scholarly journals Validation of the Leiden Visual Sensitivity Scale and Visual Discomfort Scale in Chronic Pain Conditions

Perception ◽  
2021 ◽  
pp. 030100662110053
Author(s):  
Antonia F. Ten Brink ◽  
Michael J. Proulx ◽  
Janet H. Bultitude
Keyword(s):  
Chronic Pain ◽  
Construct Validity ◽  
Central Sensitization ◽  
Negative Relationship ◽  
Pain Syndrome ◽  
Visual Sensitivity ◽  
Visual Discomfort ◽  
Online Study ◽  
Good Internal Consistency ◽  
Chronic Pain Conditions

Discomfort provoked by normally innocuous visual stimuli has been reported by people with chronic pain. Visual discomfort may be higher in pain conditions in which central sensitization is implicated, such as Complex Regional Pain Syndrome (CRPS) and fibromyalgia. In an online study, we validated the Leiden Visual Sensitivity Scale (L-VISS) and Visual Discomfort Scale (VDS) in people with CRPS ( n =  57), fibromyalgia ( n =  75), and general chronic pain ( n =  53); investigated whether these groups and pain-free controls ( n =  125) differed in visual discomfort; and evaluated the effect of age. The L-VISS and VDS had good internal consistency. Both scales were positively related with experimentally induced visual distortions for mid-spatial frequency striped patterns, suggesting good construct validity. The scales were positively related with each other, and dissociated between the pain and pain-free groups in similar ways, suggesting good construct validity. There was no relationship between age and L-VISS scores and a small negative relationship between age and VDS scores. Visual discomfort was highest in the fibromyalgia group, followed by the CRPS group. This research confirms the utility of the L-VISS and VDS for measuring visual sensitivity in chronic pain and adds to evidence that central sensitization is an important mechanism of visual discomfort.

Ketamine Infusions for Complex Regional Pain Syndrome

2016 ◽  
Author(s):  
Roy K. Esaki
Keyword(s):  
Chronic Pain ◽  
Complex Regional Pain Syndrome ◽  
Hepatic Dysfunction ◽  
Case Reports ◽  
Pain Syndrome ◽  
Nmda Receptor Antagonist ◽  
Treatment Resistant ◽  
Urinary Tract Symptoms ◽  
Chronic Pain Conditions ◽  
Lower Urinary

Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that has been increasingly used in the management of treatment-resistant chronic pain conditions, particularly representing neuropathic involvement or central sensitization. Complex regional pain syndrome (CRPS) is a prototypical condition often treated with ketamine infusions. Although the analgesic benefits of ketamine as an opioid-sparing adjunct in the preoperative period have been well studied, the use of ketamine to mitigate chronic pain conditions remains largely anecdotal, composed largely of case reports and uncontrolled small studies. The limited evidence and published reports support the use of ketamine infusions as one aspect of a comprehensive, multimodal approach for CRPS. Although ketamine infusions are relatively safe when titrated appropriately, with minimal respiratory depression, side effects include sympathetic activation, unpleasant psychomimetic effects, lower urinary tract symptoms, and hepatic dysfunction. 

scholarly journals Ketamine for Non-Neuropathic Pain

2021 ◽  
Author(s):  
Subbulakshmi Sundaram ◽  
Ashok Swaminathan Govindarajan
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Complex Regional Pain Syndrome ◽  
Antinociceptive Effect ◽  
Pain Syndrome ◽  
Well Being ◽  
Pain Mechanisms ◽  
Cardiovascular Side Effects ◽  
Chronic Pain Conditions ◽  
Rescue Agent

Chronic pain is one of the leading causes of years lost to disability, as most of the time it is refractory to conventional treatment. Recent advances in understanding the pain mechanisms have favored the use of ketamine as a rescue agent in refractory chronic pain conditions, as it has potential modulating effect on both sensory-discriminative and affective motivational components of pain. Preclinical studies also suggested the antinociceptive effect of sub anesthetic dose of ketamine against central and peripheral neuropathic pain conditions and non-neuropathic pain conditions such as inflammatory and nociceptive pain states. Subanesthetic infusion of ketamine along with adjuvants such as midazolam and clonidine is found to reduce the psychomimetic and cardiovascular side effects of ketamine. Even though the consensus guidelines for intravenous use of ketamine for chronic pain advocate the use of ketamine only for complex regional pain syndrome, various other clinical studies suggested its role in other refractory painful conditions. Hence the present topic focuses specifically on the effect of ketamine on non-neuropathic pain conditions such as complex regional pain syndrome, fibromyalgia, headache, ischemic limb pain, etc. Many studies had shown that ketamine not only reduces the pain scores but also the analgesic medications, which further improves the well-being and quality of life.

scholarly journals Virtual Environment Rehabilitation for Patients with Motor Neglect Trial (VERMONT): A Single-Center Randomized Controlled Feasibility Trial

2021 ◽  
Vol 11 (4) ◽  
pp. 464
Author(s):  
Elsje de Villiers ◽  
Thomas Stone ◽  
Nai-Wei Wang ◽  
Viswadeep Sarangi ◽  
Adar Pelah ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Intervention Group ◽  
Pain Syndrome ◽  
Feasibility Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Still Images ◽  
Novel Approach ◽  
Motor Neglect ◽  
Chronic Pain Conditions

Background: Motor neglect occurs in patients with chronic pain conditions. Virtual environments (VE) help rehabilitation through biofeedback and improving motivation. Aim: To assess the feasibility of a VE for patients with motor neglect with chronic pain. Methods: 10 subjects with chronic pain (Fibromyalgia, Sciatica, and Complex Regional Pain Syndrome) underwent a treadmill task three times per week for two weeks. Groups were randomized to receive real-time biofeedback from the VE (intervention) or shown still images (control). Primary outcomes were: (i) distance walked at baseline compared to the final 5 min cycle of week 2; (ii) the Lower Extremity Functional Index (LEFI) questionnaire. A satisfaction questionnaire was used. Follow up was to 24 weeks. Results: Total distance walked was significantly higher in the intervention group (p < 0.05), and 33% (2/6) of the intervention group had a clinically important LEFI improvement compared to 0/4 in the control group at week 2. No secondary outcome measures demonstrated any significant differences. The intervention received high satisfaction scores, significantly greater than the control group at week 24. No harms were recorded. Discussion: This feasibility study showed that VE and treadmill-walking improved walking distances and function for subjects with motor neglect. This is a promising novel approach and requires further validation through larger study.

Qualitative pain research emphasizes that patients need true information and physicians and nurses need more knowledge of complex regional pain syndrome (CRPS)

2017 ◽  
Vol 15 (1) ◽  
pp. 104-105 ◽  
Author(s):  
Harald Breivik ◽  
Stephen Butler
Keyword(s):  
Chronic Pain ◽  
Complex Regional Pain Syndrome ◽  
Muscle Pain ◽  
Scandinavian Journal ◽  
Young Patients ◽  
Pain Syndrome ◽  
Rehabilitation Team ◽  
Multidisciplinary Rehabilitation ◽  
Chronic Pain Conditions ◽  
Depth Interviews

AbstractIn this issue of the Scandinavian Journal of Pain Kari Sørensen and Bjørg Christiansen publish their report on in depth interviews of young patients suffering from CRPS or from severe muscle pain [1]. These patients were recovering from their chronic pain conditions after treatment by a multidisciplinary rehabilitation team.

scholarly journals Current Innovations in Peripheral Nerve Stimulation

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Raghavendra Nayak ◽  
Ratan K. Banik
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Pain Syndrome ◽  
Peripheral Nerve Stimulation ◽  
Intractable Pain ◽  
Nerve Blocks ◽  
Pulse Generators ◽  
Cranial Neuralgias ◽  
Chronic Pain Conditions

Peripheral nerve stimulation has been used in the treatment of several chronic pain conditions including pain due to peripheral nerve dysfunctions, complex regional pain syndrome, and cranial neuralgias. It has been shown to be effective for chronic, intractable pain that is refractory to conventional therapies such as physical therapy, medications, transcutaneous electrical stimulations, and nerve blocks. Recently, a new generation of peripheral nerve stimulation devices has been developed; these allow external pulse generators to transmit impulses wirelessly to the implanted electrode, and their implantation is significantly less invasive. In this review, we discuss the history, pathophysiology, indications, implantation process, and outcomes of employing peripheral nerve stimulation to treat chronic pain conditions.

Building the evidence for CRPS research from a lived experience perspective

2015 ◽  
Vol 9 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Colleen M. Johnston ◽  
Florin I. Oprescu ◽  
Marion Gray
Keyword(s):  
Chronic Pain ◽  
Lived Experience ◽  
Subjective Experience ◽  
Treatment Guidelines ◽  
Pain Treatment ◽  
Pain Syndrome ◽  
Health Practitioners ◽  
Body Self ◽  
Chronic Pain Conditions ◽  
Public Health Practitioners

ABSTRACTBackground and aims Pain is known to be a subjective experience yet the majority of pain related research does not address the lived experience of the condition. Difficult to diagnose, Complex Regional Pain Syndrome (CRPS) is often poorly managed. The aim of this paper was to identify and synthesise the currently available literature on experiences of living with chronic pain in order to understand where and how CRPS research may be best situated in the future.MethodsA narrative review was performed and ProQuest, EBSCO, Informit, Scopus/Science Direct and Web of Science, Medline, CINHAL and Google Scholar were searched in order to identify the literature from 1998 until 2015. 301 papers were identified of which 197 described the lived experience of chronic pain conditions. 12 papers were examined closely to determine the experience of living with CRPS or a similar chronic pain condition that does not have a definite pain origin such as cancer or endometriosis.Results Known understandings of pain were identified and a model was developed depicting the lived experience of chronic pain starting with loss of the former healthy, pain free self and culminating in acceptance of the condition. Major themes identified were disbelief/invisibility of pain, loss, coping with a non-compliant/constant painful body, self-management and alleviating pain/treatment. The review also found that there is no peer-reviewed published literature on the lived experience of CRPS.Conclusions Little is known about the lived experience of CRPS. There appears to be a clear indication that research needs to be conducted into CRPS from a lived experience perspective in order to provide information to patients, the general public, health practitioners and policy makers of previously unknown characteristics of this condition which may improve health outcomes for this patient cohort.It has been identified that patients and their families should be active participants in education of health practitioners and in providing information to inform the development of National Pain Strategies currently being devised throughout the world.ImplicationsResearch into the lived experience of chronic pain conditions, and CRPS in particular, can help to provide information to enhance understanding enabling national pain strategies and future treatment guidelines strategies to be devised appropriately.

scholarly journals Creation of a Multispecialty Clinic for Patients with Central Sensitization–Based Chronic Pain Conditions

2022 ◽  
Vol 6 (1) ◽  
pp. 45-54
Author(s):  
Conor G. Loftus ◽  
Jon O. Ebbert ◽  
Christopher A. Aakre ◽  
Natalie A. Caine ◽  
Meredith A. DeZutter ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Central Sensitization ◽  
Chronic Pain Conditions

Disability, Chronic Pain, and Medically Unexplained Symptoms

2021 ◽  
pp. 55-71
Author(s):  
David Beaumont
Keyword(s):  
Chronic Pain ◽  
Central Sensitization ◽  
Medically Unexplained Symptoms ◽  
Pain Syndrome ◽  
Chronic Fatigue ◽  
Case Examples ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Irritable Bowel ◽  
Definition Of

The concept of disability (including the WHO definition). Case example: disability cf ‘challenge’. Chronic pain, chronic fatigue, and spina bifida, Author’s keynote speech to New Zealand Disability Support Network. The experience of 100 people with different disabilities: system failure and ‘all some doctors see is my disability’. Author’s personal experience of disability resulting from osteoarthritis in both hips. Effect of aquajogging and gentle walking in easing pain, losing weight, and lifting mood. The experience of pain. Chronic pain syndrome and Professor Clifford Woolf’s (Harvard Medical School) 1983 definition of central sensitization. The role of the brain in the experience of pain. Central sensitization and case examples of carpal tunnel syndrome and low back pain. Regional pain syndrome, pain medication and the patient’s expertise with gabapentin. Number needed to treat of gabapentin is 6–8. Effectiveness of paracetamol. Medically unexplained symptoms explained, the example of fibromyalgia, irritable bowel syndrome. The concept of ‘curing’ compared with ‘healing’. The concept of homeostasis. The WHO’s ICD-11 (2018) and the new overarching concept of bodily distress disorder.

Classification of Neuropathic Pain

2018 ◽  
pp. 11-16
Author(s):  
Abdullah Kandil ◽  
Danielle Perret
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Phantom Limb Pain ◽  
Pain Syndrome ◽  
Phantom Limb ◽  
Charcot Marie Tooth Disease ◽  
Amputation Stump ◽  
Stump Pain ◽  
Chronic Pain Conditions

Neuropathic pain encompasses a category of chronic pain conditions that are caused by disease or lesion of the somatosensory nervous system. Depending on the location of the lesion or disease, neuropathic pain can be categorized as peripheral, central, or mixed. Peripheral neuropathic pain includes such common pain conditions as painful diabetic neuropathy, postherpetic neuralgia, radiculopathies, post-amputation stump pain, various nerve entrapment syndromes, and neuropathies due to immune, hereditary, metabolic, and toxic factors. Central neuropathic pain is pain caused by stroke, spinal cord injury, spinal infarction, syringomyelia, multiple sclerosis, Parkinson disease, and phantom limb pain. In contrast, some conditions may cause pain through both central and peripheral mechanisms, such spinal stenosis, complex regional pain syndrome type II, Charcot-Marie-Tooth disease, fibromyalgia, and cancer pain. Classification of neuropathic may not only help guide the diagnosis and treatment of these chronic pain conditions but may also provide the framework for research of the mechanisms of generation of neuropathic pain.

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