APS Press Room
News Highlights from The Journal of Pain • July 2006
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
COPING, PAIN SEVERITY, INTERFERENCE AND DISABILITY: THE POTENTIAL MEDIATING AND MODERATING ROLES OF RACE AND EDUCATION
Study Shows Race and Education Influences Pain Coping Ability
Annmarie Cano, Ainoa Mayo and Matthew Ventimiglia Wayne State University, Detroit
GLENVIEW, Ill., July 26, 2006 – This study examined the roles of race and education as pain-coping variables. Coping strategies are based on the individual’s judgments of pain as a threat as well as perceived ability to deal with pain. Pain and coping can affect long-term functional disability, and changes in coping are related to improved psychological and physical functioning. Some studies have shown racial differences in pain coping strategies, as African Americans report using prayer and hoping more than Caucasians to cope with pain. To date, the role of education in this relationship has been uncertain.
The authors recruited 105 diverse subjects with chronic pain and their spouses to examine the role of education in pain coping. Participants completed the Coping Strategies Questionnaire, Multidimensional Pain Inventory and the Sickness Impact Profile. Results showed the African Americans in the sample reported significantly more pain severity, interference and disability. They also reported using attention diversion, prayer and hoping strategies more often than Caucasian subjects. However, only the differences in prayer and hoping remained when controlled for education, and there were significant differences in reported physical and psychosocial disability.
The authors concluded that race and education should be considered together when evaluating the ability to cope with pain.
INTENSITY DEPENDENCE OF AUDITORY-EVOKED CORTICAL POTENTIAL IN FIBROMYALGIA PATIENTS: A TEST OF THE GENERALIZED HYPERVIGILANCE HYPOTHESIS
Serotonin Response Could Play Role in Treating Fibromyalgia Pain
M.T. Carrillo-de-le-Pena, M. Vallet. M.I. Perez and C. Gomez-Perretta University of Santiago Compostella, Spain
Clinical studies have shown that fibromyalgia patients have impaired noise tolerance and prefer lower levels of external stimulation than control subjects. Recent studies have shown mixed results ranging from generalized increased sensitivity to stimuli to hypersensitivity restricted to tender points. A concern is the lack of accepted, robust measures of hypervigilance, which most often has been characterized on the basis of subjective ratings of aversion to non-painful stimulation. There is evidence showing migraine patients are hyper-sensitive to auditory evoked potentials (AEPs) elicited by tones of increasing intensity, but no studies have applied this methodology to fibromyalgia patients.
The authors hypothesized that fibromyalgia patients may be hypervigilant to sensory stimuli, especially when loud tones are used. Further, a generalized hypervigilance to painful and non-painful sensations may be at the root of this disorder. For this study, the researchers examined 27 fibromyalgia patients and 25 control subjects.
Results showed the difference in sensitivity to the increasing tones among fibromyalgia patients was concentrated almost entirely at the highest sound levels. The authors concluded that since stronger tone sensitivity has been related to weak serotonergic transmission, the response of fibromyalgia patients to intense auditory stimuli may be due to a serotonergic deficit. These findings may be useful in guiding pharamcological treatment of fibromyalgia.
COMPARISON OF CLINICAL AND EVOKED PAIN MEASURES IN FIBROMYALGIA
Study Questions Validity of “Tender Points” in Diagnosing Fibromyalgia
Richard E. Harris, Richard H. Gracely, Samuel A McLean, David A. Williams, Thorsten Giesecke, Frank Petzke, Ananda Sen and Daniel J. Clauw University of Michigan
Fibromyalgia affects up to 4 percent of the US population and is characterized by chronic diffuse pain. According to diagnostic criteria developed years ago, patients must report widespread spontaneous pain and have 11 to 18 “tender points” in various parts of the body. However, there have been several studies disputing the validity of the tender point diagnostic concept in clinical practice. For example, does having less than 11 tender points preclude a fibromyalgia diagnosis? Although early studies suggested that fibromyalgia patients had tenderness in discrete areas, it is well established today they have increased pain sensitivity throughout the body. The goal of this study was to compare randomly presented evoked pressure pain assessment and more standard methods in tracking changes in clinical pain.
Sixty-five subjects participating in a clinical trial of the efficacy of acupuncture were evaluated for this study. Although both the evoked and standard pain measures improved during the study, only one of the evoked measures, multiple random staircase stimuli (MRS), improved with acupuncture treatment. With MRS, pressure stimuli are administered from a remote device from which patients are shielded. Subjects, therefore, are not able to anticipate the intensity of the stimuli.
The authors concluded that pressure pain testing that applies stimuli in a random order is associated with improvements in clinical pain, but this association is was not stronger than other experimental techniques.