Common functional pain syndromes

Crabtree, David; Ganty, Praveen

doi:10.1093/bjaed/mkw010

Cited by 13 publications

(15 citation statements)

References 18 publications

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“…Another interesting result in this study was that head and neck pain increased 2.5 times ( p = 0.039), and functional pain disorders increased 13 times the risk of OrCC ( p < 0.001) in our multivariable analysis. Functional pain syndromes typically concur with anxiety, depression, and chronic fatigue syndrome [ 51 ], conditions for which opioids are usually ineffective [ 52 ]. Therefore, the treatment of chronic functional pain should be centered in non-opioid pharmacotherapy with active use of physiotherapeutic and psychological methods to improve coping with pain [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Castañeda

Lee

Kim

et al. 2018

JCM

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Opioid consumption has increased worldwide, which carries the risk of opioid use disorder (OUD). However, the literature on OUD and opioid-related chemical coping (OrCC) in chronic noncancer pain (CNCP) is heterogeneous, with most studies conducted in the United States. We performed a multicenter, observational, cross-sectional study to address OrCC in long-term opioid therapy (LtOT) for CNCP in South Korea. The objectives were to determine the frequency and predictors of OrCC. We included 258 patients. Among them, fifty-five (21%) patients showed OrCC. The sample had high pain catastrophizing (≥30 points; 66%), moderate-severe insomnia (≥15 points; 63%), low resilience (68 points), and high suicidal ideation (67%). OrCC patients had greater pain interference (85.18% vs. 58.28%, p = 0.017) and lower satisfaction with the LtOT (56.4% vs. 78.3%, p = 0.002). In multivariable analysis, alcohol abuse (OR = 6.84, p = 0.001), prescription drugs abuse (OR = 19.32, p = 0.016), functional pain (OR = 12.96, p < 0.001), head and neck pain (OR = 2.48, p = 0.039), MEDD (morphine equivalent daily dose) ≥ 200 mg/day (OR = 3.48, p = 0.006), and ongoing litigation (OR = 2.33, p = 0.047) were significant predictors of OrCC. In conclusion, the break-out of OrCC in CNCP in South Korea was comparable to those in countries with high opioid consumption, such as the United States, regardless of the country’s opioid consumption rate.

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Section: Discussionmentioning

confidence: 99%

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Castañeda

Lee

Kim

et al. 2018

JCM

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“…In the end, all these functional complaints are a phenotypic expression of multiple interrelations between genetic predictors and other environmental factors that act as triggers. 29 , 30 Since hereditary aggregation and genetic particularities are difficult to manage yet, a practical approach of FPS, based on environmental factors study, could be a possible lead to a better understanding of this issue. Thus, we have focused our research on finding out answers to some common questions, and to our knowledge, this is the first study addressing this issue.…”

Section: Discussionmentioning

confidence: 99%

Migraine in young females with irritable bowel syndrome: still a challenge

Doina

Reisz

Gurban

et al. 2017

NDT

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Migraine without aura is frequently reported in female patients with irritable bowel syndrome (IBS), but knowledge about the relationship between these two conditions is still lacking. This study was aimed to explore the particularities of migraine without aura in young female patients with IBS in order to establish a possible link between them. From a cohort of young female patients hospitalized with IBS in the Internal Medicine Department, 30 joined this pilot study, and they were assigned into two groups on the basis of presence or absence of migraine. In this sample, 15 patients have mild to moderate migraine without aura, with a recently taken normal brain scan, and 15 were without migraine. Diseases and conditions not related to migraine and other possible specific female comorbidities were ruled out. Patients undertook a thorough clinical examination in order to assess fibromyalgia (FM) and chronic pelvic pain (CPP), Questionnaires for migraine disability assessment (MIDAS) and generalized anxiety disorder (GAD) were performed. Laboratory testing of blood, urine, and stool were also performed. Optimized lymphocyte proliferation test for food allergy (FA) and a fecal microbiota (microbiological semiquantitative method) for dysbiosis (DB) assessment were performed. Based on the results, migraine-positive group displayed more severe comorbidities: FM (p=0.0002), FA (p=0.0006), CPP (p=0.026), higher scores of anxiety (GAD, p=0.0008), and more severe DB (p=0.0009). We noticed a strong positive correlation between MIDAS and GAD (r=0.83), a good positive correlation between MIDAS and DB (r=0.56), and a moderate positive correlation between MIDAS, FM, and FA (r=0.46 and 0.41). In conclusion, young female patients with IBS and migraine without aura displayed more severe associated issues – anxiety, intestinal DB, FM, FA, and CPP. The severity of migraine correlated well with anxiety range and DB magnitude and moderately with FM and FA.

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“…These include pain at various locations (abdomen, chest, head, back, muscles or joints), diarrhea or constipation, dizziness, palpitations, fatigue, exhaustion, movement disorders, pseudo-seizures, and more (Henningsen et al 2007(Henningsen et al , 2018. The most prevalent FSS include irritable bowel syndrome (IBS), functional dyspepsia, fibromyalgia, chronic fatigue syndrome, and chronic low-back pain, and these share clinical features (Henningsen et al 2007(Henningsen et al , 2018Crabtree and Ganty 2016). In one study, FSS were diagnosed in 40-49 % of all primary care patients (Haller et al 2015).…”

Section: Functional Somatic (Pain) Syndromesmentioning

confidence: 99%

Imaging Brain Mechanisms of Functional Somatic Syndromes: Potential as a Biomarker?

Kano

Oudenhove

Dupont

et al. 2020

Tohoku J. Exp. Med.

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When patients present with persistent bodily complaints that cannot be explained by a symptom-linked organic pathology (medically unexplained symptoms), they are diagnosed with 'functional' somatic syndromes (FSS). Despite their prevalence, the management of FSS is notoriously challenging in clinical practice. This may be because FSS are heterogeneous disorders in terms of etiopathogenesis. They include patients with primarily peripheral dysfunction, primarily centrally driven somatic symptoms, and a mix of both. Brain-imaging studies, particularly data-driven pattern recognition methods using machine learning algorithms, could provide brain-based biomarkers for these clinical conditions. In this review, we provide an overview of our brain imaging data on brain-body interactions in one of the most well-known FSS, irritable bowel syndrome (IBS), and discuss the possible development of a brain-based biomarker for FSS. Anticipation of unpredictable pain, which commonly elicits fear in FSS patients, induced increased activity in brain areas associated with hypervigilance during rectal distention and non-distention conditions in IBS. This was coupled with dysfunctional inhibitory influence of the medial prefrontal cortex (mPFC) and pregenual anterior cingulate cortex (pACC) on stress regulation systems, resulting in the activated autonomic nervous system (ANS) and neuroendocrine system stimulated by corticotropin-releasing hormone (CRH). IBS subjects with higher alexithymia, a risk factor for FSS, showed stronger activity in the insula during rectal distention but reduced subjective sensitivity. Reduced top-down regulation of the ANS and CRH system by mPFC and pACC, discordance between the insula response to stimulation and subjective sensation of pain, and stronger threat responses in hypervigilance-related areas may be a candidate brain-based biomarker.

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Common functional pain syndromes

Cited by 13 publications

References 18 publications

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study

Migraine in young females with irritable bowel syndrome: still a challenge

Imaging Brain Mechanisms of Functional Somatic Syndromes: Potential as a Biomarker?

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