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- W2021242512 abstract "Deficits in central pain modulatory mechanisms, such as conditioned pain modulation (CPM) and enhanced suprathreshold heat pain response (SHPR), have been suggested to play a role in the development of post surgical pain. However, it remains unclear whether: a) central pain modulatory mechanisms change differentially in patients who improve from those that do not improve their level of pain intensity 6 months after shoulder surgery, and b) CPM and SHPR explain significant variability in post operative clinical pain after psychological factors (pain catastrophizing and depression) are considered. Seventy three patients with shoulder pain were examined before shoulder surgery, at 3 months, and 6 months after surgery. SHPR was generated with repeated thermal stimuli, and CPM was assessed using SHPR as the experimental stimulus and cold water bath as the conditioning stimulus. Patients were classified into improved (greater than 30% reduction in shoulder pain from baseline to 6 months after surgery)and not improved groups based on responses to Brief Pain Inventory (BPI) 6 months post-surgery. This study revealed that: 1) CPM, SHPR, and pain threshold did not differ at baseline in patients whose pain improved at 6 months compared to patients who did not improve, 2) Improved patients showed significant decreases in 5th pain rating of SHPR 3 months after surgery, however they did not change in CPM or pain threshold, 3) The change score of 5th pain rating of SHPR accounted for a significant amount of variance in 6 month post surgical pain intensity after psychological factors were considered. The results from the present study imply that baseline level of central pain modulation may not be a risk factor for continued pain at 6 months post surgery. However, plasticity of the central modulatory system may be a key factor in the transition to continued post operative pain. Funding: #AR055899 NIAMS/NIH. Deficits in central pain modulatory mechanisms, such as conditioned pain modulation (CPM) and enhanced suprathreshold heat pain response (SHPR), have been suggested to play a role in the development of post surgical pain. However, it remains unclear whether: a) central pain modulatory mechanisms change differentially in patients who improve from those that do not improve their level of pain intensity 6 months after shoulder surgery, and b) CPM and SHPR explain significant variability in post operative clinical pain after psychological factors (pain catastrophizing and depression) are considered. Seventy three patients with shoulder pain were examined before shoulder surgery, at 3 months, and 6 months after surgery. SHPR was generated with repeated thermal stimuli, and CPM was assessed using SHPR as the experimental stimulus and cold water bath as the conditioning stimulus. Patients were classified into improved (greater than 30% reduction in shoulder pain from baseline to 6 months after surgery)and not improved groups based on responses to Brief Pain Inventory (BPI) 6 months post-surgery. This study revealed that: 1) CPM, SHPR, and pain threshold did not differ at baseline in patients whose pain improved at 6 months compared to patients who did not improve, 2) Improved patients showed significant decreases in 5th pain rating of SHPR 3 months after surgery, however they did not change in CPM or pain threshold, 3) The change score of 5th pain rating of SHPR accounted for a significant amount of variance in 6 month post surgical pain intensity after psychological factors were considered. The results from the present study imply that baseline level of central pain modulation may not be a risk factor for continued pain at 6 months post surgery. However, plasticity of the central modulatory system may be a key factor in the transition to continued post operative pain. Funding: #AR055899 NIAMS/NIH." @default.
- W2021242512 created "2016-06-24" @default.
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- W2021242512 date "2012-04-01" @default.
- W2021242512 modified "2023-09-23" @default.
- W2021242512 title "Investigation of central pain processing in post-operative shoulder pain" @default.
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