Pain Experience Research Articles

The effect of Rebozo technique on perceived labour pain and childbirth experience: A randomized controlled trial.

Pain, stress, and anxiety experienced during childbirth can have detrimental effects on labor and delivery. The rebozo technique is an ancestral method used to minimize pain and enhance relief during gestation. This study aimed to investigate the effects of the rebozo technique on the birth process and its probable benefits on the birth experience. This survey was conducted from January to May 2021 in a randomized and controlled manner. A total of 113 pregnant women with their first children were surveyed. Women between 37 and 41 weeks of gestation without complications who were admitted to the delivery room with a cervical dilation of 4 cm or more were chosen as participants. In the Rebozo group, subjects were randomly selected by trained personnel to apply the standardized method, while the control group received a relaxing massage. Cervical dilation, fetal position, contraction patterns, and measures related to the birth experience were key indicators. Women in the rebozo group had lower pain levels during birth and greater birth satisfaction. Mean cervical dilation in the latent phase was 5.61 cm in the rebozo group and 5.71 cm in the control group. In the active phase, cervical dilatation was 6.03 cm in the rebozo group and 6.68 cm in the control group, and this difference was statistically significant (P < .001). In the transition phase, the birth time was 46.29 minutes in the rebozo group and 68.71 minutes in the control group (P = <.007**). In the total birth experience score, the rebozo group received an average of 68.52 points, while the control group received 51.58 points (P < .001). This research has established that the use of the rebozo technique throughout labor helps enhance her feelings about being pregnant, as well as heightening fulfillment with delivery.

Efficacy of topical local anesthetic, topical cooling spray, and audiovisual distraction on relief of needle-related pain during blood collection: A randomized controlled trial.

Venipuncture is one of the most common invasive procedures in healthcare, often resulting in the experience of pain. While audiovisual distraction, topical anesthesia and cold spray application have been reported as methods to reduce pain, there is a lack of studies that focus on comparing their efficacy and safety. We aimed to compare the efficacy and safety of pain reduction during venipuncture using audiovisual distraction, topical anesthesia and cold spray application. A randomized controlled study was conducted at Walailak University (Nakhon Si Thammarat, Thailand) from April 2023 to July 2023. Eligible adult participants voluntarily enrolled in the study and were randomly assigned to 1 of 4 groups: group 1 (control), group 2 (topical anesthetic), group 3 (cooling spray), and group 4 (audiovisual distraction). Pain scores and satisfaction levels were assessed following the venipuncture procedure on the upper extremities. Forty-seven participants were included in the final analysis. The participants had a mean age of 42.3 years (standard deviation (±SD): 13.1), with the majority being female (66.0%). The participants in the intervention groups reported lower pain scores than those in group 1. The mean differences were 2.67 points in group 2 (95% confidence interval (95% CI): 1.49-3.84; p < 0.001), 1.56 points in group 3 (95% CI: 0.15-2.98; p = 0.077), and 1.67 points in group 4 (95% CI: 0.37-2.96; p = 0.042). However, the pain reduction did not reach statistical significance when comparing these 3 interventions. All groups reported a median satisfaction level of 3, with no significant difference among them (H(3) = 6.050, p = 0.109). Pain reduction interventions, including topical anesthetic, cooling spray and audiovisual distraction, are effective methods for alleviating pain during venipuncture. Participants who received a topical anesthetic reported the lowest pain scores and highest levels of satisfaction.

Investigating basics and principles of ergonomics in the sheet

The development of work-related musculoskeletal disorders depends on the pattern of work and does not belong to a particular industry or occupation. One way to assess the amount of stress and tension on the body is to evaluate posture. The aim of this study was to determine the risk factors for musculoskeletal disorders in cellulose industry workers. Study, 22 stations were examined using RULA method, of which 7 stations were at level 2, 14 stations were at level 3 and one station was at level 4. 14 stations were surveyed using REBA method, among which, 2 stations were at level 1 and 12 stations were at level 2. Also, 38 stations were surveyed using the KIM-LHC method, of which 26 stations were at level 2 and 12 stations were at level 3. Statistical studies showed that there was a significant relationship between low back pain and work experience at the level of 0.01. The prevalence of shoulder, arm, back and leg pain was significantly different between men and women at the level of 0.01. There was also a significant relationship between the prevalence of musculoskeletal disorders in the lumbar and shoulder area over a period of time and the level of risk of work postures. The results of the study showed that the prevalence of musculoskeletal disorders and risk levels calculated by RULA and KIM methods were high in the subjects, but the risk level calculated by REBA method was low and moderate. Therefore, any program to prevent the occurrence of these disorders in the workplace and control the relevant ergonomic risk factors and take corrective measures to improve working conditions at all stages of production, is necessary.

Short-latency afferent inhibition is reduced with cold-water immersion of a limb and remains reduced after removal from the cold stimulus.

The experience of pain that is induced by extremely cold temperatures can exert a modulatory effect on motor cortex circuitry. Although it is known that immersion of a single limb in very cold water can increase corticomotor excitability it is unknown how afferent input to the cortex shapes excitatory and inhibitory processes. Therefore, the purpose of this study was to examine motor-evoked potentials (MEP), short-latency afferent inhibition (SAI) and long-latency afferent inhibition (LAI) in response to immersion of a single hand in cold water. Transcranial magnetic stimulation (TMS) was used to assess MEPs, and peripheral nerve stimulation of the median nerve paired with TMS was used to measure SAI and LAI in motor circuits of the ipsilateral hemisphere. Measurements were obtained from electromyography (EMG) of the first dorsal interosseous (FDI) at baseline, during cold-water immersion, and during recovery from cold-water immersion. The intervention caused unconditioned MEPs to increase during exposure to the cold stimulus (P=0.008) which then returned to baseline levels once the hand was removed from the cold water. MEP responses were decoupled from SAI responses, where SAI was reduced during exposure to the cold stimulus (P=0.005) and remained reduced compared to baseline when the hand was removed from the cold water (P=0.002). The intervention had no effect on LAI. The uncoupling of SAI from MEPs during the recovery period suggests that the mechanisms underlying the modulation of corticospinal excitability by sensory input may be distinct from those affecting intracortical inhibitory circuits. HIGHLIGHTS: What is the central question of this study? Does immersion of a limb in very cold water influence corticospinal excitability and the level of afferent inhibition exerted on motor cortical circuits? What is the main finding and its importance? In additional to perception of temperature, immersion in 6°C water also induced perceptions of pain. Motor evoked potential (MEP) amplitude increased during immersion, and short-latency afferent inhibition (SAI) of the motor cortex was reduced during immersion; however, these responses differed after the limb was removed from the cold stimulus, as MEPs returned to normal levels while SAI remained suppressed.

Withdrawal pain following patients discontinuing Trk inhibitors.

This article aims to expand on the existing literature regarding the incidence of withdrawal pain following discontinuation of Trk inhibitors and to explore strategies that mitigate this withdrawal pain. A retrospective observational study was conducted among patients who were at least 18 years-old or older and had documentation of starting larotrectinib or entrectinib at University of California, San Francisco (UCSF) between November 2018 and November 2022. Data were collected from electronic records and pharmacy databases and a total of 21 patients were identified in this study. Of the 21 patients included in this study, five patients (24%) experienced pain during temporary or permanent discontinuation of Trk inhibitor with the onset of withdrawal pain ranging from a few hours to three days following discontinuation. Various strategies were implemented to manage this pain including restarting of Trk inhibitor, tapering of Trk inhibitor on discontinuation, minimizing dose interruptions and use of prescription pain medications. This article illustrates the presence of withdrawal pain syndrome in patients stopping a Trk inhibitor treatment and highlight the need for patient education to avoid missing any doses and for development of a guideline for Trk inhibitor discontinuation.

Comparative Evaluation of Endo Ice® Refrigerant Spray, Endo Frost® Refrigerant Spray and Topical Anesthetic Agent Precaine B® on the Pain Perception in Children Prior to Administration of Local Anaesthesia – An Invivo Study

To compare and evaluate the efficacy of Endo Ice® refrigerant spray, Endo Frost® refrigerant spray and topical anaesthetic agent Precaine B® on the pain perception during local anaesthesia administration in pediatric dental patients.  Material and methods: A total of 87 participants in the age group of 6-12 years were divided into 3 groups randomly with 29 in each group. The cotton applicator sprayed with Endo Ice was held in contact with the buccal mucosa for 10 seconds. Immediately after the removal of the cotton applicator, inferior alveolar nerve block was administered. Similarly, Endo Frost was used on the participants. 0.1 mg of Precaine B was applied over the injection site contacting the buccal mucosa using sterile cotton applicator. FLACC evaluation was done by one trained personnel during the local anaesthesia administration. Following the local anesthesia, the participants were asked to rate their pain experience using VAS.  Results: The mean score of the Endo ice, Endo frost, and Precaine B were 4.3793, 4.4828 and 5.5517 respectively using the FLACC scale. The mean score of the Endo ice, Endo frost, and Precaine B were 4.2069, 4.2069 and 4.931 respectively using the VAS scale. Greater reduction in pain perception were observed in Endo Ice group followed by Endo Frost group and Precaine group. It was not statistically significant (p&lt;0.005).  Conclusion: Endo ice, Endo frost and Precaine B were effective in reducing the pain perception in children, thereby reducing their fear and anxiety. Endo Ice group showed greater reduction in pain perception and higher efficacy than other groups, even though the results were not statististically significant.

Can Pain Be Understood by Words? A Literature Review of Pain-Language Association

This review systematically explores the complicated interplay between pain and language, including nociceptive pain and empathic pain. While previous study focusing on physiological aspects of pain, this paper addressed how linguistics influence pain communication and perception. The finding reveals that language can influence bother subjective pain and the pain when we observe others. It is notable that the use of specific pain descriptors and metaphors significantly impacts individuals' pain perception and linguistic context can influence peoples nociceptive pain experience. For empathic pain, there are similar brain activations when communicating with people who are suffering from pain. Besides, there is evidence that communication and interactions can benefit painful patients and reduce pain. To conclude, this paper empathizes the vital role language plays in individuals own pain experience and feeling others pain. Future studies should aim to have standardized tools and frameworks for studying the linguistic aspect of pain, especially in the social inter-brain context, which is vital for understanding and communicating pain. Addressing the linguistic dimension of pain can help with pain assessment and management, leading to better patient care.

Considerations on the Setting of Cervantes’s Captivity Narratives

This study aims to explore the issues of Islamophobia and Christian ideology prevalent in Spanish society in the 16th and early 17th centuries by examining the slave trade conducted by Barbary corsairs and the hard lives of Christian captives depicted in the literary works of Miguel de Cervantes, and to highlight his efforts to overcome the clash of civilizations between Christianity and Islam. To achieve this goal, first, the study delves into the historical context of the clash between Spain and Islam in the Mediterranean during the 16th century. Cervantes, who took part in the Battle of Lepanto in 1571, was captured by Barbary corsairs on his return from military service and spent five years as a captive in the Bagnio of Algiers. The painful experience left indelible marks on his works. This study focuses on the dual meaning of Orientalism in his works. One prevalent form of Orientalism in Spain and Europe during that period portrayed Muslims as barbaric and anti-Christian. However, Cervantes presented an alternative Orientalism to propose a pathway to co-existence, rather than conflict, between civilizations and religions. Therefore, this study explores how Cervantes, even though he himself was a victim of the clash of civilizations, sought to overcome the confrontations and conflicts in his works, rather than perpetuating the prevalent Islamophobia of his time.

Pain pathophysiology and pharmacology of cattle: how improved understanding can enhance pain prevention, mitigation, and welfare.

Globally, humans rely on cattle for food production; however, there is rising societal concern surrounding the welfare of farm animals. From a young age, cattle raised for dairy and beef production experience pain caused by routine management procedures and common disease conditions. The fundamental mechanisms, nociceptive pathways, and central nervous system structures required for pain perception are highly conserved among mammalian species. However, there are limitations to a comparative approach to pain assessment due to interspecies differences in the expression of pain. The stoicism of prey species may impede pain identification and lead to the assumption that cattle lack pain sensitivity. This highlights the importance of establishing validated bovine-specific indicators of pain-a prerequisite for evidence-based pain assessment and mitigation. Our first objective is to provide an overview of pain pathophysiology to illustrate the importance of targeted analgesia in livestock medicine and the negative welfare outcomes associated with unmitigated pain. This is followed by a review of available analgesics, the regulations governing their use, and barriers to implementation of on-farm pain management. We then investigate the current research undertaken to evaluate the pain response in cattle-a critical aspect of the drug approval process. With an emphasis on emerging research in animal cognition and pain pathology, we conclude by discussing the significant influence that pain has on cattle welfare and areas where further research and modified practices are indicated.

Clinical impact of pectoral nerve ii block on postoperative pain, opioid usage, and patient recovery experience in robot-assisted transaxillary thyroidectomy: a prospective, randomized controlled trial

clinical impact of pectoral nerve ii block on postoperative pain, opioid usage, and patient recovery experience in robot-assisted transaxillary thyroidectomy: a prospective, randomized controlled trial

EFFICACY OF INTRAPERITONEAL BUPIVACAINE INSTILLATION FOR POSTOPERATIVE PAIN CONTROL: A QUALITY IMPROVEMENT STUDY

Laparoscopic surgery is associated with better pain experience, reduced Length of Hospital Stay and better scar. However, the resulting postoperative pain is distinct and can be disturbing, hence the need for multimodal analgesia. The side effects of parenteral analgesics and low practice of regional anaesthesia has limited their role in multimodal analgesia. Therefore, strategies that limit the reliance on these pain control modalities will be beneficial. Our study evaluated the efficacy of intraperitoneal instillation of plain bupivacaine after laparoscopic surgeries. The double blinded randomized study enrolled 50 consenting patients who fulfilled recruitment criteria. The bupivacaine group received 20mls of 0.25% plain Bupivacaine while the saline group received 20mls normal saline instillation into the peritoneal cavity via the umbilical port of the laparoscopy device. Visual Analogue Scale (VAS) was assessed at presentation at the Post anaesthesia care unit (PACU) and at 4, 8, 12, 16, 20, 24 hours afterward. In addition, the interval between end of surgery, first request for analgesia and total analgesic requirements were recorded. The VAS at presentation was significantly lower in the Bupivacaine group compared to the saline group, however, there was no statistically significant difference at other times. In addition, there was a significant difference in time to first analgesic request in both groups. The only observed post operative complications were nausea and vomiting. Intraperitoneal Instillation of Bupivacaine is an easy, non-invasive, cheaper and safer method of pain control following laparoscopic surgery in carefully selected patients.

Effect of Coping Strategies on Pain Intensity in Patients with Rheumatoid Arthritis

Background Rheumatoid arthritis (RA) is a systemic autoimmune disease that imposes significant challenges globally. This research seeks to contribute valuable insights that can inform the development of targeted interventions, enhancing the quality of care for RA patients and potentially mitigating the broader societal burden associated with this chronic autoimmune condition. Objectives The main objective of the current study is to investigate the demographic, psychosocial, and clinical aspects of RA patients. Materials and Methods The study included 93 RA patients and examined their demographic characteristics, brief-Coping Orientation to Problems Experienced (COPE) strategies, the prevalence of depression and anxiety, pain experiences (Mankoski Pain Scale), and diagnostic markers (Disease Activity Score [DAS-28], Rheumatoid Factor [RF], Anti-Cyclic Citrullinated Peptide [ACCP]). Results The study revealed a bimodal age distribution, with a gender predominance aligning with established RA prevalence patterns. Patients exhibited a tendency toward adaptive coping strategies, notably religious coping, active coping, and positive reframing, with variability in maladaptive strategies. The prevalence of depression (14.0%) and anxiety (18.3%) among RA patients was consistent with documented mental health burdens. Pain experiences exhibited a heterogeneous spectrum, and diagnostic markers indicated elevated disease activity in a substantial proportion of patients, with varied distribution in RF and ACCP subcategories. Conclusion This study provides nuanced insights into RA, emphasizing the importance of personalized coping and pain management strategies. The prevalence of mental health challenges and the spectrum of pain experiences underscore the multidimensional nature of RA, informing holistic approaches to care for enhanced patient outcomes.

TEMPOROMANDIBULAR DISORDER, BODY PAIN, AND OTOLOGIC AND PSYCHOLOGIC SYMPTOMS: THEIR INTERRELATIONSHIPS IN ASIAN YOUTHS.

To establish the interrelationships between temporomandibular disorders (TMDs), pain, and otologic and psychologic comorbidities in Asian youths. Youths from a local polytechnic, aged 17 to 24 years old, were enrolled and an electronic survey encompassing demographic variables-the DC/TMD TMD pain screener (TPS), Short- form Fonseca Anamnestic Index (SFAI), modified Maciel's Otologic/Pain Symptom Inventory, and Patient Health Questionnaire-4-was administered. Par.cipants were subsequently categorized into groups: no TMD pain (NP), with TMD pain (WP), no TMDs (NT), and with any TMDs (WT). Data were evaluated with chi-square test, nonparametric, and logistic regression analyses (α &#61; .05). Among the 198 participants (mean age 18.8 ± 1.7 years), 11.1% had painful TMDs and 18.2% experienced TMD pain or dysfunction. Significant differences in total-otologic symptoms (total-OS), vertigo, and dizziness plus otalgia, tinnitus, and hearing loss scores were observed between the WP-NP and WT-NT groups correspondingly. While total-comorbid pain (total-CP) and psychologic distress (total-PD) scores varied substanally between the WT-NT group, only a significant difference in total-PD scores was discerned between the WP-NP group. Total-OS scores were moderately correlated to TPS/SFAI, total-CP, and total-PD scores, and psychologic distress was a risk factor for painful TMDs. Otologic and pain comorbidities were prevalent among Asian youths with TMDs and appear to be interrelated. The complex interaction of TMDs with pain, otologic, and psychologic comorbidities must be considered when caring for youths with multiple somatic complaints.

Do individuals' beliefs vary based on low back pain (LBP) experience or health care professional exposure for LBP care?

Background Maladaptive beliefs about low back pain (LBP) are associated with increased pain levels and may impede recovery from LBP episode. The objective of this study was to assess the Saudis' LBP-related beliefs and attitudes related to their LBP experience and health care professional (HCP) exposure. The secondary objective was to examine the psychological distress and health-related quality of life (HRQoL) related to their LBP experience and HCP exposure. Methods This study was a cross-sectional online survey which included Saudis adults with or without LBP. The LBP-related beliefs and attitudes were assessed using the Back Pain Attitudes Questionnaire (Back-PAQ). The psychological status and HRQoL were measured using the Depression, Anxiety and Stress Scale-12 (DASS-12) and 12-item Short Form (SF-12), respectively. Results There were 598 people (median age [IQR]: 30 [16]) responded to the survey invitation (419 of them had LBP). Of those who have LBP, 22% visited HCP for LBP. There were no significant differences found in LBP-related beliefs when comparing people with LBP with those without LBP (p = 0.744). There were no significant differences found in LBP-related beliefs, psychological distress, or HRQoL, when comparing LBP individuals who visited HCPs with those who did not. Compared to those with LBP, people without LBP had significantly better HRQoL and lower psychological distress. Conclusion Respondents experiencing LBP held the same negative beliefs as those who were not experiencing LBP. No differences in LBP-related beliefs were found between people who visited HCP and those who did not seek care.

A multi-modal evaluation of experimental pain and psychological function in women with carpometacarpal osteoarthritis

ObjectiveThumb carpometacarpal osteoarthritis (CMC1 OA) is a prevalent and debilitating condition that lacks effective treatments. Understanding the multidimensional pain experience across CMC1 OA disease stages is crucial to improving treatment outcomes. This study examined how radiographic CMC1 OA severity is associated with physical, psychological, and somatosensory function. MethodThirty-one women with early-stage (Eaton-Littler 1–2) or end-stage (Eaton-Littler 3–4) radiographic CMC1 OA completed validated questionnaires to assess pain, disability, and psychological function. Additionally, experimental pain was measured in each participant using quantitative sensory testing (QST) (mechanical, pressure, vibratory, thermal) at seven body sites (thenar, hypothenar, brachioradialis bi-laterally; quadriceps on affected side). Cohort differences (early-vs. end-stage) across all variables were analyzed using a multivariable modeling approach that included fixed effects and interactions; notably, age was controlled as a confounder. ResultsEnd-stage CMC1 OA participants had higher scores in the pain (p ​= ​0.01) and function (p ​= ​0.02) portions of the AUSCAN assessment, self-reported disability of the DASH questionnaire (p ​= ​0.04), and painDETECT scores (p ​= ​0.03), indicating greater pain and disability compared to early-stage participants. Additionally, end-stage CMC1 OA participants demonstrated reduced vibratory detection and heat pain thresholds at multiple body sites (p's ​< ​0.05), with significant interactions observed across the mechanical and cold stimuli. ConclusionFindings revealed women with end-stage CMC1 OA exhibited increased neuropathic pain characteristics and somatosensory loss compared to those with early-stage CMC1 OA. These results underscore the importance of addressing both peripheral and centralized pain mechanisms and the need for multimodal approaches in the treatment of CMC1 OA.

Imbalance in positive and negative acceleration ratio of alpha oscillation in patients with complex regional pain syndrome

ObjectivesTo elucidate the functional characteristics of the brain in the presence of chronic pain using electroencephalography (EEG), with a focus on the dynamics of neural excitation and inhibition. MethodsResting-state EEG was performed in: 17 patients with complex regional pain syndrome (CRPS) who exhibited chronic pain higher than 20 on the visual analogue scale (VAS), 6 patients with reduced CRPS symptoms and chronic pain less than 20 on VAS, and healthy age-matched controls. For the analysis, 50 s of electroencephalogram (EEG) signals were extracted from EEG recordings during wakefulness and rest with eyes closed. The envelope of the alpha frequency band was calculated by examining the positive and negative accelerations of the envelope oscillation, ratio of positive (Ap) to negative (An) accelerations (Ap-An ratio), and mean amplitude of the envelope. Comparisons were made between patients and controls, and correlations between these EEG measures and the subjective pain VAS were evaluated.Significant differences in the value of Ap, An and Ap-An ratio were observed at temporal and central electrodes between patients with pain symptoms and controls. Those with reduced CRPS symptoms exhibited a distinct Ap-An ratio at the majority of electrodes when compared with those exhibiting chronic pain. ConclusionsDistinct patterns in alpha wave envelope dynamics, reflecting excitatory and inhibitory activities, were associated with chronic pain in patients with CRPS. The pain-relieved state of CRPS suggested that a new balance of activities was established. This relationship indicated a potential association between altered alpha oscillation characteristics and the subjective experience of pain. SignificanceThis study introduces a novel method for analyzing alpha oscillation envelopes, providing new insights into the neural pathophysiology of chronic pain in CRPS patients. This approach has the potential to enhance our understanding of the alterations in brain function that occur under chronic pain conditions.

Nurses' Knowledge and Attitudes about Adult Post-Operative Pain Assessment and Management: Cross Sectional Study in Qatar.

Pain is a complex and challenging phenomenon. People have different pain experiences, but everyone has the right to effective pain management. Pain assessment and management are integral components of a nurse's role. To assess the knowledge and attitudes of nurses in Qatar about adult post-operative patients' pain assessment and management, and the factors that may be associated with such knowledge and attitudes. Post-operative registered nurses from all peri-operative areas at Hamad Medical Corporation participated in a cross-sectional online survey using a self-administered questionnaire. A knowledge and attitudes (K&A) score was calculated. Associations between K&A and potential explanatory variables were assessed using t-tests and one-way ANOVA. A total of 151 post-operative nurses participated in the study. The mean knowledge and attitudes (K&A) score was 19.6 ± 4.5 out of 41 (48%), indicating a large deficit in nurses' knowledge and attitudes about adult post-operative pain. There were no statistically significant differences in the mean K&A scores of participants based on gender, nationality, education level, marital status, workplace facility, current job designation, or hours of pain education. There is a significant deficit in post-operative nurses' knowledge and attitudes about pain across the nursing workforce in post-operative care. Implications for nursing education and policy: Evidence-based, innovative nursing education courses are needed to improve nurses' knowledge and attitudes about pain assessment and management. Health service policy is required to ensure that evidence-based in-service education on pain management is compulsory for all nurses. This study was not registered.

The impact of breaking up sitting during simulated nightshifts on musculoskeletal pain: A randomised controlled trial

ObjectivesProlonged sitting is associated with an increased risk of musculoskeletal pain, especially in nightshift workers. However, research investigating effects of breaking up sitting on musculoskeletal pain during nightshifts is lacking. This study evaluated effects of prolonged sitting or breaking up sitting with short bouts of light-intensity physical activity on pain in healthy adults during simulated nightshifts. MethodsAn in-laboratory randomised controlled trial was undertaken with 52 healthy adults completing five simulated nightshifts. Participants were randomised to prolonged sitting (Sit9; n = 26) or breaking up prolonged sitting (Break9; n = 26). Break9 group completed 3-min walking every 30 min during nightshifts, while Sit9 group remained seated. Musculoskeletal pain intensity and sensory/affective pain experiences were assessed. Linear mixed models examined pain within nights (pre-to post-shift) and across nights (pre-shift-night-1 to pre-shift-night-5). ResultsMusculoskeletal pain intensity increased within nights for both Sit9 (mean change [95%CI] points: 0.14 [0.05, 0.24]) and Break9 (0.09 [0.001, 0.19], but not across nights (Sit9: −0.13 [-0.33, 0.08]; Break9: 0.07 [-0.14, 0.29]). Sensory-pain experience improved across nights for Sit9 (−3.08 [-4.72, −1.45]), but not within nights (0.77 [-0.004, 1.55]). There was no change in affective-pain experience in either group. Between-group difference was observed favouring Sit9 for improving sensory-pain across nights (β: 3.71 [1.42, 5.99]). No other between-group difference was observed. ConclusionBoth prolonged sitting and breaking up sitting were associated with a within-night increase in musculoskeletal pain intensity. Compared to prolonged sitting, breaking up sitting did not induce benefits on pain in healthy adults working simulated nightshifts. Trial registrationACTRN12619001516178.

Inequality in the Origins and Experiences of Pain: What “Big (Qualitative) Data” Reveal About Social Suffering in the United States

Inequality in the Origins and Experiences of Pain: What “Big (Qualitative) Data” Reveal About Social Suffering in the United States

GABA Analogue HSK16149 in Chinese Patients With Diabetic Peripheral Neuropathic Pain

Many patients with diabetic peripheral neuropathic pain (DPNP) experience inadequate relief, despite best available medical treatments. There are no approved and effective therapies for patients with DPNP in China. To evaluate the efficacy and safety of capsules containing γ-aminobutyric acid (GABA) analogue HSK16149 in the treatment of Chinese patients with DPNP. This phase 2 to 3 adaptive randomized clinical trial was multicenter, double blind, and placebo and pregabalin controlled. The trial started on December 10, 2020, and concluded on July 8, 2022. In stage 1, various doses of HSK16149 were evaluated to determine safety and efficacy for stage 2. The second stage then validated the efficacy and safety of the recommended dose. In stage 1, enrolled patients (n = 363) were randomized 1:1:1:1:1:1 to 4 HSK16149 doses (40, 80, 120, or 160 mg/d), pregabalin (300 mg/d), or placebo. In stage 2, patients (n = 362) were randomized 1:1:1 to receive HSK16149, 40 or 80 mg/d, or placebo. The final efficacy and safety analysis pooled data from patients receiving the same treatment. The primary efficacy end point in stage 1 was the change from baseline in average daily pain score (ADPS) at week 5. The primary efficacy end point in stage 2 was the change from baseline in ADPS at week 13. When the final statistical analysis was performed, the P values calculated from the independent data of each phase were combined using the weighted inverse normal method to make statistical inferences. Of 725 randomized patients in the full-analysis set (393 men [54.2%]; mean [SD] age, 58.80 [9.53] years; 700 [96.6%] of Han Chinese ethnicity), 177 received placebo; 178, HSK16149, 40 mg/d; 179, HSK16149, 80 mg/d; 66, HSK16149, 120 mg/d; 63, HSK16149, 160 mg/d; and 62, pregabalin, 300 mg/d. A total of 644 patients (88.8%) completed the study. The 40- and 80-mg/d doses of HSK16149 were recommended in stage 2. At week 13, the ADPS mean (SD) change from baseline was -2.24 (1.55) for the 40-mg/d and -2.16 (1.79) for 80-mg/d groups and -1.23 (1.68) for the placebo group, showing statistical significance for both HSK16149 doses vs placebo (both P < .001). In a safety set (n = 726), 545 patients (75.1%) had adverse events, which were generally mild to moderate, with dizziness and somnolence being the most common. Forty- and eighty-mg/d doses of HSK16149 were recommended for treating patients with DPNP in China. The efficacy of HSK16149 capsules was superior to placebo in all groups for relieving DPNP and appeared well tolerated. ClinicalTrials.gov Identifier: NCT04647773.