scholarly journals Opioid Taper is Associated with Improved Experimental Pain Tolerance in Patients with Chronic Pain: An Observational Study

2022 ◽  
Author(s):  
Peggy Compton ◽  
Olivia M. Halabicky ◽  
Subhash Aryal ◽  
Ignacio Badiola
Keyword(s):  
Chronic Pain ◽  
Observational Study ◽  
Experimental Pain ◽  
Pain Tolerance

scholarly journals Experimental Pain Responses in Children with Chronic Pain and in Healthy Children: How Do They Differ?

2012 ◽  
Vol 17 (2) ◽  
pp. 103-109 ◽  
Author(s):  
Jennie CI Tsao ◽  
Subhadra Evans ◽  
Laura C Seidman ◽  
Lonnie K Zeltzer
Keyword(s):  
Heart Rate ◽  
Chronic Pain ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Depression Symptoms ◽  
Healthy Children ◽  
Cold Pain ◽  
Lower Pain ◽  
Pain Responses

BACKGROUND: Extant research comparing laboratory pain responses of children with chronic pain with healthy controls is mixed, with some studies indicating lower pain responsivity for controls and others showing no differences. Few studies have included different pain modalities or assessment protocols.OBJECTIVES: To compare pain responses among 26 children (18 girls) with chronic pain and matched controls (mean age 14.8 years), to laboratory tasks involving thermal heat, pressure and cold pain. Responses to cold pain were assessed using two different protocols: an initial trial of unspecified duration and a second trial of specified duration.METHODS: Four trials of pressure pain and of thermal heat pain stimuli, all of unspecified duration, were administered, as well as the two cold pain trials. Heart rate and blood pressure were assessed at baseline and after completion of the pain tasks.RESULTS: Pain tolerance and pain intensity did not differ between children with chronic pain and controls for the unspecified trials. For the specified cold pressor trial, 92% of children with chronic pain completed the entire trial compared with only 61.5% of controls. Children with chronic pain exhibited a trend toward higher baseline and postsession heart rate and reported more anxiety and depression symptoms compared with control children.CONCLUSIONS: Contextual factors related to the fixed trial may have exerted a greater influence on pain tolerance in children with chronic pain relative to controls. Children with chronic pain demonstrated a tendency toward increased arousal in anticipation of and following pain induction compared with controls.

Experimental and Psychological Pain Phenotyping In Adults With Sickle Cell Anemia and Normal Volunteers

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2232-2232
Author(s):  
Catherine Seamon ◽  
Meghan Quinn ◽  
Gwenyth Wallen ◽  
Deepika S. Darbari ◽  
James G. Taylor
Keyword(s):  
Chronic Pain ◽  
Pain Threshold ◽  
Pain Perception ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Heat Pain ◽  
Ischemic Pain ◽  
Cold Pain ◽  
Significant Difference ◽  
Erythrocyte Sickling

Abstract Introduction Sickle cell anemia (SCA) is the most prevalent Mendelian disease in the U.S. and is characterized by HbS polymerization, hemolytic anemia and vaso-occlusion. The hallmark clinical manifestation of SCA is acute vaso-occlusive pain crisis (VOC) with severe episodes requiring hospitalization for pain management. Vaso-occlusion resulting in pain is believed to occur with hypoxia, intra-vascular erythrocyte sickling and ischemia reperfusion injury. Recurring episodes of VOC often have no clear causation and may have effects upon physiological pain perception and intrinsic psychological characteristics like catastrophizing. It is not presently known if physiological pain processing or psychological factors influence pain in SCA compared to normal volunteers (NV). We hypothesized that adults with SCA would experience hypersensitivity to painful stimuli compared to NV as seen in other chronic painful conditions. Methods 18 subjects with SCA and 19 age and sex matched NV underwent quantitative sensory testing (QST) for thermal, pressure and ischemic experimental pain phenotypes. Thermal testing (cold and heat) was performed at 4 sites on the volar forearm for temperature at first detection, threshold for sensing pain, and pain tolerance. Pressure pain threshold and tolerance were measured bilaterally at the thumb, forearm, and trapezius with an algometer. Ischemic pain testing was performed on the non-dominant arm inflating a blood pressure cuff of 220 mmHg and determining time to threshold and tolerance. Subjects were also administered the Pain Catastrophizing Scale (PCS-E) which is composed of 13 questions that address 3 dimensions: rumination, magnification, and helplessness. SCA and NV subjects with chronic pain unrelated to complications of SCA were excluded. All SCA subjects tested at baseline pain levels at least 2 weeks since their last painful event requiring intravenous narcotics. Non-parametric t-tests were used to compare results between SCA subjects and NV. Results The mean age of SCA subjects was 33.4 (range 21-47) and NV was 32.1 (range 18-44). The only significant difference for thermal QST was temperature at first cold detection (SCA mean 24.5±6.3 ¢ªC vs. NV mean of 26.6±4.7 ¢ªC, P=0.05). There were no other significant thermal differences between SCA subjects and NV for cold pain threshold (P=0.84), cold pain tolerance (P=0.82), first heat detection (P=0.21), heat pain threshold (P=0.68) or heat pain tolerance (P=0.38). Furthermore, there were no differences in pressure between SCA and NV for pain thresholds at the thumb (P=0.31), forearm (P=0.44) or trapezius (P=0.10), nor were there pain tolerance differences at the thumb (P=0.63), forearm (P0.98) or trapezius (P=0.44). Surprisingly, ischemic pain QST showed no differences for initial pain threshold (468.3±263.1 seconds for SCA vs. 569.6±395.8 seconds for NV, P=0.69) or pain tolerance (642.5±245.4 seconds for SCA vs. 774.4±453.5 seconds for NV). Compared to NV, SCA subjects had significantly higher total catastrophizing (SCA median 30 vs. NV median 7, P=0.0005), rumination (SCA median 12 vs. NV median 3, P=0.0038), magnification (SCA median 8 vs. NV median 3, P=0.0006), and helplessness scores (SCA median 13 vs. NV median 3, P=0.0004). Conclusions Thermal detection of cold temperature change was the only observed difference, despite our hypothesis that recurrent painful episodes from SCA would alter sensitivity to experimental stimuli. Of particular interest are the results of ischemic pain QST, where SCA subjects appear to tolerate ischemia as well as NV despite the expectation this test would promote earlier forearm hypoxia, erythrocyte sickling and potentially vaso-occlusion. No significant difference in onset of ischemic pain between SCA and NV subjects appears to contradict the predominant pain vaso-occlusion paradigm for SCA. In addition, SCA subjects report significant levels of pain castastrophizing. Catastrophizing in other pain conditions may contribute to a psychological state that increases the severity of pain perception and a fear that pain control is impossible. Thus, catastrophizing may enhance chronic pain, pain impact, and its refractory response to pharmacotherapy. Further studies are necessary to determine if experimental pain or catastrophizing are associated with acute pain or chronic pain in SCA and to further elucidate the pathophysiology of pain in SCA. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Preferred musical attribute dimensions underlie individual differences in music-induced analgesia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Krzysztof Basiński ◽  
Agata Zdun-Ryżewska ◽  
David M. Greenberg ◽  
Mikołaj Majkowicz
Keyword(s):  
Individual Differences ◽  
Pain Perception ◽  
Specific Effect ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Order Effects ◽  
Individual Preferences ◽  
Pain Stimulation ◽  
Musical Excerpts ◽  
Average Pain

AbstractMusic-induced analgesia (MIA) is a phenomenon that describes a situation in which listening to music influences pain perception. The heterogeneity of music used in MIA studies leads to a problem of a specific effect for an unspecified stimulus. To address this, we use a previously established model of musical preferences that categorizes the multidimensional sonic space of music into three basic dimensions: arousal, valence and depth. Participants entered an experimental pain stimulation while listening to compilations of short musical excerpts characteristic of each of the three attribute dimensions. The results showed an effect on the part of music attribute preferences on average pain, maximal pain, and pain tolerance after controlling for musical attributes and order effects. This suggests that individual preferences for music attributes play a significant role in MIA and that, in clinical contexts, music should not be chosen arbitrarily but according to individual preferences.

Chronic Pain in Parturients with an Accidental Dural Puncture: A Case Controlled Prospective Observational Study

2021 ◽  
Author(s):  
Yair Binyamin ◽  
Philip Heesen ◽  
Sharon Orbach‐Zinger ◽  
Yaacov Gozal ◽  
David Halimi ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Dural Puncture ◽  
Accidental Dural Puncture

The association between selected genetic variants and individual differences in experimental pain

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Marie Udnesseter Lie ◽  
Bendik Winsvold ◽  
Johannes Gjerstad ◽  
Dagfinn Matre ◽  
Linda M. Pedersen ◽  
...  
Keyword(s):  
Individual Differences ◽  
Genetic Variants ◽  
Pain Threshold ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Heat Pain ◽  
Low Back ◽  
Secondary Hyperalgesia ◽  
Heat Pain Threshold ◽  
Pain Patients

AbstractObjectivesThe underlying mechanisms for individual differences in experimental pain are not fully understood, but genetic susceptibility is hypothesized to explain some of these differences. In the present study we focus on three genetic variants important for modulating experimental pain related to serotonin (SLC6A4 5-HTTLPR/rs25531 A>G), catecholamine (COMT rs4680 Val158Met) and opioid (OPRM1 rs1799971 A118G) signaling. We aimed to investigate associations between each of the selected genetic variants and individual differences in experimental pain.MethodsIn total 356 subjects (232 low back pain patients and 124 healthy volunteers) were genotyped and assessed with tests of heat pain threshold, pressure pain thresholds, heat pain tolerance, conditioned pain modulation (CPM), offset analgesia, temporal summation and secondary hyperalgesia. Low back pain patients and healthy volunteers did not differ in regards to experimental test results or allelic frequencies, and were therefore analyzed as one group. The associations were tested using analysis of variance and the Kruskal-Wallis test.ResultsNo significant associations were observed between the genetic variants (SLC6A4 5-HTTLPR/rs25531 A>G, COMT rs4680 Val158Met and OPRM1 rs1799971 A118G) and individual differences in experimental pain (heat pain threshold, pressure pain threshold, heat pain tolerance, CPM, offset analgesia, temporal summation and secondary hyperalgesia).ConclusionsThe selected pain-associated genetic variants were not associated with individual differences in experimental pain. Genetic variants well known for playing central roles in pain perception failed to explain individual differences in experimental pain in 356 subjects. The finding is an important contribution to the literature, which often consists of studies with lower sample size and one or few experimental pain assessments.

Attenuation of Experimental Pain by Tactile Stimulation: Effect of Vibration at Different Levels of Noxious Stimulus Intensity

1964 ◽  
Vol 19 (1) ◽  
pp. 311-316 ◽  
Author(s):  
Bernard Blitz ◽  
Albert J. Dinnerstein ◽  
Milton Lowenthal
Keyword(s):  
Stimulus Intensity ◽  
Tactile Stimulation ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Noxious Stimulus ◽  
Noxious Stimulation ◽  
Vibratory Stimulus ◽  
Vibratory Stimulation ◽  
Electric Shocks ◽  
Different Levels

The present study was concerned with the masking and pain-attenuating effect of vibration at different levels of intensity of noxious stimulation. Forty Ss were given noxious stimulation in the form of increasingly painful electric shocks in trials where such shocks were presented with and without concurrent vibratory stimulation. The masking or pain-attenuating effect of the vibration was greatest at the lowest level of noxious stimulus intensity and decreased as the noxious stimulation intensity increased. At the highest level of noxious stimulation the effect of vibration was not significant although there was a tendency for Ss with higher pain tolerance to show summation. The possible relevance of the intensity of the vibratory stimulus to this pattern of results was discussed.

Understanding the Users with Chronic Pain on AI CBT Mental Health App (Wysa): A Mixed-Methods Retrospective Observational Study (Preprint)

2021 ◽  
Author(s):  
S Meheli ◽  
Chaitali Sinha ◽  
Madhura Kabada
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Pain Management ◽  
Observational Study ◽  
Real World ◽  
Effect Size ◽  
Retrospective Observational Study ◽  
Medium Effect ◽  
Health Concerns ◽  
Perceived Needs

BACKGROUND Digital health interventions can bridge barriers in access to treatment of care for individuals with chronic pain. OBJECTIVE This study aimed to evaluate the perceived needs, engagement and the effectiveness of the mental health app Wysa on mental health outcomes among real-world users who reported chronic pain and engaged with the app for support. METHODS Real-world data from users (N = 2,194) who reported chronic pain and associated health conditions in their conversations with a mental health app was analyzed using a mixed-method retrospective observational study. An inductive thematic analysis was used to analyse conversational data of users with chronic pain to assess perceived needs, along with comparative macro-analyses of conversational flows to capture engagement within the app. Additionally, the scores from a subset of users who completed a set of pre-post assessment questionnaires, namely PHQ-9 (N=69) and GAD-7 (N=57), were examined to evaluate the effectiveness of Wysa in providing support for mental health concerns for those managing chronic pain. RESULTS The themes emerging from the conversations of users with chronic pain included Health Concerns, Socioeconomic Concerns, and Pain Management Concerns. Findings from the quantitative analysis indicated that users with chronic pain showed significantly greater app engagement (p value <2.2e-16) than users without chronic pain, with a large effect size (Vargha and Delaney’s A- 0.76 -0.8). Furthermore, the sample of users with pre-post assessments during the study period were found to have significant improvements in group means on both PHQ-9 and GAD-7 symptom scores, with medium effect size (Cohens’d, 0.6-0.61), respectively. CONCLUSIONS The findings indicate that users look for tools that can help them address their concerns related to mental health, pain management, and sleep issues. The study findings also indicate the breadth of needs for users with chronic pain and the lack of support structures, and suggests that Wysa can provide effective support to bridge the gap.

scholarly journals Laboratory Personnel Gender and Cold Pressor Apparatus Affect Subjective Pain Reports

2014 ◽  
Vol 19 (1) ◽  
pp. e13-e18 ◽  
Author(s):  
Jacob M Vigil ◽  
Lauren N Rowell ◽  
Joe Alcock ◽  
Randy Maestes
Keyword(s):  
Pain Sensitivity ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Cold Pain ◽  
Laboratory Personnel ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Pain Reports

BACKGROUND: There is no standardized method for cold pressor pain tasks across experiments. Temperature, apparatus and aspects of experimenters vary widely among studies. It is well known that experimental pain tolerance is influenced by setting as well as the sex of the experimenter. It is not known whether other contextual factors influence experimental pain reporting.OBJECTIVES: The present two-part experiment examines whether minimizing and standardizing interactions with laboratory personnel (eg, limiting interaction with participants to consenting and questions and not during the actual pain task) eliminates the influence of examiner characteristics on subjective pain reports and whether using different cold pain apparatus (cooler versus machine) influences reports.METHODS:The present experiment manipulated the gender of the experimenter (male, female and transgender) and the type of cold pressor task (CPT) apparatus (ice cooler versus refrigerated bath circulator). Participants conducted the CPT at one of two pain levels (5°C or 16°C) without an experimenter present.RESULTS:Men and women showed lower pain sensitivity when they were processed by biological male personnel than by biological female personnel before the CPT. Women who interacted with a transgendered researcher likewise reported higher pain sensitivity than women processed by biological male or female researchers. The type of CPT apparatus, despite operating at equivalent temperatures, also influenced subjective pain reports.DISCUSSION: The findings show that even minimal interactions with laboratory personnel who differ in gender, and differences in laboratory materials impact the reliable measurement of pain.CONCLUSION: More standardized protocols for measuring pain across varying research and clinical settings should be developed.

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