Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states

Yarnitsky, David

doi:10.1097/aco.0b013e32833c348b

Cited by 613 publications

(491 citation statements)

References 38 publications

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“…Nevertheless, in humans, the modulatory pain pathways are more complex, and it is now referred to as conditioned pain modulation (CPM) (Yarnitsky, 2010) (see section VI.A). 4.…”

Section: Figmentioning

confidence: 99%

Human Experimental Pain Models for Assessing the Therapeutic Efficacy of Analgesic Drugs

et al. 2012

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“…Nevertheless, in humans, the modulatory pain pathways are more complex, and it is now referred to as conditioned pain modulation (CPM) (Yarnitsky, 2010) (see section VI.A). 4.…”

Section: Figmentioning

confidence: 99%

Human Experimental Pain Models for Assessing the Therapeutic Efficacy of Analgesic Drugs

et al. 2012

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“…The 3 rd and final cold pressor task involved an immersion of the right hand lasting until a participant reached pain tolerance (or a 3 min maximum). During the first 2 cold pressor trials, we assessed conditioned pain modulation (CPM), a non-invasive test of endogenous pain-inhibitory systems using a heterotopic noxious conditioning stimulation paradigm [46,47]. During each these cold pressor tests, PPTh was assessed on the contralateral trapezius.…”

Section: Quantitative Sensory Testingmentioning

confidence: 99%

Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect

Edwards¹,

Dolman²,

Michna³

et al. 2016

Pain Med

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Objective. Opioids are frequently prescribed for chronic low back pain (CLBP), but there are broad individual differences in the benefits and risks of opioid therapy, including the development opioidinduced hyperalgesia. This study examined quantitative sensory testing (QST) data among a group of CLBP patients undergoing sustained oral opioid treatment. We investigated whether individual differences in psychological characteristics were related to opioid-induced changes in pain perception and pain modulation.Design. The six-month, open-label trial evaluated patients with low to high levels of negative affect (e.g., symptoms of distress, depression and anxiety); participants underwent QST at baseline (prior to initiating treatment) and during oral opioid treatment.Setting. A chronic pain management center.Patients. The 31 study participants had chronic discogenic back pain, with a pain intensity rating >3/10. Participants were divided into groups with high vs. low levels of Negative Affect (NA).Results. In the previously-published manuscript describing the clinical outcomes of the trial, high NA patients achieved only about half of the analgesic effect observed in the low NA group (Wasan AD, Michna E, Edwards RR, et al. Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain. Anesthesiology 2015;123:86172). The QST findings reported here suggested that tolerance to experimental (cold pressor) pain and conditioned pain modulation tended to decrease in the high NA group over the course of opioid treatment, while temporal summation of mechanical pain declined in the low NA group.Conclusions. These results reveal that while the low NA group seemed to exhibit a generally adaptive, analgesic pattern of changes during opioid management, the high NA group showed a pattern more consistent with opioid-induced hyperalgesic

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“…Тем не менее, все они были обучены выполнять операцию методично и в соответ-ствии принципами малоинвазивной хирургии, таким как минимальная диссекция мягких тка-ней, уменьшение длины доступа до минимально необходимого, предотвращение чрезмерного натяжения мягких тканей путем использования принципа подвижного окна на всех этапах опе-рации, избегание выворачивания надколенника или полного подвывиха плато большеберцовой кости кпереди и т.д. Таким образом, дальнейшее изучение обсуж-даемого немаловажного аспекта артропластики коленного сустава поможет выделить подгруп-пу пациентов с повышенным риском развития выраженного послеоперационного болевого синдрома и, соответственно, индивидуализи-ровать как профилактические, так и лечебные анальгетические мероприятия на пред-, интра-и послеоперационном этапах лечения [14,37].…”

Section: окончание таблицы 4/unclassified

What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

Сараев

Lindberg

Гэй

et al. 2017

Traumatology and Orthopedics of Russia

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Purpose – to describe the relationship of selected socio-demographic, clinical, and surgical factors with the severity and patterns of postoperative pain during the first three days following total knee arthroplasty.Material and methods. The sample included 100 patients (93 women and 7 men; mean age 63.5±7.8 years) with osteoarthritis admitted for primary total knee arthroplasty. Prior to surgery, standard measures were used to assess preoperative pain and other symptoms, clinical manifestations of osteoarthritis, functional status of the knee, comorbidities, functional abilities, quality of life, and other patient characteristics. Physical, biochemical and surgical parameters of the perioperative period were also recorded. Patterns of daily changes in postoperative pain characteristics were investigated with the use of individual diaries. Results. All the analyzed indicators of postoperative pain progressively decreased during the three days after surgery (р0,001), including the number of daily hours of moderate to severe pain (р0,001). Pain levels were generally higher among women than among men (р = 0,009). Of the analyzed preoperative factors, higher levels postoperative pain were correlated with higher levels of anxiety (р = 0,029) and preoperative pain intensity (р = 0,029). Among the perioperative factors, surgery duration longer than 90 minutes was associated with higher levels of postoperative pain in activity (р = 0,012) and more hours of moderate/severe pain (р = 0,008). Characteristics of postoperative pain were unrelated to level of patient education, social or family status, employment, lifestyle, or any other clinical or laboratory variables.Conclusion. Of the many factors previously associated with postoperative pain, only gender, anxiety and level of preoperative pain confirmed their importance in this study. Among the perioperative factors, surgery duration, which varied by the type of implant, was significantly associated with postoperative pain levels.

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Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states

Abstract: Low CPM efficiency is associated with higher pain morbidity and vice versa. Further work is awaited on clarifying plasticity of CPM and its relevance to selection and efficacy of pain therapy.

Cited by 613 publications

References 38 publications

Human Experimental Pain Models for Assessing the Therapeutic Efficacy of Analgesic Drugs

Human Experimental Pain Models for Assessing the Therapeutic Efficacy of Analgesic Drugs

Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect

What Influence on Early Postoperative Pain Intensity After Total Knee Arthroplasty?

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