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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Offset analgesia is increased intra-orally.

Tibor M Szikszay1, Juliette L M Lévénez1, Wacław M Adamczyk1,2

  • 1Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Institute of Health Sciences, Universität zu Lübeck, Lübeck, Germany.

Journal of Oral Rehabilitation
|July 16, 2022
PubMed
Summary

Offset analgesia (OA), a measure of pain inhibition, was significantly enhanced in the mouth and forearm compared to the palm. This suggests peripheral mechanisms play a key role in intra-oral pain modulation.

Keywords:
glabrousintra-oralmucosaoffset analgesiapain modulationtrigeminal

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Area of Science:

  • Neuroscience
  • Pain Research
  • Human Physiology

Background:

  • Offset analgesia (OA) quantifies endogenous pain inhibition.
  • The influence of afferent inputs and peripheral factors on OA mechanisms remains unclear.

Purpose of the Study:

  • To compare the magnitude of OA across different body areas.
  • Investigate OA in glabrous/non-glabrous skin, trigeminal/extra-trigeminal areas, and intra-/extra-oral tissues.

Main Methods:

  • Assessed OA at oral mucosa, cheek, forearm, and palm in 32 healthy participants.
  • Used heat stimulation at individualized Pain50 levels with constant and offset trials.
  • Participants continuously rated pain intensity using a computerized visual analogue scale.

Main Results:

  • Significant OA was observed at the oral mucosa, cheek, and forearm.
  • No significant OA response was detected at the palm.
  • OA magnitude differed significantly between cheek and mucosa, and palm and mucosa.

Conclusions:

  • Intra-oral endogenous pain inhibition, measured by OA, is enhanced.
  • Peripheral mechanisms contribute significantly to the OA response.