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Initial analgesic prescriptions for osteoarthritis in the United Kingdom, 2000-2016.

To examine trends in the initial prescription of commonly-prescribed analgesics and patient- as well as practice-level factors related to their selection in incident OA.

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The Effect of Transcranial Direct Current Stimulation on Chronic Neuropathic Pain in Patients with Multiple Sclerosis: Randomized Controlled Trial.

Chronic neuropathic pain is a common symptom in multiple sclerosis (MS). This randomized controlled single-blinded study investigated whether a new protocol involving five days of transcranial direct current stimulation (tDCS) with an interval period would be effective to reduce pain using the visual analog scale (VAS). Other secondary outcomes included the Neuropathic Pain Scale (NPS), Depression Anxiety Stress Score (DASS), Short Form McGill Pain Questionnaire (SFMPQ), and Multiple Sclerosis Quality of Life 54 (MSQOL54).

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Anxiety, depression, and opioid misuse among adults with chronic pain: the role of emotion dysregulation.

The opioid epidemic is a significant public health concern in the United States, particularly among adults with chronic pain. Considerable research suggests that people with mental health problems, including anxiety and depression, may experience more opioid-related problems in the context of chronic pain. Yet, little work has examined potential mechanisms underyling these relations. Emotion dysregulation is one mechanistic factor that may link anxiety and depression and opioid-related problems among persons with chronic pain. Therefore, the current study examined the explanatory role of emotion dysregulation in the cross-sectional relationship between anxiety and depression problems and current opioid misuse and severity of opioid dependence among 431 adults with chronic pain who reported currently using opioid medications (74% female, M=38.32 years, SD = 11.11). Results indicated that emotion dysregulation explained, in part, the relationship between anxiety and depression symptoms and opioid-related problems. These findings highlight the need to further consider the role of emotion dysregulation among adults with chronic pain who use prescription opioids and experience symptoms of anxiety or depression. Future prospective research will be needed to further establish emotion dysregulation as a mechanism in anxiety/depression-opioid misuse/dependence processes.

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Composite Score Is a Better Reflection of Patient Response to Chronic Pain Therapy Compared With Pain Intensity Alone.

The pain Numeric Rating Scale (NRS) score became standard when pain was introduced as the fifth vital sign in the 1990s. Although plagued with issues, it remains the basis for primary outcome measures in clinical trials for chronic pain therapies. Multidimensional composite scoring that considers all aspects of the chronic pain experience may provide a more meaningful response measure. Herein we propose a multidimensional responder index.

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A Randomized Sham-Controlled Cross-Over Study on the Short-Term Effect of Non-Invasive Cervical Vagus Nerve Stimulation on Spinal and Supraspinal Nociception in Healthy Subjects.

The aim of the present study was to test the effects of vagus nerve stimulation (VNS) on the descending pain inhibition, quantified by the nociceptive flexor (RIII) reflex and the conditioned pain modulation (CPM) paradigm, and on supraspinal nociceptive responses, assessed by pain intensity and unpleasantness ratings and late somatosensory evoked potentials (SEPs), in healthy subjects.

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Sensorimotor Peak Alpha Frequency Is a Reliable Biomarker of Prolonged Pain Sensitivity.

Previous research has observed that the speed of alpha band oscillations (8-12 Hz range) recorded during resting electroencephalography is slowed in chronic pain patients. While this slowing may reflect pathological changes that occur during the chronification of pain, an alternative explanation is that healthy individuals with slower alpha oscillations are more sensitive to prolonged pain, and by extension, more susceptible to developing chronic pain. To test this hypothesis, we examined the relationship between the pain-free, resting alpha oscillation speed of healthy individuals and their sensitivity to two models of prolonged pain, Phasic Heat Pain and Capsaicin Heat Pain, at two visits separated by 8 weeks on average (n = 61 Visit 1, n = 46 Visit 2). We observed that the speed of an individual's pain-free alpha oscillations was negatively correlated with sensitivity to both models and that this relationship was reliable across short (minutes) and long (weeks) timescales. Furthermore, the speed of pain-free alpha oscillations can successfully identify the most pain sensitive individuals, which we validated on data from a separate, independent study. These results suggest that alpha oscillation speed is a reliable biomarker of prolonged pain sensitivity with potential for prospectively identifying pain sensitivity in the clinic.

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An Initial Psychometric Evaluation of the Pain Concepts Questionnaire in a Low-SES Setting.

The examination of pain beliefs for chronic pain assessment and treatment has been a growing area of interest. A variety of questionnaires have been developed to assess pain beliefs, however, these questionnaires often require high levels of literacy and education. The Pain Concepts Questionnaire (PCQ) was developed with literacy-adaptations to better evaluate pain beliefs in a low socioeconomic (SES) population. This study is an initial exploratory evaluation of the PCQ in a sample of patients with chronic pain and multiple disparities as part of the Learning About My Pain (LAMP) trial, a randomized controlled trial comparing literacy-adapted psychosocial treatments for chronic pain. All data were collected at pre-treatment. Exploratory factor analysis (EFA) was performed to examine the underlying factor structure of the PCQ and cross-sectional correlational analyses examined relationships between pain beliefs with sociodemographic factors and chronic pain-related variables. Results suggested a 2-factor solution with a Biopsychosocial factor and Biomedical factor. Consistent with the literature, correlational analyses highlighted racial and SES disparities in pain beliefs and the importance of beliefs in pain- and cognitive/affective-related functioning. The study emphasizes the importance of pain beliefs in chronic pain management and recommends future research to further examine additional psychometric properties of the PCQ.

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Sex-Stratified Genome-Wide Association Study of Multisite Chronic Pain in UK Biobank.

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Metabolites of neuroinflammation relate to neuropathic pain after spinal cord injury.

To determine whether cervical cord levels of metabolites are associated with pain sensation after spinal cord injury (SCI), we performed magnetic resonance spectroscopy in SCI patients with and without neuropathic pain (NP).

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Evaluation of the efficacy of an internet-based pain education and exercise program for chronic musculoskeletal pain in comparison with online self-management booklet: a protocol of a randomised controlled trial with assessor-blinded, 12-month follow-up,

Chronic musculoskeletal pain is one of the main causes of years lived with disability and generates the highest cost of health care among chronic pain conditions. Internet-based treatments have been shown to be an alternative for the treatment of musculoskeletal conditions, in addition to reducing barriers such as travel, high demands on the public health system, lack of time, lack of insurance coverage for private care, and high costs for long-term treatment. The aim of this clinical trial is to develop and test the effectiveness and cost-effectiveness of, an internet-based self-management program based on pain education and exercise for people with chronic musculoskeletal pain.

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