CSF ENDORPHIN LEVELS IN CHRONIC PAIN PATIENTS AND IN PATIENTS BEFORE AND AFTER A PLACEBO PAIN RELIEF

The objective was to investigate the effect of nitrous/oxygen in chronic pain. Seventy-seven chronic pain patients referred to dental treatment with conscious sedation with nitrous oxide/oxygen had their records included in this research. Data were collected regarding the location and intensity of pain by the visual analogue scale before and after the treatment. Statistical analysis was performed comparing pre- and post-treatment findings. It was observed a remarkable decrease in the prevalence of pain in this sample (only 18 patients still had chronic pain, p < 0.001) and in its intensity (p < 0.001). Patients that needed fewer sessions received higher proportions of nitrous oxide/oxygen. Nitrous oxide may be a tool to be used in the treatment of chronic pain, and future prospective studies are necessary to understand the underlying mechanisms and the effect of nitrous oxide/oxygen in patients according to the pain diagnosis and other characteristics.

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Alpha entrainment drives pain relief using visual stimulation in a sample of chronic pain patients

Neuroreport ◽

10.1097/wnr.0000000000001606 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Karen Lopez-Diaz ◽

James Henshaw ◽

Alexander J. Casson ◽

Christopher A. Brown ◽

Jason R. Taylor ◽

...

Keyword(s):

Chronic Pain ◽

Pain Relief ◽

Visual Stimulation ◽

Chronic Pain Patients ◽

Pain Patients

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Extended reality for chronic pain relief

10.26686/wgtn.12470159.v1 ◽

2020 ◽

Author(s):

J Wang ◽

Craig Anslow ◽

Brian Robinson ◽

Simon McCallum

Keyword(s):

Chronic Pain ◽

Pain Relief ◽

Body Movement ◽

Daily Lives ◽

Chronic Pain Patients ◽

Pain Ratings ◽

Subjective Pain ◽

Initial Injury ◽

Physical Interactions ◽

Pain Patients

© 2019 Copyright held by the owner/author(s). Chronic pain is ongoing pain lasting for long periods of time after the initial injury or disease has healed. Chronic pain is difficult to treat and can affect the daily lives of patients. Distraction therapy is a proven way of relieving pain by redirecting the focus of patients' attention. Virtual reality is an effective platform for distraction therapy as it immerses the user visually, aurally, and even somewhat physically in a virtual world detached from reality. There is little research done on the effects that physical interactions have on pain management. This project aims to evaluate different types of extended reality (XR) interactions, including full body movement, for chronic pain patients to determine which is the best for pain relief. We are building a prototype for participants to interact both mentally and physically and measuring the reduction in subjective pain ratings at various points of the XR experience.

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Inadequate postoperative pain relief in chronic pain patients – A Qualitative Study

Nordisk Sygeplejeforskning ◽

10.18261/issn1892-2686-2012-01-02 ◽

2012 ◽

Vol 2 (01) ◽

pp. 3-14

Author(s):

Randi Maria Hanghøj Tei ◽

Pia Dreyer ◽

Lone Nikolajsen

Keyword(s):

Chronic Pain ◽

Postoperative Pain ◽

Pain Relief ◽

Qualitative Study ◽

Postoperative Pain Relief ◽

Chronic Pain Patients ◽

Pain Patients

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Placebo and Nocebo Effects in Chronic Pain Patients

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000181 ◽

2014 ◽

Vol 222 (3) ◽

pp. 135-139 ◽

Cited By ~ 2

Author(s):

Lene Vase ◽

Ina Skyt ◽

Gitte Laue Petersen ◽

Donald D. Price

Keyword(s):

Chronic Pain ◽

Pain Relief ◽

Healthy Volunteers ◽

Experimental Pain ◽

Clinical Treatment ◽

Placebo Effects ◽

Chronic Pain Patients ◽

Nocebo Effects ◽

Patients Experience ◽

Pain Patients

Placebo, as well as nocebo, effects have been primarily investigated in studies with healthy volunteers exposed to acute experimental pain. Yet with regard to chronic pain patients, there is emerging evidence for significant placebo effects but not for nocebo effects. Expectations of pain relief are known to contribute to placebo effects, and lately the influence of emotional feelings has also been investigated. In this line of research, an experiential method has been applied to capture the emotional feelings that chronic pain patients experience during placebo and nocebo interventions. The findings indicate that the patients’ expectations of treatment effects are highly embedded in their emotional feelings. Hence, in order to optimize placebo factors in the clinical treatment of patients, it may be pivotal to investigate and enhance both expectancies and emotional feelings about treatments.

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Does validation and alliance during the multimodal investigation affect patients’ acceptance of chronic pain? An experimental single case study

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0051 ◽

2019 ◽

Vol 19 (1) ◽

pp. 73-82 ◽

Cited By ~ 1

Author(s):

Mikael Svanberg ◽

Ann-Christin Johansson ◽

Katja Boersma

Keyword(s):

Chronic Pain ◽

Therapeutic Effect ◽

Pain Catastrophizing ◽

Single Case ◽

Rehabilitation Program ◽

Self Report ◽

Pain Coping ◽

Chronic Pain Patients ◽

Before And After ◽

Pain Patients

Abstract Background and aims Among chronic pain patients who are referred to participation in a multimodal rehabilitation program (MMRP), pain catastrophizing and dysfunctional pain coping is common. In many cases it may have driven the patient to a range of unsuccessful searches for biomedical explanations and pain relief. Often these efforts have left patients feeling disappointed, hopeless and misunderstood. The MMRP process can be preceded by a multimodal investigation (MMI) where an important effort is to validate the patient to create a good alliance and begin a process of change towards acceptance of the pain. However, whether the MMI has such therapeutic effect is unclear. Using a repeated single case experimental design, the purpose of this study was to investigate the therapeutic effect of MMI by studying changes in patients’ experience of validation, alliance, acceptance of pain, coping, catastrophizing, and depression before and during the MMI process. Methods Participants were six chronic pain patients with high levels of pain catastrophizing (>25 on the Pain Catastrophizing Scale) and risk for long term disability (>105 on the Örebro Musculoskeletal Pain Screening Questionnaire) who were subjected to MMI before planned MMRP. For each patient, weekly self-report measures of validation, alliance and acceptance of pain were obtained during a 5–10-weeks baseline, before the MMI started. Subsequently, these measures were also obtained during a 6–8 weeks MMI process in order to enable comparative analyses. Additionally, pain coping, depression and pain catastrophizing were measured using standardized questionnaires before and after the MMI. Results Irrespective of experiences of validation and alliance before MMI, all six patients felt validated and experienced a good alliance during MMI. Acceptance of pain improved only in one patient during MMI. None of the patients showed clinically relevant improvement in pain coping, depression or catastrophizing after the MMI. Conclusions The patients did not change their acceptance and pain coping strategies despite of good alliance and experience of validation during the MMI process. Even if the design of this study precludes generalization to chronic pain patients in general, the results suggest that MMI may not have a therapeutic effect.

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Does Pain Relief Improve Pain Behavior and Mood in Chronic Pain Patients?

Anesthesia & Analgesia ◽

10.1213/01.ane.0000078584.03856.d3 ◽

2003 ◽

pp. 791-797 ◽

Cited By ~ 22

Author(s):

Sabine M. Sator-Katzenschlager ◽

Andreas W. Schiesser ◽

Sibylle A. Kozek-Langenecker ◽

Gerhard Benetka ◽

Gudrun Langer ◽

...

Keyword(s):

Chronic Pain ◽

Pain Relief ◽

Pain Behavior ◽

Chronic Pain Patients ◽

Pain Patients

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Modulation of the Somatosensory Evoked Potential by Attention and Spinal Cord Stimulation

Frontiers in Neurology ◽

10.3389/fneur.2021.694310 ◽

2021 ◽

Vol 12 ◽

Author(s):

Guiomar Niso ◽

Marleen C. Tjepkema-Cloostermans ◽

Mathieu W. P. M. Lenders ◽

Cecile C. de Vos

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Pain Relief ◽

Spinal Cord Stimulation ◽

Brain Activity ◽

Explorative Study ◽

Brain Responses ◽

Chronic Pain Patients ◽

Electrical Pulses ◽

Pain Patients

Introduction: Spinal Cord Stimulation (SCS) is a last-resort treatment for patients with intractable chronic pain in whom pharmacological and other treatments have failed. Conventional tonic SCS is accompanied by tingling sensations. More recent stimulation protocols like burst SCS are not sensed by the patient while providing similar levels of pain relief. It has been previously reported that conventional tonic SCS can attenuate sensory-discriminative processing in several brain areas, but that burst SCS might have additional effects on the medial, motivational-affective pain system. In this explorative study we assessed the influence of attention on the somatosensory evoked brain responses under conventional tonic SCS as well as burst SCS regime.Methods: Twelve chronic pain patients with an implanted SCS device had 2-weeks evaluation periods with three different SCS settings (conventional tonic SCS, burst SCS, and sham SCS). At the end of each period, an electro-encephalography (EEG) measurement was done, at which patients received transcutaneous electrical pulses at the tibial nerve to induce somatosensory evoked potentials (SEP). SEP data was acquired while patients were attending the applied pulses and while they were mind wandering. The effects of attention as well as SCS regimes on the SEP were analyzed by comparing amplitudes of early and late latencies at the vertex as well as brain activity at full cortical maps.Results: Pain relief obtained by the various SCS settings varied largely among patients. Early SEP responses were not significantly affected by attention nor SCS settings (i.e., burst, tonic, and sham). However, late SEP responses (P300) were reduced with tonic and burst SCS: conventional tonic SCS reduced P300 brain activity in the unattended condition, while burst SCS reduced P300 brain activity in both attended and unattended conditions.Conclusion: Burst spinal cord stimulation for the treatment of chronic pain seems to reduce cortical attention that is or can be directed to somatosensory stimuli to a larger extent than conventional spinal cord stimulation treatment. This is a first step in understanding why in selected chronic pain patients burst SCS is more effective than tonic SCS and how neuroimaging could assist in personalizing SCS treatment.

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