Beyond biopsychosocial: The keystone mechanism theory of pain

Lawn, Timothy; Sendel, Manon; Baron, Ralf; Vollert, Jan

doi:10.1016/j.bbi.2023.08.018

Cited by 4 publications

(1 citation statement)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, it could be argued that the present nding is in accordance with the novel keystone pain mechanism theory that proposes the existence of essential features which can be assessed e.g. increased somatosensory sensitivity for an individual patient in order to predict treatment response rather than a more non-speci c and complex explanation offered by the bio-psycho-social pain model [70]. This study contributes to the expanding knowledge base on factors in uencing the experience of pain and in the long-term perspective also more individualized pain management.…”

Section: Discussionsupporting

confidence: 84%

Influence of Psychometric and Sleep Quality Features on Painful Mechanical Sensitivity and Pain Modulation in Patients with Temporomandibular Disorders

Salbego,

Conti,

Soares

et al. 2024

Preprint

View full text Add to dashboard Cite

Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. Objective: Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. Materials and Methods: A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls. All participants completed questionnaires characterizing their psychometric profile (anxiety, depression, stress and catastrophizing) and sleep quality, alongside quantitative tests for painful mechanical sensory (mechanical pain threshold (MPT), pressure pain threshold (PPT), and wind-up ratio (WUR)) and conditioned pain modulation (CPM). Participants were grouped into "High distress" or "Low distress" categories based on psychometric properties and sleep quality using hierarchical cluster and k-means analyses. Multiple linear regression evaluated the influence of TMD, age, and the distress cluster on MPT, WUR, PPT, and CPM in masseter and thenar muscles. Differences were statistically significant when p<0.05. Results: The presence of TMD was the strongest predictor of mechanical painful sensitivity in the trigeminal region (MPT[F(3,174)=51.902;p<,001;adjusted R2=,463]; TMD presence (β=-,682) / PPT[F(3,174)=15.573;p<,001;adjusted R2=,198] TMD presence (β=-,452), and extra-trigeminal (MPT[F(3,174)=35.897;p<,001;adjusted R2=,382] TMD (β=-,647) / CPM [F(3,174)=4.106;p<,05;adjusted R2=,050] TMD presence (β=,197). Conclusions: There is not a significant influence of impairment clusters based on psychological variables and sleep quality on painful mechanical sensitivity and pain modulation, regardless of the presence of TMD. Clinical relevance: This outcome suggests that psychosocial factors and sleep quality may not play a decisive role in the sensory-discriminative aspect of pain, particularly concerning painful TMD.

show abstract

Section: Discussionsupporting

confidence: 84%