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1.  Peripheral and central mechanisms of chronic musculoskeletal pain 
Pain management  2013;3(2):103-107.
PMCID: PMC3913277  PMID: 24504260
2.  Psychological evaluation of a primary headache patient 
Pain management  2013;3(1):19-25.
A patient’s experience with headache is influenced, not only by the frequency and pain of the attacks, but also by the patient’s perception of the controllability of the attacks, their willingness to engage in activities despite attacks and their attitude towards the medications used to treat the headaches. Clinicians are often aware of the need to evaluate their patients for the existence of comorbid psychiatric disorders but may be less aware of the importance of these nonpathological beliefs/attitudes that are present to some degree in every headache sufferer. This article gives an overview (by no means exhaustive) of several important psychological constructs, with an emphasis on how these constructs can be assessed in headache patients using freely available paper–pencil questionnaires.
PMCID: PMC3570172  PMID: 23418407
3.  The ripple effect: systems-level interventions to ameliorate pediatric pain 
Pain management  2012;2(6):593-601.
The focus of this brief review is to highlight to the reader some of the ‘ripple effects’ of broader systems-level healthcare issues and the implications they may have for effective treatment of pediatric chronic pain. Many healthcare providers focus almost exclusively on the patient, but lack the knowledge of how to intervene effectively at systems levels with families, schools and healthcare institutions surrounding the pediatric patient with pain. We provide a case example and consider this issue across three systems that are particularly relevant to pediatric pain management: the outpatient pain clinic, school and inpatient settings. The information presented will improve the healthcare provider’s ability to effectively treat pediatric pain through an enhanced understanding of the multiple systems of care that surround children with pain.
PMCID: PMC3609659  PMID: 23544034
4.  The making of a pediatric pain psychologist: education, training and career trajectories 
Pain management  2012;2(5):499-507.
Currently, there are no standard guidelines for the training of pediatric pain psychologists. This article is intended for pediatric pain medicine trainees and faculty in the USA and Canada, and includes discussion of the professional roles and responsibilities of pediatric pain psychologists, a historical perspective on the role of psychologists in the field of pediatric pain medicine, and career trajectories and recommendations for training of pediatric pain psychologists. The primary aim of this commentary is to provide a starting point for the standardization of training of pediatric pain psychologists in the future.
PMCID: PMC3546509  PMID: 23335947
6.  Ethnic differences in pain and pain management 
Pain management  2012;2(3):219-230.
Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers’ treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes.
PMCID: PMC3654683  PMID: 23687518
7.  The brain in chronic pain: clinical implications 
Pain management  2011;1(6):577-586.
This article examines the present, and potential future, impact of brain imaging on chronic pain. It is argued that novel theories of chronic pain are coming to the fore, specifically through brain imaging of the human brain in chronic pain. Such studies show that the brain reorganizes in relation to chronic pain, in a pattern specific to the type of clinical pain, and that brain networks and receptor targets are being identified and reverse translated to animal studies of their efficacy and mechanisms. Future studies need to integrate across human brain imaging techniques, as well as more intensive reverse translational methods.
PMCID: PMC3226814  PMID: 22140414
8.  Gene Therapy for Pain: A Perspective 
Pain management  2011;1(5):379-381.
PMCID: PMC3313471  PMID: 22461859
9.  Virtual reality and pain management: current trends and future directions 
Pain management  2011;1(2):147-157.
Virtual reality (VR) has been used to manage pain and distress associated with a wide variety of known painful medical procedures. In clinical settings and experimental studies, participants immersed in VR experience reduced levels of pain, general distress/unpleasantness and report a desire to use VR again during painful medical procedures. Investigators hypothesize that VR acts as a nonpharmacologic form of analgesia by exerting an array of emotional affective, emotion-based cognitive and attentional processes on the body’s intricate pain modulation system. While the exact neurobiological mechanisms behind VR’s action remain unclear, investigations are currently underway to examine the complex interplay of cortical activity associated with immersive VR. Recently, new applications, including VR, have been developed to augment evidenced-based interventions, such as hypnosis and biofeedback, for the treatment of chronic pain. This article provides a comprehensive review of the literature, exploring clinical and experimental applications of VR for acute and chronic pain management, focusing specifically on current trends and recent developments. In addition, we propose mechanistic theories highlighting VR distraction and neurobiological explanations, and conclude with new directions in VR research, implications and clinical significance.
PMCID: PMC3138477  PMID: 21779307
10.  Assessing pain in preterm infants in the neonatal intensive care unit: moving to a ‘brain-oriented’ approach 
Pain management  2011;1(2):171-179.
Preterm infants in the neonatal intensive care unit undergo repeated exposure to procedural and ongoing pain. Early and long-term changes in pain processing, stress-response systems and development may result from cumulative early pain exposure. So that appropriate treatment can be given, accurate assessment of pain is vital, but is also complex because these infants' responses may differ from those of full-term infants. A variety of uni- and multidimensional assessment tools are available; however, many have incomplete psychometric testing and may not incorporate developmentally important cues. Near-infrared spectroscopy and/or EEG techniques that measure neonatal pain responses at a cortical level offer new opportunities to validate neonatal pain assessment tools.
PMCID: PMC3161414  PMID: 21874145
11.  Pain charts (body maps or manikins) in assessment of the location of pediatric pain 
Pain management  2011;1(1):61-68.
This article surveys the use of pain charts or pain drawings in eliciting information about the location of pain symptoms from children and adolescents. While pain charts are widely used and have been incorporated in multidimensional pediatric pain questionnaires and diaries, they present a number of issues requiring further study. These include, in particular, the number and size of different locations or areas of pain that need to be differentiated; the age at which children are able to complete pain charts unassisted; and whether the intensity and other qualities of pain can be accurately recorded on pain charts by children and adolescents. Based on data currently available, it is suggested that the unassisted use of pain charts be restricted to children aged 8 years or over, while for clinical purposes many younger children can complete pain charts with adult support. Where the investigator’s interest is restricted to a few areas of the body, checklists of body parts may have greater utility than pain charts. A new pain chart adapted for use in studies of pediatric recurrent and chronic pain is presented.
PMCID: PMC3091382  PMID: 21572558

Results 1-11 (11)