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Psychometrics properties of self-reported pain sensitivity measures in individuals with shoulder pain.

BackgroundCentral sensitization (CS) is increasingly recognized as a key contributor to persistent shoulder pain. While self-report tools such as the Central Sensitization Inventory (CSI) and the Pain Sensitivity Questionnaire (PSQ) are commonly used to assess CS, the psychometric properties of these tools have not been established in individuals with shoulder pain.ObjectiveThis study aimed to examine the convergent validity and test-retest reliability of the CSI and PSQ by comparing them with objective pain sensitivity measures.MethodsFifty-three adults with chronic shoulder pain completed th…

Pain in NMOSD is not always neuropathic: multifocal avascular osteonecrosis mimicking neuropathic pain.

Neuropathic pain is a common, well-known and often difficult-to-treat symptom in neuromyelitis optica spectrum disorder (NMOSD) and is usually related to spinal cord lesions. However, non-neurological pain can coexist, posing diagnostic difficulties and delaying treatments. We describe the clinical course and diagnostic workup of a young woman with relapsing myelitis related to Aquaporin-4 (AQP4) IgG positive NMOSD who presented repeatedly to the neurology clinic with persistent pain affecting initially lower limbs and then upper limbs despite apparently stable neurological disease. Joint MRI …

Diagnostic evidence in suspected discogenic low back pain: a pain-source attribution perspective.

Discogenic low back pain (DLBP) remains difficult to identify clinically because degenerative disc changes are common and symptom patterns overlap with other lumbar or pelvic pain sources. This mini review summarizes evidence relevant to suspected DLBP from a pain-source attribution perspective, focusing on clinical features, disc and endplate magnetic resonance imaging (MRI) findings, assessment of other pain sources, provocative discography, and diagnostic blocks. Clinical features such as axial low back pain, sitting or flexion intolerance, non-radicular referral, and centralization may inc…

Global research priorities for back pain, neck pain and osteoarthritis: a scoping review.

OBJECTIVES: The primary aim of this scoping review was to synthesise published research priorities for back pain, neck pain and osteoarthritis. The secondary aim was to compare these research priorities to the priority areas identified in the Global Strategy to Improve Musculoskeletal Health. DESIGN: Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. DATA SOURCES: Literature searches were performed in MEDLINE, EMBASE and the James Lind Alliance Priority Setting Partnership database from inception t…

Risk of Cannabis Use Disorder in Chronic Pain: Longitudinal Links to Pain Outcomes.

OBJECTIVES: The aim of this study was to compare individuals with chronic pain who were cannabis nonusers and those at low, moderate, and high cannabis use disorder (CUD) risk levels on baseline psychosocial and pain-related characteristics, as well as the longitudinal trajectories of pain severity and interference. METHODS: A cohort of 1453 individuals with chronic pain, recruited online, participated in this 2-year longitudinal study, which included baseline, 3-, 12-, and 24-month follow-up surveys. The Cannabis Abuse Screening Test was used to assess CUD risk, and the Brief Pain Inventory …

Pain Intensity and Hazardous Cannabis Use: The Moderating Role of Pain-related Anxiety.

Although cannabis has gained attention as a potential treatment for chronic pain, hazardous cannabis use (i.e. patterns of use that have harmful consequences) has been linked to negative health outcomes. Pain intensity is associated with greater cannabis use, and individuals with greater pain-related anxiety may be more likely to respond to pain with substance use. However, no prior work has examined the role of pain-related anxiety in hazardous cannabis use among individuals with chronic pain. The current analyses tested whether pain-related anxiety moderates associations between pain intensi…

Prostaglandins prevent long-lasting pain in a mouse model of chronic postsurgical pain.

BACKGROUND: Chronic postsurgical pain (CPSP) affects 5-85% of patients, depending on the surgery type, with minimal treatment options. A previous study showed that immune response inhibition by dexamethasone (DEXA) or NSAIDs in inflammatory pain assays in mice leads to pain prolongation, which can be reversed by injection of neutrophils or neutrophil-released S100A8/A9 proteins. Here we tested whether DEXA or NSAIDs similarly lead to prolonged pain in the mouse paw incisional assay, and if prostaglandin (PG) receptor agonists can prevent and resolve this pain through upregulation of S100A8/A9 …

Chronic postsurgical pain and transitional pain services: a narrative review highlighting European perspectives.

BACKGROUND/IMPORTANCE: Chronic postsurgical pain (CPSP) is a significant, often debilitating outcome of surgery, impacting patients' quality of life and placing a substantial burden on healthcare systems worldwide. CPSP (pain persisting for more than 3 months postsurgery) leads to both physical and psychological distress. Recognized as a distinct chronic pain entity in International Classification of Diseases, 11th Revision, CPSP enables better reporting and improved management strategies. Despite advancements in surgical care, CPSP remains prevalent, affecting 5%-85% of patients, with higher …

Correlates of pain-related disability in older veterans with chronic low back pain.

BACKGROUND: Chronic low back pain (CLBP) is a potentially disabling condition that affects an estimated one third of older adults. Treatments recommended by existing guidelines result in modest improvements. Identification of modifiable factors that contribute to CLBP-associated disability in older adults is needed to optimize outcomes. METHODS: Baseline data were analyzed from 275 participants in the Aging Back Clinics trial, which was designed to evaluate the efficacy of a personalized approach to treating CLBP in older veterans. Participants had low back pain of moderate severity on half t…

Opioid Exposure and Associated Numeric Pain Scores in Adults with Chronic Musculoskeletal Pain.

The opioid epidemic claims tens of thousands of lives annually in the United States (US) where opioids are prescribed more per capita than in any other country. Primary care providers contribute to nearly half of these prescriptions, often for chronic non-cancer pain conditions such as back, hip, and knee pain. Despite widespread use, evidence suggests that opioids do not improve pain control for chronic non-cancer musculoskeletal pain. This study aimed to assess whether an opioid prescription in the three months preceding internal medicine primary care appointments was associated with lower p…

Pain drawings in evaluating treatment benefit of botulin toxin in masticatory muscle pain.

OBJECTIVES: Studies on the use of botulinum toxin A (BoNT-A) in TMD-related myalgia suggest that some patients benefit from the injections. The aim of this study was to assess which patient group, regarding pain sites and self-reported comorbid pains, benefits most from the injections. MATERIALS AND METHODS: 66 patients were enrolled in a randomized, double-blind, cross-over study. In the first period, patients in group 1 (n = 33) were injected with 50 U of BoNT-A, and patients in group 2 (n = 33) with saline solution. The cross-over was at 16 weeks. A final cohort of 54 patients with full fo…

Vitamin D Deficiency-Associated Neuropathic Pain Examined in a Chronic Pain Management Program.

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… Treatment Pathway The patient was admitted to the chronic pain program and assessed for neuropathic pain in the right lower extremity and right sacroiliac joint pain. For the pain management plan, the patient was referred to physical therapy, pain psychology, and pain management courses. … D plays an integral role in amplified inflammation response, pain sensitization, and pain signaling. …

Understanding chronic pain in Neurofibromatosis Type 1 using the Neurofibromatosis Pain Module (NFPM).

Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder that can cause an individual significant chronic pain (CP). CP affects quality of life and daily functioning, yet there are limited effective treatments for CP within NF1. The current study describes the impact of CP using the Neurofibromatosis Pain Module (NFPM). The NFPM is a self-reported clinical assessment that evaluates the impact of CP across multiple domains (e.g., interference, severity, tolerance, and symptomology) and three prioritized pain regions. A cross-sectional study (N = 242) asked adults with NF1 to des…

Intraoperative Pain Management for Treatment-Resistant Complex Regional Pain Syndrome: A Case Report.

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder often following trauma, associated with severe pain and autonomic disturbances in the affected limbs. Managing CRPS is challenging due to the lack of FDA-approved medications, often requiring off-label treatments. Traditional options like nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids show limited efficacy, while adjunctive treatments such as gabapentin, antidepressants, and bisphosphonates are increasingly favored. Surgical interventions, including nerve blocks and spinal cord stimulation, may help…

Understanding the sleep-pain relationship in patients with interstitial cystitis/bladder pain syndrome.

INTRODUCTION: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pelvic pain condition with critical symptoms of urinary urgency and frequency, persistent bladder-related pain, and reduced quality of life. Poor-quality sleep can lead to significant disturbances in daily life and increased pain in IC/BPS patients. Resilience, depressive symptoms, and pain catastrophizing have univariate associations with sleep and pain in IC/BPS, suggesting they may be mechanisms in this sleep and pain relationship. METHODS: This online study recruited patients self-reporting a diagnosis of IC/B…

Atypical cause of radiating leg pain: Visceral referred pain due to ulcerative colitis.

Radiating leg pain can arise from a variety of etiologies in clinical practice, the most prevalent being neuropathic or musculoskeletal in origin. In rare cases an intra-abdominal pathology may also be the underlying cause. A case is reported of a 30-year old female patient who presented with neuropathic pain in the left groin region, radiating to the left thigh since four months. The pain was ultimately attributed to visceral referred pain associated with underlying ulcerative colitis (UC). The pathophysiological mechanism behind visceral referred pain originating from the distal colon -a reg…

Percutaneous hydrodiscectomy surgery effectiveness in chronic back pain (hydrodiscectomy in chronic back pain).

ObjectivesTo investigate the pre-operative and post-operative characteristics of patients suffering from chronic back and radicular pain who had percutaneous hydrodiscectomy. Hydrodiscectomy is an advanced percutaneous discectomy technique that utilizes a concentrated, high flow water current for the cutting and simultaneous tissue aspiration of the intervertebral disc.MethodsRetrospective cohort study at a single center. We assessed the eligibility of all patients who had undergone hydrodiscectomy in the orthopedic department of our institution for four years period. Out of 40 eligible patien…

Investigation of grip strength, pain threshold, pain tolerance and function in smartphone users.

PURPOSE/AIM OF THE STUDY: Few studies have demonstrated the effects of smartphone use on grip strength and upper extremity function. The present study was purposed to compare smartphone users' grip/lateral pinch strength, pain threshold/tolerance and upper limb function. MATERIALS AND METHODS: A prospective cross-sectional study was conducted with 241 individuals. Participants were divided into three groups with the cut-off values of the Smartphone Addiction Scale (SAS). The Edinburgh Handedness Inventory (EHI) was used to determine the dominant side. Thumb pain threshold and tolerance were e…