Tendinopathies and Pain Sensitisation: A Meta-Analysis with Meta-Regression.

The presence of pain sensitisation has been documented and reported as being a possible cause of treatment failure and pain chronicity in several musculoskeletal conditions, such as tendinopathies. The aim of the present study is to analyse existing evidence on pain sensitisation in tendinopathies comparing the local and distant pain thresholds of healthy and affected subjects with distinct analysis for different tendinopathies. PubMed, Cochrane Central Register, Scopus, and Web Of Science were systematically searched after registration on PROSPERO (CRD42020164124).

High Rate of Pain Sensitization in Musculoskeletal Shoulder Diseases: A Systematic Review and Meta-analysis.

Background: Pain sensitization, defined as an increased responsiveness of nociceptive neurons to normal input, is detected in several musculoskeletal diseases, but there are no systematic reviews or meta-analyses about pain sensitization in shoulder pain.

Objectives: The aim of the study was to document pain sensitization rate and its impact in patients with shoulder pain.

Materials And Methods: PubMed, Cochrane Library, and Web of Science were searched on January 8, 2020.

Micronized Palmitoylethanolamide: A Post Hoc Analysis of a Controlled Study in Patients with Low Back Pain - Sciatica.

Background: Despite being widely prescribed, relatively few controlled trials have been conducted on the class of neurotrophic/antinociceptive nutraceuticals. While performing a search in the literature, we came across an old registration study on micronized palmitoylethanolamide in patients with low back pain - sciatica by Guida and colleagues.

Methods: We contacted the authors of the article and obtained all the original material, which allowed us to reanalyze the study.

Chronic Pain in the Elderly with Cognitive Decline: A Narrative Review.

The presence of pain in elderly persons with cognitive decline is often neglected, under-reported, underestimated, misdiagnosed and not adequately treated, with consequences that have a strong impact on health, independence in activities of daily living and quality of life. There is no empirical evidence that people with dementia experience less pain; therefore, in patients with severe cognitive impairment the progression of cognitive decline dramatically affects the ability to verbalize the presence of pain. Self-assessment scales are considered the "gold standard" for pain assessment, but the presence of cognitive impairment is likely to reduce the reliability of these measures.

Subjective correlates of stress management in outpatient cardiac rehabilitation: the predictive role of perceived heart risk factors.

The causal attributions and perceived risk factors can affect patients' health behaviors. Therefore, the present study aimed to assess (i) the effect of an outpatient cardiac rehabilitation (CR) program on perceived heart risk factors (PHRFs) and on psychological stress, and (ii) the role of changes of PHRFs at pre-post CR in predicting changes in psychological stress. In this longitudinal study, 110 CR patients were assessed from June to November 2016 in a hospital in Iran.

Coronary artery bypass graft patients' perception about the risk factors of illness: Educational necessities of second prevention.

Background: Patients' beliefs about the cause of cardiac disease (perceived risk factors) as part of the global psychological presentation are influenced by patients' health knowledge. Hence, the present study aimed to assess the relationship between actual and perceived risk factors, identification of underestimated risk factors, and indication of underestimation of every risk factor.

Materials And Methods: In this cross-sectional study, data of 313 coronary artery bypass graft (CABG) patients admitted to one hospital in the west of Iran were collected through a demographic interview, actual risk factors' checklist, open single item of perceived risk factors, and a life stressful events scale.

Risk Factors Linked to Psychological Distress, Productivity Losses, and Sick Leave in Low-Back-Pain Employees: A Three-Year Longitudinal Cohort Study.

Background. Low back pain (LBP) is one of the most common health problems worldwide. Purpose.

Non-surgical treatments for the management of early osteoarthritis.

Non-surgical treatments are usually the first choice for the management of knee degeneration, especially in the early osteoarthritis (OA) phase when no clear lesions or combined abnormalities need to be addressed surgically. Early OA may be addressed by a wide range of non-surgical approaches, from non-pharmacological modalities to dietary supplements and pharmacological therapies, as well as physical therapies and novel biological minimally invasive procedures involving injections of various substances to obtain a clinical improvement and possibly a disease-modifying effect. Numerous pharmaceutical agents are able to provide clinical benefit, but no one has shown all the characteristic of an ideal treatment, and side effects have been reported at both systemic and local level.

Burden of herpes zoster-associated chronic pain in Italian patients aged 50 years and over (2009-2010): a GP-based prospective cohort study.

Background: Post-herpetic neuralgia (PHN) is the most common complication in herpes zoster (HZ) patients.

Methods: We performed a longitudinal, prospective study in 108 general practices throughout Italy to assess how many immunocompetent patients aged ≥50 years with newly diagnosed HZ develop HZ-associated pain, its duration and management over 6-months. HZ-associated pain was assessed by a direct question to the patient and by self-assessment of the worst pain felt in the previous two weeks on a visual analogue scale (VAS), a score ≥3 was taken as pain.

Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: data from the randomized, double-blind, COMBO-DN study.

Sensory profiles are heterogeneous in neuropathic pain disorders, and subgroups of patients respond differently to treatment. To further explore this, patients in the COMBO-DN study were prospectively assessed by the Neuropathic Pain Symptom Inventory (NPSI) at baseline, after initial 8-week therapy with either duloxetine or pregabalin, and after subsequent 8-week combination/high-dose therapy. Exploratory post hoc cluster analyses were performed to identify and characterize potential subgroups through their scores in the NPSI items.

Painful diabetic polyneuropathy: approach to diagnosis and management.

Objectives: To provide a current overview of the diagnostic work-up and management of painful diabetic polyneuropathy (PDPN).

Methods: A review covering the literature from 2004 to 2011, which describes the tools designed to diagnose neuropathic pain and assess its severity, including self-administered questionnaires, validated laboratory tests and simple handheld screening devices, and the evidence-based therapeutic approaches to PDPN.

Results: The clinical aspects, pathogenesis, and comorbidities of PDPN, as well as its impact on health related quality of life (HR-QoL), are the main drivers for the management of patients with suspected PDPN.

Intrathecal therapy: what has changed with the introduction of ziconotide.

Administering drugs into the intrathecal space is becoming more popular in the treatment of patients with intractable pain or intolerable side effects of systemic analgesic treatments. Although morphine and ziconotide are the only intrathecal analgesics currently approved by regulatory authorities in the U.S.

Validation of the Italian version of the Neuropathic Pain Symptom Inventory in peripheral nervous system diseases.

The aim of this study was to validate the Italian version of the Neuropathic Pain Symptom Inventory (NPSI) in patients with neuropathic pain due to peripheral nerve diseases, and also to evaluate the validity of a new NPSI score: a frequency weighted NPSI score (NPSI-FW). First, the original version of the NPSI was translated into Italian. Then the validity and reliability of the Italian NPSI (I-NPSI) were tested in 392 Italian patients consecutively referred to 16 Italian outpatient services for peripheral nerve diseases, by correlating the I-NPSI scores with other pain scales.

The Lindblom roller.

Neuropathic pain is caused by injury of the peripheral or central nervous system. The neurological examination of the sensory system in neuropathic pain patients guides the anatomical localization of the injury. Among the sensory modalities to be tested, priority should be given to those subserved by small peripheral sensory fibers or by the spinothalamic tract that most commonly are abnormal in neuropathic pain patients.

Pre-injury lidocaine treatment prevents thermal hyperalgesia and cutaneous thermal abnormalities in a rat model of peripheral neuropathy.

The effect of lidocaine pretreatment on thermal hyperalgesia and thermal skin asymmetries provoked by experimental mononeuropathy was investigated in rats. Forty anesthetized rats were given sciatic nerve ligatures according to the technique of Bennett and Xie. Rats were divided into 3 groups: 16 were ligated without lidocaine, 16 were ligated after lidocaine bathing of the nerve, and 8 were ligated after systemic lidocaine (6-8 mg/kg).

Interactions between sympathetic vasoconstrictor outflow and C nociceptor-induced antidromic vasodilatation.

The interaction between orthodromic sympathetic vasoconstrictor and antidromic vasodilator effects of C-fiber stimulation was studied in normal human volunteers. Excitation of C fibers was achieved through administration of intermittent painful intraneural microstimulation to upper limb nerves, while recording cutaneous thermal emission profiles in the projected fields of cutaneous sensation. During initial stimulation, when both systems are co-activated, skin temperature decreased.

Lidocaine test in neuralgia.

Ten patients with organic nerve injury causing chronic neuropathic pain were tested for the effects of intravenous lidocaine versus saline upon psychophysical somatosensory variables. The variables assessed were the subjective magnitude of pain, area of mechanical hyperalgesia and presence and magnitude of thermal heat/cold hyperalgesia. The study methods applied to evaluate these conditions were the conventional testing of somatosensory submodalities with area mapping and the subjective magnitude estimation of spontaneous pain.