Pain الألم

فَبِمَا نَقۡضِهِم مِّيثَٰقَهُمۡ لَعَنَّٰهُمۡ وَجَعَلۡنَا قُلُوبَهُمۡ قَٰسِيَةࣰۖ يُحَرِّفُونَ ٱلۡكَلِمَ عَن مَّوَاضِعِهِۦ وَنَسُواْ حَظࣰّ ا مِّمَّا ذُكِّرُواْ بِهِۦۚ وَلَا تَزَالُ تَطَّلِعُ عَلَىٰ خَآئِنَةࣲ مِّنۡهُمۡ إِلَّا قَلِيلࣰ ا مِّنۡهُمۡۖ فَٱعۡفُ عَنۡهُمۡ وَٱصۡفَحۡۚ إِنَّ ٱللَّهَ يُحِبُّ ٱلۡمُحۡسِنِينَ

But they broke their pledge, so We distanced them [from Us] and hardened their hearts. They distort the meaning of [revealed] words and have forgotten some of what they were told to remember: you [Prophet] will always find treachery in all but a few of them. Overlook this and pardon them: God loves those who do good

وَإِذۡ قَالَ مُوسَىٰ لِقَوۡمِهِۦ يَٰقَوۡمِ ٱذۡكُرُواْ نِعۡمَةَ ٱللَّهِ عَلَيۡكُمۡ إِذۡ جَعَلَ فِيكُمۡ أَنۢبِيَآءَ وَجَعَلَكُم مُّلُوكࣰ ا وَءَاتَىٰكُم مَّا لَمۡ يُؤۡتِ أَحَدࣰ ا مِّنَ ٱلۡعَٰلَمِينَ

Moses said to his people, ‘My people, remember God’s blessing on you: how He raised prophets among you and appointed kings for you and gave you what he had not given to any other people

قُلۡ هَلۡ أُنَبِّئُكُم بِشَرࣲّ مِّن ذَٰلِكَ مَثُوبَةً عِندَ ٱللَّهِۚ مَن لَّعَنَهُ ٱللَّهُ وَغَضِبَ عَلَيۡهِ وَجَعَلَ مِنۡهُمُ ٱلۡقِرَدَةَ وَٱلۡخَنَازِيرَ وَعَبَدَ ٱلطَّٰغُوتَۚ أُوْلَٰٓئِكَ شَرࣱّ مَّكَانࣰ ا وَأَضَلُّ عَن سَوَآءِ ٱلسَّبِيلِ

Say, ‘Shall I tell you who deserves a worse punishment from God than [the one you wish upon] us? Those God distanced from Himself, was angry with, and condemned as apes and pigs, and those who worship idols: they are worse in rank and have strayed further from the right path

ٱلۡحَمۡدُ لِلَّهِ ٱلَّذِي خَلَقَ ٱلسَّمَٰوَٰتِ وَٱلۡأَرۡضَ وَجَعَلَ ٱلظُّلُمَٰتِ وَٱلنُّورَۖ ثُمَّ ٱلَّذِينَ كَفَرُواْ بِرَبِّهِمۡ يَعۡدِلُونَ

Praise belongs to God who created the heavens and the earth and made darkness and light; yet the disbelievers set up equals to their Lord

وَمِنۡهُم مَّن يَسۡتَمِعُ إِلَيۡكَۖ وَجَعَلۡنَا عَلَىٰ قُلُوبِهِمۡ أَكِنَّةً أَن يَفۡقَهُوهُ وَفِيٓ ءَاذَانِهِمۡ وَقۡرࣰ اۚ وَإِن يَرَوۡاْ كُلَّ ءَايَةࣲ لَّا يُؤۡمِنُواْ بِهَاۖ حَتَّىٰٓ إِذَا جَآءُوكَ يُجَٰدِلُونَكَ يَقُولُ ٱلَّذِينَ كَفَرُوٓاْ إِنۡ هَٰذَآ إِلَّآ أَسَٰطِيرُ ٱلۡأَوَّلِينَ

Among them are some who [appear to] listen to you, but we have placed covers over their hearts- so they do not understand the Quran- and deafness in their ears. Even if they saw every sign they would not believe in them. So, when they come to you, they argue with you: the disbelievers say, ‘These are nothing but ancient fables,’

أَلَمۡ يَرَوۡاْ كَمۡ أَهۡلَكۡنَا مِن قَبۡلِهِم مِّن قَرۡنࣲ مَّكَّنَّٰهُمۡ فِي ٱلۡأَرۡضِ مَا لَمۡ نُمَكِّن لَّكُمۡ وَأَرۡسَلۡنَا ٱلسَّمَآءَ عَلَيۡهِم مِّدۡرَارࣰ ا وَجَعَلۡنَا ٱلۡأَنۡهَٰرَ تَجۡرِي مِن تَحۡتِهِمۡ فَأَهۡلَكۡنَٰهُم بِذُنُوبِهِمۡ وَأَنشَأۡنَا مِنۢ بَعۡدِهِمۡ قَرۡنًا ءَاخَرِينَ

Do they not realize how many generations We destroyed before them? We established them in the earth more firmly than you, sent down abundant rain on them from the sky and made running rivers flow at their feet, yet We destroyed them for their misdeeds and raised other generations after them

Praise belongs to God who created the heavens and the earth and made the darknesses and the light. He begins by lauding Himself, thereby praising Himself with His own beginningless laudation and reporting of His own self-sufficient brilliance and unitary elevation. This is praise of the tremendous Lord, the wise Enactor. He is subsistent through His own subsistence, transcendent through His own attributes, magnificent through His own magnificence. His elevation is everlasting, His brilliance self-standing, His existence unitary, His being self- sufficient, His face majestic, His power perfect-Glory be to Him! And God is the One, the All- Subjugating [39:4], the exalted, the all-compeller, the great, the transcendent. One of the great ones of the religion and leaders of the Tariqah said, “Who is worthy of praise other than He whose power created the heavens and the earth and made the dark

(Of them are some who listen unto thee�) [6:25]. Abu Salih reported that Ibn �Abbas said: �Abu Sufyan ibn Harb, al-Walid ibn al-Mughirah, al-Nadr ibn al-Harith, �Utbah and Shaybah the sons of Rabi�ah and Umayyah and Ubayy the sons of Khalaf listened to the Messenger of Allah, Allah bless him and give him peace, [reciting the Qur�an], and so they asked al-Nadr: �O Abu Qutaylah, what does Muhammad (s)ay?� He said: �By Him who has made it [the Ka�bah ] His House, I do not know what he is saying, except that I see his lips moving, muttering something. But what he says is nothing but the fables of the people of old, like the stories I used to relate to you regarding bygone nations�. Al-Nadr used to talk abundantly about bygone nations. He used to relate this to the Quraysh who listened to what he had to say. Then, Allah, exalted is He, revealed this verse�.

God says So because bi-mā the mā is extra of their breaking their covenant We cursed them We removed them from Our mercy and made their hearts hard unyielding to the acceptance of faith; they pervert words pertaining to the descriptions of Muhammad (s) in the Torah and other things from their contexts those in which God has placed them in other words they substitute them; and they have forgotten they have abandoned a portion a part of what they were reminded of of what they were enjoined to in the Torah in the way of following Muhammad (s); and you — addressing the Prophet s now — will never cease to discover some treachery on their part in the way of breaking a covenant or some other matter except for a few of them who have submitted themselves to Islam. Yet pardon them and forgive; surely God loves the virtuous this was abrogated by the ‘sword’ verse Q. 95.

And mention when Moses said to his people ‘O my people remember God’s favour to you when He established among you that is from among you prophets and established you as kings possessing servants and retinues and gave you such as He had not given to any in all the worlds in the way of manna and quails the parting of the sea and other things.

Indeed, Allah took the covenant from the Children of Israel (Jews), and We appointed twelve leaders among them. And Allah said: "I am with you if you perform the Salah and give the Zakah and believe in My Messengers; honor and assist them, and lend to Allah a good loan, verily, I will remit your sins and admit you to Gardens under which rivers flow (in Paradise). But if any of you after this, disbelieved, he has indeed gone astray from the straight way. (12)So, because of their breach of their covenant, We cursed them and made their hearts grow hard. They changed the words from their (right) places and have abandoned a good part of the Message that was sent to them. And you will not cease to discover deceit in them, except a few of them. But forgive them and overlook (their misdeeds). Verily, Allah loves the doers of good (13)And from those who call themselves Christians, We took their c

And (remember) when Musa said to his people: "O my people! Remember the favor of Allah to you: when He made Prophets among you, made you kings and gave you what He had not given to any other among the nations (Al-'Alamin). (20)"O my people! Enter the Holy Land which Allah has assigned to you and turn not back; for then you will be returned as losers. (21)They said: "O Musa! In it are a people of great strength, and we shall never enter it, till they leave it; when they leave, then we will enter. (22)Two men of those who feared (Allah and) on whom Allah had bestowed His grace said: "Assault them through the gate; for when you are in, victory will be yours. And put your trust in Allah if you are believers indeed. (23)They said: "O Musa! We shall never enter it as long as they are there. So go, you and your Lord, and fight you two, we are sitting right here. (24)He [Musa] said: "O my Lord!

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

حَدَّثَنَا مُحَمَّدُ بْنُ يَحْيَى، قال حَدَّثَنَا إِسْحَاقُ بْنُ مُحَمَّدٍ الْفَرْوِيُّ، قال حَدَّثَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عُمَارَةَ بْنِ غَزِيَّةَ، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنْ قَتَادَةَ بْنِ النُّعْمَانِ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَالَ ‏ "‏ إِذَا أَحَبَّ اللَّهُ عَبْدًا حَمَاهُ الدُّنْيَا كَمَا يَظَلُّ أَحَدُكُمْ يَحْمِي سَقِيمَهُ الْمَاءَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى وَفِي الْبَابِ عَنْ صُهَيْبٍ وَأُمِّ الْمُنْذِرِ ‏.‏ وَهَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ ‏.‏ وَقَدْ رُوِيَ هَذَا الْحَدِيثُ عَنْ مَحْمُودِ بْنِ لَبِيدٍ عَنِ النَّبِيِّ صلى الله عليه وسلم مُرْسَلاً ‏.‏ حَدَّثَنَا عَلِيُّ بْنُ حُجْرٍ، قال أَخْبَرَنَا إِسْمَاعِيلُ بْنُ جَعْفَرٍ، عَنْ عَمْرِو بْنِ أَبِي عَمْرٍو، عَنْ عَاصِمِ بْنِ عُمَرَ بْنِ قَتَادَةَ، عَنْ مَحْمُودِ بْنِ لَبِيدٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم نَحْوَهُ وَلَمْ يَذْكُرْ فِيهِ عَنْ قَتَادَةَ بْنِ النُّعْمَانِ ‏.‏ قَالَ أَبُو عِيسَى وَقَتَادَةُ بْنُ النُّعْمَانِ الظَّفَرِيُّ هُوَ أَخُو أَبِي سَعِيدٍ الْخُدْرِيِّ لأُمِّهِ وَمَحْمُودُ بْنُ لَبِيدٍ قَدْ أَدْرَكَ النَّبِيَّ صلى الله عليه وسلم وَرَآهُ وَهُوَ غُلاَمٌ صَغِيرٌ ‏.‏

Qatadah bin An-Nu'man narrated that the Messenger of Allah (s.a.w) said:"When Allah loves a slave, He prevents him from the world, just as one of you prevents his sick from water." Another chain reports a similar narration

حَدَّثَنَا عَبَّاسُ بْنُ مُحَمَّدٍ الدُّورِيُّ، قال حَدَّثَنَا يُونُسُ بْنُ مُحَمَّدٍ، قال حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ عُثْمَانَ بْنِ عَبْدِ الرَّحْمَنِ التَّيْمِيِّ، عَنْ يَعْقُوبَ بْنِ أَبِي يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ، قَالَتْ دَخَلَ عَلَىَّ رَسُولُ اللَّهِ صلى الله عليه وسلم وَمَعَهُ عَلِيٌّ وَلَنَا دَوَالٍ مُعَلَّقَةٌ قَالَتْ فَجَعَلَ رَسُولُ اللَّهِ صلى الله عليه وسلم يَأْكُلُ وَعَلِيٌّ مَعَهُ يَأْكُلُ ‏.‏ فَقَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِعَلِيٍّ ‏"‏ مَهْ مَهْ يَا عَلِيُّ فَإِنَّكَ نَاقِهٌ ‏"‏ ‏.‏ قَالَ فَجَلَسَ عَلِيٌّ وَالنَّبِيُّ صلى الله عليه وسلم يَأْكُلُ ‏.‏ قَالَتْ فَجَعَلْتُ لَهُمْ سِلْقًا وَشَعِيرًا فَقَالَ النَّبِيُّ صلى الله عليه وسلم ‏"‏ يَا عَلِيُّ مِنْ هَذَا فَأَصِبْ فَإِنَّهُ أَوْفَقُ لَكَ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ لاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ فُلَيْحٍ ‏.‏ وَيُرْوَى عَنْ فُلَيْحٍ عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ ‏.‏ حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، قال حَدَّثَنَا أَبُو عَامِرٍ، وَأَبُو دَاوُدَ قَالاَ حَدَّثَنَا فُلَيْحُ بْنُ سُلَيْمَانَ، عَنْ أَيُّوبَ بْنِ عَبْدِ الرَّحْمَنِ، عَنْ يَعْقُوبَ، عَنْ أُمِّ الْمُنْذِرِ الأَنْصَارِيَّةِ، فِي حَدِيثِهِ قَالَتْ دَخَلَ عَلَيْنَا رَسُولُ اللَّهِ صلى الله عليه وسلم فَذَكَرَ نَحْوَ حَدِيثِ يُونُسَ بْنِ مُحَمَّدٍ إِلاَّ أَنَّهُ قَالَ ‏"‏ أَنْفَعُ لَكَ ‏"‏ ‏.‏ وَقَالَ مُحَمَّدُ بْنُ بَشَّارٍ وَحَدَّثَنِيهِ أَيُّوبُ بْنُ عَبْدِ الرَّحْمَنِ ‏.‏ هَذَا حَدِيثٌ جَيِّدٌ غَرِيبٌ ‏.‏

Umm Al-Mundhir said:"The Messenger of Allah (ﷺ) entered upon me, while `Ali was with him, and we had a cluster of unripe dates hanging." She said: "The Messenger of Allah (ﷺ) began eating, and `Ali ate with him. The Messenger of Allah (ﷺ) said to `Ali: 'Stop, stop, for you are still recovering.' So `Ali sat and the Prophet (ﷺ) ate." She said: "I made some chard and barley for them, so the Prophet (ﷺ) said: 'O `Ali eat from this, for indeed it will be more suitable for you." Another chain reports a similar narration

فقد روى أن امرأة فتح الموصلي عثرت فانقطع ظفرها فضحكت فقيل لها أما تجدين الوجع فقالت إن لذة ثوابه أزالت عن قلبي مرارة وجعه

يقول قلبي لطرفي أن بكى جزعا % تبكي وأنت الذي حملتني الوجعا

وكان يأخذه عرق الكلية وهو الخاصرة فقلنا يا رسول الله لو دعوت الله فيكشف عنك قال إنا معاشر الانبياء يشدد علينا الوجع ليكفر عنا

وقال الحسن وذكر الوجع أما والله ما هو بشر أيام المسلم أيام نورت له فيها مراحله وذكر فيها ما نسى من معاده وكفر بها عنه من خطاياه وقال بعض السلف لولا مصائب الدنيا لو لوردنا الآخرة مفاليس

قال أسامة بن زيد قال رسول الله صلى الله عليه وسلم إن هذا الوجع أو السقم رجز عذب به بعض الأمم قبلكم ثم بقي بعد في الأرض منه + حديث أسامة بن زيد إن هذا الوجع أو السقم رجز عذب به بعض الأمم قبلكمالحديث متفق عليه واللفظ لمسلم +

وجعل عقوبة من التذ بدنه كله وروحه بالوطءالحرام : إيلام بدنه وروحه بالجلد والرجم فيصل الألم إلى حيث وصلت اللذة

An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19.: Background: Chronic low back pain is the most prevalent chronic pain condition worldwide and access to behavioral pain treatment is limited. Virtual reality (VR) is an immersive technology that may provide effective behavioral therapeutics for chronic pain. Objective: We aimed to conduct a double-blind, parallel-arm, single-cohort, remote, randomized placebo-controlled trial for a self-administered behavioral skills-based VR program in community-based individuals with self-reported chronic low b

Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial.: Importance: Chronic low back pain (CLBP), the most prevalent chronic pain condition, imparts substantial disability and discomfort. Cognitive behavioral therapy (CBT) reduces the effect of CLBP, but access is limited. Objective: To determine whether a single class in evidence-based pain management skills (empowered relief) is noninferior to 8-session CBT and superior to health education at 3 months after treatment for improving pain catastrophizing, pain intensity, pain interference, and other s

Using Virtual Reality Exposure Therapy in Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.: Objectives: This study aimed to assess the effectiveness of virtual reality (VR) in managing different types of pain in different age groups and to provide evidence for the clinical application of new alternative strategy for pain management. Methods: Electronic databases, including the Cochrane Library, PubMed, EMBASE, and the Web of Science, were searched for studies published up to October 2020. Randomized controlled trials that reported on VR for pain management were included. Results: A tot

mHealth Intervention for Improving Pain, Quality of Life, and Functional Disability in Patients With Chronic Pain: Systematic Review.: Background: Chronic pain (CP) is 1 of the leading causes of disability worldwide and represents a significant burden on individual, social, and economic aspects. Potential tools, such as mobile health (mHealth) systems, are emerging for the self-management of patients with CP. Objective: A systematic review was conducted to analyze the effects of mHealth interventions on CP management, based on pain intensity, quality of life (QoL), and functional disability assessment, compared to conventional

Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.: Background: Chronic pain patients increasingly seek treatment through mindfulness meditation. Purpose: This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults. Method: We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pa

Systematic review and meta-analysis of psychological therapies for children with chronic pain.: Objectives: This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children. Methods: Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was

Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents.

Background: This is the first update of a review published in 2015, Issue 1. Chronic pain is common during childhood and adolescence and is associated with negative outcomes, such as increased severity of pain, reduced function, and low mood. Psychological therapies, traditionally delivered face-to-face with a therapist, are efficacious at reducing pain intensity and disability. To address barriers to treatment access, such as distance and cost of treatment, technology is being used to deliver these psychological therapies remotely. Therapies delivered remotely, such as via the Internet, computer-based programmes, and smartphone applications, can be used to deliver treatment to children and adolescents with chronic pain. Objectives: To determine the efficacy of psychological therapies delivered remotely compared to waiting list, treatment as usual, or active control treatments, for the m…

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Psychological therapies (Internet-delivered) for the management of chronic pain in adults.

Background: Chronic pain (i.e. pain lasting longer than three months) is common. Psychological therapies (e.g. cognitive behavioural therapy) can help people to cope with pain, depression and disability that can occur with such pain. Treatments currently are delivered via hospital out-patient consultation (face-to-face) or more recently through the Internet. This review looks at the evidence for psychological therapies delivered via the Internet for adults with chronic pain. Objectives: Our objective was to evaluate whether Internet-delivered psychological therapies improve pain symptoms, reduce disability, and improve depression and anxiety for adults with chronic pain. Secondary outcomes included satisfaction with treatment/treatment acceptability and quality of life. Search methods: We searched CENTRAL (Cochrane Library), MEDLINE, EMBASE and PsycINFO from inception to November 2013 fo…

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Pain in the body. Altered interoception in chronic pain conditions: A systematic review.

Interoception is the sense of the physiological condition of the body. Modern definitions differentiated three separated sub-constructs: accuracy (IAc), i.e., the ability to detect physiological states, sensibility (IAs), i.e., a self-evaluated measure of interoception, and awareness (IAw) i.e., a metacognitive awareness of the accuracy. Preliminary researches correlated pain with alterations in the interoceptive matrix albeit, to the best of our knowledge, interoceptive alterations in chronic pain conditions have never been studied systematically. We searched for studies that assessed interoception in subjects with chronic pain and compared it to healthy population. Eleven studies were included among different chronic pain conditions. Results suggested that chronic pain subjects might present low IAc and, allegedly, that IAc negatively correlates with symptoms severity in specific disor…

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Cognitive Behavioral Therapy increases pain-evoked activation of the prefrontal cortex in patients with fibromyalgia.

Interventions based on Cognitive Behavioral Therapy (CBT) are widely used to treat chronic pain, but the brain mechanisms responsible for these treatment effects are poorly understood. The aim of this study was to validate the relevance of the cortical control theory in response to an exposure-based form of CBT, Acceptance and Commitment Therapy, in patients with chronic pain. Forty-three female patients diagnosed with fibromyalgia syndrome were enrolled in a randomized, 12-week, waiting-list controlled clinical trial (CBT n=25; controls n=18). CBT was administered in groups of six patients during 12 weekly sessions. Functional magnetic resonance imaging (fMRI) during pressure-evoked pain was assessed before and after treatment or the 12-week period. Self-report questionnaires of depression and anxiety were administered pre- and posttreatment as well as 3 months following end of treatmen…

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Catastrophizing, pain, and functional outcomes for children with chronic pain: a meta-analytic review.

Pediatric chronic pain is associated with numerous negative outcomes including increased physical disability, increased rates of depression and anxiety, and decreased quality of life (QOL). Pain catastrophizing-broadly conceptualized as including rumination, magnification, and helplessness cognitions surrounding one's pain-has been linked with poor functional outcomes in children with chronic pain. Pain catastrophizing in pediatric chronic pain is often considered a key factor on which to focus treatment efforts. However, absent a systematic review that integrates the relevant literature, this call for routine assessment and targeted treatment may be premature. This study aimed to: (1) meta-analytically quantify the relationship between catastrophizing and pain and functional/psychosocial outcomes (functional disability/physical functioning, anxiety, depression, and QOL) in children with…

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Structural and functional brain abnormalities in chronic low back pain: A systematic review.

Objectives: The purpose of this systematic review is to analyze the available literature on structural and functional brain abnormalities in chronic low back pain (CLBP) using several brain magnetic resonance imaging (MRI) techniques. Methods: PubMed and Web of Science were systematically screened for relevant literature using different combinations of keywords regarding structural and functional brain imaging techniques in patients with CLBP. Reference lists of included articles were hand-searched for additional literature. Eligible articles were assessed on risk of bias and reviewed by two independent researchers. Results: The search query returned 27 articles meeting the inclusion criteria. Methodological quality varied from poor to good. A total of 10 studies evaluated structural gray matter changes. There is conflicting evidence in global gray matter changes, with both increases and…

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A Systematic Review of Technology-assisted Self-Management Interventions for Chronic Pain: Looking Across Treatment Modalities.

Objectives: The use of technology to provide chronic pain self-management interventions has increased in the recent years. Individual studies have primarily focused on a single technology-assisted modality and direct comparisons of different technology-assisted modalities are rare. Thus, little is known about the relative strengths and weaknesses of each technology-assisted modality. Materials and methods: This article is a systematic review of technology-assisted self-management interventions for chronic nonheadache, noncancer pain in adults. We examined 3 treatment modalities: telephone, interactive voice response, and Internet. Electronic searches of OVID MEDLINE, OVID PsychINFO, and the Cochrane Database of Systematic Reviews were conducted. Forty-four articles including 9890 participants were reviewed. Results: Across modalities, the existing evidence suggests that technology-assist…

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Psychological flexibility as a mediator of improvement in Acceptance and Commitment Therapy for patients with chronic pain following whiplash.

Cognitive behavior therapy (CBT) has made important contributions to chronic pain management, but the process by which it is effective is not clear. Recently, strong arguments have been raised concerning the need for theory driven research to e.g. identify mechanisms of change in CBT and enhance the effectiveness of this type of treatment. However, the number of studies addressing these issues is still relatively scarce. Furthermore, the arrival of varieties of CBT with seemingly different process targets increases the need for such information. The present study explored the processes of change in a previously reported successful randomized controlled trial evaluating the effectiveness of an exposure-based form of behavioral and cognitive therapy, Acceptance and Commitment Therapy (ACT), on improvement in pain-related disability and life satisfaction for patients suffering from whiplash…

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Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs).

Controversy remains regarding the mechanisms of acupuncture analgesia. A prevailing theory, largely unproven in humans, is that it involves the activation of endogenous opioid antinociceptive systems and mu-opioid receptors (MORs). This is also a neurotransmitter system that mediates the effects of placebo-induced analgesia. This overlap in potential mechanisms may explain the lack of differentiation between traditional acupuncture and either non-traditional or sham acupuncture in multiple controlled clinical trials. We compared both short- and long-term effects of traditional Chinese acupuncture (TA) versus sham acupuncture (SA) treatment on in vivo MOR binding availability in chronic pain patients diagnosed with fibromyalgia (FM). Patients were randomized to receive either TA or SA treatment over the course of 4 weeks. Positron emission tomography (PET) with (11)C-carfentanil was perfo…

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Expectations predict chronic pain treatment outcomes.

Accumulating evidence suggests an association between patient pretreatment expectations and numerous health outcomes. However, it remains unclear if and how expectations relate to outcomes after treatments in multidisciplinary pain programs. The present study aims at investigating the predictive association between expectations and clinical outcomes in a large database of chronic pain patients. In this observational cohort study, participants were 2272 patients treated in one of 3 university-affiliated multidisciplinary pain treatment centers. All patients received personalized care, including medical, psychological, and/or physical interventions. Patient expectations regarding pain relief and improvements in quality of life and functioning were measured before the first visit to the pain centers and served as predictor variables. Changes in pain intensity, depressive symptoms, pain inte…

matched on Chronic Pain (mesh), Pain Management (mesh), chronic pain (text), Catastrophization (mesh), Pain Measurement (mesh)

Pain perception as a function of self-focused rumination.

Pain sensitivity and tolerance were studied using the cold-pressor technique. A 3 independent groups design was employed using rumination as the independent variable. Group 1 was given a situation in which anger-related self-rumination was introduced. Group 2 was given a self-related rumination task in which anger was not induced. Group 3 received a rumination task not related to the self. In addition, the State-Trait Anger Expression Inventory was given prior to the experiment to test the hypothesis that ratings on the Anger-In subtest would correlate with pain sensitivity. In each group were 6 men and 6 women. Each participant took the anger and another inventory not relevant to the present study before the experiment. An anger measure was taken before and after the experiment for each group to see if the anger induction in Group 1 actually increased anger. There were no differences am…

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Volitional limbic neuromodulation exerts a beneficial clinical effect on Fibromyalgia.

Volitional neural modulation using neurofeedback has been indicated as a potential treatment for chronic conditions that involve peripheral and central neural dysregulation. Here we utilized neurofeedback in patients suffering from Fibromyalgia - a chronic pain syndrome that involves sleep disturbance and emotion dysregulation. These ancillary symptoms, which have an amplificating effect on pain, are known to be mediated by heightened limbic activity. In order to reliably probe limbic activity in a scalable manner fit for EEG-neurofeedback training, we utilized an Electrical Finger Print (EFP) model of amygdala-BOLD signal (termed Amyg-EFP), that has been successfully validated in our lab in the context of volitional neuromodulation. We anticipated that Amyg-EFP-neurofeedback training aimed at limbic down modulation would improve chronic pain in patients suffering from Fibromyalgia, by r…

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Telehealth Versus In-Person Acceptance and Commitment Therapy for Chronic Pain: A Randomized Noninferiority Trial.

The purpose of this randomized noninferiority trial was to compare video teleconferencing (VTC) versus in-person (IP) delivery of an 8-week acceptance and commitment therapy (ACT) intervention among veterans with chronic pain (N = 128) at post-treatment and at 6-month follow-up. The primary outcome was the pain interference subscale of the Brief Pain Inventory. Secondary outcomes included measures of pain severity, mental and physical health-related quality of life, pain acceptance, activity level, depression, pain-related anxiety, and sleep quality. In intent to treat analyses using mixed linear effects modeling, both groups exhibited significant improvements on primary and secondary outcomes, with the exception of sleep quality. Further, improvements in activity level at 6-month follow-up were significantly greater in the IP group. The noninferiority hypothesis was supported for the pr…

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Age moderates response to acceptance and commitment therapy vs. cognitive behavioral therapy for chronic pain.

Objective: The purpose of this study was to examine age differences in response to different forms of psychotherapy for chronic pain. Methods: We performed a secondary analysis of 114 adults (ages 18-89 years) with a variety of chronic, nonmalignant pain conditions randomly assigned to 8 weeks of group-administered acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT). Treatment response was defined as a drop of at least three points on the Brief Pain Inventory-interference subscale. Results: Older adults were more likely to respond to ACT, and younger adults to CBT, both immediately following treatment and at 6-month follow-up. There were no significant differences in credibility, expectations of positive outcome, attrition, or satisfaction, although there was a trend for the youngest adults (ages 18-45 years) to complete fewer sessions. Conclusions: These data s…

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Efficacy of a Telephone-Delivered Self-Management Intervention for Persons With Multiple Sclerosis: A Randomized Controlled Trial With a One-Year Follow-Up.

Objective: To evaluate the efficacy of a telephone-delivered self-management intervention for fatigue, pain, and depression in adults with multiple sclerosis (MS). Design: Single-center, randomized (1:1), single-blind (outcome assessors), parallel-group trial with a primary endpoint of posttreatment (9-11 wk postrandomization) and long-term follow-up at 6 and 12 months. Setting: Telephone-delivered across the United States. Participants: Adults with MS (N=163) with fatigue, chronic pain, and/or moderate depressive symptoms (age range, 25-76 y). Interventions: Eight-week individual telephone-delivered self-management intervention (T-SM) (n=75) versus an 8-week individual telephone-delivered MS education intervention (T-ED) (n=88). Main outcome measures: The primary outcome was the proportion who achieved a ≥50% decrease in 1 or more symptoms-fatigue impact, pain interference, and/or depre…

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Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial.

A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, pain coping skills training (PCST), in patients' doctors' offices (N=129 patients); the control group received usual care (N=127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: pain intensity, physical functioning, psychological distress, self-efficacy, catastrophizing, use of coping strategies, and quality of life. Secondary measures included fatigue, social functioning, health satisfaction, and use of pain medication. Methods favoring external validity, consistent with pragmatic, effectiveness research, were utilized. Primary ITT and secondary per-protocol analyses were conducted. Attrition was within the expect…

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A trial of a brief group-based form of acceptance and commitment therapy (ACT) for chronic pain in general practice: pilot outcome and process results.

Unlabelled: Acceptance and commitment therapy (ACT) is a developing approach for chronic pain. The current study was designed to pilot test a brief, widely inclusive, local access format of ACT in a UK primary care setting. Seventy-three participants (68.5% women) were randomized to either ACT or treatment as usual (TAU). Many of the participants were aged 65 years or older (27.6%), were diagnosed with fibromyalgia (30.2%) and depression (40.3%), and had longstanding pain (median = 10 years). Standard clinical outcome measures included disability, depression, physical functioning, emotional functioning, and rated improvement. Process measures included pain-related and general psychological acceptance. The recruitment target was met within 6 months, and 72.9% of those allocated to ACT completed treatment. Immediately post treatment, relative to TAU, participants in ACT demonstrated lower …

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Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial.

Objective: To examine whether pain physiology education was capable of changing pain cognitions and pain thresholds in patients with chronic fatigue syndrome (CFS) and chronic widespread pain. Design: Double-blind randomized controlled trial. Setting: Specialized chronic fatigue clinic in university hospital. Participants: A random sample of patients (N=48) with CFS patients (8 men, 40 women) experiencing chronic pain, randomly allocated to the control group (n=24) or experimental group (n=24). Two women in the experimental group did not complete the study because of practical issues (lack of time and restricted mobility). Interventions: One individual pain physiology education session (experimental) or 1 pacing and self-management education session (control). Main outcome measures: Algometry, the Neurophysiology of Pain Test, and questionnaires evaluating pain cognitions-the Pain Coping…

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A Community Health Worker-Led Positive Psychology Intervention for African American Older Adults With Chronic Pain.

Background and objectives: Experiencing structural racism over the life course contributes to disproportionate pain-related disability among African American older adults. Positive STEPS, delivered by community health workers, is a culturally congruent chronic pain self-management intervention that incorporates positive psychology principles and gives attention to social determinants of pain and pain management. Research design and methods: We conducted a randomized pilot trial among older adults with chronic musculoskeletal pain in an underserved, primarily African American community (Detroit, Michigan). The 7-week intervention included weekly telephone sessions with a community health worker; web-based videos teaching pain self-management skills; positive activities (e.g., Life Review, Gratitude Jar); and use of wearable activity trackers. Outcomes were measured at baseline and 8-week …

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Efficacy of a Psychosocial Pain Management Intervention for Men and Women With Substance Use Disorders and Chronic Pain: A Randomized Clinical Trial.

Importance: Chronic pain is common in those with substance use disorders (SUDs) and predicts poorer addiction treatment outcomes. A critical challenge for addiction treatment is to develop effective methods to improve pain-related and substance use-related outcomes for those in treatment for SUDs. Objective: To examine the efficacy of an integrated behavioral pain management intervention (Improving Pain During Addiction Treatment [ImPAT]) for men and women with SUDs to treat pain, functioning, and substance use. Design, setting, and participants: In this randomized clinical trial, 8 sessions of ImPAT were compared with 8 sessions of a supportive psychoeducational control (SPC) condition for adults with pain treated at a large residential SUD treatment program. Follow-up occurred at 3, 6, and 12 months postbaseline. A total of 1372 adults were screened, including 960 men and 412 women, an…

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Happy Despite Pain: A Randomized Controlled Trial of an 8-Week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients With Chronic Pain.

Objectives: There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. Materials and methods: A randomized controlled trial was carried out with 3 conditions: an internet-delivered positive psychology program, an internet-delivered cognitive-behavioral program and waitlist control. A total of 276 patients were randomized to 1 of the 3 conditions and posttreatment data were obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at posttreatment and at 6-month follow-up. Intention-to-treat analyses were carried out using mixed regression analyses. Results: Both treatments led to significant i…

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Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: a randomized controlled multicenter trial.

Internet-delivered interventions are emerging as a strategy to address barriers to care for individuals with chronic pain. This is the first large multicenter randomized controlled trial of Internet-delivered cognitive-behavioral therapy (CBT) for pediatric chronic pain. Participants included were 273 adolescents (205 females and 68 males), aged 11 to 17 years with mixed chronic pain conditions and their parents, who were randomly assigned in a parallel-group design to Internet-delivered CBT (n = 138) or Internet-delivered Education (n = 135). Assessments were completed before treatment, immediately after treatment, and at 6-month follow-up. All data collection and procedures took place online. The primary analysis used linear growth models. Results demonstrated significantly greater reduction on the primary outcome of activity limitations from baseline to 6-month follow-up for Internet …

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Fear-avoidance beliefs-a moderator of treatment efficacy in patients with low back pain: a systematic review.

Background context: Psychological factors are believed to influence the development of chronic low back pain. To date, it is not known how fear-avoidance beliefs (FABs) influence the treatment efficacy in low back pain. Purpose: To summarize the evidence examining the influence of FABs measured with the Fear-Avoidance Belief Questionnaire or the Tampa Scale of Kinesiophobia on treatment outcomes in patients with low back pain. Study design/setting: This is a systematic review. Patient sample: Patients with low back pain. Outcome measures: Work-related outcomes and perceived measures including return to work, pain, and disability. Methods: In January 2013, the following databases were searched: BIOSIS, CINAHL, Cochrane Library, Embase, OTSeeker, PeDRO, PsycInfo, PubMed/Medline, Scopus, and Web of Science. A hand search of the six most often retrieved journals and a bibliography search com…

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Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review.

Study design: Systematic literature review. Objective: To categorize published evidence systematically for lumbar fusion for chronic low back pain (LBP) in order to provide an updated and comprehensive analysis of the clinical outcomes. Summary of background data: Despite a large number of publications of outcomes of spinal fusion surgery for chronic LBP, there is little consensus on efficacy. Methods: A MEDLINE and Cochrane database search was performed to identify published articles reporting on validated patient-reported clinical outcomes measures (2 or more of visual analogue scale, Oswestry Disability Index, Short Form [36] Health Survey [SF-36] PCS, and patient satisfaction) with minimum 12 months of follow-up after lumbar fusion surgery in adult patients with LBP due to degenerative disc disease. Twenty-six total articles were identified and stratified by level of evidence: 18 lev…

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The effect of adverse childhood experiences on chronic pain and major depression in adulthood: a systematic review and meta-analysis.

Background: Adverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often associated with mood disorders, such as major depressive disorder (MDD); both have been linked to adverse childhood experiences. It is unclear how the effect of adverse childhood experiences on neural processing impacts on vulnerability to chronic pain, MDD, or both, and whether there are shared mechanisms. We aimed to assess evidence for central neural changes associated with adverse childhood experiences in subjects with chronic pain, MDD, or both using systematic review and meta-analysis. Methods: Electronic databases were systematically searched for neuroimaging studies of adverse childhood experiences, with chronic pain, MDD, or both. Two independent reviewers screened title, abstracts, and full text, and assessed…

matched on Chronic Pain (mesh), Chronic Pain (keyword), chronic pain (text)