Self-reported Pain Perception Research Articles

An initial investigation into the use of virtual reality (VR) glasses on self-reported pain perception during mammography

ObjectivePain is one of the causes of refraining from mammography. This study aimed to investigate the use of virtual reality (VR) glasses for management of pain during mammography. MethodsFifty subjects who were referred to the radiology unit for mammography screening were invited to participate in the study. The study was approved by the hospital's ethics committee and participants provided written and oral informed consent. Craniocaudal (CC) and mediolateral oblique (MLO) views of the right breast were first acquired, followed by left CC and MLO mammographic views with the VR glasses on. After the examination, participants completed a questionnaire including a validated visual analog scale (VAS) scoring system to analyze pain scores. Data were analyzed using Spearman's rho and the Kruskal-Wallis test, as well as the Bland–Altman analysis to examine discrepancy. ResultsThe association of the right breast pain score with the parameters of age, breast density, previous mammography, family history of breast cancer, educational attainment, and employment status was examined using a correlation test. All the parameters showed no significant correlation with the right breast pain score except age (p: 0.016, correlation coefficient: −.340). Apart from that this study demonstrated no significant correlation between the perceived pain experienced during mammography and the utilization of VR technology. ConclusionThe findings indicate an inverse correlation between participant's age and pain perception during mammography examinations. Moreover, the utilization of Virtual Reality (VR) did not demonstrate efficacy in reducing pain perception.

The influence of harvesting free gingival graft on self-reported pain perception: A randomized two-arm parallel clinical trial

Background/purposeFree gingival graft (FGG) is used as an effective method to increase the width of keratinized tissue. However, it can cause pain at the donor site. Techniques accompanied by lesser tissue harvesting can reduce pain after surgery. The purpose of this study was to evaluate the self-reported pain perception following harvesting FGG using conventional and accordion methods.Materials and methodsIn this randomized clinical trial study, 31 patients with a deficiency of keratinized tissue around implant were investigated. Sixteen subjects in the accordion group and 15 subjects in the control group received conventional FGG. In the accordion group, FGG was harvested with a length of 60% of the mesiodistal length of the recipient area and with the same length as the mesiodistal length of the recipient area in the conventional group. The patients were asked to record their daily pain using a numerical rating scale.ResultsThe severity of the pain after reaching to the peak on the second day was reduced and reached zero at day 14 in both groups. Pain severity showed no significant difference between the treatment groups. The highest level of pain was reported in the conventional group in those subjects under 50 years old, and the lowest one was in the conventional group's subjects above 50 years old. There was no difference between men and women in the reported pain between the treatment groups.ConclusionHarvesting graft with a smaller size in the accordion group has no effect on reducing pain.Registration numberIRCT20190721044296N1.

Live Music Therapy During Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial.

Total knee arthroplasty (TKA) is a common orthopedic surgery known to be very painful. Emphasis has been placed on TKA pain management for postoperative care and during rehabilitation. Music therapy is used as a nonpharmacologic intervention for pain management and to promote rehabilitation exercise adherence. The objective of this study was to explore the effects of music therapy/physical therapy co-treatment using live music-supported exercise on pain and exercise adherence during a lower extremity pedaling exercise to facilitate range of motion (ROM). The researcher randomized 32 TKA inpatient rehabilitation participants to an intervention or control group. Following baseline measures, two study intervals occurred with the intervention group receiving live music for the first interval followed by no music during the second interval; the control group received no music during both intervals. Self-reported pain measures, observed pain measures, and observed measures of pedaling adherence were collected for each participant. A mixed analysis of variance (ANOVA) with repeated measures showed no significant effects for self-reported pain perception. For observed pain, ANOVA results did show a significant interaction (p < .05) between group and study interval. There were no statistically significant effects for pedaling adherence. Conclusions show an important role for live music therapy intervention on observed pain while engaged in co-treatment during this lower extremity ROM exercise. Additional implications and limitations are discussed.

Nitrous oxide analgesic effect on children receiving restorative treatment on primary molars.

Pain experienced during dental treatment increases the risk of developing dental anxiety in children who will became anxious adults, avoiding dental care. It is therefore essential to provide pain-free dental treatment. The strongest fears are often associated with injections: being able to successfully complete painless restorative treatment without the need for local anesthesia injection is therefore an important goal. Nitrous oxide administration by means of Langa's Relative Analgesia (RA) technique has been demonstrated to have both sedative and bland analgesic properties: the mechanism by which N2O exerts its analgesic effects is now understood. The purpose of this study was to test the analgesic effectiveness of Nitrous Oxide used in the RA technique as the only analgesic agent for restorative treatment of primary molars presenting caries lesions without pulp involvement. Ninety patients aged between 3.2 and 9.4 years, 38 males and 52 females, ASA I and II, were included in the study. One hundred and thirty-four restorations were completed on primary molars with caries lesions without pulp involvement (1/3 to 2/3 into dentin): 72 restorations were completed on 48 patients under RA in the Study Group and 62 restorations were performed on 42 patients under RA and local anaesthesia (LA) in the Control Group. At the end of each session, the perception of pain experienced during treatment was rated by each patient using the Wong-Baker FACES® Pain Rating Scale. No statistical difference on self-reported pain perception was seen in the Study Group (treatment under RA) and in the Control Group (treatment under RA plus LA administration). The results also showed no significant difference in pain sensation between males and females; age as well as gender did not affect the results between groups. Nitrous oxide as used in the Langa's RA technique is effective in providing a sufficient analgesic outcome during restorations of primary molars when there is no pulp involvement, with no need for LA supplement.

Influence of Dynamic Neuromuscular Stabilization Approach on Maximum Kayak Paddling Force.

The purpose of this study was to examine the effect of Dynamic Neuromuscular Stabilization (DNS) exercise on maximum paddling force (PF) and self-reported pain perception in the shoulder girdle area in flatwater kayakers. Twenty male flatwater kayakers from a local club (age = 21.9 ± 2.4 years, body height = 185.1 ± 7.9 cm, body mass = 83.9 ± 9.1 kg) were randomly assigned to the intervention or control groups. During the 6-week study, subjects from both groups performed standard off-season training. Additionally, the intervention group engaged in a DNS-based core stabilization exercise program (quadruped exercise, side sitting exercise, sitting exercise and squat exercise) after each standard training session. Using a kayak ergometer, the maximum PF stroke was measured four times during the six weeks. All subjects completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire before and after the 6-week interval to evaluate subjective pain perception in the shoulder girdle area. Initially, no significant differences in maximum PF and the DASH questionnaire were identified between the two groups. Repeated measures analysis of variance indicated that the experimental group improved significantly compared to the control group on maximum PF (p = .004; Cohen’s d = .85), but not on the DASH questionnaire score (p = .731) during the study. Integration of DNS with traditional flatwater kayak training may significantly increase maximum PF, but may not affect pain perception to the same extent.

Individual Differences in the Effects of Perceived Controllability on Pain Perception: Critical Role of the Prefrontal Cortex

The degree to which perceived controllability alters the way a stressor is experienced varies greatly among individuals. We used functional magnetic resonance imaging to examine the neural activation associated with individual differences in the impact of perceived controllability on self-reported pain perception. Subjects with greater activation in response to uncontrollable (UC) rather than controllable (C) pain in the pregenual anterior cingulate cortex (pACC), periaqueductal gray (PAG), and posterior insula/SII reported higher levels of pain during the UC versus C conditions. Conversely, subjects with greater activation in the ventral lateral prefrontal cortex (VLPFC) in anticipation of pain in the UC versus C conditions reported less pain in response to UC versus C pain. Activation in the VLPFC was significantly correlated with the acceptance and denial subscales of the COPE inventory [Carver, C. S., Scheier, M. F., & Weintraub, J. K. Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267-283, 1989], supporting the interpretation that this anticipatory activation was associated with an attempt to cope with the emotional impact of uncontrollable pain. A regression model containing the two prefrontal clusters (VLPFC and pACC) predicted 64% of the variance in pain rating difference, with activation in the two additional regions (PAG and insula/SII) predicting almost no additional variance. In addition to supporting the conclusion that the impact of perceived controllability on pain perception varies highly between individuals, these findings suggest that these effects are primarily top-down, driven by processes in regions of the prefrontal cortex previously associated with cognitive modulation of pain and emotion regulation.

Beta-Endorphin Levels During Pregnancy and Labor

Discovery of the endogenous opiate system of the brain has revolutionized the study of pain and pain management. In this study a convenience sample of 10 pregnant women, 16 nonpregnant women, and 18 men were studied to determine if changes in plasma beta-endorphin-like immunoreactivity affected pain perception during labor. Pregnant women had plasma levels of beta-endorphin significantly higher than nonpregnant women at the midpoint of their menstrual cycle, t = 3.74, df = 31, p = .007. Self-reported pain perception scores were not correlated with plasma beta-endorphin levels. However, as labor progressed, the women reported increased discomfort between contractions and during contractions while beta-endorphin levels increased only slightly. Close examination of the pain pattern indicates that pain perceived by the women between contractions increased at a greater rate than during contractions. This pattern suggests that opiate-active beta-endorphin may increase the ability of women to tolerate acute pain.