Pain Tolerance Research Articles

Interactive and passive mixed reality distraction: effects on cold pressor pain in adults.

While interactive distractors are predicted to be more effective in reducing acute pain than passive distractors, the underlying mechanisms remain poorly understood. Previous work using Virtual-Reality (VR) has suggested that interactive distraction may be enhanced by increasing the person's sense of immersion. Despite the possible utility of immersive VR in reducing pain, some people report being disoriented and motion sick, and it doesn't allow for interactions with environment (e.g., following instructions from medical staff). Here, we explore the role of the immersion in the effectiveness of interactive distraction by employing an alternative technology, a Mixed-Reality (MR) headset that limits disorientation by projecting virtual objects into the real world. Healthy volunteers (18-35 years) participated in two experiments employing either a between (N = 84) or a within-subject (N = 42) design to compare Interactive and Passive distraction tasks presented via MR or a standard computer display. For both experiments, a cold-pressor task was used to elicit pain, with pain tolerance and pain perception being recorded. Analysis revealed that whilst interactive distraction was more effective in reducing pain perception and increasing pain tolerance than passive distraction, the interpretation of results was sensitive to experimental design. Comparison of devices did not reveal significant differences in pain tolerance or pain intensity, while pain unpleasantness was significantly reduced during the MR task using a within-subject design. Our findings add to existing VR studies reporting little additional analgesic benefit of new, immersive technologies compared to traditional computers, but underscores the important impact the choice of experimental design can have on the interpretation of results.

The impact of exercise intensity on depression in fibromyalgia: a randomized controlled trial.

Fibromyalgia (FM) is characterized by widespread chronic pain. Although pain is the main symptom, approximately 90% of patients have depression. This study aimed to analyze the effects of Resistance Training (RT) with low and high intensity on depression in patients with FM. Thirty-eight women with FM and 31 healthy women were allocated to the low-intensity, high-intensity, preferred-intensity, and control groups. The patients underwent 8 weeks of supervised RT, with two sessions per week of approximately 1 h. The low-intensity resistance training group (LIRT) performed two sets of 12 maximum repetitions. The high-intensity resistance training group (HIRT) performed four sets with six maximum repetitions, and the preferred intensity group (PI) performed three sets, with eight to 12 repetitions, according to the patient's tolerance. The healthy control group did not perform any type of exercise. Depression was assessed using the Beck depression inventory before the start of the intervention, after 4 and 8 weeks. FM patients have higher levels of depression than women without the disease. After 4 weeks, there was a difference in depressive symptoms between the HIRT and LIRT (p = 0.048), and the PI and LIRT (p = 0.048). Prescribing RT with low or high intensity did not significantly reduce depression in patients with FM after 8 weeks, however, analyses between groups after 4 weeks indicated that low-intensity training is more effective than high-intensity training. The prescription of RT exercise to FM could vary among low, high, and preferred intensity, following the patient's tolerance for pain. https://ensaiosclinicos.gov.br/rg/RBR-74pcmw, RBR-74pcmw.

The Influence of Skin Parameters and Body Composition on the Tolerance of Pain Stimulus Generated During Electrical Muscle Stimulation (EMS) in Women - Pilot Study.

This pilot study aims to explore how skin parameters and body composition impact the tolerance to EMS (Electrical Muscle Stimulation) stimuli in women, particularly focusing on pain tolerance in response to varying intensities of EMS. This research seeks to understand what is essential for optimizing EMS applications. The study involved 16 females (age 35.9 ± 12.3). Body composition and anthropometric measurements were taken, including BMI (Body Mass Index), weight percentage, WHtR (Waist to Height Ratio), WHR (Waist-Hip Ratio), and Bioelectrical Impedance Analysis. High-frequency ultrasound scans were conducted to assess skin parameters. The EMS stimulation was performed using an Evolvex (InMode, Israel), with applicators placed around the abdomen and intensity adjusted according to patient tolerance, recorded at the pain threshold. The maximum tolerated EMS stimulus varied from 12V to 55V, with a median of 33V. Body weight showed a strong positive correlation (R=0.76, p<0.001) and hip circumference (R=0.66, p<0.001) with EMS intensity. Body fat mass (R=0.61, p=0.012) and visceral fat area (R=0.55, p=0.029) were positively correlated with EMS intensity. However, no significant correlations were observed between EMS tolerance and muscle tissue parameters or total body water content. The study also found that skin structure parameters showed no significant impact on EMS tolerance. The study reveals that women's tolerance to EMS stimuli is influenced by various factors. Anthropometric parameters like hip circumference, body weight, skinfold, and BMI are strongly correlated with EMS tolerance. Body composition factors, particularly adipose tissue characteristics such as body fat mass and percentage, also significantly impact EMS intensity requirements, with no notable correlation to muscle tissue or water content. However, variations in skin structure, including thickness and density, do not significantly affect EMS tolerance. These insights are crucial for tailoring personalized EMS therapy to enhance effectiveness and comfort in both aesthetic and rehabilitative applications.

Pressure Pain Sensitivity and Chronotype: A Population-based Study of Middle-aged Finns

Evening chronotype individuals experience pain more often than morning chronotypes, but relationships with pain sensitivity have rarely been studied. We examined whether chronotype is associated with pressure pain sensitivity, with special reference to mental health disorders, insomnia, and chronic musculoskeletal (MSK) pain as potential moderating factors. The study sample consisted of members of the Northern Finland Birth Cohort 1966 aged 46. Pressure pain threshold and tolerance were measured via the standardized protocol, categorized as lowest quartile versus others. Chronotype (morning [M; the reference], intermediate [I], and evening [E]) was defined using the Short Morningness-Eveningness questionnaire. Sex-stratified binary logistic regression models were separately adjusted for education, body mass index, long-term diseases (fully adjusted model), and for mental health disorders, insomnia, and chronic MSK pain (a residual confounding analysis). Interaction terms (Chronotype × Mental health/insomnia/chronic MSK pain) were tested. The study had 2,132 males and 2,830 females. The E-type males had 1.5-fold odds of having a low pain threshold (fully adjusted odds ratio [OR] 1.45, 95% confidence interval 1.05–2.00) and pressure pain tolerance (fully adjusted OR 1.47, 1.07–2.02), in comparison to M-types. Having a mental health disorder intensified the association with low pain threshold fourfold (4.06, 1.56–10.6). Being an E-type female was also associated with a low pain threshold, but the association was statistically nonsignificant (fully adjusted OR 1.18, .90–1.53). No statistically significant interactions were found among females. These results emphasize the role of chronotype in pain sensitivity and add an understanding of pain experience in light of innate circadian types. PerspectiveMale evening chronotypes are more sensitive to pain than morning chronotypes. Diagnosed mental health disorders in particular indicate a low pain threshold for evening chronotype males.

Investigating the Immune Dysregulation in Long COVID-19

The long COVID-19 syndrome is a complex clinical state that lasts for several months and extends beyond the initial acute infectious phase. More than 200 known symptoms impact two or more organ systems. The most common symptoms include arthralgia, weakness, exhaustion, low effort tolerance, cognitive impairment, poor focus, palpitations, and chest pain. Approximately 65 million people globally are affected by long coronavirus disease (COVID-19), calculated from a conservative estimate of 10% of infected individuals and over 651 million officially recorded COVID-19 cases globally. The actual number is likely much greater because of numerous unregistered cases. The estimated incidence is 10% to 30% for non-hospitalized cases, 50% to 70% for hospitalized cases, and 10% to 12% for vaccinated cases.

Logistic Regression Based Model for Pain Intensity Level Detection from Biomedical Signal

Hospitals today make the effort to assess acute pain with self-report assessments such as the quantitative pain the level of intensity Index and visual input index. However, because these techniques rely on patient input, they are imprecise. Thus, an objective, statistical approach to ongoing pain monitoring is necessary. In computer vision research, identifying pain intensity is a difficult challenge to solve. However, current subjective pain evaluation is unreliable because it heavily relies on the patient's response. In order to improve the standardization of pain evaluation, automated pain identification using physiological data might provide essential objective information. In the present study, we provide an objective pain recognition approach based on physiological signals that can extract novel features from electromyography (EMG), electrodermal activity (EDA), and electrocardiogram (ECG) data that have not previously been utilized for pain recognition. Utilizing the Bio-Vid Heat Pain Database (Part A) for evaluation and clinical validation, the proposed machine learning logistic regression-based method performs significantly better than previous techniques recorded in the literature for both the electrodermal activity (EDA) and fusion approaches, with average performances of 82.36% and 83.20% for the binary classification experiment that discriminates within the baseline and the pain tolerance level (T0 vs. T4). Our result shows that it outperforms most of the previously proposed methods in related works.

A Comparison of Myofascial Release and Positional Release in Conjunction with Static Stretching for Treatment of Upper Trapezius Trigger Points among University Students: A Pilot Study

Introduction: Myofascial trigger points are considered to be a major cause of neck pain and shoulder muscle tenderness among the working population. Aim: To investigate the efficacy of combining Myofascial Release Therapy (MFR) and Positional Release Therapy (PRT) on pain intensity and pain tolerance for managing neck pain caused by Myofascial Trigger Points (MTrPs) of the upper trapezius muscle. Materials and Methods: A pilot study was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India on a total of 16 participants were randomly assigned to Group A (MFR) and Group B (PRT), receiving treatment 3 days a week for two weeks. Both groups also received conventional treatment (such as static stretching of the upper trapezius along with a cold pack). The Numeric Pain Rating Scale (NPRS) and the Pain Pressure Threshold (PPT) were employed to compare the pre- and postintervention assessment of the participants. Results: As the baseline data were normally distributed, the statistical analysis used independent t-tests for between-group comparisons and paired t-tests for within-group analysis. For within-group analysis, both groups revealed highly significant improvement (p&lt;0.05) in all the outcome measures such as (NPRS and PPT). However, upon comparing both groups, the between-group analysis showed significant improvement across all parameters (p&lt;0.05). Conclusion: Both PRT and MFR combined with static stretching were found to be effective in reducing pain and raising the pain threshold; however, comparing patients who received MFR combined with static stretching had more significant results.

내면화된 수치심, 고통감내력이 비자살적 자해에 미치는 영향 : 회피-분산 정서조절양식의 조절된 매개효과

The purpose of this study is to verify the effect of adolescents' internalized shame, distress tolerance, and avoidant-distractive emotion regulation style on non-suicidal self-injury. This study participated 415 male and female teenagers with non-suicidal self-injury experience attending six middle and high schools in Gwangju. It was found that the mediating effect of distress tolerance was significant in the path of internalized shame toward non-suicidal self-injury. It was found that the moderated mediation effects of the avoidant-distractive emotion regulation on the path of non-suicidal self-injury through distress tolerance was significant. These results suggest that in order to prevent adolescents with high internalized shame from engaging in non-suicidal self-harm, it is important to increase their pain tolerance and enable them to have a healthy emotion regulation style instead of habitually choosing an avoidant emotion regulation style.

내면화된 수치심, 고통감내력이 비자살적 자해에 미치는 영향 : 회피-분산 정서조절양식의 조절된 매개효과

The purpose of this study is to verify the effect of adolescents' internalized shame, distress tolerance, and avoidant-distractive emotion regulation style on non-suicidal self-injury. This study participated 415 male and female teenagers with non-suicidal self-injury experience attending six middle and high schools in Gwangju. It was found that the mediating effect of distress tolerance was significant in the path of internalized shame toward non-suicidal self-injury. It was found that the moderated mediation effects of the avoidant-distractive emotion regulation on the path of non-suicidal self-injury through distress tolerance was significant. These results suggest that in order to prevent adolescents with high internalized shame from engaging in non-suicidal self-harm, it is important to increase their pain tolerance and enable them to have a healthy emotion regulation style instead of habitually choosing an avoidant emotion regulation style.

‘Pushing through the pain cave’: Lived experiences of pain tolerance in male ultra-marathon runners

Extant research has typically focused on the study of pain tolerance in endurance sport from a psychophysiological perspective, with findings illustrating that ultra-runners can tolerate pain for a longer duration of time than non-running active controls. However, qualitative investigation that explores the lived experiences of pain tolerance in ultra-running has been limited thus far.This research explored the lived experiences of pain tolerance in male ultra-marathon runners and how this evolved over time. Six male ultra-marathon runners were interviewed using a semi-structured interview guide. The methodology and analysis were guided by Interpretative Phenomenological Analysis. Four group experiential themes (GETs) were identified, and these are: building relationships with pain, what is ‘real’ pain? gratification of pushing through pain, and the trajectory of enduring hardship.The findings highlight the challenge of distinguishing between discomfort and real pain and the influence of socio-cultural norms on pain tolerance within ultra-running. The study raises important applied implications for coaches and sport psychology practitioners with regards to developing a holistic picture of ultra-runners’ pain experiences and cultivating environments that facilitate multiple narratives and enhance individuals ultra-running experiences.

Predictive Modeling of The Chronic Pain-Induced Depression in Old Adults Based on Music Intervention

Chronic pain is a prevalent concern for older individuals, often leading to a decline in mental well-being, especially through conditions like depression. This study explores the potential effectiveness of Music Intervention (MI) as a non-pharmacological approach to alleviate depressive symptoms in those experiencing chronic pain. Existing methodologies lack predictive accuracy, prompting the introduction of the Predicting Chronic Pain-based Music Intervention (PCP-MI) model. Utilizing machine learning, the PCP-MI model customizes music treatments based on individual characteristics and preferences, showcasing promising results across various metrics related to pain, anxiety, heart and respiratory rates, pain tolerance, emotional well-being, quality of life, and depression severity. The PCP-MI method demonstrated a mean performance across multiple metrics, encompassing pain intensity (17.75%), anxiety level (27.79%), heart rate (78.30 bpm), respiratory rate (15.90 bpm), pain tolerance threshold (59.37 seconds), emotional well-being (75.56%), quality of life (74.81%), and depression severity (65.27%). This research suggests a promising avenue for enhancing the psychological well-being of a vulnerable group, representing a significant advancement in comprehensive pain treatment approaches.

Top-down threat bias in pain perception is predicted by higher segregation between resting-state networks.

Top-down processes such as expectations have a strong influence on pain perception. Predicted threat of impending pain can affect perceived pain even more than the actual intensity of a noxious event. This type of threat bias in pain perception is associated with fear of pain and low pain tolerance, and hence the extent of bias varies between individuals. Large-scale patterns of functional brain connectivity are important for integrating expectations with sensory data. Greater integration is necessary for sensory integration; therefore, here we investigate the association between system segregation and top-down threat bias in healthy individuals. We show that top-down threat bias is predicted by less functional connectivity between resting-state networks. This effect was significant at a wide range of network thresholds and specifically in predefined parcellations of resting-state networks. Greater system segregation in brain networks also predicted higher anxiety and pain catastrophizing. These findings highlight the role of integration in brain networks in mediating threat bias in pain perception.

Barefoot walking is beneficial for individuals with persistent plantar heel pain: A single-blind randomized controlled trial

BackgroundA lack of data exist about the effectiveness of active treatments for persistent plantar heel pain (PPHP). ObjectivesTo compare short-term functional and clinical effects of a 4-week barefoot or shod treadmill walking program for people with PPHP. MethodsA single-blinded clinical trial randomized 52 participants with PPHP into either a barefoot walking group (BWG), or a shod walking group (SWG). All participants received therapeutic ultrasound. Outcomes were measured at baseline (t0), following 4 weeks of treatment (t1), and at 1-month follow-up (t2). The SF-36 functional questionnaire score was the main outcome. Secondary outcomes were self-reported and clinically-assessed pain provocation levels, pressure pain thresholds and pain tolerance. Treadmill walking time and speed were measured at t0 and t1; people also recorded the time spent walking each day in a diary. ResultsThe BWG exhibited significant improvements in all SF-36 items (except “emotional well-being”) (P < 0.05), whereas the SWG exhibited improvements only in “pain” and “health change” items (P = 0.0001; effect size 0.13–0.94). Greater improvements were observed in the BWG than the SWG for “physical function” (P = 0.019) and “role limitations due to physical health” items (P = 0.035). Both groups demonstrated significant improvements in pain, with greater improvements in the BWG (P = 0.0001; effect size 0.89). Only the BWG showed significant improvements in pain pressure thresholds (P < 0.05; effect size 0.70) and pain tolerance (P < 0.001; effect size 0.67). Both groups significantly increased their speed and time spent walking on the treadmill (BWG Δ=19.7 min and Δ=1.7 km/h; SWG Δ=16.7 min and Δ=1.1 km/h) and time outdoors (SWG ∆=38.2 min/week; BWG mean ∆=48.5 min/week) (P < 0.001). All clinical tests of pain were significantly less positive in the BWG at all time points (P < 0.05). ConclusionsBoth walking programs benefited people with PPHP by alleviating pain and improving function and quality of life. Greater improvements were observed in the BWG than the SWG overall.

Changes in pain perception during pregnancy after one-time maximal physical exertion and an 8-week high-intensity interval training.

Background: Pain, a subjective sensation, poses a great challenge to the human body as a stressor. There is empirical evidence that moderate to intense physical activity increases pain tolerance and this may be critical during pregnancy for optimal pregnancy, fetal development, and delivery. To the best of our knowledge, it is the first study examining the changes in pain perception in pregnant women after a maximal progressive exercise test and after 8weeks of high-intensity interval training (HIIT). Methods: Thirty-five women with uncomplicated singleton pregnancies between 13 and 28weeks of gestation participated in the study. The HIIT intervention was developed in accordance with the recommendations and available data on HIIT during pregnancy. The maximal progressive cardiopulmonary exercise test was performed on a cycle ergometer with an electronically controlled load. Pressure pain threshold and pressure pain tolerance were measured with an algometer. Results: We found significant effects of the maximal exercise test and high-intensity interval training, such that the pregnant women had higher pain tolerance after the maximal exercise test than before and after the high-intensity interval training than the baseline. Conclusion: Our results suggest that post-exercise analgesia may be important in pregnant women and that high-intensity interval training appears to be beneficial for pregnant women to improve their pain tolerance while being obstetrically safe. Increased pain tolerance before labor could lead to better management of pain during labor and in the postpartum and lactation periods. Increasing pregnant women's awareness of this issue can improve their wellbeing and provide more comfort during labor.

The effectiveness of using pulsed electromagnetic fields for osteoarthritis of the knee joint

BACKGROUND: Osteoarthritis is one of the most common forms of pathology of the musculoskeletal system with significant impairment of motor function, which is one of the main causes of disability in the population.&#x0D; AIM: This study was aimed at testing the effectiveness of the portable device "ALMAG+" with pulsed electromagnetic fields in the treatment of pain in patients with osteoarthritis of the knee joint.&#x0D; MATERIALS AND METHODS: This randomized, double-blind, placebo-controlled clinical trial included patients with radiographic evidence of knee osteoarthritis and persistent pain greater than 40 mm on a visual analogue scale (VAS). The study included daily treatment with pulsed electromagnetic fields from the ALMAG+ device for 1 month in 60 patients with knee osteoarthritis. The primary outcome measure was reduction in pain intensity assessed by VAS and WOMAC scales. Secondary outcomes included the 36-item Short Form Medical Outcomes Study version 2 (SF-36 v2) quality of life, pressure pain threshold, and changes in non-steroidal anti-inflammatory drug/analgesic use.&#x0D; RESULTS: Sixty-six patients were enrolled in the study, and 60 completed the study. After 1 month of treatment, pulsed electromagnetic fields caused a significant reduction in pain VAS and WOMAC scores compared to placebo. In addition, patients receiving pulsed electromagnetic fields improved pain tolerance, which was reflected in changes in pain threshold, and physical condition. We obtained a significant and statistically significant effect of the organized pulsed electromagnetic fields factor on VAS pain scores (F=47.6; p=0.00006); assessments of the severity of pain, joint function and stiffness on the scales of the WOMAC questionnaire also significantly changed under the influence of the pulsed electromagnetic fields factor (F=14.7; p=0.001). 26% of patients in the pulsed electromagnetic fields group discontinued non-steroidal anti-inflammatory drug/analgesic therapy. No adverse events were identified during treatment.&#x0D; CONCLUSION: These results suggest that pulsed electromagnetic fields therapy is effective in relieving pain in patients with knee osteoarthritis and also affects pain threshold, stiffness, and physical functioning. In the future, it is desirable to conduct larger studies, including those comparing the effectiveness of pulsed electromagnetic fields therapy with standard pharmacological approaches for osteoarthritis.

Changes in pain, daily occupations, lifestyle, and health following an occupational therapy lifestyle intervention: a secondary analysis from a feasibility study in patients with chronic high-impact pain.

This study explored changes in pain-related parameters, occupational function, occupational balance, lifestyle factors, and self-perceived health status in adults with chronic high-impact pain participating in an occupational therapy lifestyle intervention. This one-group longitudinal feasibility study was performed in three continuous feasibility rounds. The occupational therapists-led intervention targeted meaningful occupations, regular physical activity, and a healthy diet. The intervention contained individual and group sessions and was added to the standard multidisciplinary chronic pain treatment. Outpatients (n=40, 85 % females, 46.6 ± 10.9 years old) participated in the study between April 2019 and December 2021. The analysis includes data for 31 participants. Analysis of pre-post changes assessed after each feasibility round were performed for the outcomes: pain intensity, pain sensitivity and pain modulation (pressure pain threshold and tolerance, temporal summation of pain and conditioned pain modulation), pain self-efficacy, pain catastrophizing, motor and process skills, occupational balance, daily wake-time movement, daily walking steps, body mass index, waist circumference, blood pressure, and self-perceived health status. Improvements in motor skills (assessment of motor and process skills score=0.20 (1.37; 1.57), 95 % CI 0.01; 0.38) and temporal summation of pain (-1.19 (2.86; -1.67), 95 % CI -2.16; -0.22), but a decrease in pain tolerance (-7.110 (54.42; 47.32), 95 % CI -13.99; -0.22) were observed. Correlation analysis suggested moderate-to-very strong statistically significant relationships in several outcomes related to pain, health, pain coping, occupational balance, occupational functioning, body anthropometrics, and pain sensitivity. This study suggested that the lifestyle intervention would benefit motor skills while effects on other outcomes were unclear in adults with chronic pain. To confirm the findings, a randomized trial evaluating effectiveness is needed. Ethical committee number: SJ-307 Reg. Clinicaltrials.gov: NCT03903900.

Raising patients hope in despair: The culture of nursing care of burn pain: An ethnographic study.

Although many studies have been carried out to address burn patients' pain and suffering, pain relief still remains an immense unsolved challenge with individual, social, and cultural aspects. This study was conducted aiming to investigate and explain nursing care in burn patients. This was a semifocused ethnographic research conducted in burns units in a referral teaching hospital (Mazandaran, Iran). The data were collected through descriptive, focused, and selective participant observations and ethnographic interviews with burns unit nurses selected via a purposeful sampling method. The collected data were analyzed on the basis of James Spradley's approach. Three main categories and nine subcategories were obtained from data analysis that are as follows: 1) Bending over backward (tenacity, altruism, dedication, and conscience and constancy), 2) Prevention is worth a pound of cure (unique clinical methods, enhanced frustration tolerance through self-motivation and self-efficacy, raise patient's hope in despair), and 3) undisputed dominance of nursing art (reduced unsettling experiences, burnt and ripped body rehabilitation, patient stress management, and avoidance of false hope). Although burn nurses are under huge physical and mental pressure, they enhance patients' pain tolerance through their art of nursing, which is a collection of empirical knowledge, huge work conscience, unique clinical skills, and various therapeutic communication techniques.

Physical activity, sitting time, and thermal quantitative sensory testing responses in African Americans.

Prior research suggests that African Americans (AAs) have more frequent, intense, and debilitating pain and functional disability compared with non-Hispanic Whites (NHWs). Potential contributing factors to this disparity are physical activity and sedentary behavior, given that AAs are less physically active, and physical activity is associated with antinociception (whereas sedentary behavior is linked to pronociception). However, impact of these factors on pain processing has largely been unexplored in AAs, especially before chronic pain onset. This study examined relationships between physical activity, sedentary behavior (sitting time), and laboratory measures of pain and pain modulation in adult AAs. These included heat pain threshold and tolerance, temporal summation of pain (TSP, a marker of central sensitization), and conditioned pain modulation (CPM, a marker of descending pain inhibition). Multiple regressions were conducted to examine the effects of physical activity and sitting time on heat threshold and tolerance. Multilevel models were conducted to assess the relationship between physical activity, sitting time, and temporal summation of pain. Additional multilevel models were conducted to assess the relationship between physical activity, sitting time, and conditioned pain modulation. Higher level of physical activity, but not sitting time, was associated with reduced TSP slopes. Neither physical activity nor sitting time was associated with CPM slopes. No significant relationships between physical activity or sitting time and heat pain threshold or tolerance were detected. These findings suggest that physical activity is associated with reduced TSP, an effect which may be driven by reduced spinal hyperexcitability in more active individuals. Thus, structural and individual interventions designed to increase physical activity in healthy, young AAs may be able to promote antinociceptive processes (ie, reduced TSP/reduced pain facilitation) potentially protective against chronic pain.

Willingness to vaccinate against herpes zoster in Chinese urban population: a mixed-methods study

ObjectiveAlthough the herpes zoster vaccine has been available in mainland China since June 2020, residents’ knowledge of herpes zoster and the herpes zoster vaccine is poor, and vaccination rates are...

Predicting Pain Intensity after Mandibular Third Molar Surgery using Cold Pressor Testing: A Quasi-Experimental Study.

Patients complain differently about their experiences of post-operative pain. However, clinicians are often guided by their own viewpoints despite the highly subjective nature of pain resulting in suboptimal post-operative pain management. This impacts negatively on the quality of life of patients in the immediate post-operative period. Investigating patients' pain behavior in the pre-operative period may therefore help to predict the intensity of post-operative pain, thereby assisting in identifying patients who are at risk of greater pain after third molar surgery, and allocating extra resources for pain control. This study aims to predict the intensity of pain after third molar surgery by correlating post-operative pain perception with the sensory-discriminative dimension and affective response to a cold pressor stimulus. This study is a quasi-experimental study that was conducted in the oral surgery clinic of (name of hospital in the title page). The procedure was undertaken in an isolated clinic cubicle with well-controlled room temperature and minimal distraction. Study participants were recruited by convenience sampling. Forty-three consenting participants, 20 years and above, who met eligibility criteria were subjected to pre-operative cold pressor testing. Subsequently, third molar surgery was done and post-operative pain intensity was recorded at specific intervals. Data analyses were completed using IBM SPSS version 25. The Kolmogorov-Smirnov (KS) test was used to test for normality of continuous variables. Ordinal regression was used to test for contributory value of pre-operative measurement while Spearman's rank correlation test was used to test their degree of relationships with post-operative pain P < 0.05. The median pain threshold was 20 s (Interquartile Range, IQR 12.75-32.25) and the median pain tolerance was 33 s (IQR = 23.00-54.00) from the cold pressor test. The peak median pain score in this study was reached at 3-h after the last stitch. There was a statistically significant predictive effect of both variables on post-operative pain at 3-h. Sensory-discriminative dimension and affective response to cold pressor test are significant predictors of peak post-operative pain after impacted mandibular third molar surgery.