APS Press Room
News Highlights from The Journal of Pain • July 2008
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
Study Links Herpes with Widespread Neuropathic Pain
GLENVIEW, IL, July 17, 2008—Reactivation of genital herpes is linked in some cases with the emergence of widespread neuropathic pain, according to a Finnish study reported in The Journal of Pain.
In the clinic at the University of Helsinki, 17 patients were examined who presented widespread chronic pain with no visible lesions in brain magnetic imaging. Because the majority had herpes simplex virus (HSV) infections, the researchers studied a possible association between herpes and neuropathic pain. They hypothesized that in HSV-positive patients, the active virus may alter pain processing at different levels of the central nervous system (CNS).
Results of the study showed 80 percent of the patients reported at least moderate pain relief with anti-herpetic medication, and in more than half there was positive correlation between the activity of the HSV infection and pain.
The authors concluded that a CNS dysfunction is the most likely explanation for the widespread pain. Latency and possible activations of the herpes virus in brain areas involved in pain processing might cause functional changes in the pain matrix, even if there are no detectable lesions in anatomical MRI. Further, the strong inflammatory reactions in the CNS caused by activation of the virus may sensitize nerves at different levels.
Source: Widespread Unilateral PainAssociated with Herpes Simplex Virus; Katarina Kallio-Laine, Mikko Seppanen, Marja-Liisa Lokki, Maija Lappalainen, Irma-Leena Notkola, Ilkka Seppala, Mika Koskinen, Ville Valtonen, and Eija Kalso; Haartman Institute, University of Helsinki
PTSD Influences Levels of Depression and Pain
Patients with accident or trauma related chronic pain often have post-traumatic stress disorder (PTSD) and depression. What isn't clearly known, however, is how PTSD relates to mood disorders and pain severity in chronic pain patients.
University of Michigan researchers examined the contribution of PTSD to the pain experience, functional disability and frequency of depressive symptoms. They studied 241 patients referred to the university hospital's pain rehabilitation program who reported their pain began after a traumatic injury. The subjects completed the McGill Pain Questionnaire and were administered the Pain Disability Index and the Post-traumatic Chronic Pain Test.
Results showed PTSD and depression are significantly correlated and both disorders are associated with perceived disability attributed to chronic pain. Therefore, in cases of disabling accident-related chronic pain with comorbid depression, symptoms of PTSD may be critical to understanding both disorders. The authors concluded that increased attention to treating PTSD as a primary focus in the rehabilitation of patients with chronic pain and comorbid depression is important when prior treatment efforts for pain and depression have not been successful.
Source: The Relation of Post-traumatic Stress Symptoms to Depression and pain in Patients with Accident-related Chronic Pain; Randy S. Roth, Michael E. Geisser and Rachel Bates; University of Michigan, Ann Arbor
Personal Motivation Helps Pain Coping in the Disabled
Spinal cord injury victims and others with long term physical disabilities usually suffer chronic pain that cannot be relieved with pharmacologic interventions. Research has suggested that patient motivation to engage in adaptive pain coping strategies, such as exercise and task persistence, can determine the overall impact of pain on quality of life.
University of Washington researchers tested the Motivational Model of Pain Self Management on 130 individuals with spinal cord injuries who completed surveys, including the Multi- dimensional Pain Readiness to Change Questionnaire. They hypothesized that assessment of a patient's readiness to engage in self management may have important implications for cognitive- behavioral and other interventions for pain.
Results showed the vast majority of the spinal cord injury patients believed that exercise was important to them for pain management, and their readiness to change was positively associated with self-reports of exercise regimens. The authors believe their findings could aid clinicians in identifying factors that influence patient motivation to self-manage pain.
Source: A Preliminary Evaluation of the Motivational Model of Pain Self Management in Persons with Spinal Cord Injury Related Pain; Ivan R. Molton, Mark P. Jensen, Warren Nielson, Diana Cardenas and Dawn M. Ehde; University of Washington, Seattle