Questions related to Chronic Pain
What mediation model should I chose
Hypothesis: Pain Catastrophizing Mediating the effect of Psychological Flexibility on Physical Functioning in Patients with Chronic Pain over time
I have one measure before starting acceptance commitment therapy (in an RCT), 6 months after, 12 months after, and now years after.
Could I use a longitudinal meditation model to look at the relationship between pain catstrophising, psychological flexibility and physical functioning over time?
Is latent difference score mediation appropriate?
I often use Dry Needling (DN) to treat Myofascial Syndrome with is very frequent in Chronic Pain.
Some of the patients are treated with acetylsalicylic acid (ASA).
Is this condition a problem to use DN?
Thank you and have a nice day
Ph. Rault - MD
Are there any new researches about Therepeutic Touch and its effects? I am desperately looking for studies for my bachelor thesis. It should contain Therapeutic Touch and chronic pain/musculoskeletal pain.
My lab is looking for a reliable, valid measure of pain for our nonprofit-funded phase 1 clinical trial. We were originally considering the Brief Pain Inventory (BPI) but the paywall (~400) is a bit higher than anticipated. Has anyone had luck with other pain measures similar to the BPI but is either free or more budget-friendly? I did see the McGill Pain Questionnaire, but this appears to require a fee as well (still waiting to hear what that fee will be).
We are looking for a scale that reports both acute and more chronic pain, ideally including history of pain medication/treatment effectiveness. Hence, some of the scales that initially come to mind (e.g., visual analogue scale, numerical rating scale) don't seem like the best fit.
Any help would be appreciated, many thanks!
We are starting an investigation, in the field of physiotherapy, on the evaluation and clinic of pain.
We are interested in knowing which diagnostic evaluation scales are being evaluated.
We are also interested in knowing how to qualitatively assess pain: do you know interview protocols for patients with chronic pain?
Working in the sport and fitness industry since 20 years before studying in a post- graduate program on chronic non-cancer pain management (CNCP), questions raised up about potential therapeutic use of Androgen Anabolic Steroid (AAS).
If anybody knows if these sports enhancing performance agents (mostly known as sports doping agents) can help for CNCP relief ?
Since more than 20 years, mostly in the field of bodybuilding, I've been witness of devastating chronic pain syndrome such as Chronic Regional Pain Syndrome (CRPS), neuropathic pain and also MSK nociceptive somatic pain injuries happening on athletes. In a large proportion of injured subjects, those who continued to use supra-physiological dose of AAS seems to have a much better functionality than everyone else. I would add that the use of those doping agents allows the injured subjects with chronic pain to self-manage their pain condition a hundred times better than every other method, medication, muti-modal pain rehabilitation, regular HRT commonly used in chronic pain clinic and hospital. The users, or I would say, the abusers understand that a decade before now.
Looking what we have in the literature on that topic is fairly poor and limited. It seems to be a totally new spectrum of research in pain science, as on the ground AAS are often used for CNCP control.
Feel free to add your comments and impressions as in a brain storming reflexion. If anyone finds out publications on that topic please let me know. That research avenu is probably brand new, maybe cause of the toxicity and teratogen potentials of AAS ?
If anyone observed the same thing as I, just let me know.
I'm looking into a possible correlation of some types of chronic pain (those related to ptsd and mood disorders) correlating with balance issues, one-sided pain, or inner ear damage. Thanks for any help!
Pain is such sign/symptom that any patient can describe it as high or low although he/she have no pain.
I know there are many pain provocation MSK tests but patient can also express it as false.
Is there any tool to assess pain severity, which patient exactly have, not that patient describe?
I have a survey with dichotomous variables and need tetrachoric/polycoric analysis. I used R module but tried to run it also in SPSS and cannot do polycoric analysis (keep getting a message - could not find function "hetcor"). I checked on extensions and it is telling me that extension HETCOR is installed. Any suggestions? I am running out of options. Thank you so much!!!
We would like to demostrate if the therapy of binaural sounds can modulate the percepetion of chronic pain. We evaluate this perception by meausuring biosignals (EEG, EDA, Heart Rate, etc.)
More information in :
Perales, F.J., Riera, L., Ramis, S. et al. Evaluation of a VR system for Pain Management using binaural acoustic stimulation. Multimed Tools Appl 78, 32869–32890 (2019). https://doi.org/10.1007/s11042-019-07953-y
What is your opinion on opioid discontinuation in chronic opioid administration, especially for chronic non cancer pain? May this article be of help? Thank you for a kind answer.
• Are you a fluent English speaker between the ages of 18 – 65?
• Have you been diagnosed with a chronic pain condition?
If you answered ‘Yes’ to these questions, you may be eligible to participate in a pain research study!
What is involved if I qualify to participate?
• Three in-lab appointments, including two blood draws.
• One 45-minute MRI brain scan
• MRI brain scan is free. In addition, you will receive up to $200, and parking or travel reimbursement for your participation
To learn more, please contact the Pain & Perceptions Lab using the information below:
Cortical Pathophysiology of Chronic Pain Study
Chronic Pain Research
I am currently studying the sacroiliac fatty lumps (known as episacroiliac lipomas or back mice or other names) that are related to low back pain and that are little known and OVERLOOKED by the medical community. Does anybody know about them and wants to collaborate in their research? LET’S MAKE THE UNSPECIFIC LOW BACK PAIN more SPECIFIC!
More information in www.backmice.info.
As far as we know the neural basis of emotional processing (amgidala, anterior insula) keep a kind of lineal stimulus dependence that is assumed to go mostly throug conscious regulation but it also go nonconsciuos . Clinically becomes relevant while working with chronic pain patients, in what degree thermosensors role (TRPV1 and 4) may participate to modulate nociception modulation increasing it or shaping an analgesic emotioanl mediated effect (anterior insula contribution)
I'm looking for information on Chronic Pain but in the point of view of the partner that support the patient.
There is good insights there :
Is there good scientific studies that you know about this topic ?
This is, indeed, a very important question that have been asked on Quora. It is sad there is only one answer. I believe that the next years will bring very important discoveries now that we have identified the action of Microglias. What is you opinion on this point ?
My team and myself are currently investigating a low-cost system that will be used to compare the effectiveness of different ablation techniques.
Ablation is a minimally invasive surgical technique used to kill body tissue. A “needle” is inserted into the tissue to be destroyed, a high frequency current ran through it to heat it rapidly, and the surrounding cells in the tissue heated to the point of fatality. This is often done to kill cancerous tissue or treat chronic pain by destroying the nerve endings that are sending the pain signals to the brain.
Because the process is so dependent on heat (the cells die at about 60 degrees Celsius), temperature monitoring during our experimental trials is critical. We are planning on performing trials on animal tissue, such as chicken breast or steak. The following image provides a vague idea of the concept I am shooting for:
I would like to be able to insert an array/system of thermocouples into the tissue, whether that be chicken, steak, pork chop, etc, and get an accurate temperature reading based off the location of that thermocouple in comparison to the heated needle.
The problem is that I am generally unfamiliar with thermocouples. For the task at hand, it would be required that the TC be rigid enough to be repeatedly shoved into and out of raw meat, but small enough as to have minimal heat sync to not throw off temperature readings. Furthermore, the more readings/data points we can collect for a 2 inch x 2 inch piece of tissue, the better. I am also curious as to any suggestions as to the software/interface used to take time sensitive readings from the thermocouples.
Dear fellow researchers,
I am a young practicing osteopath with a Bachelor of Science Honours degree in osteopathy.
Nowadays, I work as a researcher and professor assistant in the Osteopathic Research Department at Istituto Superiore di Osteopatia in Milan (Italy), publishing some scientific articles on indexed journals.
Within one year, I will obtain a Master of Science degree in osteopathic chronic pain management.
Do you know universities that could give osteopaths the opportunity to take part in a PhD studentship in pain management?
CBD and THC are cannabis sourced moleculs. The use is authorised in some countries. Some associations tends to think that these are the future of fibromialgia treatments. What does the current and serious researchs actually says ?
Hi dear RG members,
Could you please, suggest me any biopsychosocial spiritual model used for chronic pain management especially in older adults? I know Biopsychosocial model for pain wad developed by Engel, but is curious if there is any model that has incorporated spiritual component too.....
I am also interested in any theoretical model in nursing, that would address chronic pain management of older adults...Your suggestion and information is highly appreciated.
Thank you in advance
- Pruritus is an unpleasant sensation that is usually secondary to a cytokine-releasing stimulus such as histamine.
- Histamine frequently produces a local inflammatory state at the site of a noxious stimulus, and its usual manifestation is pruritus.
- Scratching secondary to pruritus increases its intensity and a vicious circle is established.
- Pruritus frequently decreases with the use of anti-inflammatory analgesics, suggesting the transmission of the stimulus by means of painful or spinothalamic pathways.
It has been discovered that microglias plays a key role in chronic pain related diseases such as Fibromyalgia. Some therapetic strategies are studied, such as Naltrexone that binds to Toll-Like Receptor 4 or Cannabidiol that is an indirect inverse agonist or Cannabioid Receptors. What are the different receptors expressed by microglias that are linked with chronic pain ?
I’m looking for information on psychiatric crisis care as it relates to chronic pain patients. The suicide rate is double for chronic pain patients. I’m trying to find out what we know and what’s being done to intervene. Any references are welcome.
Thank you in advance.
I am using the VAS as an outcome measure of spasticity-related chronic pain. The VAS has a minimum clinically important difference (MCID) of 18-19 mm according Hägg and colleagues 2003 (DOI: 10.1007/s00586-002-0464-0 ) in patients with chronic low back pain.
Can i use in my case report the previously mentioned MCID of the VAS to compare my results?
If no, can someone please suggest what should I do in this case.
Thank you in advance
Sickle cell disease is a lifelong, genetic condition characterised by acute and chronic painful exacerbations. There is increasing evidence about experiences of patients transitioning from paediatric to adolescent care. But little is known of the life experiences of young adults (18-35 Yrs) with sickle cell disease.
Our research consortium of 2 UK universities and 2 Nigerian Universities (De Montfort univ, Leeds univ, Lagos State univ, + univ of Ibadan) is interested in understanding the experiences of young adults with sickle cell disease.
We will like to hear from researchers, working with young adults with sickle cell.
Drug pumps seem an interesting option for managing chronic pain. I have seen similar devices used for insulin delivery. I wanted to know what are the disadvantages, complications, and limitations of this technology. I also wonder whether such devices could be broadly applied to deliver any medication or there are any fundamental restrictions.
Thank you very much!
The etiology of back pain could be very complex and often difficult to isolate. While there are numerous surgical interventions to help patients with certain discogenic or stenotic issues, the challenge remains for many patients that have developed chronic pain regardless.
The cadaveric transverse sections are ideal to observe the fibro-fatty tissue. The superficial and deep fascias and the so called “basic fat pads” . We are planning to do 3D reconstruction of this tissue that has been neglected and it probably explains some of the so called “non specific low back pain”. Www.Backmice.info
In 2010 Italy has promulgated a law to increase the attention for Pain and Palliative Care. This seems still very poor.
I would like to know if there are databases where I can search for drugs by disease name/targeted protein...etc
For example, I would like to have a list of currently available drugs for Chronic pain or currently available drugs that target KV7 channels.
Does anyone have a technique to know if a trigger point is a primary one or satellite (secondary). Are some myofascial trigger points more often secondary than primary?
Thanks a lot - Phil from Dijon (Burgundy - France)
I am not a researcher investigating animal behavior, but I need some data and impression from the field.
From evolutionary perspective, weak individuals, for example these who are injured have less chance to survive.
Is it the case, that in some species (I am not talking about humans now), others take care about injured, weakened individuals thus increasing the chances to survive? Which species exhibit such a behavior?
To simplify, are there examples in animal world that some representatives of e.g primates take care about injured, weakened individuals?
I draw your attention to a McGill 2015 rodent study, Overlapping signatures of chronic pain in the DNA methylation landscape of prefrontal cortex and peripheral T cells, https://www.nature.com/articles/srep19615 which supported the plausibility of DNA methylation involvement in pain as measured in T cells.
As an osteopath, I often come into contact with chronic pain, which is more and more due to a drowning inflammation.
In addition to manual techniques for optimizing blood flow, innervation and mobility, advice is given about nutrition and possible supplementation.
All too often, patients (especially in professional sports) with chronic inflammation have long taken NSAIDs. However, this is increasingly questioned by scientists.
Medication management obviously does not belong to the treatment strategy of an osteopath. Nevertheless, I often get questions from patients themselves what they should do with this.
What do you recommend? What products/supplements do you work with? What advice do you give?
The effects of Daith ear piercings on migraines was first noticed by chance.
After Dr Thomas Cohn a respected pain physician in the USA noted on his blog in March 2015 that people were reporting improvements in their migraines, increasing numbers of migraine sufferers are having Daith Piercings.
Is anybody studying this effect?
Is it necessary to take a lower limit as inclusion criteria for the ODQ? The design from our low back pain study is planned as randomized, sham treatment controlled trial. I am concerned about getting a to small difference for the stats, if we don´t choose a lower limit.... Especially the between group difference...
I am interested in your knee injury prevention, are you looking at exercises for pre-habilitation or just understanding the mechanism of injury? I have a student here working on something similar, he might like to collaborate with you.
I am a 57 year old female who is morbidly obese and have suffered three strokes on the right side. I suffer from chronic pain and numbness. Not only on my right side but my lower back as well. Are there any medications for chronic pain that work that are not narcotics? I would appreciate any information you could provide.
Kathi J Peacock
Low Level Laser Therapy (LLLT) seems to be effective to treat musculoskeletal pain. Do you have any scientific informations: indications, mechanisms, long term safety. Thanks!
Treatment of osteoarthritis hip is mainly surgical.Attempts to look at treatment options and traditional medication has not been well cited or published.
Do outline treatment options seeked by your patients in dealing with hip osteoarthritic pain and its success rate
I am doing a qualitative report on what it is like to have Fibromyalgia. I plan on doing this research at the pain clinic at Rochester, MN. The sampling strategy will be a deliberate sampling strategy. I will be choosing participants from chronic pain patients circa twenty to thirty applicants. The criteria will be Fibromyalgia for at least one year.
Looking for research on short and longterm effects of trigeminal neuralgia on patients. All aspects of condition, treatment, physical course and outcome, emotional and psychological course and outcomes are of interest.
Many patient complain of gluteal pain post L5/S1 sequestectomy or discectomy and continue for few months ,is there eexplanation for that.
Can any body tell me the best and simple "Pain Assessment scale" which can be used in all pain predomiant diseases?
According to my experience, acupuncture works excellent for PTSD patients. Please follow the link to read. If you want, you can use my treatment method to do a clinical trial. If you have any question about the article such as do not know the Chinese medicine, you can ask.
If you need my help for the clinical trial, you can apply for a grant and ask me to help. However, I want to point out that double-blind does not fit for acupuncture clinical trial. However, if can change the acupuncture treatments to be the magnet therapy, it can work for the double blind test. The difference is that the acupuncture can influence longer distance than the magnet therapy according to my experience.
In an experimental study with healthy volunteers, we are going to test the effect of breathing pattern manipulation on esophageal pain. Esophageal pain will be induced by electrical stimulation.
First, and for each subject, with threshold determination we will find the stimulus intensity (electrical current in mA) to be used during the intervention. The current method is to find the stimulus that can induce a pain rated by the subject as 6 in an 11-point NRS with 2 anchors; 0 = no pain, 10 = most intense pain imaginable. Then, we use this stimulus during the intervention and see how pain perception is influenced by the intervention. 15 stimuli will be applied during each intervention and subjects will rate the pain immediately after each stimulus using the NRS (from 0 to 10). In this way, all subjects are receiving same pain intensity in terms of the score, 6.
But why 6? because we assume that 6 is a "moderate" pain. However, although many subjects may consider 6 as a moderate pain, for some (not few) 6 is a "severe" pain and this is our concern. So, although all subjects will receive same pain intensity by score, it's not the same if we ask them to label it.
The question is: which one is more important? to have same pain intensity among subjects by same score or by same label?
Opioid-induced bowel dysfunction (OIBD) is an increasing problem due to the common use of opioids for chronic pain worldwide. It manifests with different symptoms, such as dry mouth, gastro-oesophageal reflux, vomiting, bloating, abdominal pain, anorexia, hard stools, constipation and incomplete evacuation. Opioid-induced constipation (OIC) is one of its many symptoms and probably the most prevalent.
There are no available tools to assess OIBD, but many rating scales have been developed to assess constipation, and a few specifically address OIC. A clinical treatment strategy for OIBD/OIC was proposed and presented in a flowchart. First-line treatment of OIC is conventional laxatives, lifestyle changes, tapering the opioid dosage and alternative analgesics. While opioid rotation may also improve symptoms, these remain unalleviated in a substantial proportion of patients. Should conventional treatment fail, mechanism-based treatment with opioid antagonists should be considered, and they show advantages over laxatives. It should not be overlooked that many reasons for constipation other than OIBD exist, which should be taken into consideration in the individual patient.
Does pain etiology have a moderation and/or mediation effect on the association between pain intensity/interference and psychological functioning associated variables?
I want to run an online study and ask parents to provide information about their child who is between ages 8-17 years old. It is likely that some parents have more than one child in that range. What child we have to choose, the youngest or the oldest? it is not possible to randomize.
i was thinking of adapting the sitting items of long IPAQ due to its accepted reliability & validity scores among participants from several countries.
My research is in Mobile VR and its potential use for pain management. I chose Cardboard VR for my experiments because of its affordability and simplicity. Previously my colleagues experimented to find out the effectiveness of VR with a traditional head mounted display (Oculus DK2 and DeepStream). I want to figure out how effective the Cardboard can be compared to these traditional HMDs. What would be an effective way of conducting this research?
I did an initial study of comparing the immersion in Cardboard and Oculus. (https://www.researchgate.net/publication/303519177_Immersion_in_Cardboard_VR_Compared_to_a_Traditional_Head-mounted_Display)
If I take 25 pain patients as participants, let them play a VR game for around 15mins and then record their responses using a pain questionnaire(McGill or VAS)–will that be a good approach? I can compare the results with our lab's previous experiments where the same questionnaires were used but the participants played the VR game using traditional HMDs. I should mention, the game I want to use for the Cardboard is not the same as the one used on the traditional HMDs although these are built on the same principles.
Thanks in advance.
Conference Paper Immersion in Cardboard VR Compared to a Traditional Head-mou...
Clinical pain is an important public health problem world wide. It is vital to understand the pain mechanism contributing to acute and chronic levels. It is noted that the inter-individual variability as the most crucial factor of pain prediction.
the main convergence between these syndroms is a particular memory development, accompanied with pain or fear, expressed as a fragmentation of sensory snapshots (visual, auditory, olfactory) from the original scene, or bodily distributed painful sensations. A mode of information processing perhaps akin to the one accompanying emergency situations, but deprived of relevant feedback action possibility.
I am interested in collaborating with other clinicians/ researchers regarding creative / new / effective (either / or) ACT techniques (metaphors, breathing, exercises, rituals, etc) for application in clinical practice with patients with Chronic Pain.
Some of chronic pain patients are deconditionning spending a lot of their time in bed. Motivate them to begin a physical activity is often difficult. Tai Chi seems to be a good alternative. Do you know some papers about that topic?
Thanks a lot, Phill
we want to plan a research study to determine the impact of latissimus dorsi extensibility on chronic mechanical low back pain, while intervene in combination with lumber segmental spinal joints mobilization.
Target segment will be T1 - L5.
need your feed back?
I can find lots of work surrounding pain reconceptualisation through the use of metaphors by clinicians and researchers, but very little on the use of metaphors by patients, and how such language can impact outcomes such as pain-related catastrophising, pain intensity etc.
Chronic, non-specific and widespread pain is very common among older adults. Traditional interventions which usually use physical means to deal with individual joints only cannot address the problem. Is there any effective interventions that incorporate physical, psychological and social needs of this population?