Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
Chronic Pain: Clinical Updates and Perspectives
share announcement

Chronic Pain: Clinical Updates and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 48271

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Dr. Carmen M. Galvez-Sánchez

E-Mail Website
Guest Editor
Department of Psychology, University of Jaén, 23071 Jaén, Spain
Interests: chronic pain; personality; fibromyalgia; rheumatoid arthritis; gender perspective; health-related quality of life; neuropsychological evaluation; pain sensitization syndromes
Special Issues, Collections and Topics in MDPI journals
Dr. Casandra Isabel Montoro Aguilar

E-Mail Website
Guest Editor
Department of Psychology, University of Jaén, 23071 Jaén, Spain
Interests: chronic pain; personality; fibromyalgia syndrome; emotional disorders; cognitive impairments; transcranial doppler functional ultrasonography; transcranial direct current stimulation; cerebral autoregulation; cardiovascular variability; hypotension
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Markus W. Hollmann

E-Mail Website
Guest Editor
Department of Anesthesiology, Amsterdam University Medical Center (AUMC), Amsterdam, The Netherlands
Interests: pain management; fluid management; neuromuscular management; chronic pain, regional anesthesia; pharmacology; cardioprotection; intraoperative ventilation; local anesthetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic pain exerts a serious health burden on industrialized societies, being one of the leading causes of disability. Due to its high prevalence, morbidity, and comorbidity with different psychological problems, especially anxiety, depression, insomnia and cognitive disorders, chronic pain is considered one of the diseases that consumes a great deal of health resources. As a single disease, chronic pain is one of the most common and costly medical conditions. It not only impacts the quality of life of people suffering from it, but also generates high social health expenses related to its management, in addition to the economic costs resulting from high rates of absenteeism, reduction of labor productivity, disability, etc. Unfortunately, to date there is no therapy with proven effectiveness for the management of chronic pain. As a consequence, different international resolutions have declared adequate pain therapy as a human right. Furthermore, several studies warn that chronic pain will increase with population aging, which in turn will cause a higher social health cost. Taking into account the above and that pain is a multidimensional phenomenon in which cognitive, emotional and physiological aspects converge, the scope of this Special Issue is to deepen the diagnosis, treatment, prevention and management of chronic pain in its different spheres, and to deepen and update our knowledge of the investigations that are being conducted in this field, paying special attention to the experiences of people who suffer from chronic pain. Researchers in the field of chronic pain are encouraged to submit an original research or review article to this Special Issue that can provide useful insights into the clinical updates and perspectives directed to the management of chronic pain.

Prof. Dr. Carmen María Galvez Sánchez
Prof. Dr. Casandra I. Montoro Aguilar
Prof. Dr. Markus W. Hollmann
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic pain
  • diagnosis
  • prevention
  • management
  • treatment
  • patient experiences
  • experimental studies

Published Papers (17 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Editorial

Jump to: Research, Review, Other

4 pages, 249 KiB  
Editorial
Chronic Pain: Clinical Updates and Perspectives
by Carmen M. Galvez-Sánchez and Casandra I. Montoro
J. Clin. Med. 2022, 11(12), 3474; https://doi.org/10.3390/jcm11123474 - 16 Jun 2022
Cited by 4 | Viewed by 2103
Abstract
The International Association for the Study of Pain (IASP) has defined pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, which also comprises a subjective component [...] Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)

Research

Jump to: Editorial, Review, Other

11 pages, 1201 KiB  
Article
The Impact of Comorbid Chronic Pain on Pharmacotherapy for Veterans with Post-Traumatic Stress Disorder
by Alessandra A. Pratt, Katherine Hadlandsmyth, Michelle A. Mengeling, Emily B. K. Thomas, Kelly Miell, Sonya B. Norman and Brian C. Lund
J. Clin. Med. 2023, 12(14), 4763; https://doi.org/10.3390/jcm12144763 - 19 Jul 2023
Viewed by 797
Abstract
Objective: Chronic pain can worsen PTSD symptomatology and may increase the risk of the prescription of multiple central nervous system (CNS)-active medications. The objective is to determine the impact of chronic pain on the number of CNS medications, including psychiatric medications, as well [...] Read more.
Objective: Chronic pain can worsen PTSD symptomatology and may increase the risk of the prescription of multiple central nervous system (CNS)-active medications. The objective is to determine the impact of chronic pain on the number of CNS medications, including psychiatric medications, as well as the amount of medication changes. Methods: Veterans Affairs (VA) administrative data were used to identify VA-served Veterans with PTSD (N = 637,428) who had chronic pain (50.3%) and did not have chronic pain (49.7%) in 2020. The outcomes included the number of changes in psychiatric medications and the number of currently prescribed CNS-active mediations during a one-year observation period. Results: The number of changes in psychiatric medications was significantly higher for those with chronic pain (mean (M) = 1.8) versus those without chronic pain (M = 1.6) (Z = 38.4, p < 0.001). The mean number of concurrent CNS-active medications were significantly higher for those with chronic pain (M = 2.7) versus those without chronic pain (M = 2.0) (Z = 179.7, p < 0.001). These differences persisted after adjustment for confounding factors using negative binomial regression. Conclusions: Veterans with comorbid chronic pain and PTSD are at increased risk for a higher number of medication changes and for receiving CNS-active polytherapy. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

11 pages, 1479 KiB  
Article
The Effects of Body Composition Characteristics on the Functional Disability in Patients with Degenerative Lumbar Spinal Stenosis
by Yesull Kim, Chanhong Lee, Hyunji Oh, Ji-Seon Son and Aram Doo
J. Clin. Med. 2023, 12(2), 612; https://doi.org/10.3390/jcm12020612 - 12 Jan 2023
Viewed by 1279
Abstract
Several research studies suggest that obese patients are at a higher risk of developing lumbar spinal disorder, including degenerative lumbar spinal stenosis (LSS), compared to normal-weight individuals. However, there are few investigations of how obesity affects functional disability in activities of daily living [...] Read more.
Several research studies suggest that obese patients are at a higher risk of developing lumbar spinal disorder, including degenerative lumbar spinal stenosis (LSS), compared to normal-weight individuals. However, there are few investigations of how obesity affects functional disability in activities of daily living (ADL) in patients who were diagnosed with LSS. This prospective observational study aimed to determine if an association exists between body composition parameters, such as body fat and skeletal muscle, and functional disability in ADL of LSS patients. In the results of the current study, there were significant differences in percent body fat between the mild/moderate and severe disability groups. However, there were no differences in skeletal muscle mass or index between the two groups. Furthermore, we found a positive linear relationship between percent body fat and functional disability in male sex. This study suggests that increased percent body fat predicts potential severe functional disability in ADL in LSS patients. Body composition analysis may provide useful information for predicting the disease severity of various lumbar spinal disorders in clinical practice. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

12 pages, 700 KiB  
Article
Test–Retest Reliability and Concurrent Validity of the 3 m Backward Walk Test under Single and Dual-Task Conditions in Women with Fibromyalgia
by Juan Luis Leon-Llamas, Santos Villafaina, Alvaro Murillo-Garcia, Francisco Javier Domínguez-Muñoz and Narcis Gusi
J. Clin. Med. 2023, 12(1), 212; https://doi.org/10.3390/jcm12010212 - 27 Dec 2022
Cited by 3 | Viewed by 1785
Abstract
Background: Previous studies have reported good test–retest reliability for the 3 m backward test (3MBWT) in different populations. However, reliability of the 3MBWT has not been studied in fibromyalgia (FM) under single and dual-task conditions; Methods: A total of 21 women with FM [...] Read more.
Background: Previous studies have reported good test–retest reliability for the 3 m backward test (3MBWT) in different populations. However, reliability of the 3MBWT has not been studied in fibromyalgia (FM) under single and dual-task conditions; Methods: A total of 21 women with FM participated in this study. Participants completed the Revised Fibromyalgia Impact Questionnaire and two physical fitness tests: the 3MBWT and the Timed Up and Go (TUG). The dual-task condition consisted of subtracting two by two while performing the test, starting from a random number less than 100; Results: Values showed that the 3MBWT can be considered reliable under single and dual-task conditions when measured with both a manual stopwatch and a Chronopic automatic stopwatch. A strong concurrent validity was shown of 3MBWT and TUG results in the test and retest and the different devices. The relationship between the performance of the 3MBWT in test and retest conditions under single and dual-task conditions measured with different devices and the impact of the disease were high; Conclusions: The 3MBWT is a reliable tool under the single and dual-task conditions in women with FM. It shows higher reliability values when time is taken using a Chronopic. This test also shows high concurrent validity with the TUG test. Its performance is related to the impact of the disease. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

11 pages, 1591 KiB  
Article
Do Men and Women Have a Different Association between Fear-Avoidance and Pain Intensity in Chronic Pain? An Experience Sampling Method Cohort-Study
by Sophie Waardenburg, Lars Visseren, Elke van Daal, Brigitte Brouwer, Jan van Zundert, Sander M. J. van Kuijk, Richel Lousberg, Ellen M. M. Jongen, Carsten Leue and Nelleke de Meij
J. Clin. Med. 2022, 11(19), 5515; https://doi.org/10.3390/jcm11195515 - 20 Sep 2022
Cited by 2 | Viewed by 1636
Abstract
Background: Fear-avoidance is one of the factors associated with chronic pain. However, it remains unclear whether the association between fear-avoidance and pain depends on sex. The present study aimed to investigate whether the association between fear-avoidance and pain intensity differed between men and [...] Read more.
Background: Fear-avoidance is one of the factors associated with chronic pain. However, it remains unclear whether the association between fear-avoidance and pain depends on sex. The present study aimed to investigate whether the association between fear-avoidance and pain intensity differed between men and women in chronic pain patients. Additionally, the potential confounding effect of affective experiences on the association between fear-avoidance and pain intensity was analyzed. Method: This cohort study included hospital referred chronic pain patients (n = 45). Short momentary assessment questions according to the experience sampling method (ESM) were used to repeatedly assess patients’ pain intensity, level of fear-avoidance and positive as well as negative affect during their daily life. Linear mixed-effects models were applied in the statistical analysis. Unadjusted and adjusted models were made, in which the latter corrected for statistically significant affective experiences and baseline variables, taking the Aikake Information Criterion into account to assess a better model of fit. Results: The results demonstrated an association between fear-avoidance and pain intensity that differed for men and women. In men (n = 13), no association between these variables was found (−0.04 (95% CI: −0.14, 0.06) with a p-value of 0.48), whereas in women (n = 32), an increase in fear-avoidance was associated with a (slight) increase in pain intensity (0.18 (95% CI 0.06, 0.30) with a p-value of 0.003). Affect did not confound the above-mentioned findings. Conclusion: Our data supports previous research highlighting the importance of sex differences in pain experience. These findings may be relevant for clinicians to consider more personalized (i.e., gender specific) pain management in chronic pain patients. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

12 pages, 577 KiB  
Article
Psychiatric Comorbidity and Emotional Dysregulation in Chronic Tension-Type Headache: A Case-Control Study
by Rosalinda Romero-Godoy, Sara Raquel Romero-Godoy, Manuel Romero-Acebal and Mario Gutiérrez-Bedmar
J. Clin. Med. 2022, 11(17), 5090; https://doi.org/10.3390/jcm11175090 - 30 Aug 2022
Cited by 2 | Viewed by 1421
Abstract
Background: Chronic tension-type headache (CTTH) is frequently associated with a psychiatric comorbidity of depression and anxiety. Most studies focus their attention on this association, and only few link CTTH with psycho-affective emotional regulation disorders. Objective: To evaluate the association of CTTH with anxiety, [...] Read more.
Background: Chronic tension-type headache (CTTH) is frequently associated with a psychiatric comorbidity of depression and anxiety. Most studies focus their attention on this association, and only few link CTTH with psycho-affective emotional regulation disorders. Objective: To evaluate the association of CTTH with anxiety, depression, positive and negative affectivity, and emotional management in CTTH patients with neither a previous diagnosis of psychiatric disorder nor use of psychoactive drugs or abuse of analgesics. Design: Case-control study. Methods: Validated scores for state and trait anxiety, depression, positive and negative state and trait affect, cognitive reappraisal, and expressive suppression were assessed in 40 subjects with CTTH and 40 healthy subjects. Associations between CTTH and psychological status were assessed through linear multivariate regression models. Results: CTTH was associated with higher scores for depression (Beta = 5.46, 95% CI: 1.04–9.88), state and trait anxiety (Beta = 12.77, 95% CI: 4.99–20.56 and Beta = 8.79, 95% CI: 2.29–15.30, respectively), and negative state affect (Beta = 5.26, 95% CI: 0.88–9.64). Conclusions: CTTH is directly associated with depression, anxiety, and negative affectivity signs despite the absence of a previously diagnosed psychiatric disorder or psychopharmacological intake. The recognition of these comorbid and psycho-affective disorders is essential to adapt the emotional management of these patients for better control. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

14 pages, 380 KiB  
Article
Fibromyalgia Syndrome and Cognitive Decline: The Role of Body Mass Index and Clinical Symptoms
by Cristina Muñoz Ladrón de Guevara, Gustavo A. Reyes del Paso, María José Fernández Serrano and Casandra I. Montoro
J. Clin. Med. 2022, 11(12), 3404; https://doi.org/10.3390/jcm11123404 - 14 Jun 2022
Cited by 9 | Viewed by 2012
Abstract
The high prevalence of obesity and overweight in fibromyalgia (FM) may be an important factor in the well-known cognitive deficits seen in the disorder. This study analyzed the influence of body mass index (BMI) and primary clinical symptoms of FM (pain, fatigue, insomnia, [...] Read more.
The high prevalence of obesity and overweight in fibromyalgia (FM) may be an important factor in the well-known cognitive deficits seen in the disorder. This study analyzed the influence of body mass index (BMI) and primary clinical symptoms of FM (pain, fatigue, insomnia, anxiety, and depression) on attention, memory, and processing speed in FM. Fifty-two FM patients and thirty-two healthy participants completed cognitive tasks assessing selective, sustained, and divided attention; visuospatial and verbal memory; and information processing speed. Furthermore, they were evaluated in terms of the main clinical symptoms of the disorder. FM patients showed a marked reduction of cognitive performance in terms of selective, sustained, and divided attention; visuospatial memory; and processing speed, but no group differences were observed in verbal memory. BMI negatively affects sustained and selective attention, verbal memory, and processing speed and is the main predictor of performance in these basic cognitive domains. Our findings confirm the presence of cognitive deficits with respect to attention and visual memory, as well as slower processing speed, in FM. Moreover, the results support a role of BMI in the observed cognitive deficits. Interventions increasing physical activity and promoting cognitive stimulation could be useful for strengthening cognitive function in FM patients. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
9 pages, 1332 KiB  
Article
Differences in Postural Balance, Pain Sensitivity and Depression between Individuals with Acute and Chronic Back Pain
by José Antonio Mingorance, Pedro Montoya, José García Vivas Miranda and Inmaculada Riquelme
J. Clin. Med. 2022, 11(10), 2700; https://doi.org/10.3390/jcm11102700 - 10 May 2022
Cited by 2 | Viewed by 2137
Abstract
To compare differences in postural balance, pain and depression in patients with chronic and acute low back pain, twenty patients with chronic and twenty patients with acute low back pain from the Edward Francis Small Hospital (Banjul, Gambia), as well as 20 age-matched [...] Read more.
To compare differences in postural balance, pain and depression in patients with chronic and acute low back pain, twenty patients with chronic and twenty patients with acute low back pain from the Edward Francis Small Hospital (Banjul, Gambia), as well as 20 age-matched healthy controls participated in the study. A modified Romberg test was used to assess postural balance during one minute with closed eyes. Body sway in the anteroposterior and mediolateral axes was video-recorded during test performance and further analyzed with an open source software for movement analyses (CvMob). Pain sensitivity was assessed by means of pressure pain thresholds and depression by a self-report questionnaire (PHQ-9). As results, patients with chronic low back pain displayed higher body sway in the anteroposterior and mediolateral axes, as well as faster body sway than patients with acute low back pain and healthy controls. Nevertheless, group differences disappeared when depression was introduced as a covariate, indicating a major role of depression in postural balance deficits of patients with pain disorders. As conclusions, the assessment of postural balance and depression should be implemented in the clinical routine for the design of tailored interventions in pain conditions. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

14 pages, 864 KiB  
Article
Self-Reported Practices and Emotions in Prescribing Opioids for Chronic Noncancer Pain: A Cross-Sectional Study of German Physicians
by Erika Schulte, Frank Petzke, Claudia Spies, Claudia Denke, Michael Schäfer, Norbert Donner-Banzhoff, Ralph Hertwig and Odette Wegwarth
J. Clin. Med. 2022, 11(9), 2506; https://doi.org/10.3390/jcm11092506 - 29 Apr 2022
Viewed by 1509
Abstract
Background: The pressure on physicians when a patient seeks pain relief and their own desire to be self-effective may lead to the prescription of strong opioids for chronic noncancer pain (CNCP). This study, via physician self-reporting, aims to identify and measure (i) physician [...] Read more.
Background: The pressure on physicians when a patient seeks pain relief and their own desire to be self-effective may lead to the prescription of strong opioids for chronic noncancer pain (CNCP). This study, via physician self-reporting, aims to identify and measure (i) physician adherence to national opioid prescribing guidelines and (ii) physician emotions when a patient seeks a dosage increase of the opioid. Methods: Within a cross-sectional survey—conducted as part of a randomized controlled online intervention trial (ERONA)—600 German physicians were queried on their opioid prescribing behavior (choice and formulation of opioid, indications) for CNCP patients and their emotions to a case vignette describing a patient seeking an opioid dosage increase without signs of objective deterioration. Results: The prescription of strong opioids in this study was not always in accordance with current guidelines. When presented with a scenario in which a patient sought to have their opioid dose increased, some physicians reported negative feelings, such as either pressure (25%), helplessness (25%), anger (23%) or a combination. The risk of non-guideline-compliant prescribing behavior using the example of ultrafast-acting fentanyl for CNCP was increased when negative emotions were present (OR: 1.7; 95%-CI: 1.2–2.6; p = 0.007) or when sublingual buprenorphine was prescribed (OR: 15.4; 95%-CI: 10.1–23.3; p < 0.001). Conclusions: Physicians’ emotional self-awareness represents the first step to identify such direct reactions to patient requests and to ensure a responsible, guideline-based opioid prescription approach for the long-term well-being of the patient. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

14 pages, 10961 KiB  
Article
Sensory Thresholds and Peripheral Nerve Responses in Chronic Tension-Type Headache and Neuropsychological Correlation
by Rosalinda Romero-Godoy, Sara Raquel Romero-Godoy, Manuel Romero-Acebal and Mario Gutiérrez-Bedmar
J. Clin. Med. 2022, 11(7), 1905; https://doi.org/10.3390/jcm11071905 - 29 Mar 2022
Cited by 2 | Viewed by 2055
Abstract
Chronic tension-type headache (CTTH) is a common disease with no fully defined pathophysiological processes. We designed a study to value electrophysiological responses in these patients and their correlation with possible psychopathological manifestations in order to deepen understanding of central and peripheral mechanisms of [...] Read more.
Chronic tension-type headache (CTTH) is a common disease with no fully defined pathophysiological processes. We designed a study to value electrophysiological responses in these patients and their correlation with possible psychopathological manifestations in order to deepen understanding of central and peripheral mechanisms of CTTH. In 40 patients with CTTH and 40 healthy controls, we used electrical stimulation to determine sensory threshold (SPT) and pain perception threshold (PPT) and the characteristics of the electrophysiological sensory nerve action potential (SNAP): initial sensory response (ISR) and supramaximal response (SMR). We then calculated the intensity differences between thresholds (IDT), namely SPT-PPT, ISR-SMR and SMR-PPT, and correlated these IDTs with psychological characteristics: trait and state anxiety, depression, and emotional regulation. The SPT, together with the ISR and SMR thresholds, were higher (p < 0.01) in CTTH patients. The SMR-PPT IDT was smaller and correlated with significantly higher indicators of depression, state and trait anxiety, and poorer cognitive reappraisal. CTTH patients have less capacity to recognize non-nociceptive sensory stimuli, greater tendency toward pain facilitation, and a poor central pain control requiring higher stimulation intensity thresholds to reach the start and the peak amplitude of the SNAP. This is consistent with relative hypoexcitability of the Aβ nerve fibers in distant regions from the site of pain, and therefore, it could be considered a generalized dysfunction with a focal expression. Pain facilitation is directly associated with psychological comorbidity. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

Review

Jump to: Editorial, Research, Other

24 pages, 1123 KiB  
Review
The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review
by Ömer Elma, Katherine Brain and Huan-Ji Dong
J. Clin. Med. 2022, 11(19), 5950; https://doi.org/10.3390/jcm11195950 - 9 Oct 2022
Cited by 10 | Viewed by 9699
Abstract
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of [...] Read more.
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one’s dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

14 pages, 321 KiB  
Review
The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
by Matthias Vogel, Marius Binneböse, Hannah Wallis, Christoph H. Lohmann, Florian Junne, Alexander Berth and Christian Riediger
J. Clin. Med. 2022, 11(18), 5490; https://doi.org/10.3390/jcm11185490 - 19 Sep 2022
Cited by 2 | Viewed by 2266
Abstract
Introduction: Chronic pain is a multifaceted disorder genuinely entangled with psychic and psychosomatic symptoms, which are typically involved in the processes of chronification. The impingement syndrome of the shoulder is no exception to this rule, but several studies have shown respective peculiarities among [...] Read more.
Introduction: Chronic pain is a multifaceted disorder genuinely entangled with psychic and psychosomatic symptoms, which are typically involved in the processes of chronification. The impingement syndrome of the shoulder is no exception to this rule, but several studies have shown respective peculiarities among those with pain and impingement of the shoulder. Notably, chronic pain is a lateralized experience, and, similarly, its psychosomatic correlates may be attached to the hemispheres functionally. Aim: The present review therefore gives an overview of the respective findings, with regard not only to psychopathology, but also to personality factors and psychologic trauma, since the latter are reportedly associated with chronic pain. Moreover, we acknowledge symmetry as a possible pathogenic factor. Methods: This narrative review followed the current standards for conducting narrative studies. Based on prior findings, our research strategy included the relevance of psychotraumatologic and symmetrical aspects, as well as comorbidity. We retrieved the relevant literature reporting on the impact of psychopathology as well as personality features on shoulder pain, as published up to January 2022 from the Medline database (1966–2022). Study selecton: We included numerous studies, and considered the contextual relevance of studies referring to the neuropsychosomatics of chronic pain. Results: Pain-specific fears, depression, and anxiety are important predictors of shoulder pain, and the latter is generally overrepresented in those with trauma and PTSD. Moreover, associations of shoulder pain with psychological variables are stronger as regards surgical therapies as compared to conservative ones. This may point to a specific and possibly trauma-related vulnerability for perioperative maladaptation. Additionally, functional hemispheric lateralization may explain some of those results given that limb pain is a naturally lateralized experience. Not least, psychosocial risk factors are shared between shoulder pain and its physical comorbidities (e.g., hypertension), and the incapacitated state of the shoulder is a massive threat to the function of the human body as a whole. Conclusions: This review suggests the involvement of psychosomatic and psychotraumatologic factors in shoulder impingement-related chronic pain, but the inconclusiveness and heterogeneity of the literature in the field is possibly suggestive of other determinants such as laterality. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
13 pages, 1174 KiB  
Review
Practical Considerations for the Use of Cannabis in Cancer Pain Management—What a Medical Oncologist Should Know
by Alecsandra Gorzo, Andrei Havași, Ștefan Spînu, Adela Oprea, Claudia Burz and Daniel Sur
J. Clin. Med. 2022, 11(17), 5036; https://doi.org/10.3390/jcm11175036 - 27 Aug 2022
Cited by 3 | Viewed by 2718
Abstract
Pain is a highly debilitating emotional and sensory experience that significantly affects quality of life (QoL). Numerous chronic conditions, including cancer, are associated with chronic pain. In the setting of malignancy, pain can be a consequence of the tumor itself or of life-saving [...] Read more.
Pain is a highly debilitating emotional and sensory experience that significantly affects quality of life (QoL). Numerous chronic conditions, including cancer, are associated with chronic pain. In the setting of malignancy, pain can be a consequence of the tumor itself or of life-saving interventions, including surgery, chemotherapy, and radiotherapy. Despite significant pharmacological advances and awareness campaigns, pain remains undertreated in one-third of patients. To date, opioids have been the mainstay of cancer pain management. The problematic side effects and unsatisfactory pain relief of opioids have revived patients’ and physicians’ interest in finding new solutions, including cannabis and cannabinoids. The medical use of cannabis has been prohibited for decades, and it remains in Schedule 1 of the Misuse of Drugs Regulations. Currently, the legal context for its usage has become more permissive. Various preclinical and observational studies have aimed to prove that cannabinoids could be effective in cancer pain management. However, their clinical utility must be further supported by high-quality clinical trials. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

19 pages, 748 KiB  
Review
Chronic Pain and Emotional Stroop: A Systematic Review
by Lidia Amaro-Díaz, Casandra I. Montoro, Laura R. Fischer-Jbali and Carmen M. Galvez-Sánchez
J. Clin. Med. 2022, 11(12), 3259; https://doi.org/10.3390/jcm11123259 - 7 Jun 2022
Cited by 13 | Viewed by 4333
Abstract
Chronic pain is an unpleasant sensory and emotional experience that persists for more than 3 months and is often accompanied by symptoms such as depression, fatigue, sleep disturbances, and cognitive impairment. Emotional dysregulation may also be involved in its etiology. Emotions are known [...] Read more.
Chronic pain is an unpleasant sensory and emotional experience that persists for more than 3 months and is often accompanied by symptoms such as depression, fatigue, sleep disturbances, and cognitive impairment. Emotional dysregulation may also be involved in its etiology. Emotions are known to modulate the experience of pain by influencing cognition and behavior (emotional awareness, emotional expression and experience, and verbalizations). A useful task to explore emotional processing and emotional dysregulation is the emotional Stroop task. Despite the large number of studies using this task, their objectives are diverse; it is necessary to integrate them. The main objective of the present systematic review was to determine the extent of the abnormalities in behavioral performance (including attentional biases) and/or brain alterations in patients with chronic pain during the emotional Stroop task. This systematic review was conducted in accordance with the Cochrane Collaboration guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The protocol was previously registered in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were extracted from the PubMed, Scopus, and Web of Science databases. Fifteen studies were identified as eligible for systematic review. The studies reported alterations in brain regions related to pain and emotional regulation, as well as attentional bias and higher response time latencies (related to the words’ emotional load) in patients with chronic pain. The results confirm the validity of the emotional Stroop task to measure emotions and selective attention. As attentional bias towards negative information is often seen in chronic pain patients, and given the relation between selective attention and greater activation of the brain areas associated with pain and emotional processing, this type of task plays a crucial role in research on emotional and attentional processes among chronic pain patients. Further, attentional bias towards negative information has been associated with higher levels of pain. Taken together, the results suggest the need for cognitive training and an emotional approach to chronic pain therapies, especially targeting attentional biases and negative mood. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

13 pages, 543 KiB  
Review
Dry Needling in Physical Therapy Treatment of Chronic Neck Pain: Systematic Review
by Manuel Rodríguez-Huguet, Maria Jesus Vinolo-Gil and Jorge Góngora-Rodríguez
J. Clin. Med. 2022, 11(9), 2370; https://doi.org/10.3390/jcm11092370 - 23 Apr 2022
Cited by 4 | Viewed by 5113
Abstract
Chronic Neck Pain (CNP) is one of the main causes of disability worldwide, and it is necessary to promote new strategies of therapeutic approach in the treatment of chronic pain. Dry needling (DN) is defined as an invasive physiotherapy technique used in the [...] Read more.
Chronic Neck Pain (CNP) is one of the main causes of disability worldwide, and it is necessary to promote new strategies of therapeutic approach in the treatment of chronic pain. Dry needling (DN) is defined as an invasive physiotherapy technique used in the treatment of neuromusculoskeletal disorders. The purpose of this review was to assess the effectiveness of invasive techniques in treatment of CNP. The search focused on randomized clinical trials, and according to the selection criteria, eight studies were obtained. In conclusion, DN can be an effective treatment option for CNP, positive outcomes were achieved in the short-term and in the follow-up performed between three and six months, and this technique may offer better outcomes than a placebo intervention based on the application of simulated DN. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

24 pages, 982 KiB  
Review
The Link between Fibromyalgia Syndrome and Anger: A Systematic Review Revealing Research Gaps
by Carmen M. Galvez-Sánchez, Gustavo A. Reyes del Paso, Stefan Duschek and Casandra I. Montoro
J. Clin. Med. 2022, 11(3), 844; https://doi.org/10.3390/jcm11030844 - 5 Feb 2022
Cited by 10 | Viewed by 3202
Abstract
Anger has been associated with increased pain perception, but its specific connection with Fibromyalgia Syndrome (FMS) has not yet been established in an integrated approach. Therefore, the present systematic review focuses on exploring this connection, and based on this connection, delimiting possible gaps [...] Read more.
Anger has been associated with increased pain perception, but its specific connection with Fibromyalgia Syndrome (FMS) has not yet been established in an integrated approach. Therefore, the present systematic review focuses on exploring this connection, and based on this connection, delimiting possible gaps in the research, altogether aimed at improving FMS clinical intervention and guiding future research lines. Anger is considered a basic negative emotion that can be divided into two dimensions: anger-in (the tendency to repress anger when it is experienced) and anger-out (the leaning to express anger through verbal or physical means). The current systematic review was performed based on the guidelines of the PRISMA and Cochrane Collaborations. The Prospective Register of Systematic Reviews (PROSPERO) international database was forehand used to register the review protocol. The quality of chosen articles was assessed and the main limitations and research gaps resulting from each scientific article were discussed. The search included PubMed, Scopus, and Web of Science databases. The literature search identified 13 studies eligible for the systematic review. Levels of anger-in have been shown to be higher in FMS patients compared to healthy participants, as well as patients suffering from other pain conditions (e.g., rheumatoid arthritis). FMS patients had also showed higher levels of state and trait anxiety, worry and angry rumination than other chronic pain patients. Anger seems to amplify pain especially in women regardless FMS condition but with a particularly greater health-related quality of life´s impact in FMS patients. In spite of the relevance of emotions in the treatment of chronic pain, including FMS, only two studies have proposed intervention programs focus on anger treatment. These two studies have observed a positive reduction in anger levels through mindfulness and a strength training program. In conclusion, anger might be a meaningful therapeutic target in the attenuation of pain sensitivity, and the improvement of the general treatment effects and health-related quality of life in FMS patients. More intervention programs directed to reduce anger and contribute to improve well-being in FMS patients are needed. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

Other

11 pages, 622 KiB  
Brief Report
Changes in Psychological Outcomes after Cessation of Full Mu Agonist Long-Term Opioid Therapy for Chronic Pain
by Marcelina Jasmine Silva, Zhanette Coffee, Chong Ho Alex Yu and Joshua Hu
J. Clin. Med. 2023, 12(4), 1354; https://doi.org/10.3390/jcm12041354 - 8 Feb 2023
Viewed by 1514
Abstract
Improved understanding of psychological features associated with full mu agonist long-term opioid therapy (LTOT) cessation may offer advantages for clinicians. This preliminary study presents changes in psychological outcomes in patients with chronic, non-cancer pain (CNCP) after LTOT cessation via a 10-week multidisciplinary program [...] Read more.
Improved understanding of psychological features associated with full mu agonist long-term opioid therapy (LTOT) cessation may offer advantages for clinicians. This preliminary study presents changes in psychological outcomes in patients with chronic, non-cancer pain (CNCP) after LTOT cessation via a 10-week multidisciplinary program which included treatment with buprenorphine. Paired t-tests pre- and post-LTOT cessation were compared in this retrospective cohort review of data from electronic medical records of 98 patients who successfully ceased LTOT between the dates of October 2017 to December 2019. Indicators of quality of life, depression, catastrophizing, and fear avoidance, as measured by the 36-Item Short Form Survey, the Patient Health Questionnaire-9-Item Scale, the Pain Catastrophizing Scale, and the Fear Avoidance Belief Questionnaires revealed significant improvement. Scores did not significantly improve for daytime sleepiness, generalized anxiety, and kinesiophobia, as measured by the Epworth Sleepiness Scale, the Generalized Anxiety Disorder 7-Item Scale, and the Tampa Scale of Kinesiophobia. The results suggest that successful LTOT cessation may be interconnected with improvements in specific psychological states. Full article
(This article belongs to the Special Issue Chronic Pain: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-17
Back to TopTop