Monday, February 1, 2016

Comparative effectiveness of conservative interventions for non-specific chronic spinal pain: Physical, behavioural/psychologically informed or combined? A systematic review and meta-analysis

Non-specific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioural interventions, or a combination of these approaches. Physical interventions aim to enhance physical capacity by using methods such as exercise, manual therapy and ergonomics. Behavioural and/or psychologically informed interventions aim to enhance behaviours, cognitions or mood by using methods such as relaxation and cognitive behavioural therapy (CBT). Combined interventions aim to target both physical and behavioural and/or psychological factors contributing to patients’ pain by using methods such as multidisciplinary pain management programmes.

from The Journal of Pain http://ift.tt/1WYywqQ
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High-Definition Transcranial Direct Current Stimulation Enhances Conditioned Pain Modulation in Healthy Volunteers: A Randomised Trial

Transcranial Direct Current Stimulation (tDCS) is a form of brain stimulation which allows for the selective increase or decrease in the cortical excitability of a targeted region. When applied over the motor cortex it has been shown to induce changes in cortical and subcortical brain regions involved in descending pain inhibition or Conditioned Pain Modulation (CPM).The aim of the current study was to assess whether activation of pain inhibitory pathways via tDCS of the motor cortex facilitates the CPM response.

from The Journal of Pain http://ift.tt/1PR1j0Q
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Histone acetylation in microglia contributes to exercise-induced hypoalgesia in neuropathic pain model mice

Physical exercise can attenuate neuropathic pain (NPP), but the exact mechanism underlying exercise-induced hypoalgesia (EIH) remains unclear. Recent studies have shown that histone hyperacetylation via pharmacological inhibition of histone deacetylases in the spinal cord attenuates NPP, and that histone acetylation may lead to the production of analgesic factors including interleukin-10. We intended to clarify whether histone acetylation in microglia in the spinal dorsal horn contributes to EIH in NPP model mice.

from The Journal of Pain http://ift.tt/1WYyuPx
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Brain areas involved in anticipation of clinically-relevant pain in low back pain populations with high levels of pain behaviour

The purpose of this study was to identify neural correlates of pain anticipation in people with non-specific low back pain (NSLBP) that correlated with pain-related distress and disability, thus providing evidence for mechanisms underlying pain behaviour in this population. Thirty NSLBP sufferers, with either high levels of pain behaviour (WS-H) or low levels (WS-L) based on Waddell Signs (WS), were scanned with functional Magnetic Resonance Imaging (fMRI) whilst a straight-leg raise (of the side deemed to cause moderate pain in the lower back) was performed.

from The Journal of Pain http://ift.tt/1PR1l92
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Increasing Neuroplasticity to Bolster Chronic Pain Treatment: A Role for Intermittent Fasting and Glucose Administration?

Neuroplastic changes in brain structure and function are not only a consequence of chronic pain but are involved in the maintenance of pain symptoms. Thus, promotion of adaptive, treatment-responsive neuroplasticity represents a promising clinical target. Emerging evidence about the human brain's response to an array of behavioral and environmental interventions may assist in identifying targets to facilitate increased neurobiological receptivity, promoting healthy neuroplastic changes. Specifically, strategies to maximize neuroplastic responsiveness to chronic pain treatment could enhance treatment gains by optimization of learning and positive central nervous system adaptation.

from The Journal of Pain http://ift.tt/1PbAEpT
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Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

Impact of Out-of-Pocket Expenditure on Physical Therapy Utilization for Nonspecific Low Back Pain: Secondary Analysis of the Medical Expenditure Panel Survey Data