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

Acceptance and Commitment Therapy (ACT) for Chronic Pain: A Systematic Review and Meta-Analyses.

Objectives: Chronic pain places a burden on individuals and the economy. Although there is evidence for the effectiveness of cognitive-behavior therapy, it is recognized that the effects are limited. Acceptance and Commitment Therapy (ACT), which aims to increase valued action in the presence of pain, has been suggested as an alternative approach. The objective of this review was to determine the clinical effectiveness of ACT for chronic pain in adults when compared with control conditions and other active treatments. Methods: The searches of this systematic review were conducted in the Cochrane library, MEDLINE, EMBASE, CINAHL Plus (EBSCO), and PsycINFO. Grey literature, reference list, and reverse citation searches were also completed. Results: Eleven trials were included. ACT was favored over controls (no alternative intervention or treatment as usual). Significant, medium to large ef…

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Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews.

Background: Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews'. Objectives: To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults. Methods: We searched the Cochrane Database of Systematic Reviews (the Cochrane Library) Issue 3, 2017 on 8 March 2017 to identify all Cochrane Reviews of studies of medium- or long-term opioid use (2 weeks or more) for CNCP in adults aged 18 and over. We assessed the quality of the…

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Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.

Importance: Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. Objective: To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids. Data sources: Twenty-eight databases from inception to April 2015. Study selection: Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. Data extraction and synthesis: Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. Main outcomes and measures:…

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The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis.

Acceptance and Commitment therapy (ACT) has attracted a lot of interest during the last 10-15 years with a strong increase of the number of randomized controlled trials (RCTs). The present review and meta-analysis includes 60 RCTs (4234 participants) on psychiatric disorders, somatic disorders, and stress at work. The mean effect size across all comparisons was small (0.42). Compared to the Öst (2008) meta-analysis there was no significant improvement in methodological quality and deterioration in effect size (from 0.68). When ACT was compared to various forms of cognitive or behavioral treatments a small and non-significant effect size of 0.16 was obtained. An evidence-base evaluation showed that ACT is not yet well-established for any disorder. It is probably efficacious for chronic pain and tinnitus, possibly efficacious for depression, psychotic symptoms, OCD, mixed anxiety, drug abu…

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A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions.

Hypnosis is regarded as an effective treatment for psychological and physical ailments. However, its efficacy as a strategy for managing chronic pain has not been assessed through meta-analytical methods. The objective of the current study was to conduct a meta-analysis to assess the efficacy of hypnosis for managing chronic pain. When compared with standard care, hypnosis provided moderate treatment benefit. Hypnosis also showed a moderate superior effect as compared to other psychological interventions for a nonheadache group. The results suggest that hypnosis is efficacious for managing chronic pain. Given that large heterogeneity among the included studies was identified, the nature of hypnosis treatment is further discussed.

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Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years.

Observational (behavioral) scales of pain for children aged 3 to 18 years were systematically reviewed to identify those recommended as outcome measures in clinical trials. This review was commissioned by the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (www.immpact.org). In an extensive literature search, 20 observational pain scales were identified for review including behavior checklists, behavior rating scales, and global rating scales. These scales varied in their reliance on time sampling and inclusion of physiological items, facial and postural items, as well as their inclusion of multiple dimensions of assessment (e.g., pain and distress). Each measure was evaluated based on its reported psychometric properties and clinical utility. Scales were judged to be indicated for use in specific acute pain contexts rather than for general use. Two s…

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Cross-cultural adaptation and validation of the Brazilian Portuguese version of the pain catastrophizing scale.

Objective: Catastrophizing is a maladaptive response to pain and is one of the factors that contribute to the chronicity of some pain syndromes. The Pain Catastrophizing Scale (PCS) assists both treatment planning and outcome assessment. Its use is limited in Portuguese-speaking countries because of the lack of a validated translated version. We conducted the validation of the Brazilian Portuguese (BP)-PCS and explored its psychometric properties. This study reports the internal consistency, factor structure, and its capability to discriminate pain reported by patients with specific chronic pain conditions. Methods: Three hundred eighty-four patients, 317 women (82.55%), aged 18-79 years with chronic nonmalignant pain attending an outpatient multidisciplinary pain center participated in this cross-sectional study. The instruments were the BP-PCS, pain intensity, pain interference in func…

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Pain sensitivity can be assessed by self-rating: Development and validation of the Pain Sensitivity Questionnaire.

Experimental determination of pain sensitivity has received increasing attention because of emerging clinical applications (including prediction of postoperative pain and treatment response) and scientific implications (e.g. it has been proposed that above-average pain sensitivity is a risk factor for the development of chronic pain disorders). However, the use of experimental pain sensitivity assessment on a broad scale is hampered by its requirements on time, equipment and human resources and the fact that it is painful for the tested subject. Alternatives to experimental pain testing are currently lacking. Here we developed a self-rating instrument for the assessment of pain sensitivity, the Pain Sensitivity Questionnaire (PSQ) that is based on pain intensity ratings of daily life situations and takes 5-10min to complete. Adequate reliability of the PSQ was confirmed in 354 subjects. …

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Multidisciplinary biopsychosocial rehabilitation for chronic low back pain.

Background: Low back pain (LBP) is responsible for considerable personal suffering worldwide. Those with persistent disabling symptoms also contribute to substantial costs to society via healthcare expenditure and reduced work productivity. While there are many treatment options, none are universally endorsed. The idea that chronic LBP is a condition best understood with reference to an interaction of physical, psychological and social influences, the 'biopsychosocial model', has received increasing acceptance. This has led to the development of multidisciplinary biopsychosocial rehabilitation (MBR) programs that target factors from the different domains, administered by healthcare professionals from different backgrounds. Objectives: To review the evidence on the effectiveness of MBR for patients with chronic LBP. The focus was on comparisons with usual care and with physical treatments…

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Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial.

Importance: Chronic back pain (CBP) is a leading cause of disability, and treatment is often ineffective. Approximately 85% of cases are primary CBP, for which peripheral etiology cannot be identified, and maintenance factors include fear, avoidance, and beliefs that pain indicates injury. Objective: To test whether a psychological treatment (pain reprocessing therapy [PRT]) aiming to shift patients' beliefs about the causes and threat value of pain provides substantial and durable pain relief from primary CBP and to investigate treatment mechanisms. Design, setting, and participants: This randomized clinical trial with longitudinal functional magnetic resonance imaging (fMRI) and 1-year follow-up assessment was conducted in a university research setting from November 2017 to August 2018, with 1-year follow-up completed by November 2019. Clinical and fMRI data were analyzed from January …

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Preliminary efficacy of a lovingkindness meditation intervention for patients undergoing biopsy and breast cancer surgery: A randomized controlled pilot study.

Purpose: Despite more women undergoing treatment for breast cancer and increased survival rates, many women suffer from anxiety and physical symptoms (e.g., pain, fatigue) surrounding diagnosis and surgery. Research investigating the efficacy of psychosocial interventions for breast cancer patients during this period is limited. This randomized controlled pilot study examined the effect of a brief lovingkindness meditation intervention on these key outcomes. Methods: Participants were 60 women who underwent core needle breast biopsy, received an abnormal biopsy result, and underwent breast surgery (White = 73.6%; African American = 22.6%; Asian American = 3.8%; Age M = 56). Participants were randomly assigned to one of three treatment conditions at breast biopsy: (1) lovingkindness meditation, (2) music, and (3) usual care. Assessments of anxiety, pain, fatigue, physiologic reactivity, a…

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The Role of Inflammation in the Pain, Fatigue, and Sleep Disturbance Symptom Cluster in Advanced Cancer.

Context: Symptom researchers have proposed a model of inflammatory cytokine activity and dysregulation in cancer to explain co-occurring symptoms including pain, fatigue, and sleep disturbance. Objectives: We tested the hypothesis that psychological stress accentuates inflammation and that stress and inflammation contribute to one's experience of the pain, fatigue, and sleep disturbance symptom cluster (symptom cluster severity, symptom cluster distress) and its impact (symptom cluster interference with daily life, quality of life). Methods: We used baseline data from a symptom cluster management trial. Adult participants (N = 158) receiving chemotherapy for advanced cancer reported pain, fatigue, and sleep disturbance on enrollment. Before intervention, participants completed measures of demographics, perceived stress, symptom cluster severity, symptom cluster distress, symptom cluster …

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Efficacy of Mindfulness-Based Cognitive Therapy on Late Post-Treatment Pain in Women Treated for Primary Breast Cancer: A Randomized Controlled Trial.

Purpose: To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer. Methods: A randomized wait list-controlled trial was conducted with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3 on pain intensity or pain burden assessed with 10-point numeric rating scales). Participants were randomly assigned to a manualized 8-week MBCT program or a wait-list control group. Pain was the primary outcome and was assessed with the Short Form McGill Pain Questionnaire 2 (SF-MPQ-2), the Present Pain Intensity subscale (the McGill Pain Questionnaire), and perceived pain intensity and pain burden (numeric rating scales). Secondary outcomes were quality of life (World Health Organization-5 Well-Being Index), psychological distress (the Hospital Depression and Anxiety Scale), and self-reported use…

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Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression.

This research examined whether cognitive behavioral therapy and mindfulness interventions that target responses to chronic stress, pain, and depression reduce pain and improve the quality of everyday life for adults with rheumatoid arthritis (RA). The 144 RA participants were clustered into groups of 6-10 participants and randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P); mindfulness meditation and emotion regulation therapy (M); or education-only group (E), which served as an attention placebo control. The authors took a multimethod approach, employing daily diaries and laboratory assessment of pain and mitogen-stimulated levels of interleukin-6 (IL-6), a proinflammatory cytokine. Participants receiving P showed the greatest Pre to Post improvement in self-reported pain control and reductions in the IL-6; both P and M groups showed more improvement in cop…

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Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study: design and practical implications of an intervention for comorbid pain and depression.

Objective: Depression and pain are common comorbid conditions that have reciprocal adverse effects on disability and treatment outcomes. The objective of this article is to describe a study that tests the effectiveness of a stepped-care approach using a combined medication-behavioral intervention. Method: Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) is an NIMH-sponsored randomized clinical trial nested within a prospective cohort study. A total of 250 patients with clinically significant depression (PHQ-9 scores > or =10) and musculoskeletal pain of the lower back or legs (hip or knee) and 250 nondepressed patients with similar pain are enrolled, with baseline and serial follow-up assessments to be conducted over 12 months. The depressed patients are randomized to either a stepped-care intervention group or a usual-care control group. Stepped-care patients receiv…

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The No Worries Trial: Efficacy of Online Dialectical Behaviour Therapy Skills Training for Chronic Pain (iDBT-Pain) Using a Single Case Experimental Design.

Emotion dysregulation frequently co-occurs with chronic pain, which in turn leads to heightened emotional and physical suffering. This cycle of association has prompted a recommendation for psychological treatment of chronic pain to target mechanisms for emotion regulation. The current trial addressed this need by investigating a new internet-delivered treatment incorporating emotional skills training from dialectical behavioral therapy (DBT). Using a single-case experimental design that is suited to heterogeneous populations and can demonstrate efficacy with a small sample, three participants with chronic pain were recruited. Participants received four weeks of online DBT skills training (iDBT-Pain intervention) which incorporated one-on-one sessions over Zoom and a web app. Results revealed compelling evidence for the intervention on the primary outcome of emotion dysregulation and wer…

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Exercise combined with Acceptance and Commitment Therapy (ExACT) compared to a supervised exercise programme for adults with chronic pain: study protocol for a randomised controlled trial.

Background: Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioural therapy, which may be beneficial for people with chronic pain. The approach aims to enhance daily functioning through increased psychological flexibility. Whilst the therapeutic model behind ACT appears well suited to chronic pain, there is a need for further research to test its effectiveness in clinical practice, particularly with regards to combining ACT with physical exercise. Methods/design: This prospective, two-armed, parallel-group, single-centre randomised controlled trial (RCT) will assess the effectiveness of a combined Exercise and ACT programme, in comparison to supervised exercise for chronic pain. One hundred and sixty patients, aged 18 years and over, who have been diagnosed with a chronic pain condition by a physician will be recruited to the trial. Participants will be individually ra…

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Implementing a hybrid cognitive-behavioural therapy for pain-related insomnia in primary care: lessons learnt from a mixed-methods feasibility study.

Objectives: To test the feasibility of implementing a brief but intensive hybrid cognitive behavioural therapy (Hybrid CBT) for pain-related insomnia. Design: Mixed-methods, with qualitative process evaluation on a two-arm randomised controlled feasibility trial. Setting: Primary care. Participants: Twenty-five adult patients with chronic pain and insomnia. Intervention: Hybrid CBT or self-help control intervention. Primary and secondary outcome measures: Primary outcomes measures were the Insomnia Severity Index and interference scale of the Brief Pain Inventory (BPI). Secondary outcomes measures were the present pain intensity rating from the BPI, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale and EQ-5D-5L. Results: Fourteen participants were randomised to receive Hybrid CBT, 11 to receive the self-help control treatment. Of the 14 in the Hybrid CBT group, 9 …

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Mindfulness-based interventions for chronic pain: Evidence and applications.

Chronic pain is estimated to occur in from 5.5% to 33% of the world's adult population (Gureje et al., 1998). Chronic pain is frequently treated with opiates, which has produced an opiate addiction crisis (Dowell et al., 2016). Several non-pharmacological treatment alternatives can help manage chronic pain. There is moderate evidence that mindfulness-based interventions (MBIs) such as meditation, yoga, and stress reduction lower the perception of pain, increase mobility, improve functioning and well-being. By integrating MBIs and other therapeutic interventions in a multi-disciplinary pain management plan, clinicians can improve treatment outcomes and potentially decrease pain-related medication utilization.

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The psychological flexibility model: a basis for integration and progress in psychological approaches to chronic pain management.

Unlabelled: Scientific models are like tools, and like any tool they can be evaluated according to how well they achieve the chosen goals of the task at hand. In the science of treatment development for chronic pain, we might say that a good model ought to achieve at least 3 goals: 1) integrate current knowledge, 2) organize research and treatment development activities, and 3) create progress. In the current review, we examine models underlying current cognitive behavioral approaches to chronic pain with respect to these criteria. A relatively new model is also presented as an option, and some of its features examined. This model is called the psychological flexibility model. This model fully integrates cognitive and behavioral principles and includes a process-oriented approach of treatment development. So far it appears capable of generating treatment applications that range widely wi…

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The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury.

Purpose: To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth. Method: Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates. Results: In the regression model of depression, the effect of pain severity on depression was decreased (β was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (…

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Designing and developing a nature-based virtual reality with heart rate variability biofeedback for surgical anxiety and pain management: evidence from total knee arthroplasty patients.

Objectives: Total knee arthroplasty (TKA) is one of the most common joint surgeries, with over a million procedures performed annually in the US. Over 70% of patients report moderate to high pain and anxiety surrounding TKA surgery, and 96% are discharged with an opioid prescription. This population requires special attention as approximately 90% of TKA patients are older adults and one of the riskiest groups prone to misusing opioids. This study aimed to develop and compare the efficacy of nature-based virtual reality (VR) with heart rate variability biofeedback (HRVBF) to mitigate surgical pain and anxiety. Methods: This randomized control trial recruited 30 patients (mean age = 66.3 ± 8.2 years, 23 F, 7 M) undergoing TKA surgery and randomly assigned to a control, 2D video with HRVBF, or VR with HRVBF group. A visual analog scale (VAS) was used to measure pain levels before and after …

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Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies.

Objective: To systematically assess credibility and certainty of associations between cannabis, cannabinoids, and cannabis based medicines and human health, from observational studies and randomised controlled trials (RCTs). Design: Umbrella review. Data sources: PubMed, PsychInfo, Embase, up to 9 February 2022. Eligibility criteria for selecting studies: Systematic reviews with meta-analyses of observational studies and RCTs that have reported on the efficacy and safety of cannabis, cannabinoids, or cannabis based medicines were included. Credibility was graded according to convincing, highly suggestive, suggestive, weak, or not significant (observational evidence), and by GRADE (Grading of Recommendations, Assessment, Development and Evaluations) (RCTs). Quality was assessed with AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). Sensitivity analyses were conducted. Results:…

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Couple Interventions for Chronic Pain: A Systematic Review.

Objective: Couple interventions for chronic pain have been shown to more effectively reduce pain intensity for individuals with chronic pain (ICPs) than individual behavioral interventions or usual care. This systematic review identified randomized controlled trials of couple interventions to highlight strategies that could be incorporated into psychotherapy with ICPs and their romantic partners. Methods: The authors identified articles reporting randomized controlled trials of couple interventions for chronic pain. Three databases were searched (ie, PubMed, Embase, and PsycInfo), resulting in 18 studies and 22 articles. Results: Couple interventions resulted in statistically significant improvements in pain intensity compared with other conditions in 8% to 40% of the studies depending on the comparator group (i.e., control, individual intervention, another couple intervention), and in s…

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Pain and Depression: A Systematic Review.

Background: Pain comorbid with depression is frequently encountered in clinical settings and often leads to significant impaired functioning. Given the complexity of comorbidities, it is important to address both pain and depressive symptoms when evaluating treatment options. Aim: To review studies addressing pain comorbid with depression, and to report the impact of current treatments. Method: A systematic search of the literature databases was conducted according to predefined criteria. Two authors independently conducted a focused analysis of the full-text articles and reached a consensus on 28 articles to be included in this review. Results: Overall, studies suggested that pain and depression are highly intertwined and may co-exacerbate physical and psychological symptoms. These symptoms could lead to poor physical functional outcomes and longer duration of symptoms. An important bio…

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