Pain Management Commons^™

The Benefits And Risks Of Pudendal Nerve Block And Dorsal Root Ganglion Stimulation In Pudendal Neuralgia, Pooja A. Patel

Rowan-Virtua Research Day

Context: Pudendal neuralgia is a chronic neuropathic pain syndrome worsening throughout daily activities. Although temporarily relieved when standing or lying down, it is often misdiagnosed, improperly treated, and/or refractory to treatment leading to a negative impact on quality of life. The lack of research in proper diagnosis and interventional management (such as dorsal root ganglion stimulation (DRGS) and pudendal nerve block) further contributes to the delay in relief from the chronic pain. Objective: The goal of this scoping review is to assess if research exists on benefits and risks of pudendal nerve block and dorsal root ganglion and …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Inpatient Opioid Use Varies By Construct Length Among Laminoplasty Versus Laminectomy And Fusion Patients, Harry M. Lightsey, Peter J. Georgakas, Matthew H. Lindsey, Caleb M. Yeung, Joseph H. Schwab, Harold A. Fogel, Stuart H. Hershman, Daniel G. Tobert, Kevin M. Hwang

Rothman Institute Faculty Papers

BACKGROUND: Laminoplasty (LP) and laminectomy and fusion (LF) are utilized to achieve decompression in patients with symptomatic degenerative cervical myelopathy (DCM). Comparative analyses aimed at determining outcomes and clarifying indications between these procedures represent an area of active research. Accordingly, we sought to compare inpatient opioid use between LP and LF patients and to determine if opioid use correlated with length of stay.

METHODS: Sociodemographic information, surgical and hospitalization data, and medication administration records were abstracted for patients >18 years of age who underwent LP or LF for DCM in the Mass General Brigham (MGB) health system between 2017 and …

The Effect Of A Gratitude Intervention On Acute Pain Toleration, Cynthia Ware

Honors College Theses

Gratitude interventions are emerging as a method to improve physical health outcomes; however, gratitude’s effect on pain perception and the autonomic response is understudied. Recent research suggests the perigenual anterior cingulate cortex is activated in gratitude interventions and is also involved in the perception of pain and the activation of the sympathetic nervous system. In this study, we investigated the effect of state gratitude induction on pain through the use of the cold pressor method. We found that although there were no significant differences in self-reported unpleasantness, participants in the gratitude condition reported a higher intensity of pain. Nevertheless, participants …

The Effectiveness Of Laser Acupuncture In Pain Management: A Systematic Review, June Park

Theses and Graduate Projects

Background: Pain is a common symptom across many medical conditions that patients experience. Pain management is complex and may need a combination of several management techniques. Laser acupuncture(LA) has been previously used as an adjunct to conventional pain treatments.

Objective: This systematic review aims to evaluate the effectiveness of laser acupuncture in various fields of medical situations such as chronic pain, low back pain, osteoarthritis, osteoporosis, postoperative pain and dental procedures.

Methods: A computer based literature search of databases through GoogleScholar and PubMed was used to identify randomized controlled trials(RCTs) published after 2018 that studied the effect of LA in …

The Genetics Of Pain: An Exploration Of Gene-By-Environment Interactions And Their Effects On Pain, Mohamad F. Fakhereddin

Electronic Thesis and Dissertation Repository

The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood …

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …

The Impact Of Parental Health Mindset On Postoperative Recovery In Children, Alexandra Kain, Claudia Mueller, Brenda J. Goliamu, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Background

Mindset, or one’s beliefs about the ability to change one’s outcomes, has been studied in the educational domain but not in surgical settings. The purpose of this study was to examine the role of parental health mindset on children’s recovery.

Methods

Participants were part of a larger National Institutes of Health‐funded trial that included 1470 children undergoing outpatient tonsillectomy and adenoidectomy. We used measures of parental coping style (Monitor Blunter Style Scale; MBSS) and medication attitudes (Medication Attitudes Questionnaire; MAQ) to validate the Health Beliefs Scale (HBS; Criterion validity, Cohen’s kappa). HBS categorizes parents as having a growth mindset, …

Systematic Literature Review Of Cognitive Behavioral Treatments For Patients With Classical, Secondary, And Idiopathic Trigeminal Neuralgia, Linnea B. Herzog

Honors Undergraduate Theses

Trigeminal neuralgia is a painful neuralgia with a complicated pathology that is not clearly understood. Due to the ambiguity of the condition, patients often have to search for medical providers that specialize in trigeminal neuralgia, and even with the guidance of a specialist, some patients do not respond well to treatment.¹ Despite the uncertainty surrounding the specifics of the disease, there are treatments available that can provide some level of pain relief for patients suffering from this disorder. When a patient does not respond well to medical therapy, surgery can be the next appropriate step in patient care management. …

Pain Management In Dementia Patients In Nursing Homes, Tiffany Kneuss, Kelsey Weisenburger, Hannah Stewart, Kelly Reilly Kroustos

Pharmacy and Wellness Review

Pain in the elderly, especially those with dementia, is often undertreated and misdiagnosed by health care professionals in the long-term care setting. Communication barriers in patients with cognitive impairment force pain assessment to rely heavily on subjective interpretation of behavioral factors due to the inability of patients to self-report pain symptoms. It is important for clinicians to develop a standard method of identifying and assessing signs of pain in patients with dementia in order to appropriately treat those experiencing discomfort. Patients with dementia who present with a sudden onset of behavioral changes should receive a comprehensive evaluation that includes a …

Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.

Methods

This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain …

Increasing Doses Of Intraoperative Hydromorphone Do Not Reduce Postoperative Pain, Craig S. Curry, Michael B. Henry, Wendy Craig, Janelle M. Richard, Denham S. Ward

Maine Medical Center

Introduction:

• Intermediate and long acting opioids are given intraoperatively to reduce pain during emergence from anesthesia.

• Recent evidence suggests that intraoperative opioids have inconsistent effects on nociception and pain in the immediate postoperative period.

• Multiple potent, short-acting opioids such as remifentanil, sufentanil and fentanyl have been shown to produce dose-related increases in pain scores and opioid consumption in the immediate postoperative recovery period.

• Intraoperative doses of longer acting opioids such as morphine and methadone6 have been shown to reduce pain scores and narcotic requirements in the immediate postoperative period.

• Hydromorphone is an intermediate duration narcotic …

Art In The Stages Of Suffering And Death, Joanna Aramini

Visual Arts Department Student Scholarship

There has always been a strong link between art and the study of science and medicine, and one of the most iconic images of suffering and death in history to date is Christ suffering on the cross. In this thesis, I examine if and how art can make it possible to transcend human pain and overcome suffering, especially in our modern society where pain is seen as something we cannot deal with, and where we look to medicine and prescriptions to diminish it. I argue that art in the states of suffering and death, closely examining Michelangelo’s La Pieta and …

A Program Evaluation On The Effectiveness Of Chronic Pain Management In A Rural Community, Sylvia D. Ramirez

Doctor of Psychology (PsyD)

Chronic pain is a well-known, significant problem in the United States, affecting approximately 55% of adults in Western countries. Opioid use to manage chronic pain impacts individual’s social, psychological, and physiological health. The shortcomings of monotherapy, such as opioid use, have been led to extensive research to develop and assess the outcome of multi-disciplinary evidence-based programs. Rather than eliminating pain, interventions focus on pain management and improving quality of life, independence, and mobility. This quasiexperimental study examined the effectiveness of the Persistent Pain Program (PPP), an 8-week Cognitive Behavioral Treatment program and movement therapy intervention for patients living in a …

Chronic Pain Profiles And Past Bullying Experiences, Stephen Ratliff

Electronic Theses and Dissertations

The biopsychosocial model of chronic pain posits that chronic pain is influenced by factors such as depression, somatization, and psychological trauma (Gatchel, Peng, Peters, Fuchs, & Turk, 2007). Being bullied in childhood is one such factor that has been shown to be associated with chronic pain (Sigurdson, Wallander, & Sund, 2014; Voerman et al. 2015). Furthermore, those with chronic pain fit into one of three distinct psychological profiles (Williams, Urban, Keefe, Shutty, & France, 1995). The purpose of the current study was to examine the relationship between chronic pain profiles and reports of past bullying experiences. It was hypothesized that …

Emotion Regulation And Positive Affect In The Context Of Salivary Alpha-Amylase Response To Pain In Children With Cancer, Brooke N. Jenkins, Douglas A. Granger, Ryan J. Roemer, Ariana Martinez, Tara K. Torres, Michelle A. Fortier

Psychology Faculty Articles and Research

Background

Children with cancer routinely undergo painful medical procedures invoking strong physiological stress responses. Resilience to this pain may be conferred through resources such as emotion regulation strategies and positive affect.

Procedure

This study measured dispositional positive affect in children with cancer (N = 73) and randomly assigned participants to one of three emotion regulation strategy conditions (distraction, reappraisal, or reassurance). Children applied their assigned strategy during an experimental pain procedure (the cold pressor task [CPT]) and provided saliva samples before, immediately after, and 15 min after the CPT. Saliva samples were later assayed for salivary alpha amylase (sAA)—a surrogate …

Optimism And Pain Interference In Aging Women, Stephanie T. Judge

Theses and Dissertations--Psychology

Pain interferes with people's daily lives and often limits the extent to which they can pursue goals and engages in activities that promote well-being. The present study test how optimism affects and is affected by pain interference and activity among older women. Every three months for two years, middle- and older-age women (N = 199) complete daily diaries at home for a seven-day period, reporting their daily pain, pain interference, and activity. Optimism was measured at baseline and end-of-study. Multilevel models test the between- and within-person relationships among pain, optimism, pain interference and activity. Pain best predicted pain interference …

A Comparison Of Combined Versus Individual Cognitive Coping Strategies For Managing Pain, Grant Pointon

Senior Honors Projects, 2010-2019

Several cognitive coping strategies for reducing pain sensation have been identified, but their effects have traditionally only been examined in isolation. The current investigation instead compared the effectiveness of traditional cognitive coping strategies based upon imagery and pain acknowledgement/attention against an “integrated” strategy (that required both strategies to be used in combination) within a cold pressor test (CPT). Participants (N = 24, M_age= 19.46, SD = 1.47) underwent a baseline condition followed by counterbalanced strategy trials: imagery, attention, & integrated condition. Tolerance times, pain ratings, and perceived control ratings were recorded. The imagery condition had lower pain …

Phantom Limb Pain, Stephanie J. Stockburger, Mandakini Sadhir, Hatim A. Omar

Pediatrics Faculty Publications

Phantom limb pain is pain that is perceived in a part of the body which is no longer present. It is estimated that 80 percent of amputees experience phantom limb pain. Although the term is “phantom limb pain” the feeling is often more of a burning, twisting, itching, or pressure sensation than pain. The exact mechanism of phantom limb pain is unknown although proposed mechanisms include pain origination from either the central nervous system or the peripheral nervous system. Since the exact mechanism of phantom limb pain is unknown, treating this pain may be difficult. Treatments include pharmacological and nonpharmacological. …

Use Of Video Games In Patients' Self-Management Of Pain: A Feasibility Study, Janet Donnelly Phd(C), Rn-Bc, Acns-Bc, Pccn

Dissertations

Background: Pain affects more than 75 million Americans and is the primary reason people seek medical attention. Pain is a common cause of disability and diminished quality of life. While anecdotal evidence exists regarding nurses’ use of distraction therapy activities in pain management, little empirical research data is available.

Purpose: To examine the effects of video game use (VGU) on pain perception, pain interference perception and perceived self-efficacy in pain management in adult inpatients.

Conceptual Model: The conceptual model is based on Self-efficacy Theory (Bandura, 1995). The antecedents of the concept of distraction therapy with use of VGs in patients’ …

Report Of The Working Group On Animal Distress In The Laboratory, Marilyn Brown, Larry Carbone, Kathleen Conlee, Marian Dawkins, Ian J. Duncan, David Fraser, Gilly Griffin, Victoria A. Hampshire, Lesley A. Lambert, Joy A. Mench, David Morton, Jon Richmond, Bernard E. Rollin, Andrew N. Rowan, Martin L. Stephens, Hanno Würbel

Andrew N. Rowan, DPhil

Finding ways to minimize pain and distress in research animals is a continuing goal in the laboratory animal research field. Pain and distress, however, are not synonymous, and often measures that alleviate one do not affect the other. Here, the authors provide a summary of a meeting held in February 2004 that focused on distress in laboratory animals. They discuss the difficulties associated with defining ‘distress,’ propose methods to aid in recognizing and alleviating distressful conditions, and provide recommendations for animal research conduct and oversight that would minimize distress experienced by laboratory animals.

Use Of Topical Nsaids In Acute Musculoskeletal Sports Injury: A Brief Review, Amit M. Deokar, Shawn J. Smith, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this chapter is to summarize the current standards of pain management in minor sports-related musculoskeletal injuries. This chapter also addresses the topical form of non-steroidal anti-inflammatory drug as an effective pain management option in an outpatient setting. Design: Quantitive systematic review of randomized controlled trials. Methods: The data was obtained through literature review of articles published in the last 10 years. In addition, FDA information on non-steroidal anti-inflammatory medications was also reviewed. The patient population studied in the articles included children and adults. Conclusion: Current standards of managing pain resulting from sports injuries involve a number of …

Update - March 1999, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Mark Carr, Richard Rice and Siroj Sorajjakool join LLU Faculty of Religion
-- Scholars, Clinicians, and Patients Highlight February Palliative Care Conference
-- [ The Meaning of Pain and Suffering ]
-- MA in Clinical Ethics
-- MA in Clinical Ministry