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Conditioned pain modulation and pain sensitivity in functional somatic disorders: The DanFunD study.
Disrupted pain regulation has been proposed as a component in functional somatic disorders (FSD). The objective of this study was to examine a general population sample, encompassing three delimitations of FSD while assessing pain sensitivity and conditioning pain modulation (CPM). Pressure pain thresholds (PPTs) at the tibialis and trapezius muscles were recorded at baseline. During cold pressor stimulation of the hand, the tibialis PPTs were re-assessed and the difference from baseline measures defined the CPM effect. Participants (n=2,198, 53% females) were randomly selected from the adult Danish population. FSD was established by self-reported symptom questionnaires. With a few exceptions, only weak associations were seen between PPTs and CPM in cases with FSD (p>0.1). A high PPT was associated with lower odds of having multi-organ bodily distress syndrome (OR : 0.66, 95% CI: 0.49-0.88, p=0.005), with the symptom profile characterized by all symptoms (OR : 0.72, 95% CI: 0.58-0.90, p=0.003 and OR : 0.75, 95% CI: 0.62-0.91, p=0.004), and with multiple chemical sensitivity (OR : 0.81, 95% CI: 0.67-0.97, p=0.022). High CPM was associated with high odds of having irritable bowel (OR : 1.22, 95% CI: 1.04-1.43, p=0.013 and OR =2.66, 95% CI: 1.07-6.45, p=0.033). However, only PPT measured over the trapezius muscle were still significant after correction for multiple testing for the symptom profile characterized by all symptoms. Findings from this study do not support altered pain regulation in questionnaire-based FSD which is in contrast with the existing presumption. Further epidemiological studies in this field are needed.
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Learn More >Chronic postsurgical pain (CPSP) is a common and underreported but significant outcome following surgery. Pharmacological treatment with analgesics, including non-opioids and opioids, is frequently used. It has been debated whether neuraxial anesthesia can reduce persistent analgesic use. We aimed to survey long-term analgesic prescription after different surgeries under general and neuraxial anesthesia, using a nationwide database.
Learn More >Associations of chronic and intrusive pain with sarcopenia and disability in older men are unclear.
Learn More >Patients with psoriasis have an impaired quality of life and higher use of analgesics than the general population. Whether such use is due to skin pain or a consequence of joint pain resulting from psoriatic arthritis (PsA) is unclear.
Learn More >Chronic postsurgical pain (CPSP) is a common complication of surgery. This study was conducted to evaluate the efficacy and safety of paresthesia-free, 10-kHz spinal cord stimulation (SCS) as a treatment for CPSP. Subjects in this prospective, single-arm study had an average pain intensity of ≥5 cm on a 10-cm visual analog scale. The subjects who had pain relief of ≥50% (response) with temporary trial stimulation were permanently implanted with 10-kHz SCS and assessed for 1 year. At 12 months, 94% of subjects were responders to 10-kHz SCS, and 88% had pain remission (visual analog scale ≤2.5 cm). The pain relief was durable in CPSP subjects and the safety profile of 10-kHz SCS was as expected. VT005076953 (Privacy Commission of Belgium).
Learn More >Although chronic postsurgical pain (CPSP) after breast cancer surgery is a common and prevalent postsurgical adverse event, the need for CPSP treatment has not been investigated. This study examined the proportion of patients who needed treatment for CPSP and associated predictors.
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