Pain Ratings Research Articles

Retrospective Study of the Efficacy of Biofeedback Therapy for Pediatric Persistent Posttraumatic Headache.

Posttraumatic headache is common in pediatrics. Studies have examined treatment of postconcussion symptoms, but few target posttraumatic headache. Biofeedback therapy has been studied in children and teens with primary headaches, but not posttraumatic headache. Our goal was to examine the changes in posttraumatic headache associated with biofeedback therapy in pediatric patients. This retrospective study included 74 children aged 10-18 years who received biofeedback therapy for posttraumatic headache. "Positive response" to biofeedback therapy was defined as ≥50% reduction in headache days per week, or 3-point drop in pain rating between the first and last biofeedback therapy visits. Patient characteristics were analyzed using logistic regression to identify factors associated with response. In our cohort, 42% of all patients with posttraumatic headache had a positive response to biofeedback therapy. Thirty-six percent experienced ≥50% decrease in headache frequency, 13% had a ≥3-point decrease in headache severity and 8% reported both changes. For those with daily headaches, 36% had a positive response to biofeedback therapy. School absences, selective serotonin reuptake inhibitor or prescription preventive medication use were associated with nonresponse. Biofeedback therapy is a reasonable treatment to consider to manage pediatric posttraumatic headache because more than 40% of our cohort had a beneficial response and biofeedback therapy has few adverse effects.

Two-stage revision anterior cruciate ligament reconstruction reduces failure risk but leads to lesser clinical outcomes than single-stage revision after primary anterior cruciate ligament graft failure: a retrospective cohort study

BackgroundThere are no studies that compare the outcomes and complications of single-versus two-stage revision anterior cruciate ligament reconstruction (ACLR) after primary ACLR failure. This purpose of this study is to examine clinical and functional outcomes and complications associated with single and two-stage revision ACLR after primary ACLR failure.MethodsAll patients who underwent single or two-stage revision ACLR after primary ACLR failure between 2012 and 2021 with a minimum of a 2 year follow-up were included. Patients were excluded if they were not treated at our single academic institution, had inadequate follow-up, or had incomplete medical records. Revision intraoperative data, concomitant injuries, and complications were collected by chart review. Return to sport, numerical pain rating scale (NPRS) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Veteran Rands 12-item health survey (VR-12 scores) were collected.ResultsThe final analysis included 176 patients. A total of 147 (83.5%) had a single-stage revision ACLR (87 male, 60 female), and 29 (16.5%) had a two-stage revision ACLR (13 male, 16 female). Two-stage revision ACLR was significantly associated with anterior knee pain [odds ratio (OR) 4.36; 95% confidence interval (CI) 1.5 to 12.65; P = 0.007] but with lower failure rates (OR 0.12, 95% CI 0.02 to 0.9; P = 0.04). On multivariate analysis, a two-stage revision ACLR reduced the risk of graft failure by 85% (OR 0.15; 95% CI 0.02 to 1.17; P = 0.07). Two-stage revision ACLR was significantly associated with a lower KOOS pain score (OR −11.7; 95% CI −22.35 to −1.04; P = 0.031), KOOS symptoms score (OR −17.11; 95% CI −28.85 to −5.36; P = 0.004), KOOS Activities of Daily Living (ADL) score (OR −11.15; 95% CI −21.71 to −0.59; P = 0.039) and Veterans RAND 12-Item Health Survey (VR-12) physical component score (OR −9.99; 95% CI −15.77 to −4.22; P = 0.001).ConclusionsThe clinical outcomes and subjective patient scores significantly differed between the single-stage and two-stage revision ACLR after primary ACLR failure. Patients with a two-stage revision ACLR had a significantly reduced risk of revision graft failure but higher rates of postoperative anterior knee pain, lower pain scores, and lesser knee functional scores than single-stage revision patients.Study designRetrospective cohort study; level of evidence, 3

Can guilt enhance sensitivity to other's suffering? An EEG investigation into moral emotions and pain empathy.

As a unique form of empathy, pain empathy often has a close relationship with society and morality. Research has revealed that moral emotions can influence pain empathy. The underlying physiological mechanism still needs to be further examined to understand how moral emotions affect pain empathy. This study employs EEG and Machine Learning techniques, using a painful image induction paradigm to explore the impact of moral emotion (guilt)-on pain empathy and its neural mechanisms. Participants without pain sensation were instructed to observe and evaluate pictures of an anonymous hand in painful or non-painful pictures under feelings of guilt or neutral emotion. Results found slower reaction times and higher pain ratings for painful pictures. Furthermore, guilt led to higher pain ratings. Under conditions of painful pictures, guilt-induced greater P3(350-450ms) amplitudes and higher α oscillations and enhanced the functional connectivity between the prefrontal cortex, the central frontal region, and the parieto-occipital lobe. K-nearest neighbor can effectively classify high and low-pain empathy under guilt emotion. The result showed that guilt promotes the brain's processing of painful picture, causing individuals to pay high attention and engage in deep cognitive processing. This study provides insights into enhancing empathy and fostering interpersonal relationships.

Analgesic Safety and Efficacy of Peri-Operative Posterior Cervical Muscle Plane Blocks in Elective Posterior Cervical Spine Surgery: A Systematic Review with Meta-Analyses.

Posterior cervical spine surgery can result in significant discomfort in the post-operative period. Post-operative pain management presents a challenge, particularly in the elderly population which is more sensitive to adverse effects from analgesia. We aimed to compare outcomes after peri-operative posterior cervical muscle plane blocks versus patients who received general anesthesia only. MEDLINE, EMBASE, and the Cochrane Library were searched for articles concerning the use of blocks in posterior cervical spinal surgery from January 1, 1974, to December 11, 2023. Data from studies meeting inclusion criteria were analyzed. Fixed-effect and random-effects models were used to establish odds ratios (ORs) and mean difference (MD) with 95% confidence intervals (CIs) for each outcome. The results of the pooled analysis showed that in patients undergoing elective posterior cervical spine surgery, a peri-operative posterior cervical muscle plane block resulted in a statistically significant decrease in numerical pain rating scores at 2 hours post-operatively, 12 hours post-operatively, adverse events, and post-operative nausea/vomiting. A pre-operative posterior cervical block resulted in a decrease in the duration of surgery, and numerical pain rating scores at 24 hours post-operatively though not to a level of statistical significance. These meta-analyses suggest that peri-operative posterior cervical muscle plane blocks are safe and result in improved post-operative analgesic efficacy when compared to controls. More robust prospective, randomized studies are necessary to help inform the safety and efficacy of peri-operative posterior cervical blocks for elective posterior cervical spine surgery.

Auxillary aids for pain and anxiety reduction during dental local anesthesia in pediatric patients: a systematic review.

This systematic review aimed to evaluate the effectiveness of auxiliary aids-Transcutaneous Electrical Nerve Stimulation (TENS), vibrotactile devices, and Low-Level Laser Therapy (LLLT) in reducing pain and anxiety during dental local anesthesia in pediatric patients. The review followed PRISMA guidelines, employing a comprehensive search strategy across multiple databases (PubMed, Cochrane, EBSCO, LILACS, Google Scholar, and Embase) from 2014 to July 2024. Eligibility criteria were based on the PICOS framework, focusing on randomized clinical trials and clinical studies involving pediatric patients undergoing dental procedures with local anesthesia. The interventions included TENS, vibrotactile devices, or LLLT. Pain and anxiety were assessed using validated scales such as the Wong-Baker Faces Pain Rating Scale and physiological measures like heart rate. Nineteen studies with a total of 1094 pediatric patients aged 4-12 were included. TENS and vibrotactile devices consistently showed significant reductions in pain and anxiety compared to standard methods. LLLT results were more variable, with some studies reporting significant pain reduction while others showed no significant difference. Meta-analysis was not possible due to heterogeneity among the studies. Overall, TENS and vibrotactile devices were more effective in alleviating injection-related pain, especially when combined with cold applications or topical anesthetics. The findings highlight the potential of these auxillary aids as non-invasive and effective adjuncts for reducing pain and anxiety in pediatric dental procedures. LLLT showed mixed outcomes, likely due to variability in application protocols, suggesting a need for standardized methods. While all interventions demonstrated promise, inconsistencies in study designs and subjective measures limit the generalizability of the results. TENS and vibrotactile devices are effective auxiliary aids for reducing pain and anxiety during dental local anesthesia in children. Further research is required to optimize LLLT protocols and standardize intervention applications to achieve consistent results across studies.

A clinical comparative study of domestic nasal packing sponge and imported nasopore sponge in post-sinusotomy care

Objective:This study aims to investigate the differences in hemostatic efficacy and patient comfort between an innovative domestically produced biodegradable nasal packing sponge and a traditional absorbent sponge following endoscopic nasal surgery. Methods:A prospective, randomized controlled trial design was utilized, including 30 patients who were divided into two groups according to random allocation, each receiving one of the two types of nasal packing. The study assessed the hemostatic efficacy, comfort, and safety of the materials by comparing the rates of no bleeding within 24 hours after packing, re-bleeding rates after 48 hours, pain ratings in the head and nasal areas, scores on a visual analog scale for nasal ocular symptoms, and safety indicators between the two groups. Results:The rates of no bleeding within 24 hours post-packing were 73.33% for both the experimental and control groups, with a no-bleeding rate of 100% after 48 hours in both groups. The pain rating in the head and nasal areas at various times post-packing was Grade Ⅰ（100%） in both groups, with no statistically significant difference（P=1.000）. The experimental groups sneezing score on the day of packing was（0.73±1.03）, lower than the control groups（2.27±1.67）, （P=0.007）; after 48 hours, the experimental groups sneezing score was（0.67±0.98）, also lower than the control groups（1.67±1.18）, （P=0.019）. There was no significant difference between the two groups in the Lund-Kennedy scoring during endoscopic examinations at the screening period, 7 days, 1 month, and 3 months post-packing（P>0.05）. Laboratory tests for other examination indicators were normal in both groups. Conclusion:The innovative domestically produced biodegradable nasal packing sponge not only provides hemostatic efficacy comparable to imported materials but also significantly improves patient comfort after surgery. It represents an economical and effective choice for nasal packing materials.

The Investigation of the Relationship Between Individual Pain Perception, Brain Electrical Activity, and Facial Expression Based on Combined EEG and Facial EMG Analysis.

Pain is a multidimensional, unpleasant emotional and sensory experience, and accurately assessing its intensity is crucial for effective management. However, individuals with cognitive impairments or language deficits may struggle to accurately report their pain. EEG provides insight into the neurological aspects of pain, while facial EMG captures the sensory and peripheral muscle responses. Our objective is to explore the relationship between individual pain perception, brain activity, and facial expressions through a combined analysis of EEG and facial EMG, aiming to provide an objective and multidimensional approach to pain assessment. We investigated pain perception in response to electrical stimulation of the middle finger in 26healthy subjects. The 32-channel EEG and 3-channel facial EMG signals were simultaneously recorded during a pain rating task. Group difference and correlation analysis were employed to investigate the relationship between individual pain perception, EEG, and facial EMG. The general linear model (GLM) was used for multidimensional pain assessment. The EEG analysis revealed that painful stimuli induced N2-P2 complex waveforms and gamma oscillations, with substantial variability in response to different stimuli. The facial EMG signals also demonstrated significant differences and variability correlated with subjective pain ratings. A combined analysis of EEG and facial EMG data using a general linear model indicated that both N2-P2 complex waveforms and the zygomatic muscle responses significantly contributed to pain assessment. Facial EMG signals provide pain descriptions which are not sufficiently captured by EEG signals, and integrating both signals offers a more comprehensive understanding of pain perception. Our study underscores the potential of multimodal neurophysiological measurements in pain perception, offering a more comprehensive framework for evaluating pain.

The Two Sides of Placebo Analgesia: Differential Functional Connectivity Reveals Mechanisms of Placebo Analgesic Response.

Previous research has demonstrated that placebo induction manipulations can reduce an individual's pain through non-specific mechanisms, such as expectancy manipulations. However, despite robust research characterizing these effects, individual differences in predicting placebo analgesic responses are not well understood. Fifty-four healthy pain-free adults over 18 (M=22.8, SD=7.82) were recruited (66.7% women). Participants completed a baseline followed by a placebo session involving the application of an inactive cream in the context of an expectancy-enhancing instruction set while undergoing a functional magnetic resonance imaging scan (fMRI). Painful heat stimuli were applied to the thenar eminence of the right palm. Stimulus intensity was individually calibrated to produce pain ratings of approximately 40 on a 100-point visual analog scale. Generalized psychophysiological interaction (gPPI) was used to assess the group differences in functional connectivity during painful stimulation compared to warmth stimulation. About 68.5% showed a reduction in pain in the placebo condition with an average decrease of 30.3%. Non-responders showed an increase in pain in the placebo condition, with an average increase of 18.6%. Repeated measures ANOVA demonstrated a significant within-subjects interaction between expectancy and responder type (F(1,49)=4.27, p=0.04, ηp2=0.08). Expected pain was significantly associated with pain in the placebo session for the responders (b=0.37, R2=0.29, p<0.001), but not for the non-responders (b=0.11, R2=0.04, p=0.42). gPPI analysis revealed three clusters exhibiting greater increases in FC in areas related to attention and sensory integration in placebo responders compared to non-responders. One cluster was identified where greater increases in functional connectivity were associated with non-responders compared to responders in regions associated with attention and motor processing. Our results provide evidence that responders and non-responders have differential behavioral and functional responses to acute pain during a placebo analgesic task.

Psychometric Properties of the Persian Version of Sickness Impact Profile-30 (SIP-30) in Community-Dwelling Older Adults.

Purpose: Accurate measurement tools are essential for evaluating the health-related quality of life in older adults. We aimed to translate and evaluate the psychometric properties of the Sickness Impact Profile-30 (SIP-30) in community-dwelling older adults. Materials and Methods: One hundred and fifty older adults participated in this study. To evaluate construct validity, its correlation with General Health Questionnaire-28, Geriatric Depression Scale-15, Hospital Anxiety and Depression Scale, Modified Health Assessment Questionnaire, Numeric Pain Rating Scale, and Fullerton Advanced Balance Scale was assessed. Reliability features were also investigated. Results: The results of construct validity analysis demonstrated a moderate to high (r = 0.61-0.84) correlation between the total score of SIP-30 and GHQ-28, GDS-15, HADS, MHAQ, and NPRS. There was a moderate inverse (r = -0.67) correlation between the total score of the SIP-30 and the FAB Scale. Test-retest reliability (ICC > 0.83) and internal consistency (α = 0.94) of the Persian SIP-30 were high. Conclusions: The results indicated that the Persian SIP-30 is a reliable and valid measure to assess health-related quality of life in community-dwelling older adults.

Assessment and Management of Pain and Anxiety in Pediatric Patients in Emergency

Objective: To assess pain level in pediatric patients presented with dental pain at the emergency department of Jinnah Postgraduate Medical Center, Karachi. Study design: A cross-sectional study. Place and Duration: The study was conducted in a Pediatric Emergency Department at the Jinnah Postgraduate Medical Center, Karachi, for 6 months from March 2024 to September 2024. Methodology: Total 230 hospitalized children over 6 months were assessed the pain levels of these children on admission and 8 hours after admission. Analgesic treatment was given to children and pain was assessed according to Wong-Baker Faces Pain Rating Scale. SPSS version 27 was used for data analysis. Descriptive statistics, such as means and standard deviations, were used to summarize the quantitative variables. Results: Paracetamol was the most given analgesic to the patients as 41.7%, whereas brufen and intravenous analgesics were given as 30.0% and 10.0%, respectively. There were 19.6% patients who had no pain at admission, 19.6% had mild pain, 37.8% had moderate pain and 23.0% had severe pain. Whereas, 110 (47.8%) patients had no pain after analgesics, 35.2% had mild pain, 13.5% and 3.5% had severe pain. The association of severity of pain at admission and after analgesics was statistically significant, (p&lt;0.001). Conclusion: Pain scales are indeed valuable tools for assessing and managing pain in children, as they provide a standardized and systematic way to measure and communicate pain levels. Pain relief and management are important aspects of patient care, as untreated or poorly managed pain can have detrimental effects on a patient's physical and emotional well-being.

Validation of the Korean version of Defense and Veterans Pain Rating Scale for assessment of postoperative pain: a prospective observational cohort study.

The Defense and Veterans Pain Rating Scale (DVPRS) is a pain assessment tool combining a numerical rating scale (NRS) with descriptive words, colors, and facial expressions. This study aimed to validate the Korean version of the DVPRS (K-DVPRS) for postoperative pain assessment. This study included patients who underwent elective laparoscopic or robotic abdominal surgery. The original DVPRS was translated into Korean using a forward-backward method. Pain intensities at rest and during coughing were assessed at 24 and 48 hours postoperatively using the NRS and K-DVPRS, respectively. The EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire was also used. The validity, reliability, and responsiveness of the K-DVPRS were evaluated. Of the 174 patients screened, 150 were enrolled, and 148 completed the study. The K-DVPRS had strong convergent validity with the NRS at 24 and 48 hours postoperatively (ρ: 0.75 to 0.78, all P < 0.001). Construct validity was confirmed by significant differences in pain scores based on surgical extent and duration. The internal consistency was acceptable (Cronbach's alpha: 0.77 and 0.85 at 24 and 48 hours, respectively), and test-retest reliability at 24 hours was excellent (intraclass correlation coefficient: 0.90 at rest and 0.95 during coughing). Responsiveness, measured by Cliff's effect size, was high from preoperative to 24 hours postoperatively and moderate from 24 to 48 hours. At 48 hours, the K-DVPRS had stronger correlations with the EQ-5D-5L index and EQVAS than with the NRS. The K-DVPRS is a valid, reliable, and responsive tool for assessing postoperative pain in Korean patients.

Shared Decision-Making in Total Hip and Knee Arthroplasty: Understanding Surgeon and Patient Perspectives Regarding When It Is Time for Surgery.

Although total hip and total knee arthroplasty are highly successful operations, the decision of whether and when to undergo surgery is highly subjective and discretionary, and specific guidelines regarding readiness for surgery remain elusive. The nature of these decisions underscores the importance of shared decision-making, which is founded on the concept that patients substantially contribute to determining their own readiness for surgery. The OPTION survey was developed as a conversation aid to facilitate shared decision-making in the context of total joint arthroplasty. The OPTION survey was created in partnership with a panel of 10 active joint replacement patients and 15 arthroplasty surgeons, using a modified Delphi methodology that employed 3 sequential meetings by each group. The survey interrogates patient and surgeon ratings of pain, activity limitation, duration of treatment, prior treatments, and quality of life; patient-rated treatment priorities, readiness for surgery, and surgeon engagement; and surgeon-graded radiographic disease. The survey was administered as an institutional review board-approved pilot during 641 patient-clinician encounters for hip or knee arthritis at 9 U.S. sites, and was independently completed by the patient and surgeon. Patient self-assessment of readiness for surgery includes consideration of existing functional impairment, outcome priorities, realistic expectations, and personal socioeconomic circumstances. Patients most commonly ranked removal of activity limitations as their top treatment priority, while alleviation of pain and avoidance of a long recovery were also ranked highly. Mild and severe pain were associated with similar radiographic disease severity, and worsening radiographic disease was associated with increasing patient-reported readiness for surgery. Patients and surgeons agreed on symptom severity in >90% of cases. When disagreement occurred, surgeons typically underestimated patient-reported symptoms; these cases were associated with lower patient-rated surgeon engagement in shared decision-making conversations. Shared decision-making conversations substantially contributed to the assessment of patient readiness for joint replacement surgery. When patient and surgeon assessments were not aligned, surgeons most commonly underestimated patient-perceived impairment. These observations should inform optimal surgeon-patient communications. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

How does pain management differ - the basics of analgesia in pediatric patients compared to the adult population

Pain management is a key component of medical care that shows significant differences in pharmacodynamics, epidemiology or psychological approaches between pediatric and adult patient populations. An analgesic drug is an agent used to treat pain. It is often inadequate and ineffective in pediatric patients - the younger the children, the less likely they are to receive adequate analgesia. Optimizing pain management in both populations requires continuous improvement in clinical practice and education of medical personnel and patients on pharmacological and non-pharmacological approaches. This article discusses the characteristics of analgesic use in children and adults and non-pharmacological approaches to pain management. Objectives: The purpose of our study is to evaluate the methods of analgesia used in the pediatric population and in adult patients and the differences associated with age group membership. Materials and Methods: The literature review was performed using Internet research paper databases (PubMed, Google Scholar, Medline), using 28 articles available in English and Polish from 1983-2024. Results: Analgesia in children has its own specific characteristics that differ from analgesia in adults. These include differences in pain sensitivity, age dependence, pain rating scale, psychological aspects, choice of analgesic drug or drug dosage. Conclusion: Improving the quality of analgesia in children requires both pharmacological support and the use of non-pharmacological methods, education of doctors and parents, and emotional support.

Pain Scales: Types and Comparison

Objective: Pain is a common and significant symptom in clinical practice, particularly among emergency and cancer patients. This article explores various pain scales and their clinical applications, alongside postoperative pain management in oncologic patients. A review of unidimensional pain scales, including the Numeric Rating Scale (NRS), Visual Analog Scale (VAS), Verbal Rating Scale (VRS), and Faces Pain Rating Scale (FPS), is presented. Additionally, the pathophysiology and pharmacological and non-pharmacological strategies for managing postoperative pain in cancer patients are discussed. Pain scales vary in sensitivity, ease of use, and clinical suitability. NRS is widely preferred for its simplicity and statistical applicability, whereas VAS offers higher sensitivity but practical limitations. Postoperative pain in oncologic patients is influenced by surgical trauma, psychological factors, and pre-existing pain conditions, with inadequate management leading to systemic complications and increased cancer recurrence risk. Effective management incorporates both non-opioid and opioid analgesics based on pain severity. Pain assessment tools and effective management strategies are critical for improving patient outcomes in clinical settings. Tailored approaches, particularly in oncologic postoperative care, can mitigate complications and enhance quality of life.

Intercostal Nerve Cryoablation as an Effective Pain Management Strategy in the Nuss Procedure: Reducing Opioid Use and Hospital Stay.

Erector spinae plane (ESP) blocks, thoracic epidural, and patient-controlled analgesia (PCA) have all been used for perioperative pain management in the Nuss procedure without a consensus on what modality produces the best outcomes. Intercostal nerve cryoablation (INC) is a relatively new modality that involves freezing the nerves to prevent pain during recovery. Our hypothesis is that using INC for the Nuss procedure will decrease opioid use, pain scores, and length of stay (LOS) but will increase cost compared with ESP block, thoracic epidural, and PCA. This retrospective, observational study compared 108 patients who underwent the Nuss procedure at a pediatric acute care children's hospital in the southeast US. Patient charts were evaluated for significant differences in LOS, opioid use, and reported pain ratings based on type of analgesia administered: INC (n = 30), ESP block (n = 19), thoracic epidural (n = 41), and PCA (n = 18). Secondary variables included emergency department visits, readmissions, opioid refills, and various anesthetic and operative costs. Analysis of variance was performed on all outcome measures. Average LOS was significantly decreased in the INC group (2.9 days) compared with the thoracic epidural (4.7 days, p < 0.05) and the PCA groups (3.7 days, p < 0.05). Average cumulative opioid use was significantly decreased in the INC group (50.4 morphine milligram equivalents [MME]) compared with the thoracic epidural (117 MME, p < 0.05) and PCA groups (172.1 MME, p < 0.05). This study suggests that INC can be a viable and cost-effective option for reducing postoperative opioid consumption and LOS in Nuss procedure patients. Pain perception was lower in the INC group compared with the rest of the groups, except the epidurals, which were similar. However, the opioid consumption of the INC group was significantly lower than any other group. Despite the INC group having higher initial costs, it did not result in the highest total hospital charges, indicating its potential cost-effectiveness. There is a need for larger prospective randomized controlled trials to guide future research efforts.

Effects of Alternative Wrist Grip Techniques on Pain, Strength, and Function in the Wrists of Novice Weightlifters

Introduction. The wrist, with its composite anatomical composition, is deemed the most complex joint in the human body, vital for multifaceted hand movements. However, diseases or injuries can significantly impair wrist function, necessitating a comprehensive understanding of its anatomy and biomechanics. Concurrently, weightlifting, a popular exercise regimen, demands precise wrist functionality for optimal performance. Objective. This study investigates the influence of alternative wrist grip methods and wrist strength on wrist function among novice weightlifters. Method. Through a cross-sectional observational design, data was collected from 88 participants, aged 16 to 35 years, encompassing wrist pain, strength, and functionality. Bench and shoulder press exercises were performed, with grip methods discreetly noted. Wrist strength was measured using a dynamometer, while functionality was assessed through the Patient Rated Wrist Evaluation (PRWE) questionnaire, and goniometer-assisted range of motion assessments were done. Results. Descriptive statistics unveiled diverse characteristics among participants, including age, wrist strength, BMI, pain ratings, PRWE scores, and wrist range of motion, underscoring individual differences in wrist functionality. Average wrist strength values further highlighted these variations. Conclusion. These findings provide valuable insights into the intricate relationships between grip methods, wrist strength, and overall wrist functionality among beginner weightlifters, offering a foundation for targeted interventions to optimize wrist health and enhance performance. This literature found out that the overall wrist function and strength of both dominant and non-dominant wrists were better in participants of neutral wrist group. Participants of extended wrist group were experiencing more pain as compared to neutral wrist group.

Peer Status Influences In-Group Favoritism in Pain Empathy During Middle Childhood: Evidence from Behavioral and Event-Related Potentials Studies.

Empathy for pain enhances our ability to perceive pain and recognize potential dangers. Empathic bias occurs when members of the in-group evoke more intense empathic responses compared to out-group members. In the process of interacting with peers, children develop peer status and spontaneously form peer groups. The present study examined how peer status affects pain empathy in mid-childhood individuals. A behavior and an event-related potential (ERP) study were conducted. Participants were exposed to pictures of different peers in painful or non-painful situations and completed the pain and unpleasantness rating tasks. Four types of peers were included: popular, rejected, neglected and unfamiliar peers. The behavioral results suggested that the influence of peer status on cognitive empathy is more salient, and the empathic response to unfamiliar peers is higher than neglecting and rejecting peers. The ERP results indicated that larger P3 and LPP amplitude were observed in the painful stimulus condition than in the non-painful stimulus condition. The findings also showed that the popular peers elicited larger LPP amplitude than other peers. The LPP response to unfamiliar peers was larger than to neglected peers. All these results demonstrated that mid-childhood individuals showed empathic bias to in-group members, but it was influenced by peer status in the cognitive processes of pain empathy.

Different ways to reach the same goal: Are the analgesic effects of different types of tactile stimuli similar?

Tactile-induced analgesia (TIA) is a phenomenon in which different types of tactile stimulation alleviate pain via different mechanisms including empathy. As TIA plays an essential role in therapeutic situations and clinical conditions, it is crucial to determine whether specific tactile stimulations confer distinct benefits. Fifty-two subjects (31 females; 21-47 years) were exposed to four distinct experimental conditions involving three types of touch provided within a simulated supportive therapeutic setting. First, a contact heat (70 s) at a pain intensity of 60/100 Numerical Pain Scale (NPS) was applied to the forearm. The pain stimulus was then given simultaneously with vibration, gentle stroking, or handholding in random order. Pain ratings were reported at 5 and 65 s of each stimulation. Given the role of empathy in TIA, we also assessed the levels of empathy experienced by the subjects and the experimenter. Handholding and vibration conditions were associated with a more rapid decrease in pain ratings compared to pain-alone (B values: handholding = -150.94 vs. pain-alone = -99.38, p = 0.01; vibration = -163.54 vs. pain-alone = -99.38, p < 0.001). Higher levels of the experimenter's empathy toward the subjects were associated with greater pain alleviation during vibration vs. pain-alone condition (B values: vibration = -56.42 vs. B pain-alone = -9.57, p = 0.04). Vibration's potent analgesic effects may be attributed to its multi-channel analgesic mechanisms, including the therapist's empathy toward the participant. On the other hand, for handholding establishing an empathic interaction should be considered in a therapeutic setting to enhance its analgesic efficacy. This article explores the effectiveness of touch-based pain relief methods and their association with empathetic therapeutic interactions. The study emphasizes the significance of positive therapeutic interactions in facilitating tactile-induced analgesia.

Posterior-superior insula repetitive transcranial magnetic stimulation reduces experimental tonic pain and pain-related cortical inhibition in humans.

High frequency repetitive transcranial magnetic stimulation (rTMS) to the posterior-superior insula (PSI) may produce analgesic effects. However, the alterations in cortical activity during PSI-rTMS analgesia remain poorly understood. The present study aimed to determine whether tonic capsaicin-induced pain and cortical inhibition (indexed using TMS-electroencephalography) are modulated by PSI-rTMS. Twenty healthy volunteers (10 females) attended 2 sessions randomized to active or sham rTMS. Experimental pain was induced by capsaicin administered to the forearm for 90 minutes, with pain ratings collected every 5 minutes. Left PSI-rTMS was delivered (10 Hz, 100 pulses per train, 15 trains) ∼50 minutes postcapsaicin administration. Transcranial magnetic stimulation-evoked potentials (TEPs) and thermal sensitivity were assessed at baseline, during capsaicin pain prior to rTMS and after rTMS. Bayesian evidence of reduced pain scores and increased heat pain thresholds were found after active rTMS, with no changes occurring after sham rTMS. Pain (prior to active rTMS) led to an increase in the frontal negative peak ∼45 ms (N45) TEP relative to baseline. After active rTMS, there was a decrease in the N45 peak back to baseline levels. In contrast, after sham rTMS, the N45 peak was increased relative to baseline. We also found that the reduction in pain numerical rating scale scores after active vs sham rTMS was correlated with and partially mediated by decreases in the N45 peak. These findings provide evidence of the analgesic effects of PSI-rTMS and suggest that the TEP N45 peak is a potential marker and mediator of both pain and analgesia. This study demonstrates that high-frequency rTMS targeting the posterior-superior insula reduces capsaicin-induced pain and alters cortical activity, with changes in the N45 TMS-evoked potential peak mediating the analgesic effects.

Pain is what you think: functional magnetic resonance imaging evidence toward a cognitive and affective approach for pain research

The sensory/discriminative domain of pain is often given more consideration than the cognitive and affective influences that ultimately make pain what it is: a highly subjective experience that is based on an individual's life history and experiences. While many investigations of the underlying mechanisms of pain have focused on solely noxious stimuli, few have compared somatosensory stimuli that cross the boundary from innocuous to noxious. Of those that have, there is little consensus on the similarities and differences in neural signaling across these sensory domains. The purpose of this study was to apply our established network connectivity analyses toward the goal of understanding the neural mechanisms behind sensory, cognitive, and affective responses to noxious and innocuous stimuli. Functional MRI data were collected from 19 healthy women and men that experienced warm and hot thermal stimuli across multiple trials. This is a within-subjects cross-sectional experimental study with repeated measures. Ratings of stimulus intensity and unpleasantness that were collected during each run confirmed significant perceptual differences between the two types of stimuli. Despite this finding, no group differences in network connectivity were found across conditions. When individual differences related to pain ratings were investigated, subtle differences were found in connectivity that could be attributed to sensory and association regions in the innocuous condition, and cognitive, affective, and autonomic regions in the pain condition. These results were reflected in the time-course data for each condition. Overall, signaling mechanisms for innocuous and noxious somatosensation are intricately linked, but pain-specific perception appears to be driven by our psychological and autonomic states.