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Chronic widespread pain (CWP) is common and associated with loss of functioning and health. Subjects with chronic non-widespread pain (CnWP) are at increased risk of developing CWP, but few studies have described the nature of the development over time.We followed a random sample of 3105 participants from the population-based HUNT-3 study with five annual measurements of pain over four years. While 29% reported CWP on at least one occasion, only 7% reported it consistently on four or fsive occasions. The average annual cumulative incidence was 5% and the recovery rate was 38%. In mutual adjusted analysis, the risk of developing CWP from one year to the next was higher in subjects with chronic pain (RR=2.4; 95% CI: 1.8-3.4), two or more pain regions (RR= 3.3; 95% CI: 2.5-4.4), moderate pain or more (RR=1.8; 95% CI: 1.5-2.6) and with comorbid chronic disease (RR=1.6; 95% CI: 1.3-1.9). Developing CWP was associated with a modest concurrent change in self-reported mental and physical health. The risk of developing CWP between the fourth and fifth occasions was 80% lower for subjects without a history of CWP, compared to those with. For subjects without previous CWP, the development was associated with previously reported CnWP, but not with the number of occasions with CnWP, in analyses adjusted for sex, age and pain severity.A substantial proportion of the new cases of CWP originates from subjects floating below and above the definition for CWP over time, and thus, do not seem to involve major transitions in health.
Learn More >Nocebo hyperalgesia (i.e., increased pain sensitivity based on expectations) can be induced by conditioning, but is supposed to be mediated by conscious expectation. Although recent evidence points to the feasibility of subliminal conditioning of nocebo hyperalgesia with masked faces, face processing might be a special case and the practical implications of subliminal conditioning remain questionable. This study aimed to implicitly condition nocebo hyperalgesia using supraliminal cues.
Learn More >To characterize unmet treatment needs in a sample of Migraine in America Symptoms and Treatment (MAST) Study participants using oral, acute prescription migraine medications.
Learn More >Previous research has shown that self-compassion is associated with improved functioning and health outcomes among multiple chronic illnesses. However, the role of self-compassion in chronic pain-related functioning is understudied. The present study sought to understand the association between self-compassion and important measures of functioning within a sample of patients with chronic pain. Treatment-seeking individuals (N= 343 with chronic pain) that were mostly White (97.9%) and female (71%) completed a battery of assessments that included the Self-Compassion Scale (SCS), as well as measures of pain-related fear, depression, disability, pain acceptance, success in valued activity, and use of pain coping strategies. Cross-sectional multiple regression analyses that controlled for age, sex, pain intensity, and pain duration, revealed that self-compassion accounted for a significant and unique amount of variance in all measures of functioning (r range: .07 – .32, all p < .001). Beta weights indicated that higher self-compassion was associated with lower pain-related fear, depression, and disability, as well as greater pain acceptance, success in valued activities, and utilization of pain coping strategies. These findings suggest that self-compassion may be a relevant adaptive process in those with chronic pain. Targeted interventions to improve self-compassion in those with chronic pain may be useful. SIGNIFICANCE: Self-compassion is associated with better functioning across multiple general and pain-specific outcomes, with the strongest associations among measures related to psychological functioning and valued living. These findings indicate that self-compassion may be an adaptive process that could minimize the negative impact of chronic pain on important areas of life. This article is protected by copyright. All rights reserved.
Learn More >Pain in Parkinson's disease (PD) is a common and heterogeneous non-motor symptom. Though the characteristics and predictors of pain in general and of central pain in particular are still largely unknown.
Learn More >A comparative cohort study with 13-year follow-up.
Learn More >To prospectively evaluate the abuse potential of NKTR-181, a novel opioid analgesic, in two phase 3 clinical trials using a newly developed reporting system: the Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS®).
Learn More >Although pain reduction after alcohol administration has repeatedly been demonstrated, alcohol effects on advanced and clinically relevant dynamic pain paradigms are still unknown. As such, temporal summation of pain (TSP) and conditioned pain modulation (CPM) indicate mechanisms of endogenous pain modulation and involve certain neurotransmitter systems crucially influenced by alcohol. Our study is the first to investigate acute alcohol effects on TSP and CPM. We investigated 39 healthy subjects in a placebo-controlled within-subject design and targeted alcohol levels of 0.06% (dose 1) and 0.08% (dose 2). Pain threshold, TSP, and CPM were evaluated before and after an alcoholic or placebo drink. Temporal summation of pain was assessed as enhanced pain response to 5 repetitive contact heat stimuli (threshold +3°C). Conditioned pain modulation was tested as pain inhibition when a conditioning stimulus (46°C hot water) was applied concurrently to a test stimulus (contact heat; threshold + 3°C). Both alcohol doses boosted CPM, with a greater effect size for the higher dose. Conditioning stimulus ratings increased after alcohol intake but were not correlated with CPM, suggesting independence of these effects. Temporal summation of pain was not affected by alcohol, and alcohol effects on pain threshold were small and limited to the higher dose. Our findings suggest that analgesic alcohol effects might be mainly driven by an enhancement of endogenous pain inhibition. The frequent use of alcohol as self-medication in chronic pain might be motivated by alcohol temporarily restoring deficient CPM, thus leading to pain relief in the short run and alcohol-related problems in the long run.
Learn More >Finding an effective preventive agent for the individual migraineur is often long and frustrating. An individual-specific, efficacy-predicting tool, would be invaluable in directing, shortening, and improving this process. As the serotonin norepinephrine reuptake inhibitors (SNRI) duloxetine is a pain modulator, we hypothesized that pro-nociceptivity will directly predict drug efficacy, so that the more pro-nociceptive the patient is, the more efficacious the drug. Therefore, we used psychophysical pain measures to predict duloxetine efficacy in migraine prevention.
Learn More >Chronic musculoskeletal pain is often accompanied by depression or anxiety wherein co-occurring pain and mood symptoms can be more difficult to treat than either alone. However, few clinical trials have examined interventions that simultaneously target both pain and mood conditions.
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