Acute and persistent pain, and its psychology.
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Tafsīr
التفسير6 shownCommentary on the verses above, at most two editions per verse.
en-asbab-al-nuzul-by-al-wahidi on 6:1en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
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
en-asbab-al-nuzul-by-al-wahidi on 6:25en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
(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�.
en-al-jalalayn on 5:13en-al-jalalayncommentary on an ayah this subject surfaced
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.
en-al-jalalayn on 5:20en-al-jalalayncommentary on an ayah this subject surfaced
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.
en-tafisr-ibn-kathir on 5:13en-tafisr-ibn-kathircommentary on an ayah this subject surfaced
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
en-tafisr-ibn-kathir on 5:20en-tafisr-ibn-kathircommentary on an ayah this subject surfaced
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!
Research library, full list
476 to 500 of 1,002Psychosocial factors and central sensitivity syndromes.
Central sensitivity syndromes (CSSs) represent a heterogeneous group of disorders (e.g., fibromyalgia [FM], irritable bowel syndrome [IBS], chronic headache, temporomandibular disorders [TMDs], pelvic pain syndromes) that share many common symptoms, with persistent pain being the most prominent feature. Although the etiology and pathophysiology of CSSs are currently incompletely understood, central sensitization has emerged as one of the significant mechanisms. Given that there are currently no known cures for CSSs, people living with these disorders must learn to cope with and manage their symptoms throughout their lives. Medical interventions alone have not proven to be sufficient for helping people with CSSs manage their symptoms. A biopsychosocial perspective that considers the ways that biological, psychological, and social factors work independently and jointly to affect a person's…
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Pain during menopause.
Menopause is a biological process marking the end of a woman's reproductive years, typically occurring between the ages of 45 and 55. While often associated with hot flashes, mood swings, and hormonal changes, pain is a frequently overlooked and under-addressed aspect of the menopausal experience. This review article explores the multifaceted nature of pain during menopause, and sheds light on its various manifestations and the factors contributing to its prevalence and severity. Pain during menopause may include musculoskeletal discomfort, headaches or migraines, and vulvovaginal pain. The etiology of these is intricate, involving hormonal fluctuations, psychosocial factors, and genetic predispositions. Fluctuations in estrogen and progesterone levels play a pivotal role in musculoskeletal pain and joint stiffness, and increase susceptibility to conditions such as osteoarthritis. Furthe…
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Integration of pain score and morphine consumption in analgesic clinical studies.
Unlabelled: In pain clinical trials, the rescue analgesic medication such as patient-controlled analgesia morphine is often made available for patients for breakthrough pain. The patient-controlled analgesia morphine usage decreases the study agent's effect on pain relative to placebo and introduces greater variability in attainment of pain scores. For assessment of analgesic efficacy, the isolated statistical analysis of pain score or morphine consumption as a surrogate marker for pain not only loses statistical efficiency but also may incur increased false-positive findings because of multiple testing. The aim of this article is to review the research to date for choices of statistical tests for pain or morphine consumption outcome, with a focus on systematically evaluating a means for collective analgesic assessment of pain and morphine consumption using an integrated outcome. A case …
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Rumination, Magnification, and Helplessness: How do Different Aspects of Pain Catastrophizing Relate to Pain Severity and Functioning?
Objectives: Although there is a large body of research on the relationship between pain catastrophizing and functioning among individuals with chronic pain, little is known about the potential differential impact of specific aspects of pain catastrophizing. The current study evaluates the relationship between the Rumination, Helplessness, and Magnification subscales of the Pain Catastrophizing Scale and pain-related outcomes.
Materials and methods: In total, 844 patients who were admitted to a chronic pain rehabilitation program completed survey measures of pain, catastrophizing, quality of life (QOL), and depression.
Results: A series of analyses were conducted entering the 3 subscales simultaneously in a predictive model after pain intensity and demographic variables (ie, age, sex, pain duration, current opioid use). The Helplessness subscale accounted for unique variance in the predic…
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Chronic postsurgical pain: current evidence for prevention and management.
Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pa…
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Bruce J, Thornton AJ, Powell R, Johnston M, Wells M, Heys SD, Thompson AM, Smith CW, Chambers AW, Scott NW, Recovery Study Group (2014)cohort or longitudinalMEDLINE-indexed journal, not yet read by usPain176 citations Psychological, surgical, and sociodemographic predictors of pain outcomes after breast cancer surgery: a population-based cohort study.
Chronic postsurgical pain (CPSP) is a common postoperative adverse event affecting up to half of women undergoing breast cancer surgery, yet few epidemiological studies have prospectively investigated the role of preoperative, intraoperative, and postoperative risk factors for pain onset and chronicity. We prospectively investigated preoperative sociodemographic and psychological factors, intraoperative clinical factors, and acute postoperative pain in a prospective cohort of 362 women undergoing surgery for primary breast cancer. Intraoperative nerve handling (division or preservation) of the intercostobrachial nerve was recorded. At 4 and 9months after surgery, incidence of chronic painful symptoms not present preoperatively was 68% and 63%, respectively. Univariate analysis revealed that multiple psychological factors and nerve division was associated with chronic pain at 4 and 9month…
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Default mode network connectivity encodes clinical pain: an arterial spin labeling study.
Neuroimaging studies have suggested the presence of alterations in the anatomo-functional properties of the brain of patients with chronic pain. However, investigation of the brain circuitry supporting the perception of clinical pain presents significant challenges, particularly when using traditional neuroimaging approaches. While potential neuroimaging markers for clinical pain have included resting brain connectivity, these cross-sectional studies have not examined sensitivity to within-subject exacerbation of pain. We used the dual regression probabilistic Independent Component Analysis approach to investigate resting-state connectivity on arterial spin labeling data. Brain connectivity was compared between patients with chronic low back pain (cLBP) and healthy controls, before and after the performance of maneuvers aimed at exacerbating clinical pain levels in the patients. Our anal…
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Baliki MN, Baria AT, Apkarian AV (2011)cohort or longitudinalMEDLINE-indexed journal, not yet read by usThe Journal of neuroscience : the official journal of the Society for Neuroscience241 citations The cortical rhythms of chronic back pain.
Chronic pain is maladaptive and influences brain function and behavior by altering the flow and integration of information across brain regions. Here we use a power spectral analysis to investigate impact of presence of chronic pain on brain oscillatory activity in humans. We examine changes in BOLD fluctuations, across different frequencies, in chronic back pain (CBP) patients (n = 15) as compared to healthy controls (n = 15) during resting-state fMRI. While healthy subjects exhibited a specific, frequency band-dependent, large-scale neural organization, patients showed increased high-frequency BOLD oscillations (0.12-0.20 Hz) circumscribed mainly to medial prefrontal cortex (mPFC) and parts of the default mode network. In the patients a correlation analysis related the mPFC aberrant BOLD high-frequency dynamics to altered functional connectivity to pain signaling/modulating brain regio…
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Risk factors for acute and chronic postoperative pain in patients with benign and malignant renal disease after nephrectomy.
Aims: This longitudinal study was performed in order to analyze the incidence of and perioperative risk factors for the development of chronic postsurgical pain (CPSP) in patients after nephrectomy.
Methods: For baseline data acquisition, valid instruments were used for scoring sociodemographic, psychological, psychosocial, pain, pain treatment, and comorbidity factors: the Mainz Pain Staging System (MPSS) for pain chronicity, the Chronic Pain Grading Questionnaire (CPGQ), the Neuropathic Pain Scale (NPS), the Hospital Anxiety and Depression Scale (HADS), the Short Form 12 (SF-12) for health-related quality of life, the Habitual Well-Being Questionnaire (HWBQ), the Symptom Check List (SCL-8) for detecting psychosomatic dysfunction, and the Weighted Illness Check List (WICL) for evaluation of comorbidities and their impact on activities of daily living. Pain intensities were recorded over…
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Kawasaki T, Tozawa R (2020)cohort or longitudinalMEDLINE-indexed journal, not yet read by usPM & R : the journal of injury, function, and rehabilitation3 citations Grit in Community-Dwelling Older Adults with Low Back Pain Is Related to Self-Physical Training Habits.
Introduction: Self-management is an effective way to manage chronic low back pain (LBP) and is frequently recommended. However, the psychological aspects, including grit (ie, perseverance and passion for long-term goals), of the habit of self-management remain unclear.
Objective: To investigate the relationship between grit and the self-directed exercise.
Design: Cross-sectional observational study.
Setting: Community-dwelling older adults.
Participants: Fifty-nine older adults with LBP (30 men, 29 women; mean age 72 ± 5 years, range 65-82 years).
Intervention: Not applicable.
Main outcome measures: Primary outcome measures included grit scores on the Short Grit Scale and the number of months performing self-directed exercise. Correlation and multiple regression analyses were performed to determine the relationship between participants' grit and duration of self-directed exercise.
Result…
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Comparative efficacy of pharmacological and non-pharmacological interventions in fibromyalgia syndrome: network meta-analysis.
Objectives: To synthesise the available evidence on pharmacological and non-pharmacological interventions recommended for fibromyalgia syndrome (FMS).
Methods: Electronic databases including MEDLINE, PsycINFO, Scopus, the Cochrane Controlled Trials Registry and the Cochrane Library were searched for randomised controlled trials comparing any therapeutic approach as recommended in FMS guidelines (except complementary and alternative medicine) with control interventions in patients with FMS. Primary outcomes were pain and quality of life. Data extraction was done using standardised forms.
Results: 102 trials in 14 982 patients and eight active interventions (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors (SNRIs), the gamma-amino butyric acid analogue pregabalin, aerobic exercise, balneotherapy, cognitive behavioural therapy (…
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Differential effects on pain intensity and unpleasantness of two meditation practices.
Pain is an unpleasant sensory and emotional experience that can be regulated by many different cognitive mechanisms. We compared the regulatory qualities of two different meditation practices during noxious thermal stimuli: Focused Attention, directed at a fixation cross away from the stimulation, which could regulate negative affect through a sensory gating mechanism; and Open Monitoring, which could regulate negative affect through a mechanism of nonjudgmental, nonreactive awareness of sensory experience. Here, we report behavioral data from a comparison between novice and long-term meditation practitioners (long-term meditators, LTMs) using these techniques. LTMs, compared to novices, had a significant reduction of self-reported unpleasantness, but not intensity, of painful stimuli while practicing Open Monitoring. No significant effects were found for FA. This finding illuminates the…
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Edwards RR (2008)cohort or longitudinalMEDLINE-indexed journal, not yet read by usJournal of behavioral medicine105 citations The association of perceived discrimination with low back pain.
A handful of recent studies have documented perceived discrimination as a correlate of poor physical and mental health status among ethnic and racial minority groups. To date, however, despite a proliferation of research on ethnic disparities in the severity and impact of a number of persistent pain conditions, there have been no reports on associations between perceived discrimination and pain-related symptoms. Using data from a national survey (the National Survey of Midlife Development in the United States; MIDUS), we explore the relationships between perceived discriminatory events and the report of back pain among African-American and white men and women. As expected, African-American participants reported substantially greater perceptions of discrimination than white participants. Moreover, in models that included a variety of physical and mental health variables, episodes of major…
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Poiraudeau S, Rannou F, Le Henanff A, Coudeyre E, Rozenberg S, Huas D, Martineau C, Jolivet-Landreau I, Revel M, Ravaud P (2006)cohort or longitudinalMEDLINE-indexed journal, not yet read by usRheumatology (Oxford, England)45 citations Outcome of subacute low back pain: influence of patients' and rheumatologists' characteristics.
Objectives: To assess the outcome of subacute low back pain, to identify the characteristics of patients and physicians which were related to outcome and to evaluate the influence of rheumatologists' beliefs about back pain on their following the guidelines for physical and occupational activity.
Methods:
Design: a longitudinal descriptive survey.
Setting: a secondary care practice in France.
Participants: 266 rheumatologists; 440 patients with subacute low back pain.
Outcome measures: the main outcome measure was persistence of back pain 3 months after baseline evaluation. A self-administered questionnaire for physicians assessed attitudes and beliefs about back pain [Fear-Avoidance Beliefs Questionnaire (FABQ)], and one for patients assessed pain, perceived handicap and disability (Quebec Scale), anxiety and depression (Hospital Anxiety Depression Questionnaire), and beliefs about back…
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Substance use in pregnancy.
Objective: To improve awareness and knowledge of problematic substance use in pregnancy and to provide evidence-based recommendations for the management of this challenging clinical issue for all health care providers.
Options: This guideline reviews the use of screening tools, general approach to care, and recommendations for clinical management of problematic substance use in pregnancy.
Outcomes: Evidence-based recommendations for screening and management of problematic substance use during pregnancy and lactation.
Evidence: Medline, PubMed, CINAHL, and The Cochrane Library were searched for articles published from 1950 using the following key words: substance-related disorders, mass screening, pregnancy complications, pregnancy, prenatal care, cocaine, cannabis, methadone, opioid, tobacco, nicotine, solvents, hallucinogens, and amphetamines. Results were initially restricted to system…
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Qaseem A, Snow V, Shekelle P, Casey DE, Cross JT, Owens DK, Clinical Efficacy Assessment Subcommittee of the American College of Physicians, Dallas P, Dolan NC, Forciea MA, Halasyamani L, Hopkins RH, Shekelle P (2008)guidelineMEDLINE-indexed journal, not yet read by usAnnals of internal medicine158 citations Evidence-based interventions to improve the palliative care of pain, dyspnea, and depression at the end of life: a clinical practice guideline from the American College of Physicians.
RECOMMENDATION 1: In patients with serious illness at the end of life, clinicians should regularly assess patients for pain, dyspnea, and depression. (Grade: strong recommendation, moderate quality of evidence.) RECOMMENDATION 2: In patients with serious illness at the end of life, clinicians should use therapies of proven effectiveness to manage pain. For patients with cancer, this includes nonsteroidal anti-inflammatory drugs, opioids, and bisphosphonates. (Grade: strong recommendation, moderate quality of evidence.) RECOMMENDATION 3: In patients with serious illness at the end of life, clinicians should use therapies of proven effectiveness to manage dyspnea, which include opioids in patients with unrelieved dyspnea and oxygen for short-term relief of hypoxemia. (Grade: strong recommendation, moderate quality of evidence.) RECOMMENDATION 4: In patients with serious illness at the end …
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Mechanisms of pain in endometriosis.
Pain is the central symptom in endometriosis and often persists despite treatment of the disease. Multiple mechanisms underlie endometriosis-associated pain including nociception, inflammation, and alterations in peripheral and central nervous system pain processing. As also occuring in other chronic conditions, pain in endometriosis is often associated with psychological distress and fatigue, both of which may amplify pain. It is hoped that in the future methods of phenotyping women on the basis of the underlying pain mechanisms will be developed, likely combining a critical evaluation of clinical symptoms and signs with laboratory and imaging tests. Optimal pain relief for an individual is more likely if her specific contributory pain mechanisms are identified and appropriately addressed. Such methods may also improve the selection of patients for clinical trials, potentially increasin…
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Music therapy, a review of the potential therapeutic benefits for the critically ill.
Intensive care units are a stressful milieu for patients, particularly when under mechanical ventilation which they refer to as inhumane and anxiety producing. Anxiety can impose harmful effects on the course of recovery and overall well-being of the patient. Resulting adverse effects may prolong weaning and recovery time. Music listening, widely used for stress release in all areas of medicine, tends to be a reliable and efficacious treatment for those critically ill patients. It can abate the stress response, decrease anxiety during mechanical ventilation, and induce an overall relaxation response without the use of medication. This relaxation response can lower cardiac workload and oxygen consumption resulting in more effective ventilation. Music may also improve sleep quality and reduce patient's pain with a subsequent decrease in sedative exposure leading to an accelerated ventilato…
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Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases.
Neuroplasticity, which is the dynamic structural and functional reorganization of central nervous system connectivity due to environmental and internal demands, is recognized as a major physiological basis for adaption of cognition, and behavior, and thus of utmost importance for normal brain function. Pathological alterations of plasticity are increasingly explored as pathophysiological foundation of diverse neurological and psychiatric diseases. Non-invasive brain stimulation techniques (NIBS), such as repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS), are able to induce and modulate neuroplasticity in humans. Therefore, they have potential to alter pathological plasticity on the one hand, and foster physiological plasticity on the other, in neuropsychiatric diseases to reduce symptoms, and enhance rehabilitation. tDCS is an emergin…
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Clinical Policy Recommendations from the VHA State-of-the-Art Conference on Non-Pharmacological Approaches to Chronic Musculoskeletal Pain.
As a large national healthcare system, Veterans Health Administration (VHA) is ideally suited to build on its work to date and develop a safe, evidence-based, and comprehensive approach to the care of chronic musculoskeletal pain conditions that de-emphasizes opioid use and emphasizes non-pharmacological strategies. The VHA Office of Health Services Research and Development (HSR&D) held a state-of-the-art (SOTA) conference titled "Non-pharmacological Approaches to Chronic Musculoskeletal Pain Management" in November 2016. Goals of the conference were (1) to establish consensus on the current state of evidence regarding non-pharmacological approaches to chronic musculoskeletal pain to inform VHA policy in this area and (2) to begin to identify priorities for the future VHA research agenda. Workgroups were established and asked to reach consensus recommendations on clinical and research pr…
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McCracken LM, Vowles KE (2008)MEDLINE-indexed journal, not yet read by usHealth psychology : official journal of the Division of Health Psychology, American Psychological Association95 citations A prospective analysis of acceptance of pain and values-based action in patients with chronic pain.
Objective: Acceptance of pain and values-based action appear important in the emotional, physical, and social functioning of individuals with chronic pain. The purpose of the current study was to prospectively investigate these combined processes.
Method: 115 patients attending an assessment and treatment course for chronic pain in the U.K. completed a standard set of measures on two occasions separated by an average of 18.5 weeks.
Results: Correlation analyses showed that acceptance of pain and values-based action measured at Time 1 were significantly correlated with pain, pain-related distress, pain-related anxiety and avoidance, depression, depression-related interference with functioning, and physical and psychosocial disability measured at Time 2. Multiple regression analyses, in which pain and relevant patient background variables were controlled, showed that the combined acceptanc…
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Estimating the clinical effectiveness of cognitive behavioural therapy in the clinic: evaluation of a CBT informed pain management programme.
Randomized controlled trials and meta-analyses provide evidence for the efficacy of cognitive-behaviourally informed treatment (CBT) programmes for chronic pain. The current study aims to provide practice-based evidence for the effectiveness of CBT in routine clinical settings. Over a 10-year period 1013 pain patients were accepted into a 4 week in-patient pain management programme. Data from more than 800 patients was available at pre-treatment and at one month post-treatment and for around 600 patients at pre-treatment and at 9 months follow-up. Measures reported in this analysis were pain experience and interference, psychological distress (depression and anxiety), self-efficacy, catastrophizing, and walking. Change from pre-treatment to post-treatment and follow-up was assessed with conventional statistical tests, the computation of effect sizes and by the reliable change index (RCI)…
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Acceptance and values-based action in chronic pain: a study of treatment effectiveness and process.
Developing approaches within cognitive behavioral therapy are increasingly process-oriented and based on a functional and contextual framework that differs from the focus of earlier work. The present study investigated the effectiveness of acceptance and commitment therapy (S. C. Hayes, K. Strosahl, & K. G. Wilson, 1999) in the treatment of chronic pain and also examined 2 processes from this model, acceptance and values-based action. Participants included 171 completers of an interdisciplinary treatment program, 66.7% of whom completed a 3-month follow-up assessment as well. Results indicated significant improvements for pain, depression, pain-related anxiety, disability, medical visits, work status, and physical performance. Effect size statistics were uniformly medium or larger. According to reliable change analyses, 75.4% of patients demonstrated improvement in at least one key domai…
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Pain and affective distress in arthritis: relationship to immunity and inflammation.
Introduction: Most arthritides are associated with pain and psychological distress (clinically significant depression and anxiety). Pain and depression are mutually exacerbating; both may continue even when joint involvement appears well controlled. Area covered: There is strong evidence that arthritis-related stress impacts the central nervous system and, together with peripheral inflammatory changes, can cause central sensitization that can lead to chronic pain and worsening of affective distress. Cytokines and chemokines participate both in joint inflammation and in central sensitization. We review evidence of these relationships in five arthritides, namely rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout, and in osteoarthritis of the hips and knees. Central sensitization in these conditions results in long-lasting pain and psychological distress. Expert comment…
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A Reciprocal Model of Pain and Substance Use: Transdiagnostic Considerations, Clinical Implications, and Future Directions.
Pain and substance use are highly prevalent and co-occurring conditions that continue to garner increasing clinical and empirical interest. Although nicotine and tobacco, alcohol, and cannabis each confer acute analgesic effects, frequent or heavy use may contribute to the development and progression of chronic pain, and pain may be heightened during abstinence. Additionally, pain can be a potent motivator of substance self-administration, and it may contribute to escalating use and poorer substance-related treatment outcomes. We integrated converging lines of evidence to propose a reciprocal model in which pain and substance use are hypothesized to interact in the manner of a positive feedback loop, resulting in the exacerbation and maintenance of both conditions over time. Theoretical mechanisms in bidirectional pain-substance use relations are reviewed, including negative reinforcemen…
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