aimed to explore how whole-brain connectivity of a core modulatory region, the periaqueductal grey (PAG), is associated with conditioned pain modulation, and endogenous pain modulation more broadly.
Methods: We measured CPM and resting-state connectivity of 35 healthy volunteers, absent of chronic pain diagnoses. As a region of interest, we targeted the PAG, which is directly involved in endogenous modulation of input to the spinal cord and is a key node within the descending pain modulation network.
Results: We found that CPM was associated with heightened connectivity between the PAG and key regions associated with pain processing and inhibition, such as the primary and secondary somatosensory cortices, as well as the motor, premotor, and dorsolateral prefrontal cortices. These findings are consistent with connectivity findings in other resting-state and event-related fMRI studies.
Conclusion: These findings indicate that individuals who are efficient modulators have greater functional connectivity between the PAG and regions involved in processing pain. The heightened connectivity of these regions may contribute to the beneficial outcomes in clinical pain management, as quantified by CPM. These results may function as brain-based biomarkers for vulnerability or resilience to pain.
{"title":"Conditioned pain modulation is associated with heightened connectivity between the periaqueductal grey and cortical regions.","authors":"Richard Harrison, Wiebke Gandhi, Carien M van Reekum, Tim V Salomons","doi":"10.1097/PR9.0000000000000999","DOIUrl":"10.1097/PR9.0000000000000999","url":null,"abstract":"<p><strong>Introduction: </strong>Conditioned pain modulation (CPM) is a psychophysical assessment used to estimate the efficiency of an individual's endogenous modulatory mechanisms. Conditioned pain modulation has been used as a predictive assessment for the development of chronic pain and responses to pain interventions. Although much is known about the spinal cord mechanisms associated with descending pain modulation, less is known about the contribution of supraspinal and especially cortical regions.</p><p><strong>Objectives: </strong>We aimed to explore how whole-brain connectivity of a core modulatory region, the periaqueductal grey (PAG), is associated with conditioned pain modulation, and endogenous pain modulation more broadly.</p><p><strong>Methods: </strong>We measured CPM and resting-state connectivity of 35 healthy volunteers, absent of chronic pain diagnoses. As a region of interest, we targeted the PAG, which is directly involved in endogenous modulation of input to the spinal cord and is a key node within the descending pain modulation network.</p><p><strong>Results: </strong>We found that CPM was associated with heightened connectivity between the PAG and key regions associated with pain processing and inhibition, such as the primary and secondary somatosensory cortices, as well as the motor, premotor, and dorsolateral prefrontal cortices. These findings are consistent with connectivity findings in other resting-state and event-related fMRI studies.</p><p><strong>Conclusion: </strong>These findings indicate that individuals who are efficient modulators have greater functional connectivity between the PAG and regions involved in processing pain. The heightened connectivity of these regions may contribute to the beneficial outcomes in clinical pain management, as quantified by CPM. These results may function as brain-based biomarkers for vulnerability or resilience to pain.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"7 1","pages":"e999"},"PeriodicalIF":3.4,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9084428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41402612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001006
C. E. Taylor, C. Murray, T. Stanton
Supplemental Digital Content is Available in the Text. Patient perspectives highlight the need for presurgical information about expected recovery trajectories after total knee replacement and enhanced postsurgical follow-up with practical support. Abstract Introduction: Joint replacement surgery typically results in good clinical outcome, although some people experience suboptimal pain relief and functional improvement. Predicting surgical outcome is difficult. Objectives: There is merit in better understanding patients' perspectives of pain and function to identify avoidable problems perceived to contribute to their outcome, to inform prognostic expectations, and to identify potential cointerventions to sit alongside surgery that might mitigate pain/functional problems. Here, we aimed to synthesise the available literature exploring perspectives of people with knee osteoarthritis about their pain and function following joint replacement. Methods: Six electronic databases and 2 websites were searched. Two independent reviewers completed study inclusion, quality assessment, and data extraction. Data were iteratively synthesised using first-, second-, and third-order analyses. Results: Twenty-eight studies were included. Four themes were identified; perceptions of pain and function were inseparable. Theme 1 addressed experiences of recovery after surgery, which often differed from expectations. Theme 2 described the challenges of the pain experience and its functional impact, including the difficulty navigating medication use in context of personal beliefs and perceived stigma. Theme 3 articulated the toll of ongoing problems spanning pain–function–mood, necessitating the need to “endure.” Theme 4 encompassed the importance of clinical/social interactions on mood and pain, with reports of concerns dismissed and practical support missing. Conclusions: Together, these findings show that numerous individual considerations beyond the technical aspects of surgery influence experiences of pain and function. A tailored approach addressing these considerations from the patient perspective could provide a basis for improved success of knee replacement surgery.
{"title":"Patient perspectives of pain and function after knee replacement: a systematic review and meta-synthesis of qualitative studies","authors":"C. E. Taylor, C. Murray, T. Stanton","doi":"10.1097/PR9.0000000000001006","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001006","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Patient perspectives highlight the need for presurgical information about expected recovery trajectories after total knee replacement and enhanced postsurgical follow-up with practical support. Abstract Introduction: Joint replacement surgery typically results in good clinical outcome, although some people experience suboptimal pain relief and functional improvement. Predicting surgical outcome is difficult. Objectives: There is merit in better understanding patients' perspectives of pain and function to identify avoidable problems perceived to contribute to their outcome, to inform prognostic expectations, and to identify potential cointerventions to sit alongside surgery that might mitigate pain/functional problems. Here, we aimed to synthesise the available literature exploring perspectives of people with knee osteoarthritis about their pain and function following joint replacement. Methods: Six electronic databases and 2 websites were searched. Two independent reviewers completed study inclusion, quality assessment, and data extraction. Data were iteratively synthesised using first-, second-, and third-order analyses. Results: Twenty-eight studies were included. Four themes were identified; perceptions of pain and function were inseparable. Theme 1 addressed experiences of recovery after surgery, which often differed from expectations. Theme 2 described the challenges of the pain experience and its functional impact, including the difficulty navigating medication use in context of personal beliefs and perceived stigma. Theme 3 articulated the toll of ongoing problems spanning pain–function–mood, necessitating the need to “endure.” Theme 4 encompassed the importance of clinical/social interactions on mood and pain, with reports of concerns dismissed and practical support missing. Conclusions: Together, these findings show that numerous individual considerations beyond the technical aspects of surgery influence experiences of pain and function. A tailored approach addressing these considerations from the patient perspective could provide a basis for improved success of knee replacement surgery.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48636329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001008
Zachary Ashmore, Michael M. Bies, James B. Meiling, Rajat N Moman, L. Hassett, Christine L. Hunt, Steven P. Cohen, W. Hooten
Supplemental Digital Content is Available in the Text. In this systematic review and meta-analysis, ultrasound-guided lumbar medial branch blocks and facet joint injections were associated with significant risk of incorrect needle placement.
{"title":"Ultrasound-guided lumbar medial branch blocks and intra-articular facet joint injections: a systematic review and meta-analysis","authors":"Zachary Ashmore, Michael M. Bies, James B. Meiling, Rajat N Moman, L. Hassett, Christine L. Hunt, Steven P. Cohen, W. Hooten","doi":"10.1097/PR9.0000000000001008","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001008","url":null,"abstract":"Supplemental Digital Content is Available in the Text. In this systematic review and meta-analysis, ultrasound-guided lumbar medial branch blocks and facet joint injections were associated with significant risk of incorrect needle placement.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49357006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001014
Nipaporn Akkarakittichoke, M. Jensen, A. Newman, Pooriput Waongenngarm, Prawit Janwantanakul
Number of working hours, work-related psychological demands, and use of lumbar support moderate the beneficial effects of preventive interventions for neck and low back pain. Abstract Introduction: Neck and low back pain are significant health problem in sedentary office workers. Active break and postural shift interventions has been proved to reduce the incidence of new onset of both neck and low back pain. Objectives: To identify variables that moderate the effects of active breaks and postural shift interventions on the development of neck and low back pain in office workers. Methods: Using data from a 3-arm (active break, postural shift, and control group) cluster randomized controlled trial (N = 193), we evaluated the moderating effects of age, job position, education level, sex, perceived psychological work demands, number of working hours, and using a chair with lumbar support on the benefits of 2 interventions designed to prevent the development of neck and low back pain in office workers. Moderation analyses were conducted using the Hayes PROCESS macro, with post hoc Johnson–Neyman techniques and logistic regressions. Results: Significant interactions between intervention groups and 3 moderators assessed at baseline emerged. For the prevention of neck pain, the effect of the active break intervention was moderated by the number of working hours and the effect of the postural shift intervention was moderated by the level of perceived psychological work demands and the number of working hours. For the prevention of low back pain, the effect of postural shift intervention was moderated by having or not having a chair with lumbar support. Conclusions: The study findings can be used to help determine who might benefit the most from 2 treatments that can reduce the risk of developing neck and low back pain in sedentary workers and may also help us to understand the mechanisms underlying the benefits of these interventions.
{"title":"Characteristics of office workers who benefit most from interventions for preventing neck and low back pain: a moderation analysis","authors":"Nipaporn Akkarakittichoke, M. Jensen, A. Newman, Pooriput Waongenngarm, Prawit Janwantanakul","doi":"10.1097/PR9.0000000000001014","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001014","url":null,"abstract":"Number of working hours, work-related psychological demands, and use of lumbar support moderate the beneficial effects of preventive interventions for neck and low back pain. Abstract Introduction: Neck and low back pain are significant health problem in sedentary office workers. Active break and postural shift interventions has been proved to reduce the incidence of new onset of both neck and low back pain. Objectives: To identify variables that moderate the effects of active breaks and postural shift interventions on the development of neck and low back pain in office workers. Methods: Using data from a 3-arm (active break, postural shift, and control group) cluster randomized controlled trial (N = 193), we evaluated the moderating effects of age, job position, education level, sex, perceived psychological work demands, number of working hours, and using a chair with lumbar support on the benefits of 2 interventions designed to prevent the development of neck and low back pain in office workers. Moderation analyses were conducted using the Hayes PROCESS macro, with post hoc Johnson–Neyman techniques and logistic regressions. Results: Significant interactions between intervention groups and 3 moderators assessed at baseline emerged. For the prevention of neck pain, the effect of the active break intervention was moderated by the number of working hours and the effect of the postural shift intervention was moderated by the level of perceived psychological work demands and the number of working hours. For the prevention of low back pain, the effect of postural shift intervention was moderated by having or not having a chair with lumbar support. Conclusions: The study findings can be used to help determine who might benefit the most from 2 treatments that can reduce the risk of developing neck and low back pain in sedentary workers and may also help us to understand the mechanisms underlying the benefits of these interventions.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43263699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001010
Yun Wang, Dan Wu, A. Chan, Chih-Hung Chang, V. Lee, M. Nichol
Supplemental Digital Content is Available in the Text. Abstract Introduction: The opioid epidemic persists in the United States. The use of opioid medications is often assessed by claims data but potentially underestimated. Objectives: We evaluated the temporal trend in the use of opioid and nonopioid pain medications from a national survey. Methods: Using data from the 2001 to 2018 National Health and Nutrition Examination Survey (NHANES), we examined the current use of prescription analgesics in the past 30 days among 50,201 respondents aged 20 years or older. Joinpoint regressions were used to test statistically meaningful trends of opioid vs nonopioid analgesics. Results: The mean percentage of people who had pain medications in the past 30 days was 6.4% (5.3%-7.1%) for opioid and 11.3% (9.0%-14.8%) for nonopioid analgesics. The availability of opioid and nonopioid prescriptions at home has remained stable, except for the slight decline of opioids among cancer-free patients in 2005 to 2018. The most frequently used opioid analgesic medications included hydrocodone/acetaminophen, tramadol, and hydrocodone. Conclusion: We uniquely measured the proportion of people who had opioid and nonopioid pain medications at home in the United States and supplemented the previous knowledge of prescription rates mainly obtained from claims data.
{"title":"Temporal trend of opioid and nonopioid pain medications: results from a national in-home survey, 2001 to 2018","authors":"Yun Wang, Dan Wu, A. Chan, Chih-Hung Chang, V. Lee, M. Nichol","doi":"10.1097/PR9.0000000000001010","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001010","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Abstract Introduction: The opioid epidemic persists in the United States. The use of opioid medications is often assessed by claims data but potentially underestimated. Objectives: We evaluated the temporal trend in the use of opioid and nonopioid pain medications from a national survey. Methods: Using data from the 2001 to 2018 National Health and Nutrition Examination Survey (NHANES), we examined the current use of prescription analgesics in the past 30 days among 50,201 respondents aged 20 years or older. Joinpoint regressions were used to test statistically meaningful trends of opioid vs nonopioid analgesics. Results: The mean percentage of people who had pain medications in the past 30 days was 6.4% (5.3%-7.1%) for opioid and 11.3% (9.0%-14.8%) for nonopioid analgesics. The availability of opioid and nonopioid prescriptions at home has remained stable, except for the slight decline of opioids among cancer-free patients in 2005 to 2018. The most frequently used opioid analgesic medications included hydrocodone/acetaminophen, tramadol, and hydrocodone. Conclusion: We uniquely measured the proportion of people who had opioid and nonopioid pain medications at home in the United States and supplemented the previous knowledge of prescription rates mainly obtained from claims data.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45418535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001002
F. Tu
After endless COVID-19 we were finally able to meet in person at the 24th International Pelvic Pain Society (IPPS) the The 2021 program featured several interesting and innovative research projects conducted by investigators around the globe, while the hybrid format allowed for both virtual and in-person collaboration. The abstracts presented here underwent a rigorous peer review process, whereby each abstract was evaluated by at least 2 members of the Scientific Program, Abstract, or Research IPPS committees. Abstracts were rejected if they were incomplete, if they had inadequate statistical analysis, or if the topic was not relevant to pain. Case reports were accepted for presentation but are excluded from this publication. Methods: This study followed PROMIS guidelines. We created potential PROM items in reference to IMMPACT recommenda-tions. These items were iteratively reviewed by a panel of dyspareunia experts: patient partners (n 5 4), gynecologists (n 5 2), and a psychiatrist (n 5 1). Panelists voted for inclusion, modification, or exclusion of items based on clarity and relevance. Panelists also provided suggestions for revisions or new items. Items that reached consensus ( $ 80% inclusion votes) were accepted into the PROM. New and modified items appeared on subsequent survey iterations alongside the associated votes and comments from the preceding survey. Results: Panelists reviewed 163 items. Items with $ 80% inclusion votes fell into categories of pain location, intensity, quality, timing, or effect of pain on behaviors, cognitions, affect, and sexuality. Conclusions: Items that reached consensus displayed clarity, clinical relevance, experiential relevance, and comprehensive-ness about the dyspareunia experience. The e-Delphi process contributes to establishing PROM content validity by using expert opinion to reach a consensus. Future work should use qualitative and psychometric testing to further establish validity and reliability. in a prospective study of menstrual pain. Visual and visceral sensitivity was experimentally quantified in a cohort of women (n 147) at greater risk for developing CPP (ie, mild-to-severe dysmenorrhea). Scalp EEG (electroencephalography) was recorded while participants were presented with a periodic pattern-reversal checkerboard stimulus across 5 brightness intensities to measure the visual cortex activity. Visual sensitivity was assessed using visual unpleasantness ratings provided after each brightness intensity. Visceral sensitivity was assessed using our validated bladder-filling task and visual analog scale ratings of menstrual pain. 117 participants), hypnotherapy (1 study and 36 participants), local anesthetic trigger point injections (1 study and 29 participants), and oxytocin nasal spray (1 study and 21 participants). Conclusions: Many studies showed a placebo effect possibly indicating that simple acknowledgement of pain symptoms with a treatment plan can improve pain. Physical therapy showed s
{"title":"Abstracts from the International Pelvic Pain Society Annual Scientific Meeting on Pelvic Pain 2021","authors":"F. Tu","doi":"10.1097/PR9.0000000000001002","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001002","url":null,"abstract":"After endless COVID-19 we were finally able to meet in person at the 24th International Pelvic Pain Society (IPPS) the The 2021 program featured several interesting and innovative research projects conducted by investigators around the globe, while the hybrid format allowed for both virtual and in-person collaboration. The abstracts presented here underwent a rigorous peer review process, whereby each abstract was evaluated by at least 2 members of the Scientific Program, Abstract, or Research IPPS committees. Abstracts were rejected if they were incomplete, if they had inadequate statistical analysis, or if the topic was not relevant to pain. Case reports were accepted for presentation but are excluded from this publication. Methods: This study followed PROMIS guidelines. We created potential PROM items in reference to IMMPACT recommenda-tions. These items were iteratively reviewed by a panel of dyspareunia experts: patient partners (n 5 4), gynecologists (n 5 2), and a psychiatrist (n 5 1). Panelists voted for inclusion, modification, or exclusion of items based on clarity and relevance. Panelists also provided suggestions for revisions or new items. Items that reached consensus ( $ 80% inclusion votes) were accepted into the PROM. New and modified items appeared on subsequent survey iterations alongside the associated votes and comments from the preceding survey. Results: Panelists reviewed 163 items. Items with $ 80% inclusion votes fell into categories of pain location, intensity, quality, timing, or effect of pain on behaviors, cognitions, affect, and sexuality. Conclusions: Items that reached consensus displayed clarity, clinical relevance, experiential relevance, and comprehensive-ness about the dyspareunia experience. The e-Delphi process contributes to establishing PROM content validity by using expert opinion to reach a consensus. Future work should use qualitative and psychometric testing to further establish validity and reliability. in a prospective study of menstrual pain. Visual and visceral sensitivity was experimentally quantified in a cohort of women (n 147) at greater risk for developing CPP (ie, mild-to-severe dysmenorrhea). Scalp EEG (electroencephalography) was recorded while participants were presented with a periodic pattern-reversal checkerboard stimulus across 5 brightness intensities to measure the visual cortex activity. Visual sensitivity was assessed using visual unpleasantness ratings provided after each brightness intensity. Visceral sensitivity was assessed using our validated bladder-filling task and visual analog scale ratings of menstrual pain. 117 participants), hypnotherapy (1 study and 36 participants), local anesthetic trigger point injections (1 study and 29 participants), and oxytocin nasal spray (1 study and 21 participants). Conclusions: Many studies showed a placebo effect possibly indicating that simple acknowledgement of pain symptoms with a treatment plan can improve pain. Physical therapy showed s","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44653000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001012
Megan L Uhelski, Aysegul Gorur, Ted Shi, German Corrales, Kim N Du, Yan Li, Moran Amit, Claudio E Tatsui, Laurence D Rhines, Patrick M Dougherty, Juan P Cata
Introduction: Currently, cancer pain is viewed as a process orchestrated by the release of pronociceptive molecules and the invasion of neural structures, referred to as perineural invasion (PNI). Cancer pain resulting from PNI is well-documented, but the mechanisms leading to peripheral sensitization because of tumor growth are not fully known.
Methods: A retrospective study was used to examine how the use of anti-inflammatory medications affected preoperative pain in patients with oral squamous cell carcinoma cancer. We then used an in vitro coculture model in which dorsal root ganglion (DRG) neurons were incubated together with Fadu human head and neck squamous cell carcinoma cancer cells to explore how cancer cells affect the electrical membrane properties of sensory neurons.
Results: We found that inflammation contributes to preoperative pain in patients with oral squamous cell carcinoma. After coculture with Fadu human head and neck squamous cell carcinoma cancer cells, we identified markers of inflammation in coculture media and found evidence of neuronal sensitization, including spontaneous activity, reduced current thresholds, depolarized resting membrane potential, and enhanced responses to current stimulation in human and rat DRG neurons. In rats, these effects were influenced by sex and age: neurons from young adult female rats were resistant to changes in neuronal activity, in contrast to neurons from older adult female rats or male rats of either age group.
Conclusions: Pro-inflammatory substances released in cancer cell-DRG coculture promoted neuronal hyperexcitability and may contribute to cancer pain after PNI, and these effects may differ across age groups and sexes.
{"title":"Fadu head and neck squamous cell carcinoma induces hyperexcitability of primary sensory neurons in an in vitro coculture model.","authors":"Megan L Uhelski, Aysegul Gorur, Ted Shi, German Corrales, Kim N Du, Yan Li, Moran Amit, Claudio E Tatsui, Laurence D Rhines, Patrick M Dougherty, Juan P Cata","doi":"10.1097/PR9.0000000000001012","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001012","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, cancer pain is viewed as a process orchestrated by the release of pronociceptive molecules and the invasion of neural structures, referred to as perineural invasion (PNI). Cancer pain resulting from PNI is well-documented, but the mechanisms leading to peripheral sensitization because of tumor growth are not fully known.</p><p><strong>Methods: </strong>A retrospective study was used to examine how the use of anti-inflammatory medications affected preoperative pain in patients with oral squamous cell carcinoma cancer. We then used an in vitro coculture model in which dorsal root ganglion (DRG) neurons were incubated together with Fadu human head and neck squamous cell carcinoma cancer cells to explore how cancer cells affect the electrical membrane properties of sensory neurons.</p><p><strong>Results: </strong>We found that inflammation contributes to preoperative pain in patients with oral squamous cell carcinoma. After coculture with Fadu human head and neck squamous cell carcinoma cancer cells, we identified markers of inflammation in coculture media and found evidence of neuronal sensitization, including spontaneous activity, reduced current thresholds, depolarized resting membrane potential, and enhanced responses to current stimulation in human and rat DRG neurons. In rats, these effects were influenced by sex and age: neurons from young adult female rats were resistant to changes in neuronal activity, in contrast to neurons from older adult female rats or male rats of either age group.</p><p><strong>Conclusions: </strong>Pro-inflammatory substances released in cancer cell-DRG coculture promoted neuronal hyperexcitability and may contribute to cancer pain after PNI, and these effects may differ across age groups and sexes.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"7 3","pages":"e1012"},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/98/painreports-7-e1012.PMC9113206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1097/PR9.0000000000001011
Joshua Aviram, D. Atzmony, E. Eisenberg
Supplemental Digital Content is Available in the Text. Administration of low-dose medical cannabis through the metered-dose Syqe Inhaler demonstrates similar effectiveness on pain reduction and superior safety compared with other higher-dose administration routes. Abstract Introduction: Preliminary clinical studies on medical cannabis (MC) treatment using the Syqe Inhaler showed short-term effectiveness and safety at very low and precise doses of MC. Objectives: Here, we retrospectively analyzed “real-life” long-term data collected in real time on the potential effectiveness and safety of MC administered with this device. Methods: Patients were monitored by Syqe's patient support program. (−)-Δ9-trans-Tetrahydrocannabinol (Δ9-THC) served as a dosage marker for full-spectrum MC. Pain intensity was evaluated using a numeric pain scale (NPS) from baseline to 120 days after treatment initiation. The change in quality of life (QoL) from baseline was evaluated. Adverse events (AEs) were followed up continuously for 15 months. Results: Of the 143 patients (mean age 62 ± 17 years; 54% males) included in the analysis, most (72%) were diagnosed with chronic neuropathic pain. The stable daily dose, after a mean 26 ± 10 days of titration was 1,500 ± 688 μg aerosolized Δ9-THC. Significant pain reduction, ranging from 22.8% in the intent-to-treat population to 28.4% in the population that reported baseline pain intensity ≥8 points on the NPS (P < 0.001), was observed. Ninety-two percent of patients reported improved QoL. Adverse events were reported mostly during the titration phase (34% of patients) and declined to ≤4% at 3 to 15 months. Only 7% of patients reported psychoactive AEs (anxiety and restlessness). Conclusions: Medical cannabis treatment with the Syqe Inhaler demonstrated overall long-term pain reduction, QoL improvement, and a superior AE profile compared with administration of MC by conventional routes. Additional follow-up in a larger population is warranted.
{"title":"Long-term effectiveness and safety of medical cannabis administered through the metered-dose Syqe Inhaler","authors":"Joshua Aviram, D. Atzmony, E. Eisenberg","doi":"10.1097/PR9.0000000000001011","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001011","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Administration of low-dose medical cannabis through the metered-dose Syqe Inhaler demonstrates similar effectiveness on pain reduction and superior safety compared with other higher-dose administration routes. Abstract Introduction: Preliminary clinical studies on medical cannabis (MC) treatment using the Syqe Inhaler showed short-term effectiveness and safety at very low and precise doses of MC. Objectives: Here, we retrospectively analyzed “real-life” long-term data collected in real time on the potential effectiveness and safety of MC administered with this device. Methods: Patients were monitored by Syqe's patient support program. (−)-Δ9-trans-Tetrahydrocannabinol (Δ9-THC) served as a dosage marker for full-spectrum MC. Pain intensity was evaluated using a numeric pain scale (NPS) from baseline to 120 days after treatment initiation. The change in quality of life (QoL) from baseline was evaluated. Adverse events (AEs) were followed up continuously for 15 months. Results: Of the 143 patients (mean age 62 ± 17 years; 54% males) included in the analysis, most (72%) were diagnosed with chronic neuropathic pain. The stable daily dose, after a mean 26 ± 10 days of titration was 1,500 ± 688 μg aerosolized Δ9-THC. Significant pain reduction, ranging from 22.8% in the intent-to-treat population to 28.4% in the population that reported baseline pain intensity ≥8 points on the NPS (P < 0.001), was observed. Ninety-two percent of patients reported improved QoL. Adverse events were reported mostly during the titration phase (34% of patients) and declined to ≤4% at 3 to 15 months. Only 7% of patients reported psychoactive AEs (anxiety and restlessness). Conclusions: Medical cannabis treatment with the Syqe Inhaler demonstrated overall long-term pain reduction, QoL improvement, and a superior AE profile compared with administration of MC by conventional routes. Additional follow-up in a larger population is warranted.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46535027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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