Journal of Pain

In patients with neck pain, it is unclear whether pain inhibition and facilitation endogenous pain mechanisms are altered. This systematic review and meta-analysis aimed improve their understanding by assessing conditioned pain modulation (CPM) and temporal summation of pain (TSP) in patients with neck pain associated with whiplash (WAD) or of a non-specific (NSNP) nature compared to pain-free controls. Very low certainty evidence suggests: impaired CPM when assessed remotely in chronic WAD patients (n = 7; 230 patients and 204 controls; SMD = -0...

Providing individuals with choice over treatment has been found to enhance placebo hypoalgesia. However, this choice effect is not always present. The current study tested whether the strength of the placebo context influenced the effect of choice on placebo hypoalgesia. Using an established electrocutaneous pain paradigm, the choice effect was compared when placebo hypoalgesia was induced by Continuous Reinforcement (CRF) (strong placebo context) versus partial reinforcement (PRF) (weak placebo context). Healthy volunteers (N = 133) were randomized to receive either choice over treatment administration or no choice and then to placebo conditioning under either CRF (placebo always followed by surreptitious pain reduction during training) or PRF (placebo only followed by surreptitious pain reduction on half of the training trials)...

Cross-national research using data from the Health Behavior in School-aged Children (HBSC) survey showed an increase in the prevalence of chronic back pain from 2002 to 2014. However, it is unknown if this trend has persisted beyond 2014. The aims of this study were to: (1) determine if the prevalence of chronic back pain in girls and boys aged 11, 13, and 15 continued to increase from 2014 to 2018; and if this was the case, to (2) examine whether this increase in the prevalence of chronic back pain between 2002 and 2018 was explained indirectly by increases in sleep difficulties and in psychological symptoms...

We aim to present the first psychometric evaluation of the Performance-related Pain among Musicians Questionnaire (PPAM), the first questionnaire specifically designed to evaluate performance-related pain among musicians with different musical backgrounds, based on a multicenter validation study. The psychometric evaluation was performed in a validation sample of 458 musicians, at baseline and after seven days. We assessed the applicability, reliability, internal consistency, construct validity and factor structure of the PPAM...

This randomized, double-blind, controlled clinical trial compared the effectiveness of home-based-(HB) active transcranial direct current stimulation (a-tDCS) over the left dorsolateral prefrontal cortex (l-DLPFC) or primary motor cortex (M1) with their respective sham-(s)-tDCS to determine whether a-tDCS would be more effective than s-tDCS in reducing pain and improving disability due to pain. The study included 102 patients with fibromyalgia aged 30 to 65 years old randomly assigned to one of four tDCS groups using a ratio of 2:1:2:1...

Persistent pain conditions and sleep disorders are public health problems worldwide. It is widely accepted that sleep disruption increases pain sensitivity, however the underlying mechanisms are poorly understood. In this study, we used a protocol of six hours a day of total sleep deprivation for three days in rats to advance the understanding of these mechanisms. We focused on gender differences and the dopaminergic mesocorticolimbic system. The findings demonstrated that sleep restriction increased pain sensitivity in a similar way in males and females, without inducing a significant stress response...

Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations among psychological stress and hand pain differ between them. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community dwelling adults (mean age = 51.97, 52...

Non-specific chronic low back pain (nCLBP) has been associated with nutrition. Yet, it is not clear how nutritional factors and nCLBP relate to one another. Therefore, the aim of the present study was to investigate differences in diet quality and dietary intake levels between nCLBP patients and healthy controls (HCs) and to explore the association between nutritional factors and pain sensitivity in nCLBP. In this case-control study, 106 participants (i.e., n=53 nCLBP and n=53 HCs) were recruited and completed a 3-day food diary to assess their dietary intake, which allowed to generate individual diet quality scores, (i...

Lateral epicondylalgia, commonly referred to as tennis elbow, is a musculoskeletal condition characterised by pain and sensorimotor dysfunction. In some individuals with chronic unilateral LE, sensorimotor symptoms develop on the unaffected side despite no evidence of tissue damage. Altered interhemispheric inhibition (IHI) is one mechanism that could underpin this phenomenon. The aim of this cross-sectional study was to examine IHI between the primary motor cortices (M1) in individuals with chronic LE and healthy controls...

Trigeminal neuralgia is a heterogeneous disorder with likely multifactorial and complex etiology; however, trigeminal nerve demyelination and injury is observed in almost all patients with trigeminal neuralgia. The current management strategies for trigeminal neuralgia primarily involve anticonvulsants and surgical interventions, neither of which directly address demyelination, the pathological hallmark of trigeminal neuralgia and treatments targeting demyelination are not available. Demyelination of the trigeminal nerve has been historically considered a secondary effect of vascular compression, and as a result, trigeminal neuralgia is not recognized nor treated as a primary demyelinating disorder...

Ten chronic overlapping pain conditions are currently recognized by the National Institutes of Health Pain Consortium (e.g., irritable bowel syndrome, chronic migraine headache, and chronic low back pain). These conditions affect millions of Americans, however, assessing these conditions, their co-occurrence, and their relationship to treatment has proven challenging due to time-constraints and a lack of standardized measures. We present a Chronic Overlapping Pain Conditions Screener that is logic-driven, efficient, and freely available in electronic format to non-profit entities...

This survey investigated the prevalence of de novo widespread musculoskeletal post-COVID pain and risk factors for its development in non-hospitalized COVID-19 survivors. A nationwide exploratory cross-sectional study was conducted including a cohort of 593,741 Danish residents that had suffered from a SARS-CoV-2 infection from March 2020 to December 2021. A questionnaire was distributed to the Danish population via digital mail system (e-Boks). Self-reported demographic data, previous medical comorbidities (diagnosed), socioeconomic data, time of infection, prior chronic pain conditions (diagnosed), development of de novo widespread pain after infection, pain medication, and pain intensity information were collected...

Insomnia has been identified as a predictor of reduced benefit from cognitive-behavioral treatment (CBT) for adolescent chronic pain; however, it is not well understood how insomnia leads to reduced treatment response. The purpose of this study was to evaluate executive function and self-management processes as two potential mediators of the relationship between insomnia symptoms and pain-related disability outcomes from internet-delivered CBT using a single-arm clinical trial design. Eighty-five adolescents with chronic pain (77% female, ages 12-17 years) and their caregiver received an eight-week internet-delivered CBT intervention...

Although pain is a commonly experienced and observed affective state, it is frequently misinterpreted, which leads to inadequate caregiving. Studies show the ability at estimating pain in others (estimation bias) and detecting its subtle variations (sensitivity) could emerge from independent mechanisms. While estimation bias is modulated by variables such as empathy level, pain catastrophizing tendency, and overexposure to pain, sensitivity remains unimpacted. The present study verifies if these two types of inaccuracies are partly explained by perceptual factors...

We conducted a meta-epidemiological study on all NSLBP trial registrations on the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov. We aimed to: (1) assess the uptake of the core outcome set (COS) for non-specific low back pain (NSLBP) in clinical trials; (2) assess the uptake of the core outcome measurement set (COMS) for NSLBP in clinical trials; and (3) determine whether specific study characteristics are associated with the COS uptake. After applying the relevant filters for the condition, study type, and the phase of the trial, 240 registry entries were included in this study...

Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD), which affects up to 4.3% of individuals, is a distressing and poorly understood condition characterized by persistent, unwanted, and often painful sensations of genito-pelvic arousal (e.g., throbbing) in the absence of sexual desire. PGAD/GPD is associated with significant negative impacts on psychosocial wellbeing and daily functioning. Recent research has indicated that PGAD/GPD shares many similarities with other forms of chronic genito-pelvic pain...

Offset analgesia (OA) is observed when pain relief is disproportional to the reduction of noxious input and is based on temporal contrast enhancement (TCE). This phenomenon is believed to reflect the function of the inhibitory pain modulatory system. However, the mechanisms contributing to this phenomenon remain poorly understood, with previous research focusing primarily on painful stimuli and not generalizing to non-painful stimuli. Therefore, the aim of this study was to investigate whether TCE can be induced by noxious as well as innocuous heat and cold stimuli...

Chronic pain is a costly and debilitating problem in the US, and its burdens are exacerbated among socially disadvantaged and stigmatized groups. In a cross-sectional study of Black Veterans with chronic pain at the Atlanta VA Health Care System (N=380), we used path analysis to explore the roles of racialized discrimination in healthcare settings, pain self-efficacy, and pain-related fear avoidance beliefs as potential mediators of pain outcomes among Black Veterans with and without an EHR-documented mental health diagnosis...

Elevated levels of anxiety in relation to chronic pain have been consistently associated with greater distress and disability. Thus, accurate measurement of pain-related anxiety is an important requirement in modern pain services. The Pain Anxiety Symptom Scale (PASS) was introduced over 30 years ago, with a shortened 20 item version introduced 10 years later. Both versions of the PASS were derived using principal components analysis, an established method of measure development with roots in classical test theory...

Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-mediated antiinflammatory reflexes. To investigate this relationship, we conducted a study with 55 patients undergoing minimally invasive cardiothoracic surgery to evaluate whether cardiovagal baroreflex sensitivity (BRS) can predict postoperative pain. We assessed the spontaneous cardiovagal BRS under resting pain-free conditions before surgery...