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/PR9.0000000000000999
Richard Harrison, W. Gandhi, C. V. van Reekum, T. Salomons
Resting-state functional connectivity between the periacqueductal gray and cortical regions involved in sensory, motor, and cognitive processing is associated with conditioned pain modulation. Abstract 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, W. Gandhi, C. V. van Reekum, T. Salomons","doi":"10.1097/PR9.0000000000000999","DOIUrl":"https://doi.org/10.1097/PR9.0000000000000999","url":null,"abstract":"Resting-state functional connectivity between the periacqueductal gray and cortical regions involved in sensory, motor, and cognitive processing is associated with conditioned pain modulation. Abstract 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.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"7 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41402612","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}
Pub Date : 2022-04-27DOI: 10.1097/PR9.0000000000001005
A. Geisler, Josephine Zachodnik, K. Køppen, Rehan Chakari, R. Bech-Azeddine
Supplemental Digital Content is Available in the Text.
文本中提供了补充数字内容。
{"title":"Postoperative pain treatment after spinal fusion surgery: a systematic review with meta-analyses and trial sequential analyses","authors":"A. Geisler, Josephine Zachodnik, K. Køppen, Rehan Chakari, R. Bech-Azeddine","doi":"10.1097/PR9.0000000000001005","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001005","url":null,"abstract":"Supplemental Digital Content is Available in the Text.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42911429","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 : 2022-04-27DOI: 10.1097/PR9.0000000000001004
Maria Fors, B. Öberg, P. Enthoven, K. Schröder, A. Abbott
Initial perceptions regarding prognosis and treatment effects were prominent perceptions explaining longitudinal outcomes in patients with low back pain, including explaining patients' development of self-management strategies. Abstract Introduction: Illness perception is suggested to influence outcome in patients with low back pain (LBP). It is unknown if specific illness perceptions are of more importance for longitudinal outcomes, including development of self-management strategies. Objectives: This study explores whether patients' initial illness perceptions were associated with disability, pain, health-related quality of life, and self-care enablement outcomes in patients with LBP after 3 and 12 months. Methods: Four hundred sixty-seven consecutive patients seeking physiotherapeutic primary care for LBP were eligible to participate in this prospective cohort study, providing data at baseline and after 3 and 12 months (mean age 45 years, 56% women). Multiple linear regression analysis was used to explore whether patients' illness perceptions at baseline were associated with outcome in the Oswestry Disability Index (ODI), Numeric Rating Scale–LBP (NRS-LBP), EuroQol Five Dimensions, and Patient Enablement Instrument (PEI). Results: Stronger beliefs that the back problem will last a long time at baseline were associated with worse outcome in ODI, NRS-LBP, and PEI at 3 and 12 months and in EuroQol Five Dimensions at 12 months. Negative beliefs regarding treatment's ability to improve LBP were associated with worse outcome in NRS-LBP and PEI at 3 and 12 months and in ODI at 12 months. Conclusions: Illness perceptions regarding prognosis and treatment's ability to improve symptoms were the most prominent perceptions explaining several longitudinal clinical outcomes. These expectations should be addressed in an early stage in the delivery of interventions for LBP. These expectations were also important for patients' development of coping and self-management strategies.
{"title":"The association between patients' illness perceptions and longitudinal clinical outcome in patients with low back pain","authors":"Maria Fors, B. Öberg, P. Enthoven, K. Schröder, A. Abbott","doi":"10.1097/PR9.0000000000001004","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001004","url":null,"abstract":"Initial perceptions regarding prognosis and treatment effects were prominent perceptions explaining longitudinal outcomes in patients with low back pain, including explaining patients' development of self-management strategies. Abstract Introduction: Illness perception is suggested to influence outcome in patients with low back pain (LBP). It is unknown if specific illness perceptions are of more importance for longitudinal outcomes, including development of self-management strategies. Objectives: This study explores whether patients' initial illness perceptions were associated with disability, pain, health-related quality of life, and self-care enablement outcomes in patients with LBP after 3 and 12 months. Methods: Four hundred sixty-seven consecutive patients seeking physiotherapeutic primary care for LBP were eligible to participate in this prospective cohort study, providing data at baseline and after 3 and 12 months (mean age 45 years, 56% women). Multiple linear regression analysis was used to explore whether patients' illness perceptions at baseline were associated with outcome in the Oswestry Disability Index (ODI), Numeric Rating Scale–LBP (NRS-LBP), EuroQol Five Dimensions, and Patient Enablement Instrument (PEI). Results: Stronger beliefs that the back problem will last a long time at baseline were associated with worse outcome in ODI, NRS-LBP, and PEI at 3 and 12 months and in EuroQol Five Dimensions at 12 months. Negative beliefs regarding treatment's ability to improve LBP were associated with worse outcome in NRS-LBP and PEI at 3 and 12 months and in ODI at 12 months. Conclusions: Illness perceptions regarding prognosis and treatment's ability to improve symptoms were the most prominent perceptions explaining several longitudinal clinical outcomes. These expectations should be addressed in an early stage in the delivery of interventions for LBP. These expectations were also important for patients' development of coping and self-management strategies.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47538238","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 : 2022-04-14DOI: 10.1097/PR9.0000000000001001
Bridget R. Mueller, Steven Lawrence, E. Benn, Sharon Nirenberg, Benjamin Kummer, N. Jetté, M. George, J. Robinson-Papp
Supplemental Digital Content is Available in the Text. For patients living with pain in New York City during the first wave of COVID-19, the relationship between sociodemographic factors and telehealth utilization evolved with time. Introduction: The shift from in-person visits to telehealth visits during the COVID-19 pandemic presented unique challenges for patients with pain. Disparities in health care access already existed, and the impact of telehealth on these inequities has not been studied. Objectives: To identify sociodemographic characteristics of patients with pain obtaining care through video, telephone, and in-person visits as social distancing restrictions evolved during the COVID-19 pandemic. Methods: Using our institutional clinical data warehouse, we identified 3314 patients with pain receiving care at a large academic institution in New York City during a baseline period (September 23, 2019–March 22, 2020) and counted telephone, video, and in-person visits during the following conditions: a shutdown period (March 23, 2020–May 23, 2020), when nonessential in-person visits were strictly limited, and a reopening period (May 23, 2020–September 23, 2020), when restrictions were relaxed and in-person visits were available. Patients were categorized into 4 groups based on the technology used to complete a visit: (1) video, (2) telephone, (3) in-person, and (4) no visit. Results: Patients who were older, publicly insured, and identified as Black or Hispanic were overrepresented in the telephone visit group during shutdown and the in-person group during reopening. A video visit during shutdown increased the likelihood of continued video visit use during reopening despite the return of in-person visits. Conclusions: Results show differences in how patients with pain accessed clinical care in a socially distanced world and that flexibility in method of health care delivery may reduce barriers to access. Future research will identify factors (eg, Internet access, digital literacy, provider–patient relationships) driving heterogeneity in telehealth use in patients with pain.
{"title":"Disparities in telehealth utilization in patients with pain during COVID-19","authors":"Bridget R. Mueller, Steven Lawrence, E. Benn, Sharon Nirenberg, Benjamin Kummer, N. Jetté, M. George, J. Robinson-Papp","doi":"10.1097/PR9.0000000000001001","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001001","url":null,"abstract":"Supplemental Digital Content is Available in the Text. For patients living with pain in New York City during the first wave of COVID-19, the relationship between sociodemographic factors and telehealth utilization evolved with time. Introduction: The shift from in-person visits to telehealth visits during the COVID-19 pandemic presented unique challenges for patients with pain. Disparities in health care access already existed, and the impact of telehealth on these inequities has not been studied. Objectives: To identify sociodemographic characteristics of patients with pain obtaining care through video, telephone, and in-person visits as social distancing restrictions evolved during the COVID-19 pandemic. Methods: Using our institutional clinical data warehouse, we identified 3314 patients with pain receiving care at a large academic institution in New York City during a baseline period (September 23, 2019–March 22, 2020) and counted telephone, video, and in-person visits during the following conditions: a shutdown period (March 23, 2020–May 23, 2020), when nonessential in-person visits were strictly limited, and a reopening period (May 23, 2020–September 23, 2020), when restrictions were relaxed and in-person visits were available. Patients were categorized into 4 groups based on the technology used to complete a visit: (1) video, (2) telephone, (3) in-person, and (4) no visit. Results: Patients who were older, publicly insured, and identified as Black or Hispanic were overrepresented in the telephone visit group during shutdown and the in-person group during reopening. A video visit during shutdown increased the likelihood of continued video visit use during reopening despite the return of in-person visits. Conclusions: Results show differences in how patients with pain accessed clinical care in a socially distanced world and that flexibility in method of health care delivery may reduce barriers to access. Future research will identify factors (eg, Internet access, digital literacy, provider–patient relationships) driving heterogeneity in telehealth use in patients with pain.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45200453","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 : 2022-04-05DOI: 10.1097/PR9.0000000000001000
L. Heathcote, Sarah J. Cunningham, M. Patton, F. Schulte
More than one-third of childhood cancer survivors are worried about pain as a sign of disease recurrence; pain-related worry explained unique variance in health-related quality of life. Abstract Introduction: Pain is common during childhood cancer treatment, can persist into survivorship, and can negatively affect health-related quality of life in survivors of childhood cancers (SCCs). Objective: The objective of this brief report was to assess pain frequency, pain-related worry, and their (unique) associations with health-related quality of life in SCCs. Methods: One hundred eleven SCCs (52% female individuals, M age: 17.67 years, range 8–25 years) completed self-report measures of pain frequency, pain-related worry, and health-related quality of life. Results: More than two-thirds (70%) of SCCs reported pain in the previous month (M = 1.39, SD = 1.17), and 15% reported experiencing pain often or almost always. More than one-third (39%) reported worrying about pain as a sign of cancer recurrence (M = 0.73, SD = 1.07), and 9% reported worrying about pain a lot or a whole lot. In multivariate regression models that controlled for sex, age at diagnosis, and time off treatment, both pain frequency and pain-related worry were significantly associated with physical health-related quality of life, indicating that they contribute unique variance to health-related quality of life after childhood cancer. For emotional health-related quality of life, pain frequency was no longer a significant predictor once pain-related worry was added to the model, indicating that pain-related worry may be particularly important for understanding emotional health-related quality of life. Conclusion: Postcancer pain may contribute to health-related quality of life through multiple mechanisms, including by triggering concerns of recurrence. There is a need for clinical interventions that target both the frequency of pain (eg, behavioral interventions) and pain-related worry (eg, psychoeducation and cognitive interventions) to improve health-related quality of life after childhood cancer.
{"title":"Unique associations of pain frequency and pain-related worry with health-related quality of life in survivors of childhood cancer","authors":"L. Heathcote, Sarah J. Cunningham, M. Patton, F. Schulte","doi":"10.1097/PR9.0000000000001000","DOIUrl":"https://doi.org/10.1097/PR9.0000000000001000","url":null,"abstract":"More than one-third of childhood cancer survivors are worried about pain as a sign of disease recurrence; pain-related worry explained unique variance in health-related quality of life. Abstract Introduction: Pain is common during childhood cancer treatment, can persist into survivorship, and can negatively affect health-related quality of life in survivors of childhood cancers (SCCs). Objective: The objective of this brief report was to assess pain frequency, pain-related worry, and their (unique) associations with health-related quality of life in SCCs. Methods: One hundred eleven SCCs (52% female individuals, M age: 17.67 years, range 8–25 years) completed self-report measures of pain frequency, pain-related worry, and health-related quality of life. Results: More than two-thirds (70%) of SCCs reported pain in the previous month (M = 1.39, SD = 1.17), and 15% reported experiencing pain often or almost always. More than one-third (39%) reported worrying about pain as a sign of cancer recurrence (M = 0.73, SD = 1.07), and 9% reported worrying about pain a lot or a whole lot. In multivariate regression models that controlled for sex, age at diagnosis, and time off treatment, both pain frequency and pain-related worry were significantly associated with physical health-related quality of life, indicating that they contribute unique variance to health-related quality of life after childhood cancer. For emotional health-related quality of life, pain frequency was no longer a significant predictor once pain-related worry was added to the model, indicating that pain-related worry may be particularly important for understanding emotional health-related quality of life. Conclusion: Postcancer pain may contribute to health-related quality of life through multiple mechanisms, including by triggering concerns of recurrence. There is a need for clinical interventions that target both the frequency of pain (eg, behavioral interventions) and pain-related worry (eg, psychoeducation and cognitive interventions) to improve health-related quality of life after childhood cancer.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43654329","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 : 2022-04-05DOI: 10.1097/pr9.0000000000000994
Harnek S. Bajaj, Denise D. Lester, R. Trainer
{"title":"Letter to the editor: Difficult removal of exposed peripheral nerve stimulator leads: a report of 2 cases","authors":"Harnek S. Bajaj, Denise D. Lester, R. Trainer","doi":"10.1097/pr9.0000000000000994","DOIUrl":"https://doi.org/10.1097/pr9.0000000000000994","url":null,"abstract":"","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42145969","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 : 2022-04-01DOI: 10.1097/PR9.0000000000000998
M. Izumi, Yoshihiro Hayashi, Ryota Saito, S. Oda, K. Petersen, L. Arendt-Nielsen, M. Ikeuchi
Supplemental Digital Content is Available in the Text. A simple bedside quantitative sensory testing tool kit demonstrated acceptable reliability and assessment validity for detecting altered pain facilitatory and inhibitory mechanisms in patients with painful osteoarthritis. Abstract Purpose: Altered pain facilitatory and inhibitory mechanisms have been recognized as an important manifestation in patients with chronic pain, and quantitative sensory testing (QST) can act as a proxy for this process. We have recently developed a simple bedside QST tool kit (QuantiPain) for more clinical use. The purpose of this study was to investigate its test–retest reliability and to evaluate its validity compared with the laboratory-based QST protocols in patients with knee osteoarthritis (OA). Methods: QuantiPain consists of 3 items: “pressure algometer” (for pressure pain thresholds [PPTs]), “pinprick” (for temporal summation of pain [TSP]), and “conditioning clamp” (for conditioned pain modulation [CPM]). In experiment-A, intrarater and interrater test–retest reliabilities were investigated in 21 young healthy subjects by using interclass correlation coefficient (ICC). In experiment-B, 40 unilateral painful patients with OA and 40 age-matched, healthy control subjects were included to compare the bedside tool kit against the computerized pressure algometry. Results: In experiment-A, excellent to moderate intrarater and interrater reliabilities were achieved in PPT and TSP (ICC: 0.60–0.92) while the agreements of CPM were good to poor (ICC: 0.37–0.80). In experiment-B, localized and widespread decrease of PPT, facilitated TSP, and impaired CPM was found by using the bedside tool kit in patients with OA compared with controls (P < 0.05). The data were significantly correlated with the established laboratory-based tools (R = 0.281–0.848, P < 0.05). Conclusion: QuantiPain demonstrated acceptable test–retest reliability and assessment validity with the sensitivity to separate patients with painful OA from controls, which has a potential to create more practical approach for quantifying altered pain mechanisms in clinical settings.
{"title":"Detection of altered pain facilitatory and inhibitory mechanisms in patients with knee osteoarthritis by using a simple bedside tool kit (QuantiPain)","authors":"M. Izumi, Yoshihiro Hayashi, Ryota Saito, S. Oda, K. Petersen, L. Arendt-Nielsen, M. Ikeuchi","doi":"10.1097/PR9.0000000000000998","DOIUrl":"https://doi.org/10.1097/PR9.0000000000000998","url":null,"abstract":"Supplemental Digital Content is Available in the Text. A simple bedside quantitative sensory testing tool kit demonstrated acceptable reliability and assessment validity for detecting altered pain facilitatory and inhibitory mechanisms in patients with painful osteoarthritis. Abstract Purpose: Altered pain facilitatory and inhibitory mechanisms have been recognized as an important manifestation in patients with chronic pain, and quantitative sensory testing (QST) can act as a proxy for this process. We have recently developed a simple bedside QST tool kit (QuantiPain) for more clinical use. The purpose of this study was to investigate its test–retest reliability and to evaluate its validity compared with the laboratory-based QST protocols in patients with knee osteoarthritis (OA). Methods: QuantiPain consists of 3 items: “pressure algometer” (for pressure pain thresholds [PPTs]), “pinprick” (for temporal summation of pain [TSP]), and “conditioning clamp” (for conditioned pain modulation [CPM]). In experiment-A, intrarater and interrater test–retest reliabilities were investigated in 21 young healthy subjects by using interclass correlation coefficient (ICC). In experiment-B, 40 unilateral painful patients with OA and 40 age-matched, healthy control subjects were included to compare the bedside tool kit against the computerized pressure algometry. Results: In experiment-A, excellent to moderate intrarater and interrater reliabilities were achieved in PPT and TSP (ICC: 0.60–0.92) while the agreements of CPM were good to poor (ICC: 0.37–0.80). In experiment-B, localized and widespread decrease of PPT, facilitated TSP, and impaired CPM was found by using the bedside tool kit in patients with OA compared with controls (P < 0.05). The data were significantly correlated with the established laboratory-based tools (R = 0.281–0.848, P < 0.05). Conclusion: QuantiPain demonstrated acceptable test–retest reliability and assessment validity with the sensitivity to separate patients with painful OA from controls, which has a potential to create more practical approach for quantifying altered pain mechanisms in clinical settings.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46136581","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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