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Runge N, Ahmed I, Saueressig T, Perea J, Labie C, Mairesse O, Nijs J, Malfliet A, Verschueren S, Van Assche D, de Vlam K, Van Waeyenberg T, Van Haute J, De Baets L. The bidirectional relationship between sleep problems and chronic musculoskeletal pain: a systematic review with meta-analysis. Pain 2024:00006396-990000000-00613. [PMID: 38809241 DOI: 10.1097/j.pain.0000000000003279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024]
Abstract
ABSTRACT Chronic musculoskeletal pain and sleep problems/disorders exhibit a recognized bidirectional relationship; yet, systematic investigations of this claim, particularly in a prospective context, are lacking. This systematic review with meta-analysis aimed to synthesize the literature on the prospective associations between sleep problems/disorders and chronic musculoskeletal pain. A comprehensive search across 6 databases identified prospective longitudinal cohort studies in adults examining the relationship between sleep problems/disorders and chronic musculoskeletal pain. Random-effects meta-analyses, using the Hartung-Knapp adjustment for 95% confidence intervals (CIs), were conducted, and all results were presented as odds ratios (ORs). Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Including 16 articles from 11 study populations (116,746 participants), meta-analyses indicated that sleep problems at baseline may heighten the risk of chronic musculoskeletal pain in both short term (OR 1.64, 95% CI 1.01-2.65) and long term (OR 1.39, 95% CI 1.21-1.59). The evidence for different sleep problem categories was very uncertain. Chronic musculoskeletal pain at baseline may increase the risk of short-term sleep problems (OR 1.56, 95% CI 1.02-2.38), but long-term evidence was very uncertain. The impact of only local or only widespread pain on short-term sleep problems was very uncertain, whereas widespread pain may elevate the risk of long-term sleep problems (OR 2.0, 95% CI 1.81-2.21). In conclusion, this systematic review with meta-analysis suggests that sleep problems are associated with an increased risk of chronic musculoskeletal pain, but the bidirectional nature of this relationship requires further investigation.
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Affiliation(s)
- Nils Runge
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
- Brain, Body and Cognition (BBCO), Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ishtiaq Ahmed
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Julya Perea
- Department of Physical Therapy, Federal University of São Carlos, São Paulo, Brazil
| | - Celine Labie
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Olivier Mairesse
- Brain, Body and Cognition (BBCO), Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Laboratoire de Psychologie Médicale et d'Addictologie (ULB312), Department of Psychiatry, Brugmann University Hospital, Université Libre de Bruxelles (ULB) and Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Sabine Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Kurt de Vlam
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
- Skeletal Biology & Engineering Research Center, Department of Development & Regeneration, KU Leuven, Belgium
| | - Tybo Van Waeyenberg
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Jelle Van Haute
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
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Licciardone JC, Ibrahim M, Baker J, Thornton T, Vu S. Pain catastrophizing and risk of progression to widespread pain among patients with chronic low back pain: A retrospective cohort study. Musculoskelet Sci Pract 2024; 69:102886. [PMID: 38096594 DOI: 10.1016/j.msksp.2023.102886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Chronic low back pain often progresses to widespread pain. Although many factors are associated with progression, their roles in contributing to chronic widespread pain (CWP) are often unclear. OBJECTIVE To determine if pain catastrophizing is an independent risk factor for CWP. DESIGN Retrospective cohort study within a national pain research registry from April 2016 through August 2022. METHODS A total of 1111 participants with chronic low back pain, but without CWP, were included. Participants were followed at quarterly intervals for up to 48 months to measure CWP risk. Survival analyses involved Kaplan-Meier plots and the Cox proportional hazards model to measure CWP risk according to pain catastrophizing and subscale scores for rumination, magnification, and helplessness. RESULTS Crude CWP risks for moderate pain catastrophizing (HR, 2.13; 95% CI, 1.54-2.95; P < 0.001) and high pain catastrophizing (HR, 3.98; 95% CI, 2.95-5.35; P < 0.001) were each elevated in comparison with low pain catastrophizing. Adjusted CWP risks for moderate pain catastrophizing (HR, 1.80; 95% CI, 1.27-2.53; P < 0.001) and high pain catastrophizing (HR, 2.82; 95% CI, 1.98-4.02; P < 0.001) remained elevated in analyses that controlled for potential confounders. Corresponding results were observed in the survival analyses involving rumination, magnification, and helplessness. CONCLUSIONS Pain catastrophizing appears to be an independent risk factor for progression to CWP among patients with chronic low back pain. These findings provide a rationale for interventions aimed at reducing pain catastrophizing, including rumination, magnification, and helplessness, among patients with chronic low back pain.
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Affiliation(s)
- John C Licciardone
- Department of Family Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA.
| | - Mira Ibrahim
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Joshua Baker
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Tyler Thornton
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Stephanie Vu
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Vikan KK, Landmark T, Gjeilo KH. Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study. Eur J Pain 2024; 28:273-284. [PMID: 37680005 DOI: 10.1002/ejp.2176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Pain in chronic heart failure (HF) is a significant but often unrecognized symptom. Characteristics of pain in subjects with HF are largely undescribed. The study aimed to address a knowledge gap in the relationship between HF and pain by investigating the prevalence of chronic pain and chronic widespread pain (CWP) among subjects with HF. METHODS Population data from the HUNT3 study in Norway (2006-2008, n = 50,802) was used. HF was measured by self-report. CWP was defined as having pain in both sides of the body, pain in the upper and lower limbs, and axial pain for at least 3 months in the last year. Associations between HF and CWP and HF and moderate to high pain intensity were analysed with logistic regression. RESULTS Among subjects with HF in the general population, the prevalence of chronic pain was 67.8%, 20.7% had CWP, and 58.8% had moderate to high intensity pain. Compared to participants with cardiovascular disease but not HF, the odds of both CWP (OR = 1.6; 95% CI: 1.3-2.0) and moderate to high intensity pain (OR = 1.3; 95% CI: 1.3-1.8) were higher among participants with HF-controlled for age, sex, body mass index, and comorbidity. CONCLUSIONS Our study confirmed the high prevalence of pain among HF subjects. This pain could not be explained by comorbidity or sociodemographic factors, which are relevant for clinical and research purposes. Pain management should not be restricted to cardiac-related pain but to chronic pain in general. SIGNIFICANCE This epidemiological study corroborates previous studies reporting a high prevalence of pain in the HF-population. We found that the relationship between HF, CWP, and pain intensity could not be explained by comorbidity or sociodemographic factors, illustrating the burden of chronic pain related to HF. Our results expand the understanding of pain in HF and highlight the need to identify and manage chronic pain among individuals with HF, as widespread pain adds to the symptom burden in individuals with HF.
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Affiliation(s)
- K K Vikan
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- The Norwegian Registry for Vascular Surgery (NORKAR), Department of Medical Quality Registries, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - T Landmark
- Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - K H Gjeilo
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Costa ABP, Machado LAC, Telles RW, Barreto SM. Obesity and the risk of multiple or severe frequent knee pain episodes: a 4-year follow-up of the ELSA-Brasil MSK cohort. Int J Obes (Lond) 2024; 48:65-70. [PMID: 37726404 DOI: 10.1038/s41366-023-01383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/24/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND/OBJECTIVE Knee pain is an important health problem due to its high prevalence, negative impact on daily activities and quality of life, and societal burden. While the link between excess weight and knee pain has been well-documented in the literature, many studies are limited to patients with osteoarthritis or use cross-sectional data. This longitudinal study investigated whether overweight and obesity were associated with the frequency and severity of frequent knee pain (FKP) episodes over 4 years in civil servants enrolled in the ELSA-Brasil MSK cohort. METHODS Knee pain was assessed during baseline face-to-face interviews (2012-2014) and four yearly telephone follow-ups (2015-2019). Disabling FKP episodes or those of moderate to very severe intensity were classified as severe. Multinomial logistic regression models adjusted for confounders were used to test for associations in two participant groups: those with knee pain at baseline (prognosis cohort) and those without knee pain (incidence cohort). RESULTS A total of 2644 participants were included: 54.2% female, mean age 55.8 (SD 8.8) years. In the incidence cohort (n = 1896), obesity increased the risk of one (OR: 1.63; 95% CI 1.13-2.37) and multiple FKP episodes (OR: 2.61; 95% CI 1.71-3.97), as well as the risk of non-severe (OR: 1.72; 95% CI 1.04-2.84) and severe FKP episodes (OR: 2.10; 95% CI 1.50-2.95). In the prognosis cohort (n = 748), obesity increased the risk of multiple (OR: 2.54; 95% CI 1.60-4.05) and severe FKP episodes (OR: 2.31; 95% CI 1.49-3.59). Overweight presented the same trends but fell short of significance. CONCLUSIONS These results provide further support that overweight and obesity are important contributors to the incidence and worsening of FKP, and that weight management must be prioritized in multidisciplinary knee pain prevention and treatment programs to reduce the burden of musculoskeletal disorders.
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Affiliation(s)
- Aline Bárbara Pereira Costa
- Post-graduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luciana A C Machado
- Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rosa Weiss Telles
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Rheumatology Service, Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sandhi Maria Barreto
- Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
- Department of Preventive Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Benebo FO, Lukic M, Jakobsen MD, Braaten TB. Lifestyle risk factors of self-reported fibromyalgia in the Norwegian Women and Cancer (NOWAC) study. BMC Public Health 2023; 23:1967. [PMID: 37821848 PMCID: PMC10566054 DOI: 10.1186/s12889-023-16773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND While the aetiology of fibromyalgia syndrome (FM) remains unknown, lifestyle factors have been linked to the disorder. However, there are few studies on the association between lifestyle factors and FM, thus we examine the risk of self-reported fibromyalgia given selected lifestyle factors. METHODS We used data from 75,485 participants in the Norwegian Women and Cancer study. Information on FM and the lifestyle factors body mass index (BMI), physical activity level, smoking status/intensity, and alcohol consumption were obtained from baseline and follow-up questionnaires. We used Cox proportional hazards model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS After a median follow-up time of 10 years, we observed 2,248 cases of self-reported fibromyalgia. Overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women had a relative risk of 1.34 (95% CI 1.21-1.47) and 1.62 (95% CI 1.41-1.87), respectively, compared to women with normal weight (BMI 18.5-24.9 kg/m2). Very low physical activity level (1-2) was associated with a 31% higher risk of self-reported fibromyalgia (HR 1.31, 95% CI 1.09-1.57) when compared to moderate physical activity level (5-6). There was a strong dose-response relationship between smoking status/intensity and self-reported fibromyalgia (p for trend < 0.001). Compared with moderate alcohol consumption (4.0-10 g/day), the risk of self-reported FM was 72% (HR 1.72; 95% CI 1.45-2.03) higher among teetotallers, and 38% (HR 1.38, 95% CI 1.23-1.54) higher among those with low consumption (0.1-3.9 g/day). CONCLUSIONS Overweight and obesity, very low physical activity level, smoking, and alcohol consumption were associated with an increased risk of self-reported FM.
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Affiliation(s)
- Faith Owunari Benebo
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Marko Lukic
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Gerdle B, Dragioti E, Rivano Fischer M, Dong HJ, Ringqvist Å. Catastrophizing and acceptance are mediators between insomnia and pain intensity-an SQRP study of more than 6,400 patients with non-malignant chronic pain conditions. FRONTIERS IN PAIN RESEARCH 2023; 4:1244606. [PMID: 37828972 PMCID: PMC10565667 DOI: 10.3389/fpain.2023.1244606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/05/2023] [Indexed: 10/14/2023] Open
Abstract
Background Sleep problems (insomnia) and chronic pain are associated. Chronic pain and insomnia/insufficient sleep quality share similar symptoms and features. Although they have a bidirectional relationship, more research is needed to understand how they interact via mediators and how moderators influence this relationship. Aims In this large clinical registry-based cohort study (N = 6,497), we investigate important mediators between insomnia and pain intensity in a cross-sectional sample of chronic pain patients using advanced path analysis. In addition, we investigate whether some background variables were moderators of the identified important paths or not and the correlation patterns between insomnia and pain intensity in relation to the mediators. Methods This study includes a cohort of adult patients with chronic non-cancer pain from the Swedish Quality Registry for Pain Rehabilitation (SQRP) with data on patient-reported outcome measures (PROMs) (2008-2016). The PROMs cover the background, pain aspects, psychological distress, pain-related cognitions, activity/participation, and health-related quality of life variables of the patients. Partial least squares structural equation modeling was used to explore the direct and indirect (via mediators) relationships between insomnia and pain intensity at baseline. Results In this cohort study, insomnia was prevalent at 62.3%, and both direct and indirect mediating paths were present for the insomnia-pain intensity relationship. All of the mediating effects combined were weaker than the direct effect between insomnia and pain intensity. The mediating effects via catastrophizing and acceptance showed the strongest and equal mediating paths, and mediating effects via fear avoidance were the second strongest. Insomnia showed stronger direct significant correlations with psychological distress, catastrophizing, and acceptance compared with those of pain intensity. Sex, age, education level, spatial extent of pain, or body mass index did not moderate the mediating paths. Discussion and conclusion This study confirms the existence of significant direct and mediating paths between reported insomnia and pain intensity. Future studies should focus on illuminating how sleep interventions influence pain intensity and other important key factors that contribute to the distress of chronic pain patients.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Elena Dragioti
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Åsa Ringqvist
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
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Santos M, Gabani FL, de Andrade SM, Bizzozero-Peroni B, Martínez-Vizcaíno V, González AD, Mesas AE. The bidirectional association between chronic musculoskeletal pain and sleep-related problems: a systematic review and meta-analysis. Rheumatology (Oxford) 2023; 62:2951-2962. [PMID: 37104741 DOI: 10.1093/rheumatology/kead190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/08/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVES This systematic review and meta-analysis synthesizes the evidence on prospective bidirectional associations between sleep-related problems (SRP) and chronic musculoskeletal pain (CMP). METHODS A literature search for cohort studies available in the PubMed, Scopus, Web of Science, PsycINFO and Cochrane Library databases as of 19 July 2022 was performed. Pooled odds ratios and effect sizes were calculated through random effects meta-analysis. Subgroup and meta-regression analyses were performed to explore differences by follow-up time, proportion of each sex and mean age. The Meta-analysis Of Observational Studies in Epidemiology guidelines were strictly followed. RESULTS Twenty studies with a total of 208 190 adults (aged 34.4-71.7 years) were included, with 17 of them being used in the meta-analysis. Individuals with SRP at baseline had a 1.79-fold higher incidence (odds ratio [OR] = 1.79; 95% CI: 1.55, 2.08; I2 = 84.7%; P < 0.001) and a 2.04-fold higher persistence (OR = 2.04; 95% CI: 1.42, 2.94; I2 = 88.5%; P < 0.005) of CMP than those without SRP. In the subgroup analysis of the association between SRP and CMP, the longer the follow-up time of the studies, the higher the heterogeneity between them. In the corresponding meta-regression, no significant effect was observed for follow-up time, sex proportion or age. Individuals with CMP at baseline had a 2.02-fold higher incidence of SRP (OR = 2.02; 95% CI: 1.62, 2.53; I2 = 90.0%; P < 0.001) than those without CMP. CONCLUSION This study provides robust evidence concerning the longitudinal association between SRP and incidence-persistence of CMP in adults. In addition, the available prospective studies support the existence of a bidirectional relationship between CMP and SRP. PROSPERO REGISTRATION NUMBER CRD42020212360.
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Affiliation(s)
- Mayara Santos
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Flávia L Gabani
- Department of Nursing, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Selma M de Andrade
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Instituto Superior de Educación Física, Universidad de la República, Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Alberto D González
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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Wen YR, Shi J, Hu ZY, Lin YY, Lin YT, Jiang X, Wang R, Wang XQ, Wang YL. Is transcranial direct current stimulation beneficial for treating pain, depression, and anxiety symptoms in patients with chronic pain? A systematic review and meta-analysis. Front Mol Neurosci 2022; 15:1056966. [PMID: 36533133 PMCID: PMC9752114 DOI: 10.3389/fnmol.2022.1056966] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/14/2022] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Chronic pain is often accompanied by emotional dysfunction. Transcranial direct current stimulation (tDCS) has been used for reducing pain, depressive and anxiety symptoms in chronic pain patients, but its therapeutic effect remains unknown. OBJECTIVES To ascertain the treatment effect of tDCS on pain, depression, and anxiety symptoms of patients suffering from chronic pain, and potential factors that modulate the effectiveness of tDCS. METHODS Literature search was performed on PubMed, Embase, Web of Science, and Cochrane Library from inception to July 2022. Randomized controlled trials that reported the effects of tDCS on pain and depression and anxiety symptoms in patients with chronic pain were included. RESULTS Twenty-two studies were included in this review. Overall pooled results indicated that the use of tDCS can effectively alleviate short-term pain intensity [standard mean difference (SMD): -0.43, 95% confidence interval (CI): -0.75 to -0.12, P = 0.007] and depressive symptoms (SMD: -0.31, 95% CI, -0.47 to -0.14, P < 0.001), middle-term depressive symptoms (SMD: -0.35, 95% CI: -0.58 to -0.11, P = 0.004), long-term depressive symptoms (ES: -0.38, 95% CI: -0.64 to -0.13, P = 0.003) and anxiety symptoms (SMD: -0.26, 95% CI: -0.51 to -0.02, P = 0.03) compared with the control group. CONCLUSION tDCS may be an effective short-term treatment for the improvement of pain intensity and concomitant depression and anxiety symptoms in chronic pain patients. Stimulation site, stimulation frequency, and type of chronic pain were significant influence factors for the therapeutic effect of tDCS. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=297693, identifier: CRD42022297693.
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Affiliation(s)
- Yu-Rong Wen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng-Yu Hu
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang-Yang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - You-Tian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Xue Jiang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Yu-Ling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Norman KS, Goode AP, Alvarez C, Hu D, George SZ, Schwartz TA, Danyluk ST, Fillipo R, Kraus VB, Huebner JL, Cleveland RJ, Jordan JM, Nelson AE, Golightly YM. Association of Biomarkers with Individual and Multiple Body Sites of Pain: The Johnston County Osteoarthritis Project. J Pain Res 2022; 15:2393-2404. [PMID: 36000076 PMCID: PMC9393091 DOI: 10.2147/jpr.s365187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Biochemical biomarkers may provide insight into musculoskeletal pain reported at individual or multiple body sites. The purpose of this study was to determine if biomarkers or pressure-pain threshold (PPT) were associated with individual or multiple sites of pain. Methods This cross-sectional analysis included 689 community-based participants. Self-reported symptoms (ie, pain, aching, or stiffness) were ascertained about the neck, upper back/thoracic, low back, shoulders, elbows, wrist, hands, hips, knees, ankles, and feet. Measured analytes included CXCL-6, RANTES, HA, IL-6, BDNF, OPG and NPY. A standard dolorimeter measured PPT. Logistic regression was used determine the association between biomarkers and PPT with individual and summed sites of pain. Results Increased IL-6 and HA were associated with knee pain (OR=1.30, 95% CI 1.03, 1.64) and (OR=1.32, 95% CI 1.01, 1.73) respectively; HA was also associated with elbow/wrist/hand pain (OR=1.60, 95% CI 1.22, 2.09). Those with increased NPY levels were less likely to have shoulder pain (OR=0.56, 95% CI 0.33, 0.93). Biomarkers HA (OR=1.50, 95% CI 1.07, 2.10), OPG (OR=1.74, 95% CI 1.00, 3.03), CXCL-6 (OR=1.75, 95% CI 1.02, 3.01) and decreased PPT (OR=3.97, 95% CI 2.22, 7.12) were associated with multiple compared to no sites of pain. Biomarker HA (OR=1.57, 95% CI 1.06, 2.32) and decreased PPT (OR=3.53, 95% CI 1.81, 6.88) were associated with multiple compared to a single site of pain. Conclusion Biomarkers of inflammation (HA, OPG, IL-6 and CXCL-6), pain (NPY) and PPT may help to understand the etiology of single and multiple pain sites.
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Affiliation(s)
- Katherine S Norman
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Adam P Goode
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Carolina Alvarez
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - David Hu
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Steven Z George
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Todd A Schwartz
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Stephanie T Danyluk
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Rebecca Fillipo
- Duke Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, NC, USA
| | - Virginia B Kraus
- Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
- Duke Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Rebecca J Cleveland
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
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10
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Karimi R, Mallah N, Nedjat S, Beasley MJ, Takkouche B. Association between alcohol consumption and chronic pain: a systematic review and meta-analysis. Br J Anaesth 2022; 129:355-365. [DOI: 10.1016/j.bja.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/27/2022] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
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11
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Poudyal A, Bista B, Gyanwali P, Karki S, Bhattarai S, Sharma S, Dhimal M. Prevalence and factors associated with joint pain in Nepal: findings from a countrywide cross-sectional STEPS survey. BMJ Open 2021; 11:e051536. [PMID: 34615678 PMCID: PMC8496397 DOI: 10.1136/bmjopen-2021-051536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study aims to determine the prevalence of joint pain and its association with demographic, socioeconomic and behavioural factors in Nepal. DESIGN The study was a national cross-sectional population-based study. SETTING We used the most recent nationally representative population-based cross-sectional health survey, The WHO STEPwise approach to surveillance (STEPS) survey, 2019 from all seven provinces of Nepal including both urban and rural areas. PARTICIPANTS The participants were men and women aged 15-69 years, who were usual residents of the households for at least 6 months and have stayed the night before the survey. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome in this study was prevalence of joint pain. The secondary outcome measure was factors associated with joint pain in Nepal. Joint pain in our study was based on any self-reported symptoms of joint pain, stiffness and swelling lasting for more than 1 month in the past 12 months. Data were weighted to generate national estimates. RESULTS The prevalence of self-reported joint pain in Nepal was 17% (95% CI 14.3% to 20.2%) with higher prevalence for older adults, females, ever married, none/less than primary education, smoker, lowest wealth quintile, homemaker, those with sufficient physical activity and those living in the Karnali province of Nepal. In multivariable analysis self-reported joint pain was found to be associated with advanced age (adjusted OR (AOR)=2.36; 95% CI 1.56 to 3.55), sex (AOR=1.47; 95% CI 1.19 to 1.82) and sufficient physical activity (AOR=0.40; 95% CI 0.25 to 0.65). CONCLUSIONS The results showed a high prevalence of joint pain in Nepal. Considering the process of ageing and rapid growth in non-communicable disease, this study warrants the need for health policies directed to prevention, treatment and rehabilitation for people affected by chronic musculoskeletal conditions addressing related disabilities and loss of work in Nepal.
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Affiliation(s)
| | | | | | | | | | - Sweekriti Sharma
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
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12
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de Oliveira Lima L, Saragiotto BT, Costa LOP, Nogueira LC, Meziat-Filho N, Reis FJJ. Self-Guided Web-Based Pain Education for People With Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6309587. [PMID: 34174081 DOI: 10.1093/ptj/pzab167] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/09/2021] [Accepted: 05/30/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effectiveness of web-based pain education programs without clinical support in patients with musculoskeletal pain. METHODS PubMed, Scopus, CINAHL, Web of Science, Cochrane Library, and PsycINFO were searched from inception to February 2020. Included studies were randomized clinical trials in which people with musculoskeletal pain were allocated to an experimental group that received web-based pain education as a standalone approach. Three review authors performed data extraction. The PEDro (Physiotherapy Evidence Database) scale was used to assess the methodological quality of the studies. The primary outcomes were pain intensity and disability. RESULTS Six trials with a total of 1664 participants were included. There is moderate-quality evidence with a small effect size that web-based pain education programs, as a standalone approach, are better than minimal intervention (no intervention or booklets) for pain intensity (standardized mean difference [SMD] = -0.23; 95% CI = -0.43 to -0.04) in the short term and intermediate term (SMD = -0.26; 95% CI = -0.42 to -0.10). Regarding disability, there is low-quality evidence that web-based pain education programs are better than minimal intervention (SMD = -0.36; 95% CI = -0.64 to -0.07) in the short term. Web-based pain education added to usual care was no better than usual care alone in the intermediate or long term for primary outcomes. CONCLUSIONS Web-based pain education for adults with musculoskeletal pain, as a standalone approach, was better than minimal intervention for pain intensity and disability in the short term, and for pain intensity in the intermediate term. Web-based pain education added to usual care did not provide additional benefits for primary outcomes in the intermediate or long term. IMPACT Web-based pain education as a standalone intervention provided small improvements in pain intensity and disability in patients with chronic musculoskeletal pain. Poorly resourced settings and overburdened health systems should consider this delivery method in the management of chronic musculoskeletal pain. LAY SUMMARY If you have chronic musculoskeletal pain, your physical therapist might recommend web-based pain education as treatment to help you reduce pain intensity and disability.
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Affiliation(s)
- Lívia de Oliveira Lima
- Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
| | - Bruno T Saragiotto
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | | | - Leandro Calazans Nogueira
- Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil.,Postgraduation Progam in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Ney Meziat-Filho
- Postgraduation Progam in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Felipe J J Reis
- Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil.,Postgraduation Progam in Clinical Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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13
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Wickrama KAS, Lee TK, O'Neal CW. Heterogeneity in Husbands' and Wives' Physical Pain Trajectories Over Mid-Later Years: Biopsychosocial Stratification and Implications for Later-Life Well-Being. THE GERONTOLOGIST 2021; 61:930-941. [PMID: 33453117 DOI: 10.1093/geront/gnab007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The present study investigated pain trajectories of husbands and wives over their mid-later years, the grouping of these trajectories, and differences in baseline biopsychosocial profiles and health and well-being outcomes in later years across the pain trajectory groups. RESEARCH DESIGN AND METHODS Growth mixture modeling was used to identify latent classes of 244 husbands' and wives' physical pain trajectories over their mid-later years (1994-2015, average ages of 44-65 years). Analyses were conducted to identify how these pain trajectory classes were associated with respondents' biopsychosocial profiles in 1994 and health and well-being in later years (2017 [>67 years]). RESULTS The individual pain trajectories of husbands and wives were clustered into 3 heterogeneous groups with differing trajectory patterns. Nonnormative pain trajectory groups (with either a high pain level and/or persistent pain) were associated with adverse baseline biopsychosocial characteristics. These groups also experienced poorer health and well-being outcomes in later years (2017) compared to those with consistently low pain after controlling for lagged measures in 2015. DISCUSSION AND IMPLICATIONS The identification of pain trajectory groups and characteristics of group members provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions can promote and develop resiliency factors, thereby aiding in the redirection of middle-aged husbands' and wives' adverse pain trajectories.
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Affiliation(s)
- Kandauda A S Wickrama
- Department of Human Development and Family Science, The University of Georgia, Athens, USA
| | - Tae Kyoung Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
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14
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Harvie DS, Vasco D, Sterling M, Low-Choy S, Niederstrasser NG. Psycho-sensory relationships in chronic pain. Br J Pain 2021; 15:134-146. [PMID: 34055335 PMCID: PMC8138622 DOI: 10.1177/2049463720933925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Psychological variables contribute to pain- and injury-related outcomes. We examined the hypothesis that anatomical spread and intensity of persistent pain relate to anxiety-related variables: generalised anxiety, fear of pain and pain catastrophising. METHODS An online survey was used to gather data from 413 women with persistent pain (low back pain, n = 139; fibromyalgia syndrome, n = 95; neck pain, n = 55; whiplash, n = 41; rheumatoid arthritis, n = 37; migraine, n = 46). The spread and intensity of pain were assessed using the McGill pain chart and a Numerical Rating Scale. A Bayesian Structural Equation Model assessed if the intensity and spread of pain increased with anxiety-related variables. Men were also surveyed (n = 80), but the sample size was only sufficient for analysing if their data were consistent with the model for women. RESULTS Across subgroups of women, one standard deviation increase in catastrophising, generalised anxiety and fear corresponded to 27%, 7% and -1% additional pain areas and a 1.1, 0 and -0.1 change in pain intensity (on 0-10 scale), respectively. Overall, our clinical significance criterion - a 30% shift in pain variable in relation to one standard deviation increase in psychological variable - was not met. However, in subgroups it was met for pain spread (low back pain, neck pain and migraine) and pain intensity (migraine and neck pain) in relation to pain catastrophising. The model generally had low goodness-of-fit to men. CONCLUSION These data support a meaningful relationship between some anxiety-related variables and pain in women for some conditions. Since the model did not consistently fit the men, we may conclude that the relationships are moderated by sex. Clinician attention to psychological variables as potential contributing factors can be justified; however, research is needed to understand the relationship and whether psychological treatment can reduce pain.
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Affiliation(s)
- Daniel S Harvie
- The Hopkins Centre, Menzies Health
Institute Queensland, Griffith University, Southport, QLD, Australia
- School of Allied Health Sciences,
Griffith University, Southport, QLD, Australia
| | - Daniela Vasco
- School of Education and Professional
Studies, Griffith University, Mount Gravatt, QLD, Australia
| | - Michele Sterling
- Recover Injury Research Centre and NHMRC
Centre of Research Excellence in Road Traffic Injury Recovery, The University of
Queensland, Brisbane, Australia
| | - Samantha Low-Choy
- Environmental Futures Research
Institute, Griffith University, Nathan, QLD, Australia
- Arts, Education and Law Group, Griffith
University, Mount Gravatt, QLD, Australia
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15
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Rahman MS, Winsvold BS, Chavez Chavez SO, Børte S, Tsepilov YA, Sharapov SZ, Aulchenko YS, Hagen K, Fors EA, Hveem K, Zwart JA, van Meurs JB, Freidin MB, Williams FM. Genome-wide association study identifies RNF123 locus as associated with chronic widespread musculoskeletal pain. Ann Rheum Dis 2021; 80:1227-1235. [PMID: 33926923 PMCID: PMC8372387 DOI: 10.1136/annrheumdis-2020-219624] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/18/2022]
Abstract
Background and objectives Chronic widespread musculoskeletal pain (CWP) is a symptom of fibromyalgia and a complex trait with poorly understood pathogenesis. CWP is heritable (48%–54%), but its genetic architecture is unknown and candidate gene studies have produced inconsistent results. We conducted a genome-wide association study to get insight into the genetic background of CWP. Methods Northern Europeans from UK Biobank comprising 6914 cases reporting pain all over the body lasting >3 months and 242 929 controls were studied. Replication of three independent genome-wide significant single nucleotide polymorphisms was attempted in six independent European cohorts (n=43 080; cases=14 177). Genetic correlations with risk factors, tissue specificity and colocalisation were examined. Results Three genome-wide significant loci were identified (rs1491985, rs10490825, rs165599) residing within the genes Ring Finger Protein 123 (RNF123), ATPase secretory pathway Ca2+transporting 1 (ATP2C1) and catechol-O-methyltransferase (COMT). The RNF123 locus was replicated (meta-analysis p=0.0002), the ATP2C1 locus showed suggestive association (p=0.0227) and the COMT locus was not replicated. Partial genetic correlation between CWP and depressive symptoms, body mass index, age of first birth and years of schooling were identified. Tissue specificity and colocalisation analysis highlight the relevance of skeletal muscle in CWP. Conclusions We report a novel association of RNF123 locus and a suggestive association of ATP2C1 locus with CWP. Both loci are consistent with a role of calcium regulation in CWP. The association with COMT, one of the most studied genes in chronic pain field, was not confirmed in the replication analysis.
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Affiliation(s)
- Md Shafiqur Rahman
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Bendik S Winsvold
- Department of Research, Innovation and Education,Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Department of Neurology, Oslo universitetssykehus Ullevål, Oslo, Norway.,K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sergio O Chavez Chavez
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Sigrid Børte
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Research and Communication Unit for Musculoskeletal Health (FORMI), Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Yakov A Tsepilov
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, 630090, Novosibirskaâ, Russia.,PolyOmica, 's-Hertogenbosch, PA, The Netherlands.,Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 10 Lavrentiev Avenue, Novosibirsk, 630090, Russia
| | - Sodbo Zh Sharapov
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, 630090, Novosibirskaâ, Russia.,Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 10 Lavrentiev Avenue, Novosibirsk, 630090, Russia
| | | | - Yurii S Aulchenko
- Laboratory of Theoretical and Applied Functional Genomics, Novosibirsk State University, Novosibirsk, 630090, Novosibirskaâ, Russia.,PolyOmica, 's-Hertogenbosch, PA, The Netherlands
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Clinical Research Unit Central Norway, St Olavs University Hospital, Trondheim, Norway
| | - Egil A Fors
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristian Hveem
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - John Anker Zwart
- Department of Research, Innovation and Education,Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Clinical Medicine,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Joyce B van Meurs
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Frances Mk Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
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16
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Dimmek DJ, Korallus C, Buyny S, Christoph G, Lichtinghagen R, Jacobs R, Nugraha B. Brain-Derived Neurotrophic Factor and Immune Cells in Osteoarthritis, Chronic Low Back Pain, and Chronic Widespread Pain Patients: Association with Anxiety and Depression. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:327. [PMID: 33915758 PMCID: PMC8065931 DOI: 10.3390/medicina57040327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 01/09/2023]
Abstract
Background and Objectives: Musculoskeletal dysfunction can induce several types of chronic pain syndromes. It is of particular interest to elucidate the pathomechanism of different forms of chronic pain. It is possible that patients who have developed chronic widespread pain (CWP) may endure different pathomechanisms as compared to those who suffer from local pain (osteoarthritis, OA) and regional pain (chronic low back pain, cLBP), especially with regard to pain regulation and its related biomediators. The aim of this study was to determine the differences in pathomechanisms among these patients by measuring pain-related biomediators, particularly brain-derived neurotrophic factor (BDNF). Additionally, subpopulations of immune cells were determined in parallel. Materials and Methods: Patients and healthy subjects (HSs) were recruited (age and gender-matched). BDNF was measured from serum samples of patients and HSs and the data of body composition parameters were recorded. Additionally, both patients and HSs were asked to fill in questionnaires related to pain intensity, anxiety, and depression. Results: Our results highlight that the levels of both free and total BDNF are significantly lower in pain patients compared to HSs, with p values of 0.041 and 0.024, respectively. The number of CD3- CD56bright natural killer (NK) cells shows significant differences between the groups. Comparing all chronic pain patients with HSs reveals a significantly lower number of CD4+ CD8+ T cells (p = 0.031), CD3- CD56bright NK cells (p = 0.049) and CD20+ CD3- cells (p = 0.007). Conclusions: To conclude, it seems that a general conformity between the pathomechanisms of different chronic pain diseases exists, although there are unique findings only in specific chronic pain patients.
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Affiliation(s)
- Dominique Josephine Dimmek
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (D.J.D.); (C.K.); (G.C.)
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (D.J.D.); (C.K.); (G.C.)
| | - Sabine Buyny
- Department of Rheumatology and Clinical Immunology, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (S.B.); (R.J.)
| | - Gutenbrunner Christoph
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (D.J.D.); (C.K.); (G.C.)
| | - Ralf Lichtinghagen
- Institute of Clinical Chemistry, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany;
| | - Roland Jacobs
- Department of Rheumatology and Clinical Immunology, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (S.B.); (R.J.)
| | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (D.J.D.); (C.K.); (G.C.)
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17
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Singh R, Rai NK, Rastogi A, Endukuru C, Joshi A, Mishra SS. Impact of sleep disturbances and autonomic dysfunction on the quality of life of patients with fibromyalgia. J Basic Clin Physiol Pharmacol 2021; 32:1021-1029. [PMID: 33638318 DOI: 10.1515/jbcpp-2020-0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 09/10/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Fibromyalgia, a painful musculoskeletal disorder is associated with sleep disturbances as well as autonomic dysfunction. Pathophysiology of fibromyalgia is yet not clear and neuroanatomical proximity of sleep and autonomic centre prompts probable involvement of the two impacting the quality of life of fibromyalgia patients. Present study was done with the objective to explore the extent of sleep disturbances and/or autonomic dysfunction in fibromyalgia and asses their impact on quality of life of fibromyalgia patients. METHOD AND MATERIALS Thirty consecutive fibromyalgia patients (diagnosed by ACR 2010) from out-patient department and 30 age-gender matched controls were enrolled after the ethical clearance. All participants were evaluated for: (1) sleep using Pittsburgh sleep quality index and medical outcomes study sleep scale-12 Revised, (2) Quality of life by 36 item short-form health survey-36v2TM and revised fibromyalgia impact questionnaire (only patients). Autonomic functions of patients were evaluated by standard cardiovascular autonomic function tests by Ewing's battery and heart rate variability (5-min) measurement. RESULTS Fibromyalgia patients had increased sleep disturbances compared to controls (39.46 ± 11, 59.61 ± 2.31; p=0.0001) and very poor sleep quality (13.63 ± 4.15, 3.03 ± 1.56; p=0.0001) as well as quality of life (p=0.0001) which further deteriorated with increasing severity of fibromyalgia. Twelve patients had autonomic dysfunction but it was neither associated with sleep disturbances nor with quality of life. CONCLUSIONS Mild to moderate grade fibromyalgia patients have significant sleep disturbance, poor sleep quality which remarkably impacts their quality of life. Autonomic dysfunction is not an early feature of disease. The study suggests that full spectrum of sleep disturbances and sleep quality should be explored in fibromyalgia syndrome (FMS) patients.
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Affiliation(s)
- Ruchi Singh
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Nirendra Kumar Rai
- Department of Neurology, All India Institute of Medical Sciences, Bhopal, India
| | | | - Chiranjeevi Endukuru
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
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Associations Between Musculoskeletal Conditions Risk, Sedentary Behavior, Sleep, and Markers of Mental Health: A Cross-Sectional Observational Study in Heavy Goods Vehicle Drivers. Musculoskeletal Conditions Risk in HGV Drivers. J Occup Environ Med 2020; 61:437-443. [PMID: 30889056 DOI: 10.1097/jom.0000000000001587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To explore the risk of having musculoskeletal conditions (MSKs) associated with sitting and sleeping time during workdays, presenteeism, work engagement anxiety, and depression in a sample of UK heavy goods vehicle drivers. METHODS Eighty-eight male drivers participated in this cross-sectional study. Binary logistic regression analyses were performed to explore the associations between two-or-more MSKs and common health risk factors. RESULTS Possessing two or more MSKs is associated with prolonged sitting time (odds ratio [OR] 4.34) and working hours per day (OR 3.10) and per week (OR 3.12), severe sleep deprivation (OR 33.19), presenteeism (OR 4.22), and borderline or abnormal scores of depression (OR 11.69) and anxiety (OR 4.44), compared with the reference categories. CONCLUSION Workplace policies and health promotion interventions to improve heavy goods vehicle drivers working environment are required to minimize the risk of MSK's across this sector.
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Øiestad BE, Aanesen F, Løchting I, Storheim K, Tingulstad A, Rysstad TL, Småstuen MC, Tveter AT, Sowden G, Wynne-Jones G, Fors EA, van Tulder M, Berg RC, Foster NE, Grotle M. Study protocol for a randomized controlled trial of the effectiveness of adding motivational interviewing or stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders. The MI-NAV study. BMC Musculoskelet Disord 2020; 21:496. [PMID: 32723318 PMCID: PMC7385885 DOI: 10.1186/s12891-020-03475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background Little research exists on the effectiveness of motivational interviewing (MI) on return to work (RTW) in workers on long term sick leave. The objectives of this study protocol is to describe a randomized controlled trial (RCT) with the objectives to compare the effectiveness and cost-effectiveness of usual case management alone with usual case management plus MI or usual case management plus stratified vocational advice intervention (SVAI), on RTW among people on sick leave due to musculoskeletal (MSK) disorders. Methods A multi-arm RCT with economic evaluation will be conducted in Norway with recruitment of 450 participants aged 18–67 years on 50–100% sick leave for > 7 weeks due to MSK disorders. Participants will be randomized to either usual case management by the Norwegian Labour and Welfare Administration (NAV) alone, usual case management by NAV plus MI, or usual case management by NAV plus SVAI. Trained caseworkers in NAV will give two MI sessions, and physiotherapists will give 1–4 SVAI sessions depending upon risk of long-term sick leave. The primary outcome is the number of sick leave days from randomization to 6 months follow-up. Secondary outcomes are number of sick leave days at 12 months follow-up, time until sustainable RTW (≥4 weeks of at least 50% of their usual working hours) at 12 months, proportions of participants receiving sick leave benefits during 12 months of follow-up, and MSK symptoms influencing health at 12 months. Cost-utility evaluated by the EuroQoL 5D-5L and cost-benefit analyses will be performed. Fidelity of the interventions will be assessed through audio-recordings of approximately 10% of the intervention sessions. Discussion The results from this RCT will inform stakeholders involved in supporting RTW due to MSK disorders such as staff within NAV and primary health care. Trial registration ClinicalTrials.gov ID: NCT03871712 registered March 12th 2020.
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Affiliation(s)
- Britt Elin Øiestad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.
| | - Fiona Aanesen
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
| | - Ida Løchting
- Research and Communication Unit for MSK Health (FORMI), Oslo University Hospital and Oslo Metropolitan University, Oslo, Norway
| | - Kjersti Storheim
- Department of Physiotherapy, Research and Communication Unit for MSK Health (FORMI), Oslo University Hospital, Oslo Metropolitan University, Oslo, Norway
| | - Alexander Tingulstad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
| | - Tarjei L Rysstad
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
| | - Milada C Småstuen
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.,Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.,National Advisor Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Gail Sowden
- School of Primary, Community & Social Care, Keele University, Keele, UK.,Connect Health, Newcastle upon Tyne, UK
| | - Gwenllian Wynne-Jones
- Faculty of Medicine and Health Sciences, School of Primary, Community and Social Care, and School of Nursing and Midwifery, Keele University, Keele, UK
| | - Egil A Fors
- General Practice Research Unit, Department of Public Health and Nursing Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Maurits van Tulder
- Department Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine, The University of Tromsø, Tromsø, Norway
| | - Nadine E Foster
- School of Primary, Community & Social Care, Keele University, Keele, UK
| | - Margreth Grotle
- Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway
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20
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Rethorn ZD, Pettitt RW, Dykstra E, Pettitt CD. Health and wellness coaching positively impacts individuals with chronic pain and pain-related interference. PLoS One 2020; 15:e0236734. [PMID: 32716976 PMCID: PMC7384647 DOI: 10.1371/journal.pone.0236734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/12/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives Health and wellness coaching (HWC) interventions have been reported to improve health outcomes for individuals with chronic diseases such as diabetes, cardiovascular disease, or cancer. However, HWC also holds potential as an effective intervention within a biopsychosocial chronic pain management framework. The aim of the present study was to evaluate the effects of HWC on individuals with chronic pain. Methods Participants were referred by their primary care provider or insurance company to a comprehensive telephonic 12-month pain management HWC program. Relationships between pain outcomes and physical and psychological factors were retrospectively analyzed. Mixed linear-effects modeling explored whether physical and psychological variables were associated with pain outcomes over time. Results Four hundred nineteen participants (female, 58.9%; mean age, 54.8) enrolled in the program and 181 completed the intervention. After 12 months in the program, statistically and clinically significant reductions were observed for pain intensity (Hedges’ g = 1.00) and pain-related interference (Hedges’ g = 1.13). Linear mixed-effects modeling indicated that improvements in physical functioning and psychological factors were associated with improvements in pain intensity. Discussion Our results provide a novel analysis on the effects of HWC on chronic pain and pain-related interference. HWC appears to be a promising intervention to improve pain-related outcomes in a population with chronic pain. Further investigation of HWC as an intervention for chronic pain is warranted.
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Affiliation(s)
- Zachary D. Rethorn
- Doctor of Physical Therapy Division, Duke University, Durham, North Carolina, United States of America
- Rocky Mountain University of Health Professions, Provo, Utah, United States of America
- * E-mail:
| | - Robert W. Pettitt
- Rocky Mountain University of Health Professions, Provo, Utah, United States of America
| | - Emily Dykstra
- Rocky Mountain University of Health Professions, Provo, Utah, United States of America
| | - Cherie D. Pettitt
- Rocky Mountain University of Health Professions, Provo, Utah, United States of America
- WGU Academy, Western Governors University, Salt Lake City, Utah, United States of America
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21
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McCloy K, Peck C. Common factors in the presentation and management of chronic temporomandibular disorders and chronic overlapping pain disorders. J Oral Pathol Med 2020; 49:454-460. [DOI: 10.1111/jop.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - Christopher Peck
- Westmead Initiative The University of Sydney Sydney NSW Australia
- Pain Management Research Institute Royal North Shore HospitalSt Leonards NSW Australia
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22
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Wiklund T, Gerdle B, Linton SJ, Dragioti E, Larsson B. Insomnia is a risk factor for spreading of chronic pain: A Swedish longitudinal population study (SwePain). Eur J Pain 2020; 24:1348-1356. [DOI: 10.1002/ejp.1582] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/10/2020] [Accepted: 05/01/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Tobias Wiklund
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
| | - Steven J. Linton
- Center for Health and Medical Psychology (CHAMP) School of Law, Psychology and Social Work Örebro University Örebro Sweden
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
| | - Britt Larsson
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
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23
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Dose-response associations of clinical markers of obesity and duration of exposure to excess weight with chronic musculoskeletal pain: cross-sectional analysis at baseline of ELSA-Brasil Musculoskeletal cohort. Rheumatol Int 2020; 40:881-891. [PMID: 32236646 DOI: 10.1007/s00296-020-04557-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/14/2020] [Indexed: 02/03/2023]
Abstract
The objective of this study is to investigate the association of clinical markers of obesity and weight trajectories with chronic musculoskeletal pain (CMP). This is a cross-sectional study using baseline data from ELSA-Brasil MSK cohort. CMP was evaluated at nine body sites (neck, shoulders, upper back, elbows, lower back, wrists/hands, hips/thighs, knees, ankles/feet), and defined as pain lasting > 6 months in the past year. General and abdominal obesity levels were classified according to accepted cut-offs for body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR). Binomial and multinomial logistic regressions tested for associations with CMP at any site, at ≥ 3 sites (multisite) and in upper + lower limbs + axial skeleton (generalized). A total of 2899 participants (mean age 56.0 ± 8.93) were included, 55.0% reported CMP, 19.1% had multisite, and 10.3% had generalized CMP. After adjustments for sex, age, education, physical activity and depressive symptoms, nearly all the investigated markers of obesity were associated with any CMP, multisite and generalized CMP, with strongest associations being observed for general obesity level II/III: OR 2.08 (95% CI 1.45-2.99), OR 3.19 (95% CI 2.06-4.94) and OR 3.65 (2.18-6.11), respectively. Having excess weight currently or both at age 20 and currently was also associated with all CMP presentations. Associations of greater magnitude were consistently observed at higher obesity levels and longer exposures to excess weight (dose-response). These results may support the contribution of obesity-derived mechanical and inflammatory mechanisms of CMP, and indicate a role for the accumulation of exposure to excess weight across the adult life course.
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24
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Gordon-Williams R, Farquhar-Smith P. Recent advances in understanding chemotherapy-induced peripheral neuropathy. F1000Res 2020; 9. [PMID: 32201575 PMCID: PMC7076330 DOI: 10.12688/f1000research.21625.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 12/20/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a common cause of pain and poor quality of life for those undergoing treatment for cancer and those surviving cancer. Many advances have been made in the pre-clinical science; despite this, these findings have not been translated into novel preventative measures and treatments for CIPN. This review aims to give an update on the pre-clinical science, preventative measures, assessment and treatment of CIPN.
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Affiliation(s)
- Richard Gordon-Williams
- Department of Pain Medicine, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
| | - Paul Farquhar-Smith
- Department of Pain Medicine, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
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25
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Abstract
Fibromyalgia is characterized by chronic, widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. For many patients, these symptoms persist for years and lead to frequent health care use; for some, fibromyalgia and its symptoms can be debilitating. Although many treatments are available, management remains challenging. This article highlights the clinical features of fibromyalgia, discusses diagnostic criteria and their evolution, and reviews treatment options.
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Affiliation(s)
- Matthew J Bair
- Richard L. Roudebush VA Medical Center, Indianapolis, Indiana (M.J.B.)
| | - Erin E Krebs
- Minneapolis VA Health Care System, Minneapolis, Minnesota (E.E.K.)
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26
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A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Pain 2020; 161:1169-1176. [DOI: 10.1097/j.pain.0000000000001819] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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27
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Corrêa LA, Bittencourt JV, Ferreira ADS, Reis FJJD, de Almeida RS, Nogueira LAC. The Reliability and Concurrent Validity of PainMAP Software for Automated Quantification of Pain Drawings on Body Charts of Patients With Low Back Pain. Pain Pract 2020; 20:462-470. [PMID: 31961038 DOI: 10.1111/papr.12872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/05/2019] [Accepted: 01/12/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND The assessment of painful areas through printed body charts is a simple way for clinicians to identify patients with widespread pain in primary care. However, there is a lack in the literature about a simple and automated method designed to analyze pain drawings in body charts in clinical practice. PURPOSE To test the inter- and intra-rater reliabilities and concurrent validity of software (PainMAP) for quantification of pain drawings in patients with low back pain. METHODS Thirty-eight participants (16 [42.10%] female; mean age 50.24 [11.54] years; mean body mass index 27.90 [5.42] kg/m2 ; duration of pain of 94.35 [96.11] months) with a current episode of low back pain were recruited from a pool of physiotherapy outpatients. Participants were instructed to shade all their painful areas on a body chart using a red pen. The body charts were digitized by separate raters using smartphone cameras and twice for one rater to analyze the intra-rater reliability. Both the number of pain sites and the pain area were calculated using ImageJ software (reference method). The PainMAP software used image processing methods to automatically quantify the data from the same digitized body charts. RESULTS The reliability analyses revealed that PainMAP has excellent inter- and intra-rater reliabilities to quantify the number of pain sites (intraclass correlation coefficient [ICC]2,1 : 0.998 [95% confidence interval (CI) 0.996 to 0.999]; ICC2,1 : 0.995 [95% CI 0.991 to 0.998]) and the pain area [ICC2,1 : 0.998 (95% CI 0.995 to 0.999); ICC2,1 : 0.975 (95% CI 0.951 to 0.987)], respectively. The standard error of the measurement was 0.22 (4%) for the number of pain sites and 0.03 cm2 (4%) for the pain area. The Bland-Altman analyses revealed no substantive differences between the 2 methods for the pain area (mean difference = 0.007 [95% CI -0.053 to 0.067]). CONCLUSION PainMAP software is reliable and valid for quantification of the number of pain sites and the pain area in patients with low back pain.
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Affiliation(s)
- Leticia Amaral Corrêa
- Rehabilitation Science Postgraduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Juliana Valentim Bittencourt
- Rehabilitation Science Postgraduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Arthur de Sá Ferreira
- Rehabilitation Science Postgraduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | | | - Renato Santos de Almeida
- Rehabilitation Science Postgraduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil.,Physiotherapy Department, Gaffree and Guinlé University Hospital (HUGG), Rio de Janeiro, Brazil
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil.,Physiotherapy Department, Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
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28
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O'Neill A, O'Sullivan K, O'Keeffe M, Walsh C, Purtill H. The change of pain classes over time: a latent transition analysis. Eur J Pain 2019; 24:457-469. [PMID: 31680381 DOI: 10.1002/ejp.1502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pain is common in older adults, and associated with increased morbidity and reduced quality of life. Recent research has highlighted different classes of older adults with pain, each with differing impacts on their life. It has not yet been investigated if, and how, such classes change over time and what influences individuals to prospectively transition to a profile of either improved or worsened pain impact. METHODS Latent transition analysis (LTA) is a longitudinal model-based approach to identifying underlying subgroups in a population. LTA was used to model the change in pain of people aged 50 and above, from The Irish Longitudinal Study on Ageing, across three waves (n = 5,925). The LTA model was extended to include biopsychosocial covariates to predict transition probabilities between classes over time. RESULTS Three latent classes were identified based on three pain indicators (pain presence; pain affects daily life; pain requires medication) and were characterized as "No Pain", "Low-Moderate Impact Pain" and "High Impact Pain". Results indicate that the pain class of many changes over time. However, poor physical or mental health increased the risk of transitioning to a more severe pain class, from Wave 1 to Wave 2 and Wave 2 to Wave 3. CONCLUSIONS These findings show the change in pain of older adults over time, with both marked improvement and deterioration being observed. Critically, the predictors of individuals transitioning between classes reflect the breadth of biopsychosocial factors involved in pain. SIGNIFICANT STATEMENT This article identified differing classes of pain in older adults, using latent transition analysis. The analysis demonstrated how the pain classes of older adults are broadly consistent over time, however both improvement and deterioration in pain impact were observed. Transitions between classes were associated with several biopsychosocial factors. These results have important implications for the health and quality of life of older adults. Consideration of health, lifestyle and socio-demographic factors may enhance assessment and management of pain in older adults.
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Affiliation(s)
- Aoife O'Neill
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Kieran O'Sullivan
- School of Allied Health, University of Limerick, Limerick, Ireland.,Ageing Research Centre, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Mary O'Keeffe
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Institute for Musculoskeletal Health, Sydney, NSW, Australia
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland.,Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Helen Purtill
- Ageing Research Centre, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
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29
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Malik A, Lopate G, Hayat G, Jones J, Atluri R, Malo B, Pestronk A. Prevalence of Axonal Sensory Neuropathy With IgM Binding to Trisulfated Heparin Disaccharide in Patients With Fibromyalgia. J Clin Neuromuscul Dis 2019; 20:103-110. [PMID: 30801480 DOI: 10.1097/cnd.0000000000000236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To assess the intraepidermal nerve fiber density in patients diagnosed with fibromyalgia (FM) and to evaluate the role of IgM binding to trisulfated heparin disaccharide (TS-HDS) in these patients. METHODS FM is a poorly understood pain disorder with several proposed pathophysiologic mechanisms. It is characterized by widespread pain, fatigue, and sleep abnormalities. Small fiber neuropathy (SFN) has been proposed as an underlying mechanism, and patients with FM have been shown to have a reduction in the intraepidermal nerve fiber density. An underlying inflammatory process that could be a result of autoimmune phenomena has also been suggested. Non-length-dependent SFN (NLDSFN) has been shown to have a higher incidence of autoimmune disease. Twenty-two patients with established diagnosis of FM underwent skin biopsy at 2 sites; 10 cm above the lateral malleolus and 10 cm above the patella. Serum IgM binding to TS-HDS was assayed using an ELISA method. RESULTS A total of 5/22 patients had positive TS-HDS antibodies; of these, 4 had NLDSFN (P = 0.0393). Comparison with a control group at Washington University showed no significant difference in percentage with TS-HDS antibodies (P = 0.41). When compared with Washington University database of skin biopsy, there was a trend for an increased percentage of NLDSFN in patients with FM (P = 0.06). CONCLUSIONS This study further supports the hypothesis that a subgroup of patients with FM has SFN. We suggest a correlation between the presence of NLDSFN and TS-HDS antibodies.
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Affiliation(s)
| | - Glenn Lopate
- Washington University in Saint Louis, Saint Louis, MO
| | | | | | | | - Bassam Malo
- Washington University in Saint Louis, Saint Louis, MO
| | - Alan Pestronk
- Washington University in Saint Louis, Saint Louis, MO
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30
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Abstract
Pain significantly restricts the quality of life and well-being of older adults. With our increasingly ageing population, it is important to examine whether differing classes of biopsychosocial risk factors can predict the development of pain in older adults. Latent class analysis provides a model-based approach to identifying underlying subgroups in a population, based on some measured characteristics. In this study, latent class analysis was used to identify biopsychosocial risk classes in people aged 50 years and older, from The Irish Longitudinal Study on Ageing, who reported not often being troubled by pain at wave 1 and completed the 2-year follow-up at wave 2 (n = 4458). Four classes were identified based on 11 potential risk factors at wave 1. These classes were characterised as "Low Risk," "Physical Health Risk," "Mental Health Risk," and "High Risk." The Low-Risk class accounted for over half the sample (51.2%), whereas the High-Risk class represented 7.8% of the sample. At follow-up (wave 2), 797 (17.9%) participants reported being troubled by pain. Associations between the biopsychosocial risk classes and developing pain were examined using logistic regression, adjusting for sociodemographic variables. The High-Risk class was more likely to develop pain compared with the Low-Risk class (adjusted OR = 3.16, 95% CI = 2.40-4.16). These results add to existing data in other populations supporting the role of a range of biopsychosocial risk factors that increase the risk of developing pain. These findings have important implications for the identification, and potential moderation, of these risk factors.
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31
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Lin WC, Shen CC, Tsai SJ, Yang AC. Increased Risk of Myofascial Pain Syndrome Among Patients with Insomnia. PAIN MEDICINE 2018; 18:1557-1565. [PMID: 28339643 DOI: 10.1093/pm/pnw300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective The aim of this study is to evaluate the risk of developing myofascial pain syndrome among patients diagnosed with insomnia. Methods We conducted a population-based longitudinal study of a matched cohort with 7,895 participants (1,579 patients with insomnia and 6,316 controls) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 10 years to determine the incidence of newly diagnosed myofascial pain syndrome. A Cox regression analysis was performed to identify the risk factors associated with myofascial pain syndrome in patients with insomnia. Results During the 10-year follow-up period, 182 insomnia patients (14.9 per 1,000 person-years) and 379 controls (7.5 per 1,000 person-years) were diagnosed with myofascial pain syndrome. The incidence risk ratio of myofascial pain syndrome between the insomnia and control patients was 2.00 (95% confidence interval [CI] = 1.67-2.38, P < 0.001). After adjusting for age, sex, monthly income, urbanization, and comorbidities, the insomnia patients were 1.93 times more likely to develop myofascial pain syndrome (95% CI = 1.62-2.31, P < .001) than the control patients. Malignant neoplasm (hazard ratio = 3.08) and living in urban areas (hazard ratio = 3.05) were identified as independent risk factors for myofascial pain syndrome in patients with insomnia. Conclusions Patients with insomnia had a higher risk of developing myofascial pain syndrome than controls. This study adds to the understanding of the complex relationship between sleep disturbance and pain.
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Affiliation(s)
- Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Che Shen
- Division of Psychiatry, Faculty of Medicine.,Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan.,Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine
| | - Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine.,Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan
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32
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Burri A, Hilpert P, McNair P, Williams FM. Exploring symptoms of somatization in chronic widespread pain: latent class analysis and the role of personality. J Pain Res 2017; 10:1733-1740. [PMID: 28769589 PMCID: PMC5533562 DOI: 10.2147/jpr.s139700] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Chronic widespread musculoskeletal pain (CWP) is a condition manifesting varied co-symptomatology and considerable heterogeneity in symptom profiles. This poses an obstacle for disease definition and effective treatment. Latent class analysis (LCA) provides an opportunity to find subtypes of cases in multivariate data. In this study, LCA was used to investigate whether and how individuals with CWP could be classified according to 12 additional somatic symptoms (migraine headaches, insomnia, stiffness, etc.). In a second step, the role of psychological and coping factors for the severity of these co-symptoms was investigated. Data were available for a total of N = 3,057 individuals (mean age = 56.6 years), with 15.4% suffering from CWP. In the latter group, LCA resulted in a three-class solution (ngroup1 = 123; ngroup2 = 306; ngroup3 = 43) with groups differing in a graded fashion (i.e., severity) rather than qualitatively for somatic co-symptom endorsements. A consistent picture emerged, with individuals in the first group reporting the lowest scores and individuals in group 3 reporting the highest. Additionally, more co-symptomatology was associated with higher rates of anxiety sensitivity and depression, as well as more extraversion and emotional instability. No group differences for any of the coping strategies could be identified. The findings suggest that CWP has several detectable subtypes with distinct psychological correlates. The identification of CWP subgroups is important for understanding disease mechanisms and refining prognosis as well as stratifying patients in clinical trials and targeting specific treatment at the subgroups most likely to respond.
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Affiliation(s)
- Andrea Burri
- Health and Rehabilitation Research Institute, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology.,Waitemata Pain Service, Department of Anaesthesiology and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand
| | - Peter Hilpert
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Peter McNair
- Health and Rehabilitation Research Institute, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology
| | - Frances M Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
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Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis 2017; 76:1815-1822. [DOI: 10.1136/annrheumdis-2017-211476] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/05/2017] [Accepted: 06/03/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveIt is uncertain whether persons with chronic widespread pain (CWP) experience premature mortality. Using the largest study conducted, we determine whether such a relationship exists, estimate its magnitude and establish what factors mediate any relationship.MethodsUK Biobank, a cohort study of 0.5 million people aged 40–69 years, recruited throughout Great Britain in 2006–2010. Participants reporting ‘pain all over the body’ for >3 months were compared with persons without chronic pain. Information on death (with cause) was available until mid-2015. We incorporated these results in a meta-analysis with other published reports to calculate a pooled estimate of excess risk.Results7130 participants reported CWP and they experienced excess mortality (mortality risk ratio 2.43, 95%CI 2.17 to 2.72). Specific causes of death in excess were cancer (1.73adjusted age and sex, 95% CI 1.46 to 2.05), cardiovascular (3.24adjusted age and sex, 95% CI 2.55 to 4.11), respiratory (5.66adjusted age and sex, 95% CI 4.00 to 8.03) and other disease-related causes (4.04adjusted age and sex, 95% CI 3.05 to 5.34). Excess risk was substantially reduced after adjustment for low levels of physical activity, high body mass index, poor quality diet and smoking. In meta-analysis, all studies showed significant excess all-cause (combined estimate 1.59 (95% CI 1.05 to 2.42)), cardiovascular and cancer mortality.ConclusionsEvidence is now clear that persons with CWP experience excess mortality. UK Biobank results considerably reduce uncertainty around the magnitude of excess risk and are consistent with the excess being explained by adverse lifestyle factors, which could be targeted in the management of such patients.
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Andorsen OF, Ahmed LA, Emaus N, Klouman E. A prospective cohort study on risk factors of musculoskeletal complaints (pain and/or stiffness) in a general population. The Tromsø study. PLoS One 2017; 12:e0181417. [PMID: 28727753 PMCID: PMC5519093 DOI: 10.1371/journal.pone.0181417] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 07/02/2017] [Indexed: 12/31/2022] Open
Abstract
Background Female gender has been associated with musculoskeletal complaints (MSCs), but there are limited studies on how other factors may influence women and men differently. The aim of this prospective cohort study was to explore possible predictors of MSCs in women and men free of MSCs at baseline. Methods The present study included participants from the population-based Tromsø study, with baseline data from 1994–1995 and follow-up data from 2007–2008. MSCs were defined as having pain and/or stiffness in muscles and joints for 3 consecutive months during the past year. Predictors of MSCs were examined through binary logistic regression analyses and presented as odds ratios with 95% confidence intervals. Results At baseline 4,496 participants reported no MSCs and among these 2,015 (44.8%) and 441 (9.8%) participants reported mild or severe MSCs, respectively, at follow-up. Female gender predicted MSCs in multivariable logistic regression analyses (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.29–1.66). Educational level of primary/secondary school (OR 1.73, 95% CI: 1.46–2.05) was the strongest predictor of MSCs, followed by poor self-perceived health (OR 1.62, 95% CI: 1.30–2.02). Other predictors were BMI ≥30 kg/m2 (OR 1.39, 95% CI: 1.10–1.77) and smoking (OR 1.33, 95% CI: 1.16–1.52). Age and physical activity level were not significantly associated with MSCs. Gender-stratified analyses revealed that mental health complaints (i.e., depression and/or anxiety) predicted MSCs in men (OR 2.03, 95% CI: 1.18–3.50), but not in women. Current smoking (OR 1.43, 95% CI: 1.16–1.76) and poor self-perceived health (OR 1.90, 95% CI: 1.34–2.71) showed slightly higher odds ratios among women than men, but the gender differences were not significant. Conclusion The present study demonstrates that several negative health determinants are predicting subsequent MSCs. However, the examined risk factors could not explain the higher prevalence of MSCs in women.
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Affiliation(s)
- Ole Fredrik Andorsen
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
| | - Elise Klouman
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
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Prevalence of Painful Temporomandibular Disorders and Correlation to Lifestyle Factors among Adolescents in Norway. Pain Res Manag 2017. [PMID: 28638246 PMCID: PMC5468573 DOI: 10.1155/2017/2164825] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To estimate the prevalence of painful temporomandibular disorders (TMD-P) among adolescents and to investigate correlations with health, environment, and lifestyle factors. METHODS For this cross-sectional case-control study, 562 patients were consecutively recruited at their yearly revision control from four dental clinics in Rogaland County, Norway. Patients completed a questionnaire on general health, socioeconomics, demographics, and lifestyle factors. Responses to two screening questions identified patients with TMD-P, who then underwent clinical examination to verify the TMD diagnosis. Pain intensity was assessed on a visual analogue scale. Patients without TMD-P constituted the control group and were not clinically examined. RESULTS 7% experienced TMD-P. The female-to-male ratio is 3:1; median age is 17 years. Patients at urban clinics had higher prevalence compared with those at rural clinics. TMD-P patients had headache and severe menstrual pain compared to controls. They were more likely to live with divorced/single parents and less likely to have regular physical activity. Myalgia was present in 21 patients with TMD-P, arthralgia in nine, and myalgia and arthralgia in nine. Females had higher pain intensity than males. CONCLUSIONS A low prevalence of TMD-P was shown but was comparable to other studies. Sex, health, lifestyle, and environment factors were associated with TMD-P.
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Christensen JO, Johansen S, Knardahl S. Psychological predictors of change in the number of musculoskeletal pain sites among Norwegian employees: a prospective study. BMC Musculoskelet Disord 2017; 18:140. [PMID: 28376786 PMCID: PMC5379631 DOI: 10.1186/s12891-017-1503-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/28/2017] [Indexed: 11/24/2022] Open
Abstract
Background The pathogenesis of syndromes of widespread musculoskeletal pain remains an enigma. The present study sought to determine if psychological states, job satisfaction, pain intensity, and sleep problems contributed to the spread and decline of the number of musculoskeletal pains. Methods A sample of 2989 Norwegian employees completed a questionnaire at baseline and follow-up 2 years later. Data were analyzed with multinomial and ordinal logistic regression analyses to determine effects on direction and degree of change of number of pain sites (NPS). Results After adjustment for sex, age, skill level, and number of pain sites at baseline, increases in the number of pain sites from baseline to follow-up were predicted by emotional exhaustion, mental distress, having little surplus, feeling down and sad, sleep disturbances, and intensity of headache. Decreases were predicted by low levels of emotional exhaustion, mental distress, sleep disturbances, restlessness, and lower intensity of headache, neck pain, shoulder pain, and back pain. Higher numbers of pain sites at baseline were associated with reduction of number of pain sites and lower likelihood of spread. Some factors that did not predict whether decrease or increase occurred were nevertheless associated with the degree of decrease (depression, anxiety, having surplus, self-efficacy) or increase (anxiety). Conclusions Several psychological and physiological factors predicted change in the number of pain sites. There is a need for further investigations to identify possible mechanisms by which psychological and behavioral factors propagate the spread of pain. Electronic supplementary material The online version of this article (doi:10.1186/s12891-017-1503-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Olav Christensen
- Department of Work Psychology and Physiology, The National Institute of Occupational Health, Oslo, Norway.
| | - Sissel Johansen
- Oslo and Akershus University College of Applied Sciences, Faculty of Social Sciences, Department of Social Work, Child Welfare and Social Policy, Oslo, Norway
| | - Stein Knardahl
- Department of Work Psychology and Physiology, The National Institute of Occupational Health, Oslo, Norway
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O'Sullivan K, Kennedy N, Purtill H, Hannigan A. Understanding pain among older persons: Part 1-the development of novel pain profiles and their association with disability and quality of life. Age Ageing 2017; 46:46-51. [PMID: 28181631 DOI: 10.1093/ageing/afw131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 05/12/2016] [Accepted: 06/15/2016] [Indexed: 12/18/2022] Open
Abstract
Background While a range of variables are related to the impact of pain, most population studies of older persons have simply examined the presence or intensity of pain. Objective To develop novel pain profiles based on a range of pain variables, and compare demographic and health variables across profiles. Methods Baseline data from The Irish LongituDinal study on Ageing (TILDA), a population-representative cohort study involving 8,171 community living people resident in Ireland aged 50 or over, was used. Two-step cluster analysis was performed on those who reported being often troubled by pain using all self-reported pain variables. Nine demographic and health variables were compared across pain profiles and the no-pain profile. Results Of the cohort, 65% reported not often being troubled by pain. Of those troubled by pain, four profiles emerged ranging from the profile whose pain did not have impact on daily activities (12% of cohort) to the profile with everyone taking medication to control the pain (9% of cohort). All demographic and health variables differed significantly across the profiles (all P < 0.05) with pain profiles reporting significantly greater disability and poorer quality of life than the no-pain profile (P < 0.05). Conclusions Four pain profiles, based on a range of pain variables, as well as a no-pain profile were identifiable in a large sample of older adults. Identifying those (i) with multi-site pain, (ii) who take pain medications and/or (iii) whose pain affects daily activities clearly identifies those with the highest levels of disability and poorest quality of life.
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Affiliation(s)
- Kieran O'Sullivan
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Norelee Kennedy
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Helen Purtill
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Ailish Hannigan
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Mundal I, Bjørngaard JH, Nilsen TI, Nicholl BI, Gråwe RW, Fors EA. Long-Term Changes in Musculoskeletal Pain Sites in the General Population: The HUNT Study. THE JOURNAL OF PAIN 2016; 17:1246-1256. [DOI: 10.1016/j.jpain.2016.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/21/2016] [Accepted: 08/16/2016] [Indexed: 01/03/2023]
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Morales-Espinoza EM, Kostov B, Salami DC, Perez ZH, Rosalen AP, Molina JO, Paz LGD, Momblona JMS, Àreu JB, Brito-Zerón P, Ramos-Casals M, Sisó-Almirall A. Complexity, comorbidity, and health care costs associated with chronic widespread pain in primary care. Pain 2016; 157:818-826. [DOI: 10.1097/j.pain.0000000000000440] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Bauer H, Emeny RT, Baumert J, Ladwig KH. Resilience moderates the association between chronic pain and depressive symptoms in the elderly. Eur J Pain 2016; 20:1253-65. [PMID: 26914727 DOI: 10.1002/ejp.850] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic pain is frequent in elderly people and, especially if widespread, associated with poor mental health. We investigated whether a resilient personality protects older adults against the adverse effects of chronic pain. METHODS Pain status [no pain, chronic local pain (CLP) and chronic widespread pain (CWP)] was determined using the American College of Rheumatologists' criteria for widespread pain in a cross-sectional sample of 724 participants aged 68-92 years drawn from the population-based KORA-Age study in Southern Germany. Depressive symptoms and resilience were assessed via the scales GDS-15 and RS-5. The relation between pain, resilience and depressive symptoms was modelled using logistic and quantile regression. RESULTS CLP prevalence and CWP prevalence were 57.5% and 12.3%, respectively. Confounder-adjusted logistic regression indicated a fourfold risk of depressed mood (GDS-15 ≥ 5) in CWP, vs. no pain (OR = 4.08, 95% CI 1.90-8.74). However, in quantile regression, the adverse effect of CWP was significantly attenuated by resilience when looking at the GDS-15 score lower quartile (p = 0.011) and median (p = 0.011). This effect appeared to be mainly driven by participants aged 75-84 years. Confounder adjustment reduced the effect of CLP on depressive symptoms to non-significance, and effect modification by resilience was undetectable in regression models of CLP. CONCLUSIONS Resilience was protective in the association of CWP with depressive symptoms in this analysis. Older adults with CWP may potentially benefit from interventions supporting resilience. Prospective research should investigate the protective role of resilience in the potentially self-perpetuating relation between chronic pain and depressed affect. WHAT DOES THIS STUDY ADD?: The association of chronic widespread pain with depressive symptoms in the elderly population is attenuated by resilience.
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Affiliation(s)
- H Bauer
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Klinikum der Universität München, Munich, Germany
| | - R T Emeny
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany.,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - J Baumert
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - K-H Ladwig
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany.,Department for Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Munich, Germany
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Hu J, Bortsov AV, Ballina L, Orrey DC, Swor RA, Peak D, Jones J, Rathlev N, Lee DC, Domeier R, Hendry P, Parry BA, McLean SA. Chronic widespread pain after motor vehicle collision typically occurs through immediate development and nonrecovery: results of an emergency department-based cohort study. Pain 2016; 157:438-444. [PMID: 26808013 PMCID: PMC4942849 DOI: 10.1097/j.pain.0000000000000388] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Motor vehicle collision (MVC) can trigger chronic widespread pain (CWP) development in vulnerable individuals. Whether such CWP typically develops through the evolution of pain from regional to widespread or through the early development of widespread pain with nonrecovery is currently unknown. We evaluated the trajectory of CWP development (American College of Rheumatology criteria) among 948 European-American individuals who presented to the emergency department (ED) for care in the early aftermath of MVC. Pain extent was assessed in the ED and 6 weeks, 6 months, and 1 year after MVC on 100%, 91%, 89%, and 91% of participants, respectively. Individuals who reported prior CWP at the time of ED evaluation (n = 53) were excluded. Trajectory modeling identified a 2-group solution as optimal, with the Bayes Factor value (138) indicating strong model selection. Linear solution plots supported a nonrecovery model. Although the number of body regions with pain in the non-CWP group steadily declined, the number of body regions with pain in the CWP trajectory group (192/895, 22%) remained relatively constant over time. These data support the hypothesis that individuals who develop CWP after MVC develop widespread pain in the early aftermath of MVC, which does not remit.
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Affiliation(s)
- JunMei Hu
- TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA Anesthesiology, University of North Carolina, Chapel Hill, NC, USA Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA Emergency Medicine, Spectrum Health System, Grand Rapids, MI, USA Emergency Medicine, Baystate Medical Center, Springfield, MA, USA Emergency Medicine, North Shore University Hospital, Manhasset, NY, USA Emergency Medicine, Saint Joseph Mercy Health System, Ypsilanti, MI, USA Emergency Medicine, University of Florida, Jacksonville, FL, USA Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA
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Markkula RA, Kalso EA, Kaprio JA. Predictors of fibromyalgia: a population-based twin cohort study. BMC Musculoskelet Disord 2016; 17:29. [PMID: 26772544 PMCID: PMC4715288 DOI: 10.1186/s12891-016-0873-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 01/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a pain syndrome, the mechanisms and predictors of which are still unclear. We have earlier validated a set of FM-symptom questions for detecting possible FM in an epidemiological survey and thereby identified a cluster with "possible FM". This study explores prospectively predictors for membership of that FM-symptom cluster. METHODS A population-based sample of 8343 subjects of the older Finnish Twin Cohort replied to health questionnaires in 1975, 1981, and 1990. Their answers to the set of FM-symptom questions in 1990 classified them in three latent classes (LC): LC1 with no or few symptoms, LC2 with some symptoms, and LC3 with many FM symptoms. We analysed putative predictors for these symptom classes using baseline (1975 and 1981) data on regional pain, headache, migraine, sleeping, body mass index (BMI), physical activity, smoking, and zygosity, adjusted for age, gender, and education. Those with a high likelihood of having fibromyalgia at baseline were excluded from the analysis. In the final multivariate regression model, regional pain, sleeping problems, and overweight were all predictors for membership in the class with many FM symptoms. RESULTS The strongest non-genetic predictor was frequent headache (OR 8.6, CI 95% 3.8-19.2), followed by persistent back pain (OR 4.7, CI 95% 3.3-6.7) and persistent neck pain (OR 3.3, CI 95% 1.8-6.0). CONCLUSIONS Regional pain, frequent headache, and persistent back or neck pain, sleeping problems, and overweight are predictors for having a cluster of symptoms consistent with fibromyalgia.
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Affiliation(s)
- Ritva A Markkula
- Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Eija A Kalso
- Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaakko A Kaprio
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland.,Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
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Cahalan R, O'Sullivan P, Purtill H, Bargary N, Ni Bhriain O, O'Sullivan K. Inability to perform because of pain/injury in elite adult Irish dance: A prospective investigation of contributing factors. Scand J Med Sci Sports 2015; 26:694-702. [PMID: 26040202 DOI: 10.1111/sms.12492] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 12/26/2022]
Affiliation(s)
- R. Cahalan
- Department of Clinical Therapies; University of Limerick; Limerick Ireland
| | - P. O'Sullivan
- School of Physiotherapy; Curtin University of Technology; Perth Western Australia Australia
| | - H. Purtill
- Department of Mathematics & Statistics; University of Limerick; Limerick Ireland
| | - N. Bargary
- Department of Mathematics & Statistics; University of Limerick; Limerick Ireland
| | - O. Ni Bhriain
- Irish World Academy of Music and Dance; University of Limerick; Limerick Ireland
| | - K. O'Sullivan
- Department of Clinical Therapies; University of Limerick; Limerick Ireland
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Law EF, Bromberg MH, Noel M, Groenewald C, Murphy LK, Palermo TM. Alcohol and tobacco use in youth with and without chronic pain. J Pediatr Psychol 2015; 40:509-16. [PMID: 25617047 DOI: 10.1093/jpepsy/jsu116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 12/06/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To compare rates of alcohol and tobacco use in youth with and without chronic pain and to identify risk factors for use. METHODS Participants included 186 youth (95 mixed chronic pain; 91 without chronic pain; 12-18 years old) who reported current alcohol and tobacco use, pain intensity, activity limitations, loneliness, and depressive symptoms. RESULTS Adolescents with chronic pain were less likely to use alcohol compared with adolescents without chronic pain (7.4% vs. 22%), and as likely to use tobacco (9% vs. 8%). Across groups, youth with higher depressive symptoms, less loneliness, and fewer activity limitations were more likely to endorse alcohol and tobacco use. Exploratory analyses revealed that risk factors for substance use differed among youth with and without chronic pain. CONCLUSIONS Chronic pain may not increase risk for tobacco and alcohol use in adolescents. Research is needed to understand use of other substances in this medically vulnerable population.
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Affiliation(s)
- Emily F Law
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute
| | - Maggie H Bromberg
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute
| | - Melanie Noel
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute
| | - Cornelius Groenewald
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute
| | - Lexa K Murphy
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Center for Child Health, Behavior and Development, Seattle Children's Research Institute
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Cahill CM, Taylor AMW, Cook C, Ong E, Morón JA, Evans CJ. Does the kappa opioid receptor system contribute to pain aversion? Front Pharmacol 2014; 5:253. [PMID: 25452729 PMCID: PMC4233910 DOI: 10.3389/fphar.2014.00253] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/30/2014] [Indexed: 01/18/2023] Open
Abstract
The kappa opioid receptor (KOR) and the endogenous peptide-ligand dynorphin have received significant attention due the involvement in mediating a variety of behavioral and neurophysiological responses, including opposing the rewarding properties of drugs of abuse including opioids. Accumulating evidence indicates this system is involved in regulating states of motivation and emotion. Acute activation of the KOR produces an increase in motivational behavior to escape a threat, however, KOR activation associated with chronic stress leads to the expression of symptoms indicative of mood disorders. It is well accepted that KOR can produce analgesia and is engaged in chronic pain states including neuropathic pain. Spinal studies have revealed KOR-induced analgesia in reversing pain hypersensitivities associated with peripheral nerve injury. While systemic administration of KOR agonists attenuates nociceptive sensory transmission, this effect appears to be a stress-induced effect as anxiolytic agents, including delta opioid receptor agonists, mitigate KOR agonist-induced analgesia. Additionally, while the role of KOR and dynorphin in driving the dysphoric and aversive components of stress and drug withdrawal has been well characterized, how this system mediates the negative emotional states associated with chronic pain is relatively unexplored. This review provides evidence that dynorphin and the KOR system contribute to the negative affective component of pain and that this receptor system likely contributes to the high comorbidity of mood disorders associated with chronic neuropathic pain.
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Affiliation(s)
- Catherine M Cahill
- Department of Anesthesiology and Perioperative Care, University of California Irvine Irvine, CA, USA ; Department of Pharmacology, University of California Irvine Irvine, CA, USA ; Department of Biomedical and Molecular Sciences, Queen's University Kingston, ON, Canada
| | - Anna M W Taylor
- Department of Anesthesiology and Perioperative Care, University of California Irvine Irvine, CA, USA ; Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles Los Angeles, CA, USA
| | - Christopher Cook
- Department of Anesthesiology and Perioperative Care, University of California Irvine Irvine, CA, USA ; Department of Pharmacology, University of California Irvine Irvine, CA, USA
| | - Edmund Ong
- Department of Anesthesiology and Perioperative Care, University of California Irvine Irvine, CA, USA ; Department of Biomedical and Molecular Sciences, Queen's University Kingston, ON, Canada
| | - Jose A Morón
- Department of Anesthesiology, Columbia University Medical Center, New York, NY USA
| | - Christopher J Evans
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles Los Angeles, CA, USA
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Burke NN, Finn DP, Roche M. Chronic administration of amitriptyline differentially alters neuropathic pain-related behaviour in the presence and absence of a depressive-like phenotype. Behav Brain Res 2014; 278:193-201. [PMID: 25300472 DOI: 10.1016/j.bbr.2014.09.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 01/11/2023]
Abstract
Chronic pain and depression share a complex, reciprocal relationship. Furthermore, in addition to treating depression, antidepressants such as amitriptyline are a first-line treatment for chronic pain conditions, indicating possible common neural substrates underlying both depression and pain. However, there is a paucity of studies examining the effect of antidepressant treatment on nociceptive and neuropathic pain responding in the presence of a depressive phenotype. The current study aimed to examine the effect of chronic amitriptyline administration on neuropathic pain-related behaviour and associated neuroinflammatory processes in the olfactory bulbectomised (OB) rat model of depression. Nociceptive responding to mechanical, innocuous cold or noxious heat stimuli in sham or OB rats was not altered by chronic amitriptyline administration. The induction of neuropathic pain following L5-L6 spinal nerve ligation (SNL) resulted in robust mechanical and cold allodynia and heat hyperalgesia in both sham and OB vehicle-treated animals. Chronic amitriptyline administration attenuated SNL-induced mechanical allodynia in both sham and OB rats at day 7 post-SNL, an effect which was enhanced and prolonged in OB rats. In comparison, chronic amitriptyline administration attenuated SNL-induced cold allodynia and heat hyperalgesia in sham, but not OB, rats. Evaluating the affective/motivational aspect of pain using the place escape avoidance paradigm revealed that OB-SNL rats exhibit reduced noxious avoidance behaviour when compared with sham counterparts, an effect not altered by chronic amitriptyline administration. Chronic amitriptyline administration prevented the increased expression of GFAP, IL-10 and CCL5, and enhanced the expression of TNFα, in the prefrontal cortex of OB-SNL rats. In conclusion, these data demonstrate that chronic amitriptyline differentially alters somatic nociceptive responding following peripheral nerve-injury, depending on stimulus modality and the presence or absence of a depressive-like phenotype, an effect which may involve modulation of neuroinflammatory processes.
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Affiliation(s)
- Nikita N Burke
- Physiology, School of Medicine, National University of Ireland Galway, University Road, Galway, Ireland; Pharmacology and Therapeutics, School of Medicine, National University of Ireland Galway, University Road, Galway, Ireland; NCBES Galway Neuroscience Centre and Centre for Pain Research, National University of Ireland Galway, University Road, Galway, Ireland
| | - David P Finn
- Pharmacology and Therapeutics, School of Medicine, National University of Ireland Galway, University Road, Galway, Ireland; NCBES Galway Neuroscience Centre and Centre for Pain Research, National University of Ireland Galway, University Road, Galway, Ireland
| | - Michelle Roche
- Physiology, School of Medicine, National University of Ireland Galway, University Road, Galway, Ireland; NCBES Galway Neuroscience Centre and Centre for Pain Research, National University of Ireland Galway, University Road, Galway, Ireland.
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