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BMC Musculoskeletal Disorders Jun 2023The purpose of this study was to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) versus myofascial release therapy (MRT) on college... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The purpose of this study was to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) versus myofascial release therapy (MRT) on college students with chronic mechanical neck pain (CMNP).
METHODS
Thirty-three college students with a mean age of 21.33 ± 0.98 involved in distance learning due to the Corona Virus 2019 (COVID-19) restriction were randomized to receive either IASTM on the upper trapezius and levator scapulae muscles or MRT. Researchers measured their pain with a visual analog scale (VAS), function with neck disability index (NDI), and pain pressure threshold (PPT) with a pressure algometer. The subjects received eight therapy sessions over four weeks and outcome measures were assessed pre and post-intervention. The study was registered as a clinical trial on clinicaltrials.gov (registration number: NCT05213871).
RESULT
Unpaired t-test showed no statistical significance between the two groups post-intervention regarding improvement in pain, function, and PPT (p > 0.05).
CONCLUSION
This study showed insignificant differences between groups. However, we did not use a control group, indicating that the improvement in outcomes may not have been caused by the intervention.
STUDY DESIGN
Quasi-experimental two groups pre-posttest clinical trial.
LEVEL OF EVIDENCE
Therapy, level 2b.
Topics: Humans; Young Adult; Adult; Neck Pain; Myofascial Release Therapy; COVID-19; Pain Threshold; Myofascial Pain Syndromes; Chronic Pain
PubMed: 37270471
DOI: 10.1186/s12891-023-06540-5 -
Philosophical Transactions of the Royal... Nov 2019How far back can we trace behaviour associated with pain? Behaviour is not preserved in the palaeontological record, so, for dinosaurs, we are restricted to what we can... (Review)
Review
How far back can we trace behaviour associated with pain? Behaviour is not preserved in the palaeontological record, so, for dinosaurs, we are restricted to what we can deduce from fossilized bones and tracks. This review is a thought experiment using circumstantial evidence from dinosaur fossils and from the behaviour of their extant relatives to describe probable responses of dinosaurs to serious injuries. Searches yielded 196 papers and chapters with: reports of healed serious injuries, and limping gait and injured feet in trackways; information about physiology and behaviour relevant to healing; evidence of evolutionary connections with birds and crocodilians, and their behaviour; and information about relevant aspects of evolution. Clearly, many dinosaurs survived injuries that would have seriously hampered mobility, impairing hunting or escape from predators, and affecting social interactions. Recovery from severe injuries implies pain-mediated responses. Rates of healing seem faster than for other reptiles, possibily aided by warm-bloodedness. Nesting was often communal, raising the possibility of parental and group protection for injured young. The existence of family groups, packs or herds raises the possibility of protection or feeding from pack kills. This is the first study, to our knowledge, of possible pain behaviour and responses to injury in dinosaurs. This article is part of the Theo Murphy meeting issue 'Evolution of mechanisms and behaviour important for pain'.
Topics: Animals; Biological Evolution; Dinosaurs; Fossils; Pain; Paleontology
PubMed: 31544618
DOI: 10.1098/rstb.2019.0370 -
Current Osteoporosis Reports Oct 2020Fractures are painful and disabling injuries that can occur due to trauma, especially when compounded with pathologic conditions, such as osteoporosis in older adults.... (Review)
Review
PURPOSE OF REVIEW
Fractures are painful and disabling injuries that can occur due to trauma, especially when compounded with pathologic conditions, such as osteoporosis in older adults. It is well documented that acute pain management plays an integral role in the treatment of orthopedic patients. There is no current therapy available to completely control post-fracture pain that does not interfere with bone healing or have major adverse effects. In this review, we focus on recent advances in the understanding of pain behaviors post-fracture.
RECENT FINDINGS
We review animal models of bone fracture and the assays that have been developed to assess and quantify spontaneous and evoked pain behaviors, including the two most commonly used assays: dynamic weight bearing and von Frey testing to assess withdrawal from a cutaneous (hindpaw) stimulus. Additionally, we discuss the assessment and quantification of fracture pain in the clinical setting, including the use of numeric pain rating scales, satisfaction with pain relief, and other biopsychosocial factor measurements. We review how pain behaviors in animal models and clinical cases can change with the use of current pain management therapies. We conclude by discussing the use of pain behavioral analyses in assessing potential therapeutic treatment options for addressing acute and chronic fracture pain without compromising fracture healing. There currently is a lack of effective treatment options for fracture pain that reliably relieve pain without potentially interfering with bone healing. Continued development and verification of reliable measurements of fracture pain in both pre-clinical and clinical settings is an essential aspect of continued research into novel analgesic treatments for fracture pain.
Topics: Acute Pain; Animals; Behavior, Animal; Chronic Pain; Disease Models, Animal; Fracture Healing; Fractures, Bone; Humans; Pain; Pain Management; Pain Measurement; Weight-Bearing
PubMed: 32827293
DOI: 10.1007/s11914-020-00617-z -
Pain Research & Management 2018Pain elicits fear and anxiety and promotes escape, avoidance, and adaptive behaviors that are essential for survival. When pain persists, motivational priority and... (Review)
Review
Pain elicits fear and anxiety and promotes escape, avoidance, and adaptive behaviors that are essential for survival. When pain persists, motivational priority and attention shift to pain-related information. Such a shift often results in impaired functionality, leading to maladaptive pain-related fear and anxiety and escape and avoidance behaviors. Neuroimaging studies in chronic pain patients have established that brain activity, especially in cortical and mesolimbic regions, is different from activity observed during acute pain in control subjects. In this review, we discuss the psychophysiological and neuronal factors that may be associated with the transition to chronic pain. We review information from human studies on neural circuits involved in emotional and motivational pain processing and how these circuits are altered in chronic pain conditions. We then highlight findings from animal research that can increase our understanding of the molecular and cellular mechanisms underlying emotional-motivational pain processing in the brain. Finally, we discuss how translational approaches incorporating results from both human and animal investigations may aid in accelerating the discovery of therapies.
Topics: Animals; Emotions; Humans; Motivation; Pain; Pain Management; Translational Research, Biomedical
PubMed: 30123398
DOI: 10.1155/2018/5457870 -
Minerva Anestesiologica Sep 2018Chronic non-cancer pain in children and adolescents has been described as "a modern public health disaster" that has generated significant medical and economic burdens... (Review)
Review
Chronic non-cancer pain in children and adolescents has been described as "a modern public health disaster" that has generated significant medical and economic burdens within society. Seen as a disease in its own right, chronic pain has short and long-term consequences that impact not only the patient's health but also that of friends and families, due to significant parenting stress and disruptions in family life and structure. The evidence supporting pharmacological treatments and interventional procedures is limited, and no single strategy has been shown to be completely effective in children with chronic non-cancer pain. Therefore, considering the multifactorial nature of chronic pain, these patients should be treated with a multidisciplinary, balanced approach that seeks a primary outcome of improved functioning rather than of pain reduction. Using a bio-psycho-social approach, a multidisciplinary team, including a physiotherapist, nurse, social worker, psychologist, and physician, has been effective in achieving this outcome of improved functioning in children and adolescents with chronic pain. In this review, we discuss the impact, associated conditions, and evolution of chronic pain, along with the crucial role of every member of a multidisciplinary chronic pain clinic involved in the care of the children and adolescents with chronic non-cancer pain.
Topics: Adolescent; Child; Chronic Pain; Family Health; Humans; Patient Care Team
PubMed: 29745621
DOI: 10.23736/S0375-9393.18.12367-4 -
Hormones (Athens, Greece) Jul 2016Recently, more and more studies have found that pain generation, transmission and modulation are under hormonal regulation. Indeed, hormonal dysregulation is a common... (Review)
Review
Recently, more and more studies have found that pain generation, transmission and modulation are under hormonal regulation. Indeed, hormonal dysregulation is a common component of chronic pain syndromes. Studies have attempted to determine whether the relationship between the pain and its perception and hormones is a causative relationship and how these processes interrelate. This review summarizes and analyzes the current experimental data and provides an overview of the studies addressing these questions. The relationship between pain perception and endocrine effects suggests that hormones can be used as important biomarkers of chronic pain syndromes and/or be developed into therapeutic agents in the fight against pain.
Topics: Analgesics; Animals; Biomarkers; Hormones; Humans; Pain; Pain Perception; Pain Threshold; Signal Transduction
PubMed: 27838602
DOI: 10.14310/horm.2002.1696 -
American Family Physician Mar 2022
Topics: Back Pain; Humans; Low Back Pain; Sacroiliac Joint
PubMed: 35289587
DOI: No ID Found -
Philosophical Transactions of the Royal... Nov 2019Our understanding of the biology of pain is limited by our ignorance about its evolution. We know little about how states in other species showing various degrees of...
Our understanding of the biology of pain is limited by our ignorance about its evolution. We know little about how states in other species showing various degrees of apparent similarity to human pain states are related to human pain, or how the mechanisms essential for pain-related states evolved. Nevertheless, insights into the evolution of mechanisms and behaviour important for pain are beginning to emerge from wide-ranging investigations of cellular mechanisms and behavioural responses linked to nociceptor activation, tissue injury, inflammation and the environmental context of these responses in diverse species. In February 2019, an unprecedented meeting on the evolution of pain hosted by the Royal Society brought together scientists from disparate fields who investigate nociception and pain-related behaviour in crustaceans, insects, leeches, gastropod and cephalopod molluscs, fish and mammals (primarily rodents and humans). Here, we identify evolutionary themes that connect these research efforts, including adaptive and maladaptive features of pain-related behavioural and neuronal alterations-some of which are quite general, and some that may apply primarily to humans. We also highlight major questions, including how pain should be defined, that need to be answered as we seek to understand the evolution of pain. This article is part of the Theo Murphy meeting issue 'Evolution of mechanisms and behaviour important for pain'.
Topics: Animals; Biological Evolution; Humans; Invertebrates; Nociception; Pain; Vertebrates
PubMed: 31544614
DOI: 10.1098/rstb.2019.0275 -
The Journal of Pain Apr 2009The pain and aging subfield has grown dramatically, including a 6-fold increase in publications over the last 2 decades. This subfield is based on the assumption that... (Review)
Review
UNLABELLED
The pain and aging subfield has grown dramatically, including a 6-fold increase in publications over the last 2 decades. This subfield is based on the assumption that pain in older and younger adults differs in clinically and theoretically significant ways. If this were not the case, data from younger groups could be generalized to older persons, and the subfield would not be needed. This article considers the evidence for this assumption. Possible interpretations of the discrepant findings of age-related increases, decreases and stability in pain, including methodological limitations, challenges of gerontological research, and the possibility of nonuniform age-related variation, are discussed. Evidence is presented for several unique characteristics of geriatric pain: difficulty using Visual Analog Scales, increased vulnerability to neuropathic pain, decreased vulnerability to acute pain related to visceral pathology, prolonged recovery from tissue and nerve injury, including prolonged hyperalgesia, and differences in the relationships among psychosocial factors important in adjustment to chronic pain. However, without a theoretical framework, it is difficult to integrate these results in a heuristic manner. Further research is needed to elucidate the characteristics of geriatric pain, to examine the mechanisms for age-related patterns, and to develop and test the efficacy of age-tailored interventions.
PERSPECTIVE
This article reviews the emerging subfield of pain and aging, discusses the interpretation of age-related patterns in pain, and presents several avenues for future research and subfield development. This could contribute to the continued growth of this subfield.
Topics: Aging; Chronic Disease; Humans; Pain; Pain Measurement; Pain Threshold; Research
PubMed: 19327641
DOI: 10.1016/j.jpain.2008.10.013 -
Minerva Anestesiologica 2005Our inability to measure pain effectively is a major barrier to progress in pain research and advancement in clinical interventions for pain. Historically, the mind-body... (Review)
Review
Our inability to measure pain effectively is a major barrier to progress in pain research and advancement in clinical interventions for pain. Historically, the mind-body dichotomy has constrained our thinking about pain and its quantification. One line of work has pursued pain as the sensory end product of nociception: pain is the realization of signals of tissue injury arriving at the cortex. At the other extreme, some clinicians contend that pain is ''what the patient says it is''. In other words, it is a purely mental and entirely subjective phenomenon. Research on functional brain imaging, psychophysiological research and recent neurophysiological research on animal models provide confluent evidence that both of these positions are misleading oversimplifications. Pain is the emergent product of massive, parallel, distributed processing in the brain that engages structures involved in emotion and cognition as well as in sensation. To advance pain measurement, our research team has examined Sokolov's defense response in human subjects experiencing repeated, brief painful electrical shocks delivered to a fingertip through a tiny electrode. Sokolov proposed that threatening events elicit a hypothalamically-orchestrated pattern of arousal that prepares the organism to cope with threat. Measures of sympathetic nervous system arousal and brain evoked potentials in our subjects reveal a stable pattern of this sort when we subject the data to structural equation modeling. When subjects undergo equally intense shocks delivered through a large electrode, they experience a strong vibration-like, unpleasant sensation that causes discomfort but not nociception. The non-painful shock elicits broad levels of arousal equal to those obtained with painful shocks in subjects, but structural equation modeling demonstrates that such arousal does not conform to the defense response pattern. Moreover, multivariate measures of sympathetic arousal and evoked potentials can discriminate painful from non-painful stimuli more accurately than can subjective pain reports. These observations suggest that pain may have a unique psychophysiological signature. More importantly, perhaps, this approach suggests that the combination of psychophysiological research and multivariate statistics provides an avenue for advancing pain research outside of the mind-body dichotomy.
Topics: Animals; Humans; Pain; Pain Measurement
PubMed: 16012413
DOI: No ID Found