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Bakgrund Smärta är ett stort samhällsproblem som drabbar människor urskillningslöst. Sjukdomen långvarig smärta är komplex och multidimensionell och kan ha många konsekvenser för de påverkade personerna, som sällan är helt smärtfria. Syfte Syftet var att beskriva personers upplevelser av långvarig smärta. Metod Arbetet är en litteraturöversikt med 19 vetenskapliga artiklar av kvantitativa respektive kvalitativa design, med sökning i databaserna CINAHL och PubMed. De kvalitetsgranskades enligt bedömningsunderlaget modifierat utifrån Berg, Dencker och Skärsäter (1999) samt Willman, Stoltz och Bahtsevani (2011). Resultatet kategoriserades sedan enligt vilka aspekter som identifierades: Fysiska konsekvenser, Upplevelser av sjukvården och Psykiska konsekvenser. Dessa kategorier delades sedan upp i underkategorier som presenteras i resultatet. Resultat Personer med långvarig smärta beskriver negativa konsekvenser relaterade till smärta. Fysisk, psykisk och social lidande på grund av långvarig smärta och begränsad förståelse och dåligt bemötande från vårdens sida kan påvisas i artiklarna. Slutsats Smärta och lidande är nära sammankopplat och långvarig smärta är sällan utan lidande. Undermålig vård med okunskap av vårdpersonal ökar lidandet och ökad kunskap behövs inom vården. / Background Long term pain is common and affects people in all walks of life. The disease is very complex and multidimensional and can have many consequences for the people afflicted, who are very rarely completely pain free. Aim The aim was to describe the patient experience of people living with long term pain. Method The method used is literature review with both quantitative and qualitative articles compiled from searches in the databases CINAHL and PubMed. They were put through quality control using assessment bases modified from Berg, Dencker and Skärsäter (1999) as well as Willman, Stoltz and Bahtsevani (2011). The result was then categorised according to what aspects were identified: Physical consequences, Experiences in the Healthcare system and Psychological consequences. These categories were then divided into subcategories presented in the result. Results People living with long term pain describe negative consequences related to their pain. Physical, mental, and social suffering because of long term pain and limited understanding and poor reception from the care system can be shown in the articles. Conclusions Pain and suffering are closely interlinked, and long-term pain is rarely without suffering. Subpar care with ignorance from health care personnel increases suffering and more knowledge is required within the care system.

A psychological intervention involving relaxation training and biofeedback training for the control of peripheral skin temperature was investigated in this study with 27 female rheumatoid arthritics as participants. Based on analysis of the temperature data, it was concluded that the biofeedback response was not learned. From electromyographic data, it was concluded that participants did learn to relax. The hypothesis that the two treatment components would have beneficial effects on the physical, functional, and psychological aspects of rheumatoid arthritis was answered partially. No differential effects as a function of biofeedback training were found as the data for the temperature increase and temperature decrease groups were statistically combined in multiple analyses of variance for repeated measures. Although no differential effects were obtained, numerous positive changes were found. Correlated with the relaxation training were decreases in reported subjective units of discomfort, percentage of time hurting, percentage of body hurting, and general severity of pain. Improved sleep patterns were reported as was increased performance of activities of daily living. Reductions were also found in psychological tension, and in the amount of time mood was influenced by the disease. Shifts were not found in imagery, locus of control, and other psychological dimensions. Constitutional improvements were also absent.

Introduction: Cognitive complaints are often reported by patients who also describe chronic pain. Reviews suggest chronic pain is likely to be associated with weaknesses, relative to control groups, in at least some cognitive functions including processing speed, attention, and possibly working memory, but differences between studies obscure the size of effects. Objective: This study provided a quantitative analysis of the magnitude of the association between chronic pain and neurocognitive test performances. Brief literature review is also done to focus on the functional brain changes associated with the chronic pain. Methods: Meta-analysis was performed using the Cochrane, PRISMA guidelines. The analysis included published experimental design and the tests were studied at least 3 times, by different researchers, and the outcomes were combined within the same cognitive test. Tests were excluded when heterogeneity of variance exceeded I2 = 0.60. Pain subgroups were combined. Results: 23 studies met criteria and involved heterogeneous pain populations, or subgroups including back pain, whiplash, and fibromyalgia. Seven tests had sufficient variance homogeneity. Effects sizes (- ve = chronic pain relative weakness) were: Tests measuring the attention such as PASAT and TEA, working memory (WAIS- digit span), executive functions such as Stroop test, TMT showed significant weaker performance on the tests performance, whereas performance on the test of visuospatial abilities such as ROCF and Corsi block test and WCST test, did not showed significant association. Conclusions: Chronic pain was associated with statistically significant performance reductions. The pattern suggests that chronic pain is associated with poorer performance in at least some tasks requiring processing speed, attention, working memory and learning. Differences between pain and control groups ranged from about 1/3 standard deviation to just under a full standard deviation. Too little research is available on non-verbal memory and executive functions in chronic pain. / Thesis / Master of Science (MSc)

Context: Chronic ankle instability (CAI) individuals experience residual symptoms including pain, swelling, ankle instability, etc. A small majority of CAI individuals report ankle pain during daily or physical activity. Despite the known negative effects of chronic pain on neuromuscular control, there is a paucity of research exploring the specific impact of chronic pain mechanisms on altered neuromuscular control in CAI individuals. Purpose: The purpose of this study was to identify the effects of pain levels on static and dynamic postural control and visual reliance in CAI individuals. Methods: A total of 60 participants were recruited, consisting of 20 CAI individuals with high pain, 20 CAI individuals with low pain, and 20 healthy controls. Participants performed static postural control with eyes open and closed, the star excursion balance test (SEBT), and single-leg hop stabilization. One-way ANOVA assessed differences in Romberg ratios, SEBT, dynamic postural stability index, and self-reported outcomes. Two-way ANOVA (3x2) was used to assess differences in static postural control across the three groups. Results: The high pain group showed decreased mediolateral (ML) direction of static postural stability in eyes closed and a higher Romberg ratio in ML direction compared to the low pain group. The high pain group showed decreased reach distance and increased dynamic postural control in vertical and dynamic postural stability index compared to the healthy control group and low pain group, respectively. Conclusions: The levels of chronic pain can have a significant impact on both static and dynamic postural control and visual reliance in CAI individuals. Therefore, fluctuating chronic pain levels may result in alterations in motor outcomes.