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  • 1.
    Andersson, H. Ingemar
    Kristianstad University, Department of Health Sciences.
    The course of non-malignant chronic pain: a 12-year follow-up of a cohort from the general population2004In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 8, no 1, p. 47-53Article in journal (Refereed)
    Abstract [en]

    The high prevalence of chronic pain (duration >3 months) reported from different populations indicates a public health problem. Knowledge of the long-term course of chronic non-malignant pain is incomplete and scarce.This paper describes a follow-up of a cohort recruited from a survey in the general population. The cohort (n=214) consisted initially of individuals with widespread or located (neck-shoulder) pain or without chronic pain. The individuals were initially examined and replied to questionnaires on pain, social factors, lifestyle, medication and health care after two and 12 years. The deaths during the period were obtained from the population register. Complete data exist for 77% of the eligible individuals.After 12 years one-third of the individuals initially without pain reported chronic pain, and among those with initial chronic pain 85% still reported chronic pain. The number of painful areas was the strongest predictor of chronic pain 12 years later (OR 15.8; >3 locations vs. 0) whereas a social factor (having a close friend) decreased the risk (OR 0.44). The onset of chronic pain during the same period was related to the physical workload (work with bent positions; OR 5.31; yes vs. no). Mortality was significantly higher in the group initially reporting widespread pain compared with the other groups. The chronicity of widespread chronic pain supports early and intense intervention among individuals with located pain. The association between chronic widespread pain and increased mortality needs further investigation but may deepen the view of chronic pain as a public health problem.

  • 2.
    Masferrer, Roberto
    et al.
    Masferrer Neurosurgical, Colorado Springs.
    Prendergast, Virginia
    Barrow Neurological Institute, Phoenix.
    Hagell, Peter
    Section of Restorative Neurology, Department of Clinical Neuroscience, University Hospital, Lund.
    Colored pain drawings: preliminary observations in a neurosurgical practice2003In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 7, no 3, p. 213-217Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Black and white pain drawings were introduced as a proposed means to identify patients, presenting with low back pain, who demonstrated functional overlay upon neurological testing. The use of color may enhance the usefulness of such pain drawings, but has not been described for adult patients.

    AIMS: To retrospectively explore the use of colored pain drawings in patients with neck, low back, or radicular pain.

    METHODS: Patients with neck, low back, or radicular pain referred to a community-based neurosurgical practice for evaluation during 1 year (n=359) depicted their pain on anatomical drawings using colored pencils representing different pain characteristics. Patients with abnormal (n=55) and normal (n=54) pain drawings were selected for this study. Use of medications, findings on physical examination, radiographic findings, activity levels, Waddell signs, and pending litigation were recorded and compared between patients with normal and abnormal pain drawings, as assessed according to the Ransford penalty point system.

    RESULTS: Patients whose colored pain drawings were abnormal, demonstrated a greater use of medications, more non-focal clinical findings, Waddell signs, impaired activity levels, involvement in pending litigation, and significantly fewer pathological radiographic findings than patients with normal pain drawings.

    CONCLUSIONS: Our findings agree with previous observations using black and white pain drawings, indicating that colored pain drawings are no less useful than the black and white approach. Further research is necessary to examine the psychometric properties and clinical usefulness of colored pain drawings to predict outcomes and/or determine treatment.

  • 3.
    Nilsson, Hans-Jörgen
    et al.
    Section for Neurophysiology, Department of Physiological Sciences, University of Lund.
    Psouni, Elia
    Section for Neurophysiology, Department of Physiological Sciences, University of Lund.
    Schouenborg, Jens
    Section for Neurophysiology, Department of Physiological Sciences, University of Lund.
    Long term depression of human nociceptive skin senses induced by thin fibre stimulation2003In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 7, no 3, p. 225-233Article in journal (Refereed)
    Abstract [en]

    We have recently shown that stimulation, through a multi-electrode array, of thin nerve fibres close to the dermo-epidermal junction in the skin, produces powerful inhibition of itch and, to a lesser degree, cutaneous pain in humans. Here, we have studied the induction time and frequency dependency (range 1–10 Hz) of the inhibitory effects of such stimulation on itch, mechanical, and thermal pain, in 20 healthy subjects. Sixteen electrodes applied on the skin were consecutively stimulated using a method termed cutaneous field stimulation (CFS). The results show that different treatment periods with CFS were required for the induction of significant inhibitory effects on different nociceptive qualities: 1st heat pain (1 min), itch (3 min), 2nd heat pain (6 min), pinch evoked pain (8 min). Six to ten minutes stimulation sufficed to induce peak inhibitory effects on all these sensory qualities while longer stimulation (up to 40 min) did not cause significantly stronger inhibition. The effects on itch, 1st and 2nd heat pain lasted over 55 min after termination of CFS. There was no effect on prickle. No significant difference in inhibitory effects of different stimulation frequencies (1, 4 and 10 Hz/electrode) was found. The induction time and effective stimulation frequencies may suggest that the underlying mechanisms are similar to those of long term depression (LTD) previously described in the spinal cord in animal experiments.

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