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Reward Processing under Chronic Pain from the Perspective of "Liking" and "Wanting": A Narrative Review.
Abstract The therapeutic goals of patients with chronic pain are not only to relieve pain but also to improve the quality of life. Chronic pain negatively affects various aspects of daily life, such as by decreasing the motivation to work and reward sensitivity, which may lead to difficulties in daily life or even unemployment. Human and animal studies have shown that chronic pain damages reward processing; the exploration of associated internal mechanisms may aid the development of treatments to repair this damage. Incentive salience theory, used widely to describe reward processing, divides this processing into ...
Source: Pain Research and Management - June 4, 2019 Category: Anesthesiology Authors: Liu X, Wang N, Gu L, Guo J, Wang J, Luo F Tags: Pain Res Manag Source Type: research

I don't feel your pain - Ideas - The Boston Globe
IF YOU STOPPED the average person in an emergency room and asked why she's there—not just her guess at the problem, but what really motivated her to show up—the number one answer would be "pain." For all that modern medicine has learned about disease and treatment, it's alleviating pain that still lies at the heart of the profession. And in recent years, the notion of treating "pain" as its own entity has been rising to the forefront in medicine. Pain management now has its own journals, conferences, clinics, and specialists, and pain relief is sometimes referred to as a human right. The In...
Source: Psychology of Pain - June 18, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

Encouraging Integrative, Non-opioid Approaches To Pain: A Policy Agenda
The United States is struggling to deal with an opioid epidemic that is damaging lives, resulting in overdoses, and yet not reducing chronic pain. National initiatives are underway to dramatically reduce access to prescription opioids, but these efforts lack a systematic approach to provide alternative treatments for these patients. Policy changes are urgently needed to provide better care for patients with chronic pain, and in this post, we outline three feasible policy initiatives. Innovative reimbursement initiatives by the Centers for Medicare and Medicaid Services (CMS) could frame and stimulate use of evidence-based ...
Source: Health Affairs Blog - October 4, 2016 Category: Health Management Authors: Jason Doctor, Penny Cowan, Daniella Meeker, Patricia Bruckenthal and Joan Broderick Tags: Drugs and Medical Technology Health Professionals Public Health Quality chronic pain Opioid Addiction opioids Source Type: blogs

How Morphine Can Increase Pain - Medical News Today
For individuals with agonizing pain, it is a cruel blow when the gold-standard medication actually causes more pain. Adults and children whose pain gets worse when treated with morphine may be closer to a solution, based on research published in the on-line edition of Nature Neuroscience. "Our research identifies a molecular pathway by which morphine can increase pain, and suggests potential new ways to make morphine effective for more patients," says senior author Dr. Yves De Koninck, Professor at Université Laval in Quebec City. The team included researchers from The Hospital for Sick Children (SickKids) in To...
Source: Psychology of Pain - January 20, 2013 Category: Psychiatrists and Psychologists Source Type: blogs

Women and pain: Disparities in experience and treatment
In August, The New York Times published a guest op-ed by a man named David Roberts who suffered from severe chronic pain for many years before finally finding relief. The piece immediately went viral, with distinguished news journalist and personality Dan Rather posting it to his Facebook page with the addendum that it could “offer hope” to some pain patients. However, for many of us in the chronic pain community, particularly women, the piece was regarded with weariness and frustration. The first and most prominent source of annoyance for me regarding this piece was the part when the author finally discloses his pain ...
Source: Harvard Health Blog - October 9, 2017 Category: Consumer Health News Authors: Laura Kiesel Tags: Behavioral Health Pain Management Women's Health Source Type: blogs

Reading Pain in a Human Face - NYTimes.com
How well can computers interact with humans? Certainly computers play a mean game of chess, which requires strategy and logic, and "Jeopardy!," in which they must process language to understand the clues read by Alex Trebek (and buzz in with the correct question).But in recent years, scientists have striven for an even more complex goal: programming computers to read human facial expressions.We all know what it's like to experience pain that makes our faces twist into a grimace. But can you tell if someone else's face of pain is real or feigned?The practical applications could be profound...
Source: Psychology of Pain - April 29, 2014 Category: Psychiatrists and Psychologists Source Type: blogs

When philosophy and evidence collide: is an occupation-focused approach suitable in pain management?
I have often described myself as a renegade occupational therapist: I like statistics, I think experimental research is a good way to test hypotheses, I don’t make moccasins (though I occasionally wear them!), I’m happy reading research and figuring out how I can apply findings into my clinical practice. Occupational therapy is a profession that continues to evolve. The origins of occupational therapy lie back in the “moral” model of treatment for mental illness when advocates found that giving people things to do helped them become well (mind you, some of the reasons for admission to a “menta...
Source: HealthSkills Weblog - May 6, 2018 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Clinical reasoning Coping Skills Occupational therapy Pain conditions Research Science in practice pain management Psychology rehabilitation research literature self management T Source Type: blogs

The Management of HIV- and AIDS-Related Pain in a Primary Health Clinic in Tshwane, South Africa
Abstract: Pain has been recognized as an important, highly prevalent, and debilitating symptom of HIV and AIDS. In South Africa, many people living with HIV and AIDS utilize primary health clinics for pain management. Primary health clinics are nurse led and face a variety of challenges pertaining to pain management. The purpose of this study was to explore if HIV and AIDS pain is effectively managed in a primary health clinic in Tshwane, South Africa. The study aimed to explore the level and characteristics of HIV- and AIDS-related pain, the pain-related experiences of patients and if pain was managed according to the app...
Source: Pain Management Nursing - January 24, 2011 Category: Nursing Authors: Johanna Elizabeth Maree, Susanna Catharina Dreyer Wright, Mogalagadi Rachel Makua Tags: Original Articles Source Type: research

Characterising pain flares in adolescent inflammatory and non ‐inflammatory musculoskeletal disorders: A qualitative study using an interpretative phenomenological approach
ConclusionThis study has identified a number of components of the pain flare experience. Findings show that pain flares are more than an increase in pain intensity; they are multi ‐layered and require other features to change. These findings help to differentiate pain flares from typical fluctuations in pain.
Source: European Journal of Pain - June 30, 2020 Category: Anesthesiology Authors: Sonia Khanom, Janet E McDonagh, Michelle Briggs, John McBeth Tags: ORIGINAL ARTICLE Source Type: research

Why are there not more occupational therapists in pain rehabilitation?
A question I’ve asked myself many times! As a small profession with a long history (as long as physiotherapy, TBH), it does seem odd that there are many, many pain rehabilitation services where never an occupational therapist has darkened the door. Some of the reasons lie within the profession: in general, occupational therapists are busy being clinicians and have little time for research. In New Zealand, few occupational therapists pursue higher degrees, and many avoid statistical analyses, experimental design, randomised controlled studies. In fact, some occupational therapists have argued that the tailored appr...
Source: HealthSkills Weblog - October 13, 2019 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Clinical reasoning Cognitive behavioral therapy Coping strategies Occupational therapy Pain conditions Resilience/Health interprofessional teams pain rehabilitation persistent pain Source Type: blogs

Pain-related Self-efficacy Among People With Back Pain: A Systematic Review of Assessment Tools
Conclusions: Further research should focus on assessing validity and interpretability of these questionnaires, especially in pain-related target groups. Researchers should select questionnaires that are most appropriate for their study aims and the back pain population and contribute to further validation of these scales to best predict future behavior and develop intervention programs. This systematic review aids selection of pain-related assessment tools in back pain both in research and practice.
Source: The Clinical Journal of Pain - May 11, 2020 Category: Anesthesiology Tags: Review Article Source Type: research

Characterizing pain flares in adolescent inflammatory and non ‐inflammatory musculoskeletal disorders: A qualitative study using an interpretative phenomenological approach
ConclusionThis study has identified a number of components of the pain flare experience. Findings show that pain flares are more than an increase in pain intensity; they are multi ‐layered and require other features to change. These findings help to differentiate pain flares from typical fluctuations in pain.
Source: European Journal of Pain - July 18, 2020 Category: Anesthesiology Authors: Sonia Khanom, Janet E. McDonagh, Michelle Briggs, John McBeth Tags: ORIGINAL ARTICLE Source Type: research

Intrathecal Drug Administration in Chronic Pain Syndromes
Abstract Chronic pain may recur after initial response to strong opioids in both patients with cancer and patients without cancer or therapy may be complicated by intolerable side effects. When minimally invasive interventional pain management techniques also fail to provide satisfactory pain relief, continuous intrathecal analgesic administration may be considered. Only 3 products have been officially approved for long‐term intrathecal administration: morphine, baclofen, and ziconotide. The efficacy of intrathecal ziconotide for the management of patients with severe chronic refractory noncancer pain was illustrated in ...
Source: Pain Practice - October 4, 2013 Category: Anesthesiology Authors: Ann Ver Donck, Jan H. Vranken, Martine Puylaert, Salim Hayek, Nagy Mekhail, Jan Van Zundert Tags: Review Article Source Type: research

Economic long ‐term effects of intensive interdisciplinary pain treatment in paediatric patients with severe chronic pain: Analysis of claims data
ConclusionThe results of this study support prior findings on the high economic burden of paediatric chronic pain. IIPT may contribute to a transition in healthcare utilization from somatic-focused treatments to more psychological treatments. Overall costs were reduced as soon as the first year after discharge and decreased even further in the second year.SignificanceThis study analyses original claims data from paediatric chronic pain patients in the year before and up to 2  years after intensive interdisciplinary pain treatment in a specialized paediatric pain centre. The analysis of long-term data reveals a continuous ...
Source: European Journal of Pain - July 13, 2021 Category: Anesthesiology Authors: Susanne Lopez Lumbi, Ann ‐Kristin Ruhe, Ingo Pfenning, Julia Wager, Boris Zernikow Tags: ORIGINAL ARTICLE Source Type: research