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Effect of pain induction or pain reduction on conditioned pain modulation in adults: a systematic review

Dorien Goubert (UGent) , Lieven Danneels (UGent) , Barbara Cagnie (UGent) , Jessica Van Oosterwijck (UGent) , Heleen Noyez and Mira Meeus (UGent)
(2015) PAIN PRACTICE. 15(8). p.765-777
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Abstract
Pain facilitation as well as pain inhibition might be present in chronic pain patients. A decreased efficacy of pain inhibition can be measured by conditioned pain modulation (CPM). The use of the CPM paradigm in scientific research has boosted over the last few years and is recognized for its high clinical relevance in chronic pain patients. It is however unclear whether the presence of pain and possible modulations of pain influences the efficacy of endogenous pain inhibition, measured by CPM. This systematic literature study aimed to provide an overview of the effects of clinical pain and experimental pain induction or pain reduction on CPM in adults. A systematic literature search was conducted in the databases “Pubmed” and “Web of Science”. Only full texts of original studies regarding the effect of clinical pain and experimentally induced pain and pain reduction on CPM in adults were included. The included articles were scored on methodological quality and through a CPM-paradigm. Twelve articles of good to moderate quality were included in this review. Some pain inhibitory medication and oral contraceptives inhibit the CPM mechanism. Removing chronic pain by surgery results in an improved CPM response. This effect is not observed when removing acute pain. Analgesic medication and oral contraceptives might inhibit the CPM response whereas there is limited evidence that pain relieving surgery improves CPM in chronic pain patients. However the results merely suggest that decreased CPM values (as in chronic pain patients) can improve after elimination of pain.
Keywords
chronic pain, NOXIOUS INHIBITORY CONTROLS, clinical pain, Pain inhibition, conditioning stimulus, experimental pain, diffuse noxious inhibitory control, acute pain, CHRONIC-FATIGUE-SYNDROME, LOW-BACK-PAIN, CENTRAL SENSITIZATION, TEMPORAL SUMMATION, 2ND PAIN, HUMANS, OSTEOARTHRITIS, FIBROMYALGIA, STIMULATION

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Citation

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Chicago
Goubert, Dorien, Lieven Danneels, Barbara Cagnie, Jessica Van Oosterwijck, Heleen Noyez, and Mira Meeus. 2015. “Effect of Pain Induction or Pain Reduction on Conditioned Pain Modulation in Adults: a Systematic Review.” Pain Practice 15 (8): 765–777.
APA
Goubert, D., Danneels, L., Cagnie, B., Van Oosterwijck, J., Noyez, H., & Meeus, M. (2015). Effect of pain induction or pain reduction on conditioned pain modulation in adults: a systematic review. PAIN PRACTICE, 15(8), 765–777.
Vancouver
1.
Goubert D, Danneels L, Cagnie B, Van Oosterwijck J, Noyez H, Meeus M. Effect of pain induction or pain reduction on conditioned pain modulation in adults: a systematic review. PAIN PRACTICE. 2015;15(8):765–77.
MLA
Goubert, Dorien, Lieven Danneels, Barbara Cagnie, et al. “Effect of Pain Induction or Pain Reduction on Conditioned Pain Modulation in Adults: a Systematic Review.” PAIN PRACTICE 15.8 (2015): 765–777. Print.
@article{5822369,
  abstract     = {Pain facilitation as well as pain inhibition might be present in chronic pain patients. A decreased efficacy of pain inhibition can be measured by conditioned pain modulation (CPM). The use of the CPM paradigm in scientific research has boosted over the last few years and is recognized for its high clinical relevance in chronic pain patients. It is however unclear whether the presence of pain and possible modulations of pain influences the efficacy of endogenous pain inhibition, measured by CPM. This systematic literature study aimed to provide an overview of the effects of clinical pain and experimental pain induction or pain reduction on CPM in adults. 
A systematic literature search was conducted in the databases “Pubmed” and “Web of Science”. Only full texts of original studies regarding the effect of clinical pain and experimentally induced pain and pain reduction on CPM in adults were included. The included articles were scored on methodological quality and through a CPM-paradigm. 
Twelve articles of good to moderate quality were included in this review. Some pain inhibitory medication and oral contraceptives inhibit the CPM mechanism. Removing chronic pain by surgery results in an improved CPM response. This effect is not observed when removing acute pain. 
Analgesic medication and oral contraceptives might inhibit the CPM response whereas there is limited evidence that pain relieving surgery improves CPM in chronic pain patients. However the results merely suggest that decreased CPM values (as in chronic pain patients) can improve after elimination of pain.},
  author       = {Goubert, Dorien and Danneels, Lieven and Cagnie, Barbara and Van Oosterwijck, Jessica and Noyez, Heleen and Meeus, Mira},
  issn         = {1530-7085},
  journal      = {PAIN PRACTICE},
  keywords     = {chronic pain,NOXIOUS INHIBITORY CONTROLS,clinical pain,Pain inhibition,conditioning stimulus,experimental pain,diffuse noxious inhibitory control,acute pain,CHRONIC-FATIGUE-SYNDROME,LOW-BACK-PAIN,CENTRAL SENSITIZATION,TEMPORAL SUMMATION,2ND PAIN,HUMANS,OSTEOARTHRITIS,FIBROMYALGIA,STIMULATION},
  language     = {eng},
  number       = {8},
  pages        = {765--777},
  title        = {Effect of pain induction or pain reduction on conditioned pain modulation in adults: a systematic review},
  url          = {http://dx.doi.org/10.1111/papr.12241},
  volume       = {15},
  year         = {2015},
}

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