Browsing by Subject "Chronic pain"

Now showing 1 - 4 of 4
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    Chronic Pain
    (2010-07-21) Aaron, Ashley E
    Chronic, non-cancer pain is defined as pain of at least 3 months. Chronic pain is a common health issue that effects anywhere from 20-60% of Americans and accounts for $61 billion in lost productivity time in this country alone. It is often undertreated due to the complexity and controversy surrounding management with chronic opioid analgesics. Chronic pain is often accompanied by psychosocial co-morbidities, most notably depression, that further complicates its treatment. Chronic pain is often best addressed by a multi-disciplinary team that closely monitors each patient individually. While the use of opioid analgesics poses some risks, when managed properly, the extreme improvement in patient quality of life that can be obtained often far outweigh the risk.
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    Functional Multimodal Imaging Of Sickle Cell Disease Patients To Understand How Chronic Pain Affects Neural Dynamics Of Patients
    (2018-05) Case, Michelle
    Sickle cell disease (SCD) is a red blood cell disorder that causes many complications including life-long pain. Pain is the most common reason for hospitalization in SCD patients and is often experienced on a daily basis. Treatment of pain in SCD patients remains challenging due to a poor understanding of the mechanisms, especially in the brain. Therefore, an in-depth analysis of how chronic pain affects SCD patients is needed to provide a foundation for future research and improved treatment options. The goal of this research is to use multimodal non-invasive imaging techniques to better understand the neural dynamics of SCD patients and how these differ from a normal healthy brain. Utilizing both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) allowed spatiotemporal analysis of resting state neural behavior of SCD patients and healthy controls. This work includes (1) a simultaneous EEG-fMRI study to determine biomarkers of sickle pain and how resting state networks are altered in patients, (2) an EEG analysis utilizing EEG power and electrical source imaging analysis to classify between patients and controls, and (3) a graph theory study using both EEG and fMRI to understand the global impact of sickle pain on the brain and to utilize imaging to detect differences not only between patients and controls, but also between patients with more severe chronic pain and less severe chronic pain. This study showed how imaging parameters found from non-invasive imaging modalities are related to chronic pain in SCD patients and will be used in future work to guide new treatment options and validate their effectiveness on improving brain dynamics.
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    Yoga for chronic pain in veterans: A mixed methods study
    (2018-05) Donaldson, Melvin
    Yoga is an increasingly common practice used in the management of chronic pain, largely due to its safety and demonstrated effectiveness as an adjunctive treatment. There are important challenges to understanding the effect of yoga on chronic pain, notably yoga is rarely used in isolation and the specific content of yoga interventions varies widely between studies. Additionally, yoga and complementary practices in general are under-described in veteran populations even though veterans are more highly engaged with complementary practices than civilians. This dissertation seeks to inform the evidence base of veterans who practice yoga in three ways. First, I estimate the cross-sectional association between yoga practice and disability among veterans with pain using propensity score-matching. Yoga practice is not associated with a difference in prevalence of disability. Second, I identify differences in yoga practice between veterans with chronic pain and veterans without chronic pain. A mixed methods approach is employed with a qualitative strand that builds upon the quantitative strand to explain the differences observed. This analysis shows that yoga practitioners with chronic pain are regularly using self-directed practices more frequently than yoga practitioners without chronic pain. Interviews with study participants identify convenience as a facilitator of self-directed practice and feeling self-conscious as a barrier to instructor-led group practice among practitioners with chronic pain. Finally, I describe patterns of use of 19 different non-pharmacological health approaches among all members of the sample to show how modalities are being used in integrated ways. This dissertation makes several important contributions. I piloted of a self-report instrument for describing yoga practice, the Essential Properties of Yoga Questionnaire, and a self-report instrument of use of non-pharmacologic therapies, the Health Practices Inventory. Both instruments are ready for use by others. Also, I provide a detailed description of how veterans with pain are using and experiencing yoga.