Pain medicine (Malden, Mass.)
August 2, 2024
Jeremy P Steen, Vivek Kannan, Abdullah Zaidi et al.
15 citations
A systematic review of 27 studies (22 randomized controlled trials and 5 quasi-experimental studies) examined mind-body therapies for adults with fibromyalgia. Most therapies—guided imagery, qi gong, tai chi, biofeedback, yoga, mindfulness awareness training, and progressive muscle relaxation—showed significant improvements in pain at the end of treatment in at least one study. Multiple studies on guided imagery, qi gong, and tai chi also reported improvements in fatigue, multidimensional function, and sleep. About one-third of the studies reported adverse events. The evidence suggests mind-body therapies are potentially beneficial, but more research is needed to determine if effects persist.
Pain medicine (Malden, Mass.)
May 3, 2024
Mayumi Oguchi, Michael K Nicholas, Ali Asghari et al.
9 citations
Psychologically based interventions may help adults with chronic neuropathic pain, but evidence remains limited. A scoping review of 33 articles identified four main approaches: cognitive-behavioral therapy, mindfulness/meditation, trauma-focused therapy, and hypnosis. Only 13 randomized controlled trials were found, and of those, 9 had at least 20 participants per group after treatment. Cognitive-behavioral therapy was the most common approach, while mindfulness/meditation was the most frequently used technique. Nearly half to two-thirds of studies reported significant improvements in pain, disability, or distress, suggesting potential benefit. An updated systematic review appears warranted.
Pain medicine (Malden, Mass.)
November 1, 2024
Diana J Burgess, Collin M Calvert, Ann Bangerter et al.
3 citations
Participants with chronic pain who received mindfulness-based interventions were less likely to report psychological and physical worsening than those receiving usual care. In a randomized trial of 708 patients with chronic pain, 61% of whom had a mental health diagnosis, usual care participants more often reported increases in disturbing memories, sadness, anxiousness, fatigue, isolation, loneliness, and feeling upset by reminders of the past. The mindfulness interventions did not appear to cause harm for this population with high mental health comorbidities.
Pain medicine (Malden, Mass.)
September 1, 2024
Jeongsoo Kim, Hangaram Kim, Jae Eun Kim et al.
1 citation
A retrospective study at a single tertiary hospital examined whether a positive response to thoracic sympathetic ganglion block (TSGB) predicts outcomes of ketamine infusion therapy (KIT) and spinal-cord stimulation (SCS) in patients with chronic upper-extremity pain, including complex regional pain syndrome. Among 33 patients who received KIT, 60.6% reported a pain reduction of at least 2 points on a 0-10 scale. Positive TSGB response occurred in 70.0% of KIT responders, significantly higher than the 30.8% in non-responders, with a sevenfold increased odds of positive KIT outcome. Among 32 SCS patients, 68.8% experienced short-term effectiveness; positive TSGB response was 45.5% in responders versus 0.0% in non-responders.
Pain medicine (Malden, Mass.)
September 30, 2022
Ting-Han Lin, Ka-Wai Tam, Yu-Ling Yang et al.
Meditation-based therapies reduce pain intensity and bothersomeness and improve quality of life for adults with chronic low back pain. A systematic review and meta-analysis of 12 randomized controlled trials involving 1,153 patients found that meditation-based therapies significantly lowered pain intensity compared with nonmeditation therapies, with a standardized mean difference of -0.27. They also reduced pain bothersomeness (SMD -0.21) and improved quality of life (SMD 0.27). The authors conclude that meditation-based therapies are a safe and effective alternative approach to managing chronic low back pain.
Pain medicine (Malden, Mass.)
November 26, 2021
Mohammed M Faraj, Nina M Lipanski, Austin Morales et al.
A virtual reality-based meditative intervention for patients undergoing methadone maintenance treatment for opioid use disorder reduced self-reported pain, opioid craving, anxiety, and depression after each session, though anger did not change. Saliva cortisol levels also decreased after sessions, while C-reactive protein did not. Brain scans taken before and after the 12-week intervention showed decreased activation in the left postcentral gyrus during a pain task, and connectivity within the pain neuromatrix changed from baseline. These preliminary findings suggest the intervention is feasible and may have therapeutic benefits, supported by observable brain changes.
Pain medicine (Malden, Mass.)
February 9, 2021
M. Day, Natasha Matthews, J. Mattingley et al.
Psychological treatments for chronic low back pain (CLBP) can alter brain activity, as measured by electroencephalography (EEG). In adults with CLBP who completed cognitive therapy, mindfulness meditation, or mindfulness-based cognitive therapy, there were significant reductions in theta and alpha power in the left frontal region and in beta power across all five brain regions examined. Reduced beta power in the central region was linked to lower pain intensity only for mindfulness-based cognitive therapy. These changes suggest that all three treatments lowered cortical arousal, indicating a shared neurophysiological effect.
Pain medicine (Malden, Mass.)
October 1, 2020
Michael P Berry, Jacqueline Lutz, Zev Schuman-Olivier et al.
A brief self-compassion training (eight contact hours plus two weeks of home practice) reduced clinical pain intensity and disability and increased trait self-compassion and interoceptive awareness in people with chronic low back pain. Brain imaging showed that after training, evoked pressure pain response decreased in the right temporo-parietal junction, and pain anticipation responses increased in the right dorsolateral prefrontal cortex and ventral posterior cingulate cortex. These brain changes were associated with improvements in self-compassion and body awareness. The authors argue that self-compassion may help regulate pain through self-referential, salience-processing, and emotion regulatory brain areas, but note that controlled studies are needed to confirm specificity.
Pain medicine (Malden, Mass.)
September 8, 2020
Carrie E. Brintz, Isabel Roth, K. Faurot et al.
A four-week abbreviated mindfulness program for adults with chronic pain is feasible, acceptable, and may improve quality of life and psychological functioning. In a single-arm study of 23 adults new to mindfulness, participants completed four weekly 90-minute sessions adapted from Mindfulness-Based Stress Reduction. Acceptable retention and attendance rates and high satisfaction ratings were reported. Significant pre- to post-treatment improvements occurred in pain intensity, pain interference, depressive symptoms, positive affect and well-being, sleep disturbance, pain acceptance, pain catastrophizing, perceived stress, and dispositional mindfulness, but not in physical functioning or anxiety. An appropriately powered randomized controlled trial is needed.
Pain medicine (Malden, Mass.)
September 1, 2016
K. Maskell, Michael Bailey, S. R. Rose
A 29-year-old man who self-medicated with methoxetamine (MXE), an arylcyclohexylamine drug of abuse similar to ketamine, for chronic foot pain was brought to the emergency department with altered mental status. He exhibited agitation, combative behavior, white foam around the mouth, dysphoria, psychomotor agitation, vertical nystagmus, labile mood, and dissociative confusion with partial amnesia. After receiving 10 mg intravenous diazepam, he became calmer and more euphoric but remained labile. The case illustrates the toxic effects of MXE when used outside medical supervision.
Pain medicine (Malden, Mass.)
December 1, 2014
Mark P Jensen, Leslie H Sherlin, Felipe Fregni et al.
Baseline theta brain oscillations measured by EEG predicted greater pain reduction from hypnotic analgesia in individuals with spinal cord injury and chronic pain. Less baseline alpha power predicted pain reduction with meditation. These findings suggest that different patients respond to different pain treatments, and that between-person differences in treatment response are related to brain states as measured by EEG. The results have implications for matching patients to treatments or influencing brain activity before treatment to enhance response.