Pain Intensity Research Articles

Efficacy and safety of abhal (Juniperus communis L). on pain intensity, uterine artery doppler flow, and quality of life in primary dysmenorrhea: A double-blind, randomized controlled trial.

Incorporating ancient wisdom from Unani Medicine, this study delves into the therapeutic efficacy of Juniperus communis L. in primary dysmenorrhea. By seamlessly merging traditional knowledge with modern scientific evaluation, this research illuminates Juniperus communis L. (Juniper) potential. This study stands as a testament to the value of exploring ethnopharmacological insights and bridging the gap between ancient healing traditions and evidence-based medicine. To assess the efficacy and safety of Juniper berry compared to mefenamic acid in menstrual cramps and its associated symptoms, and overall quality of life in women with PD. Additionally, the study aimed to explore the impact of these interventions on uterine blood flow using Doppler evaluation. This was a double-blind, standard-controlled study conducted on 62 participants aged 18-35 years. They were randomly assigned to receive either two capsules (750mg) of Juniper berry or 250mg mefenamic acid thrice daily from day 1 to day 3 of menstruation, spanning two menstrual cycles. Primary outcomes were measured using the Visual Analogue Scale (VAS) for pain intensity and the Numerical Rating Scale (NRS) for systemic symptoms. Pelvic Doppler flow indices and responses to the SF-12 questionnaire were analyzed as secondary outcomes. After the intervention in cycle 2, both the juniper and standard groups exhibited a significant reduction in mean VAS scores from 8.1±1.3 to 2.87±1.17 and 8.1±1.13 to 3.61±1.14, respectively (p=0.012). Intergroup comparisons revealed no statistically significant differences in systemic symptoms at baseline, and cycle 2 (C2) follow-up (p>0.05). Similarly, there were no significant differences in the SF-12 questionnaire scores at baseline, C2, and C4 (p>0.05). However, intragroup comparisons for VAS, NRS, and SF-12 in both groups showed significant differences at C2 and C4 compared to the baseline (p<0.001). In the juniper group, intergroup and intragroup comparisons indicated a small effect size for the right uterine artery (Rt UtA) RI and SD at C3 compared to C1 (0.2 and 0.33). Left UtA-PI and RI also demonstrated a medium effect size (0.482 and 0.501), respectively, between C3 and C1. Juniper demonstrated significant efficacy and safety in reducing menstrual cramps, and its associated symptoms and improving health-related quality of life. Further, changes in pelvic uterine artery flow indices were also observed.

Dual-task resistance training improves strength and reduces pain more than resistance exercise alone in elbow fracture rehabilitation: A Randomized Controlled Trial.

To examine the effects on strength, pain intensity, range of motion (ROM), and functionality of a 12-week dual-task resistance exercise program in patients undergoing rehabilitation from elbow fractures. Randomized Controlled Trial SETTING: Rehabilitation hospital. Individuals undergoing elbow fracture rehabilitation. Randomization was performed sequentially using numbered envelopes containing assignments to either an intervention group (dual-task resistance training using a mathematical task with self-regulation, n=18) or a control group (traditional resistance training, n=14) for 12 weeks. Measures: The primary outcomes were muscle strength for elbow flexors and extensors and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale-11 and disability using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and passive ROM. Dual-task resistance training improved strength and reduced pain more than resistance training alone (p<0.05), and only the dual-task group improved in kinesiophobia (p<0.05). The linear regression showed a significant negative association between kinesiophobia and increased elbow strength in the dual-task group (flexion, r=-0.53, p=0.024; extension, r=-0.65, p=0.004) but not in the control group (p>0.05). No significant differences were observed between the group for disability and passive ROM (p>0.05). Dual-task resistance training and traditional resistance training both enhance strength, reduce pain, improve functionality, and increase ROM after 12 weeks of elbow fracture rehabilitation. However, dual-task resistance training is superior to resistance training alone in enhancing strength and reducing pain.

Effects of Spinal Cord Stimulation in Patients with Small Fiber and Associated Comorbidities from Neuropathy After Multiple Etiologies.

Objectives: The aim of this study was to evaluate the effects of spinal cord stimulation (SCS) on pain, neuropathic symptoms, and other health-related metrics in patients with chronic painful peripheral neuropathy (PN) from multiple etiologies. Methods: A prospective single center observational longitudinal cohort study assessed SCS efficacy from April 2023 to May 2024, with follow-ups at 2, 4, 6, and 12 months in 19 patients suffering from the painful polyneuropathy of diverse etiologies: diabetic (DPN), idiopathic (CIAP), chemotherapy-induced (CIPN), and others. Patients were implanted with a neurostimulator (WaveWriter AlphaTM, Boston Scientific Corporation, Valencia, CA, USA) and percutaneous leads targeting the lower limbs (T10-T11) and, if necessary, the upper limbs (C4-C7). Stimulation programming was individualized based on patient preference and best response. Assessments were performed before and after implantation and included pain intensity (VAS and DN4), neuropathic pain symptoms (NPSI and SF-MPQ-2), autonomic symptoms (SFN-SIQ and SAS), sensory and small fiber nerve injury (UENS), functionality (GAF), sleep (CPSI), global impression of change (CGI and PGI), and quality of life (EQ-VAS and EQ-5D). Intra-epidermal nerve fiber density (IENFD) via skin biopsy was also performed at baseline (diagnostic) and after 12 months to assess potential small fiber re-growth. Statistical analyses were conducted to determine the evolution of treatment success. Results: To date, 19 patients have undergone implantation and completed follow-up. SCS produced a significant consistent and sustained improvement in pain intensity by 49% in DN4 and 76% in VAS, in neuropathic pain symptoms by 73%, in autonomic symptoms by 26-30%, in the sensorimotor physical exam by 8%, in functionality by 44%, in sleep by 74%, and in quality of life (69% for EQ-VAS and 134% EQ-5D). Both clinicians and patients had a meaningful global impression of change, at 1.1 and 1.3, respectively. Distal intra-epidermal nerve fiber density improved by 22% at 12 months while proximal intra-epidermal nerve fiber density decreased by 18%. Conclusions: SCS is an effective therapy for managing various types of PN.

Effect of Global Postural Re-education on Pain, Disability, And Posture in Desk Job Workers with Nonspecific Neck Pain: Randomized Control Trial

Objective: To study the effect of Global postural re-education (GPR) on pain, disability, and posture in patients with chronic nonspecific neck pain.Material and Methods: A single-blinded randomized control trial was conducted. A total of 45 individuals, with nonspecific neck pain aged between 20-40 years, with Craniovertebral Angle (CVA) of less than 49 degrees, were randomly assigned to either the GPR or control group, according to inclusion and exclusion criteria. The intervention was twice a week, spanning four weeks. Outcome measures included: the Numerical Pain Rating Scale (NPRS) for pain intensity, the Neck Disability Index (NDI) for disability assessment and the CVA for posture evaluation.Results: To establish the difference between the groups, the Mann-Whitney U test was performed, and within-group analysis was performed by the Wilcoxon sign rank test. NPRS showed significant improvement (p-value=0.02). NDI did not show significant improvement (p-value=0.83); CVA showed significant improvement (p-value=0.0009).Conclusion: This study concludes that GPR was more effective in reducing pain, increasing function, and improving posture than the control group and can be used in regular practice with proper setup.

ATHLETIC RUNNER’S QUALITY OF LIFE WITH GROIN STRAIN- A CROSS-SECTIONAL STUDY

Background: Groin pain is a common and debilitating issue among athletes, particularly those engaged in high-intensity sports involving kicking, sprinting, and rapid directional changes. It accounts for approximately 6% of all athletic injuries, with prevalence increasing to 13% in specific sports like soccer. The condition often leads to impaired mobility, reduced quality of life, and suboptimal athletic performance. Despite its impact, there is limited evidence regarding its prevalence and effects on athletic runners. Objective: To evaluate the prevalence of hip pain and assess the quality of life in athletic runners with groin strain using validated measurement tools. Methods: This cross-sectional study was conducted using non-probability convenience sampling. A total of 150 athletes aged 18-35 years with groin strain were recruited from various sports physiotherapy clinics. Participants were evaluated using the Visual Analog Scale (VAS), the Copenhagen Hip and Groin Outcome Score (HAGOS), and the Lower Extremity Functional Scale (LEFS) to assess hip pain and quality of life. Data were analyzed using SPSS version 24, and correlations were determined with a significance level of p &lt; 0.05. Results: Of the participants, 64.7% were male, and 35.3% were female, with a mean age of 25 ± 4.6 years. The prevalence of hip pain was 88%. Pain intensity levels included no pain (12%), mild pain (38.7%), moderate pain (31.3%), and severe pain (18%). Functional impairment was evident, with 38.1% scoring less than 40 on LEFS. A significant negative correlation (p &lt; 0.05) was observed between hip pain and quality of life, indicating the adverse impact of groin strain on athletic performance. Conclusion: Groin strain significantly impairs quality of life in athletic runners, reducing physical function, general well-being, and athletic performance. Early diagnosis and tailored rehabilitation protocols are essential to mitigate these effects.

Biomarkers in complex regional pain syndrome

Complex regional pain syndrome (CRPS) is asevere pain disorder with an unclear pathophysiology. Biomarkers offer opportunities to enhance diagnosis, stratification, prognosis, and monitoring. Serum markers such as cytokines and microRNAs show potential but require further research. Local skin markers, particularly pro-inflammatory cytokines, are elevated in the acute stage and correlate with disease activity. Imaging techniques such as skeletal scintigraphy and functional magnetic resonance imaging provide valuable insights into structural and functional changes, despite inconsistent results to date. Psychosocial factors, including pain intensity and psychological comorbidities, are important prognostic indicators. Future research should focus on specific biomarkers to develop mechanism-based treatments. Amultidisciplinary approach remains crucial for effective treatment.

Postoperative Pain Following Vital Pulp Therapy in Carious Permanent Teeth of Children and Adolescents: A Prospective Cohort Study.

Vital pulp therapy (VPT) is one of the treatments recommended for vital deep carious permanent molars. However, postoperative pain remains underexplored in children and adolescents who have undergone VPT. This study investigated the incidence, intensity, duration, temporal pattern, and analgesic intake of postoperative pain following VPT in children and adolescents. Additionally, factors associated with postoperative pain incidence were explored. A prospective cohort study was conducted in 159 patients aged 6-18 years, involving 174 VPT-treated teeth. Pain intensity, measured with the Wong-Baker FACES Pain Scale (WBFPS), and analgesic intake were recorded daily for 7 days post treatment. Over the 7-day period, 40.23% of patients experienced postoperative pain. Mean pain intensity decreased from 3.43 ± 1.96 on Day 1 to 1.26 ± 1.71 on Day 2. About 52.86% of patients were pain-free between Days 1 and 2, and over 97% were pain-free by Day 7. Analgesics were taken by 25.86% of patients. Compared with the protective liners group, the more invasive types of VPT were associated with higher odds of pain. Postoperative pain following VPT was common; however, it was mild, controllable with analgesics, and resolved in most patients. The more invasive VPT types were linked to an increased incidence of pain.

Evaluating Treatment Preferences and the Efficacy of Capsaicin 179 mg Patch vs. Pregabalin in a Randomized Trial for Postsurgical Neuropathic Pain in Breast Cancer: CAPTRANE.

Background/Objectives: CAPTRANE evaluated the efficacy and tolerability of high-concentration capsaicin patch (HCCP) vs. oral pregabalin for the treatment of postsurgical neuropathic pain (PSNP) following breast cancer surgery. The study was designed with the aim of demonstrating noninferiority of one HCCP against daily pregabalin. Methods: This was a multicenter, randomized, parallel-arm, open-label study conducted across nine centers in France. The primary endpoint was a change from baseline in the Numeric Pain Rating Scale (NPRS) score after 2 months. Results: Recruitment challenges resulted in the randomization of 140 patients (versus 644 planned); the per-protocol population comprised 107 patients (HCCP: n = 65; pregabalin: n = 42). Baseline characteristics were similar between the two groups. In the per-protocol analysis, the mean (standard deviation) change versus baseline in NPRS score was -1.926 (2.554) with HCCP and -1.634 (2.498) with pregabalin. The prespecified analysis showed that HCCP was not inferior to pregabalin: the lower bound of the 90% confidence interval for the between-arm difference was -0.889 and the upper bound was +0.260 (i.e., below the predefined clinical threshold of +0.4). Patient-reported outcomes showed no statistically significant differences between treatments. The painful area size decreased significantly more with HCCP. Tolerability profiles differed, with HCCP mostly causing application-site reactions. While >50% of patients switched from pregabalin to HCCP, none switched from HCCP to pregabalin. Conclusions: This comparative study in PSNP post breast cancer surgery, evaluating a single treatment of HCCP, shows a noninferior reduction in pain intensity, a superior reduction in painful area size, and a patient preference for HCCP compared with pregabalin. Despite limitations, it contributes valuable initial data for PSNP management in breast cancer care.

Gene Expression Correlates with Disability and Pain Intensity in Patients with Chronic Low Back Pain and Modic Changes in a Sex-Specific Manner.

Chronic low back pain (cLBP) lacks clear physiological explanations, and the treatment options are of limited effect. We aimed to elucidate the underlying biology of cLBP in a subgroup of patients with Modic changes type I (suggestive of inflammatory vertebral bone marrow lesions) by correlating gene expression in blood with patient-reported outcomes on disability and pain intensity and explore sex differences. Patients were included from the placebo group of a clinical study on patients with cLBP and Modic changes. Blood was collected at the time of inclusion, after three months, and after one year, and gene expression was measured at all time points by high-throughput RNA sequencing. The patients reported disability using the Roland-Morris Disability Questionnaire, and pain intensity was assessed as a mean of three scores on a 0-10 numeric rating scale: current LBP, worst LBP within the last two weeks, and mean LBP within the last two weeks. The gene expression profiles were then correlated to the reported outcomes. Changes in gene expression over time correlated significantly with changes in both disability and pain. The findings showed distinct patterns in men and women, with negligible overlap in correlated genes between the sexes. The genes involved were enriched in immunological pathways, particularly T cell receptor complex and immune responses related to neutrophils. Several of the genes harbour polymorphisms that previously have been found to be associated with chronic pain. Taken together, our results indicate gender differences in the underlying biology of disability and pain intensity in patients with low back pain.

Risk and correlates of prolonged grief disorder in bereaved Chinese university students

Bereavement can present significant challenges for university students, yet the proportion at risk of prolonged grief disorder (PGD) remains unclear. This study examined the proportion at risk of PGD and associated factors among Chinese university students. Using an online survey administered to bereaved university students in mainland China (N = 948), 424 students (Mage =21.60, 56.1% female) reported a significant loss for more than 12 months. Chi-squared and t-tests were used to examine associations between PGD risk and related factors. Results showed 14.2% of the sample were at high risk of PGD. The most frequently reported symptoms were a marked sense of disbelief, intense emotional pain, and yearning for the deceased. PGD risk was associated with physical health, age and relationship to the deceased, expectedness and cause of death, resilience, and stress since the loss. Identifying these correlates can inform future prevention or intervention strategies for bereaved university students.

SCN10A gene polymorphism is associated with pain sensitivity and postoperative analgesic effects in patients undergoing gynecological laparoscopy

BackgroundPostoperative pain intensity is influenced by various factors, including genetic variations. The SCN10A gene encodes the Nav1.8 sodium channel protein, which is crucial for pain signal transmission in peripheral sensory neurons.ObjectivesThis study aims to investigate the relationship between genetic mutations in the SCN10A gene (rs6795970) and postoperative analgesic effects following gynecological laparoscopic surgery.MethodsTwo hundred female patients undergoing gynecological laparoscopic surgery under general anesthesia were included. pain sensitivity was evaluated using the catastrophizing scale and pain sensitivity questionnaire (PSQ). Patients received patient-controlled intravenous analgesia with sufentanil and dexmedetomidine for 48 h post-surgery. Postoperative pain indicators, such as visual analog scale (VAS) scores, Ramsay scores, and side effects were recorded. SCN10A rs6795970 mutations were identified using MassARRAY SNP typing technology, and patients were categoried into homozygous mutant (AA), wild type (GG), and heterozygous mutation (GA) groups for analysis.ResultsPatients in the AA group had higher scores on the pain Catastrophizing Scale, PSQ-total, PSQ-minor, and PSQ-moderate compared to GA and GG groups (P < 0.05). VAS scores at 4, 6, and 12 h post-operation were higher in the AA group than the GG group (P < 0.05). Ramsay scores were lower in AA patients at 2 and 4 h post-operation compared to GA and GG groups (P < 0.05). The AA group exhibited more self-control analgesic pump compressions within the first 24 h post-surgery, quicker depletion of analgesics in the pump, and lower patient satisfaction with pain relief compared to GA and GG groups (P < 0.05).ConclusionsFemale patients with homozygous SCN10A mutations may experience higher preoperative pain scores and increased sensitivity to postoperative pain following gynecological laparoscopic surgery with intravenous patient-controlled analgesia.Trial registration: www.chictr.org.cn, registration number: ChiCTR2200062425.

A multidisciplinary pain management program for patients with chronic low back pain: a randomized, single-blind, controlled, feasibility study

BackgroundMultidisciplinary programs are the first recommendation for non-specific chronic low-back pain, but implementing this type of program is complicated to get up and running. The primary aim of this study was to assess the feasibility and appropriateness of the PAINDOC multidisciplinary program for subjects with chronic low-back pain. The secondary objectives were to evaluate the decrease in pain intensity, pain-related disability and pain catastrophizing, as well as the improvement in quality of life with this program. Furthermore, another of the secondary objectives was to calculate the sample size for a future randomized clinical trial.MethodsThis study was conducted in a hospital pain unit using two successive recruitment waves. First, the feasibility outcomes (recruitment, completion, and drop-out rates) of a 5-month non-random prospective cohort (n = 227) were recorded. Then, the clinical outcomes (pain intensity, quality of life, disability, and pain catastrophizing) were recorded from a prospective, controlled, two-armed and single-blind feasibility study (ClinicalTrials.gov, NCT05974072). It included 41 participants that were randomly allocated to either the pharmacological treatment (n = 21) arm or PAINDOC program (n = 20) arm.ResultsThe recruitment rate was 66%, with the completion rate standing at 80.7% and the drop-out rate at 19.3%. Significant differences and a medium size effect were observed between groups in terms of pain intensity (p = .017, r = .408) at the 4-month follow-up. The intragroup analysis of the PAINDOC group revealed significant lessening in pain intensity (p = < 0.001) and improvements in quality of life (p = .030).ConclusionsThis study showed that the PAINDOC multidisciplinary program is a feasible treatment for patients with non-specific chronic low-back pain. Furthermore, the exploratory results of this study suggest that it could be an effective treatment to reduce pain intensity and improve on self-reported quality of life in these patients, although a future randomized clinical trial is needed to determine its effectiveness.Trial registrationNCT05974072 (registration date July 11, 2023; retrospectively registered; ClinicalTrials.gov).

Effect of Acupressure Techniques and Endorphin Massage on Back Pain Intensity in Third-Trimester Pregnant Women

Back pain in pregnancy is common, especially in the third trimester of pregnancy. In the world of health, alternative methods are being created to reduce pain in mothers during pregnancy and childbirth. Endorphin massage is the best nonpharmacological therapy to deal with these problems. This study aimed to determine the effect of acupressure and endorphin massage techniques on the intensity of back pain in third-trimester pregnant women. This type of research is a pre-experiment with one group pre-test post-test design. Samples were taken from a population that met the inclusion criteria of 20 pregnant women. The sampling technique used an accidental sampling technique. The research instrument used the SOP of acupressure and endorphin massage techniques and the Numeric Rating Scale pain observation sheet. The results showed that before acupressure and endorphin massage, almost half (45%) of all pregnant women experienced severe pain. After acupressure and endorphine massage, none of the respondents (0%) experienced severe pain. The results of the Dependent T-test with α = 0.05 obtained Asymp.Sig.=0.001, so the p-value &lt;0.05 indicates the effect of acupressure and endorphin massage techniques on the intensity of back pain in pregnant women. The conclusion is that there is an effect of acupressure techniques and endorphin massage on the intensity of back pain in third-trimester pregnant women. It is recommended that health workers improve their competence in the service of acupressure techniques and endorphine massage.

Effects of centrally acting analgesics on resting-state electroencephalography biomarker candidates of chronic pain.

Resting-state electroencephalography (rsEEG) holds promise as a biomarker of chronic pain. However, the impact of centrally acting analgesics like opioids, antiepileptics, and antidepressants on rsEEG remains unclear. This confounds and limits the interpretability of previous studies and questions the specificity of rsEEG biomarker candidates of chronic pain, especially for potential diagnostic biomarkers. We, therefore, aimed to elucidate the effects of opioids, antiepileptics, and antidepressants on common rsEEG biomarker candidates of chronic pain. To this end, we analyzed two large, independent rsEEG datasets, including 217 people with chronic pain. We performed preregistered multivariate Bayesian analyses to allow for the quantification and interpretation of evidence in favor of as well as against medication effects on EEG. We specifically evaluated the effects of different centrally acting analgesics on rsEEG features and controlled for the potential confounds of age, pain intensity, and depression. Results predominantly provided evidence against effects of centrally acting analgesics on peak alpha frequency, oscillatory power in different frequency bands, and connectivity-based network measures. Although these findings do not rule out any effects of analgesics on rsEEG, they argue against medium to large effects of centrally acting analgesics on rsEEG. These results help to interpret previous and future rsEEG findings in people with chronic pain and strengthen the validity of rsEEG biomarker candidates of chronic pain. Thus, the present findings can help to develop clinically valuable biomarkers of chronic pain. PERSPECTIVE: This study investigated the effects of centrally acting analgesics on brain-based biomarker candidates of chronic pain, as assessed by electroencephalography. The results predominantly provided evidence against effects on peak alpha frequency, oscillatory power, and connectivity-based network measures. This might help to develop clinically useful biomarkers of chronic pain. DATA AVAILABILITY: Datasets are available at https://osf.io/uzgxw/files/osfstorage.

Sex and academic stage differences in work-related musculoskeletal disorders pain among dental students. A cross-center cross-sectional study

ABSTRACT Objective Dental professionals are highly vulnerable to work-related musculoskeletal disorders (WMSD). As females, who are more prone to WMSD, represent a growing proportion of the dental workforce, this study explored sex differences in WMSD-pain prevalence among dental students, and differentiated it between preclinical and clinical students. Methods A multi-center cross-sectional study was conducted among dental students at three U.S. dental schools. An anonymous survey assessed prevalence of WMSD pain over the last 12 months and 7 days using the Nordic Musculoskeletal questionnaire. Sex and academic stage differences were analyzed with independent t-tests and chi-square, adjusted for demographics and occupational habits (working hours, self-reported ergonomics, loupes, sport engagement) with ANCOVA. Results Among 175 students (26.6±3.6 years, 66.9% females), 93.7% and 57.7% reported WMSD-pain in the past 12 months and 7 days, respectively. Females scored higher than males in pain intensity (p=.025), WMSD-pain prevalence in the past 7 days (p=.006), and number of painful body sites in the past 12 months (p=.006) and 7 days (p<.001). Clinical students had higher WMSD-pain prevalence (p<.001) and number of painful body sites (p<.001) in the past 7 days than preclinical students. Differences remained significant only among females. Conclusion A high prevalence of WMSD-pain was evident in dental students, with significant sex and academic stage differences.

Depression in children with abdominal pain in the emergency department.

This cross-sectional study examined depression and associated impairment in youth presenting to a pediatric emergency department (PED) with abdominal pain. Participants were 11-17 years old, presenting to a PED with idiopathic abdominal pain. Participants completed demographics, pain, pain-related impairment, and depression surveys. Depression was assessed using the Patient Health Questionnaire (PHQ-9A). Scores ≥10 met depression threshold and ≥1 on item 9 indicated self-harm ideation. Mean difference and logistic regression analyses were conducted. Among 169 participants, 29.6% reported depression and 9.4% endorsed self-harm ideation. Depression was associated with Latinx ethnicity (X2 = 4.02, p = 0.045), higher pain intensity (Z = -3.09, p = 0.002), and higher pain-related impairment (Z = -4.86, p < 0.001). In regression analyses, pain-related impairment and Latinx ethnicity were independently associated with depression (OR = 3.89 [95%CI, 1.22-12.40]; OR = 1.13 [95%CI, 1.06-1.21]). Self-harm ideation was not associated with study variables. Results highlight the need for enhanced mental health screening for youth presenting with idiopathic abdominal pain in the ED, particularly for Latinx youth. Early identification of depression and high pain-related impairment may inform interventions and improve outcomes. Nearly 30% of youth, 11-17 years old, presenting to the ED with idiopathic abdominal pain screened positive for depression and 9.4% reported self-harm ideation. The higher likelihood of depression among Latinx youth experiencing pain emphasizes the importance of including diverse samples in future ED research to explore mechanisms contributing to poorer mental health in minoritized populations. Results highlight the need for enhanced mental health screening in youth presenting to the emergency department with idiopathic abdominal pain.

Gamified Web-Delivered Attentional Bias Modification Training for Adults With Chronic Pain: Randomized, Double-Blind, Placebo-Controlled Trial.

Attentional bias to pain-related information has been implicated in pain chronicity. To date, research investigating attentional bias modification training (ABMT) procedures in people with chronic pain has found variable success, perhaps because training paradigms are typically repetitive and monotonous, which could negatively affect engagement and adherence. Increasing engagement through the gamification (ie, the use of game elements) of ABMT may provide the opportunity to overcome some of these barriers. However, ABMT studies applied to the chronic pain field have not yet incorporated gamification elements. This study aimed to investigate the effects of a gamified web-delivered ABMT intervention in a sample of adults with chronic pain via a randomized, double-blind, placebo-controlled trial. A final sample of 129 adults with chronic musculoskeletal pain, recruited from clinical (hospital outpatient waiting list) and nonclinical (wider community) settings, were included in this randomized, double-blind, placebo-controlled, 3-arm trial. Participants were randomly assigned to complete 6 web-based sessions of nongamified standard ABMT (n=43), gamified ABMT (n=41), or a control condition (nongamified sham ABMT; n=45) over a period of 3 weeks. Active ABMT conditions trained attention away from pain-related words. The gamified task included a combination of 5 game elements. Participant outcomes were assessed before training, during training, immediately after training, and at 1-month follow-up. Primary outcomes included self-reported and behavioral engagement, pain intensity, and pain interference. Secondary outcomes included anxiety, depression, cognitive biases, and perceived improvement. Results of the linear mixed model analyses suggest that across all conditions, there was an overall small to medium decline in self-reported task-related engagement between sessions 1 and 2 (P<.001; Cohen d=0.257; 95% CI 0.13-0.39), sessions 1 and 3 (P<.001; Cohen d=0.368; 95% CI 0.23-0.50), sessions 1 and 4 (P<.001; Cohen d=0.473; 95% CI 0.34-0.61), sessions 1 and 5 (P<.001; Cohen d=0.488; 95% CI 0.35-0.63), and sessions 1 and 6 (P<.001; Cohen d=0.596; 95% CI 0.46-0.73). There was also an overall small decrease in depressive symptoms from baseline to posttraining assessment (P=.007; Cohen d=0.180; 95% CI 0.05-0.31) and in pain intensity (P=.008; Cohen d=0.180; 95% CI 0.05-0.31) and pain interference (P<.001; Cohen d=0.237; 95% CI 0.10-0.37) from baseline to follow-up assessment. However, no differential effects were observed over time between the 3 conditions on measures of engagement, pain intensity, pain interference, attentional bias, anxiety, depression, interpretation bias, or perceived improvement (all P values>.05). These findings suggest that gamification, in this context, was not effective at enhancing engagement, and they do not support the widespread clinical use of web-delivered ABMT in treating individuals with chronic musculoskeletal pain. The implications of these findings are discussed, and future directions for research are suggested. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000803998; https://anzctr.org.au/ACTRN12620000803998.aspx. RR2-10.2196/32359.

Novel Conservative Therapies in Migraine Management: The Impact of Fascia Exercises in a Randomized Controlled Trial.

Background/Objectives: Migraine is a complex neurological disorder often associated with autonomic nervous system (ANS) dysfunction. This study aimed to evaluate the effects of fascia exercises on migraine symptoms and explore their potential as a novel conservative treatment approach. Methods: A prospective, randomized controlled trial was conducted with 30 migraine patients who were randomly assigned to a treatment group (fascia exercises) or a control group (conventional physiotherapy). Both groups underwent a six-week intervention consisting of two sessions per week. Pain intensity, migraine-related disability, sleep quality, anxiety, depression, heart rate variability (HRV), and patient satisfaction were assessed before and after the intervention using validated scales. Results: Significant improvements in pain intensity, attack frequency and duration, migraine-related disability, sleep quality, and anxiety levels were observed in both groups (p < 0.05). However, the treatment group demonstrated a more pronounced reduction in depression scores compared to the control group (p < 0.05). While no significant changes in HRV parameters were detected in either group, patient satisfaction was significantly higher in the treatment group (p < 0.05). Conclusions: Fascia exercises represent a promising complementary therapy for migraine management, offering significant improvements in both physical and psychological symptoms. While immediate effects on HRV were not evident, the potential to modulate autonomic balance and address migraine pathophysiology warrants further exploration. These findings highlight the value of fascia exercises as a low-cost, non-invasive approach, emphasizing the need for further research to confirm their long-term clinical benefits and integration into migraine treatment protocols.

Correlation Between Plantar Fascia Thickness and Other Variables in Women Diagnosed with Plantar Fasciopathy.

The objective of this study was to explore the relationship between plantar fascia (PF) thickness and various factors including pain, function, anthropometric parameters, and other variables in women diagnosed with plantar fasciopathy. A total of 37 feet from female patients were randomly selected for this investigation. Utilizing ultrasound, the thickness of the PF was meticulously measured. Subsequently, the correlation between PF thickness and several factors such as pain intensity, functional impairment, height, age, weight, biconvexity of the plantar fascia, duration of the disease, recurrence of plantar fasciopathy, and daily activity levels were analyzed. The findings of this study unveiled a significant positive correlation between PF thickness and several parameters. Specifically, there was a notable correlation with pain intensity, where increased thickness corresponded to heightened pain levels. Additionally, PF thickness exhibited positive associations with height, age, and weight, indicating that these anthropometric factors may influence PF thickness. Moreover, the biconvexity of the plantar fascia, disease duration, and recurrence of plantar fasciopathy showed correlations with PF thickness, suggesting potential implications for disease progression and management. Furthermore, the study identified a relationship between PF thickness and daily activity levels, underscoring the impact of physical exertion on PF health. Notably, the presence of hyperemia in the plantar fascia, as determined by power Doppler ultrasound, also showed a correlation with PF thickness, highlighting potential vascular implications in plantar fasciopathy. In conclusion, this study provides valuable insights into the multifaceted relationship between PF thickness and various clinical parameters in women with plantar fasciopathy. Understanding these correlations may aid in the development of more targeted and effective management strategies for this debilitating condition.

Yogasana and its role in females with pre-menstrual syndrome: A randomized clinical trial

Background: Pelvic pain and fatigue make women feel uncomfortable and interfere with their regular activities, such as going to work, colleges, social events, and household chores. A natural method for dealing with pain and other discomfort is through Yogasanas and Breathing exercises. Pharmacological therapies are also an option, although they may have adverse effects. Methods: Females between the age 18 and 45 years were screened by using the Daily Record of Severity of Problems and Premenstrual Syndrome Scale for Pelvic pain intensity was assessed by Numerical Pain Rating Scale, and Fatigue was assessed by the Multidimensional Assessment of Fatigue Scale. Yogasanas and breathing exercises were given to Experimental (Group A; n = 15) under supervision, whereas Control (Group B; n = 15) were given identical instructions. Prior to the intervention, post-4 weeks, and post-8 weeks, primary outcome measures were evaluated. Results: For both groups, pain and fatigue was reduced and showed statistically significant difference, and when the groups were compared, a significant difference was seen for Numerical Pain Rating Scale and Multidimensional Assessment of Fatigue post-8 weeks. Conclusion: Our study concluded that Yogasanas and Breathing Exercises are effective in reducing Pelvic Pain and Fatigue in Females with Premenstrual Syndrome.