Chronic pain conditions are among the most common complaints seen in the emergency department (ED). Exacerbations of these conditions are often approached as one would an acute painful condition, with liberal use of imaging, labs, and analgesics. This patient population is often prescribed short courses of opioids without a definite explanation for their painful episodes and often leave the ED dissatisfied with their experience. We describe a patient with a history of chronic abdominal pain who presented to the ED with an exacerbation of his pain. Upon further review of his previous records, we noted that this patient experienced many similar events, resulting in 46 imaging studies over the past year. At this point, the patient was given the Central Sensitization Inventory, and his score demonstrated severe underlying central sensitization. The patient was counseled about his condition and provided with appropriate follow-up care.
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http://dx.doi.org/10.1016/j.ajem.2022.09.018 | DOI Listing |
BMC Musculoskelet Disord
January 2025
Department of Physical Medicine, Rheumatology and Rehabilitation, faculty of medicine, Suez Canal University, Ismailia, 41522, Egypt.
Background: Our understanding of osteoarthritis (OA) has evolved from a degenerative disease to one in which low-grade, chronic inflammation plays a central role. In addition, evidence suggests that OA is accompanied by both peripheral and central nervous system sensitization that can cause pain. It has been demonstrated that transcutaneous vagus nerve stimulation (tVNS) can relieve pain, inflammation, and central sensitization in other conditions including fibromyalgia, pelvic pain, and headaches.
View Article and Find Full Text PDFJ Endod
January 2025
Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229. Electronic address:
Introduction: Persistent post-endodontic pain following endodontic therapy is a rare but substantial clinical challenge. Mechanisms that mediate peripheral neuropathy and/or central sensitization likely play a pivotal role in its development and chronification. The objective of this case series is to describe a management plan for persistent post-endodontic pain and provide prescription guidelines using a standardized "Gabapentin Pyramid Protocol" for clinical practice.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, China.
To investigate the presence of modular loss of coupling and abnormal alterations in functional and structural networks in the brain networks of patients with postherpetic neuralgia (PHN). We collected resting-state functional magnetic resonance imaging data and diffusion tensor imaging data from 82 healthy controls (HCs) and 71 PHN patients, generated structural connectivity (SC) and functional connectivity (FC) networks, and assessed the corresponding clinical information assessment. Based on AAL(90) mapping, the brain network was divided into 9 modules, and the structural-functional connectivity (SC-FC) coupling was compared at the whole-brain level and within the modules, as well as alterations in the topological properties of the brain network in the patient group.
View Article and Find Full Text PDFPain Manag Nurs
January 2025
College of Nursing, Korea University, Seongbuk-Gu, Seoul, South Korea; Nursing Research Institute, Korea University, Seongbuk-Gu, South Korea; BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seongbuk-Gu, Seoul, South Korea. Electronic address:
Purpose: To examine the feasibility of a social networking site-based self-management intervention involving pain neuroscience education (PNE) for temporomandibular joint disorders (TMD) among young adults and its initial efficacy in exploratory outcomes, including pain and somatization.
Design: Pilot randomized controlled trial.
Methods: Korean-speaking adults aged 20-29 with temporomandibular joint pain having smartphone Internet access.
Pharmacol Res
January 2025
Post-surgical pain affects millions each year, hindering recovery and quality of life. Surgical procedures cause tissue damage and inflammation, leading to peripheral and central sensitization, resulting in pain at rest or hyperalgesia to mechanical stimuli, among others. In a rat model for post-surgical pain, spinal GABAergic transmission via GABA receptors reduces mechanical hypersensitivity but has no effect on pain at rest.
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