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Mehok LE, Walsh KT, Miller MM, Anastas TM, Hirsh AT. Exercise and Dietary Recommendations for Women with Chronic Pain: What's Weight and Race Got To Do with It? THE JOURNAL OF PAIN 2024; 25:104505. [PMID: 38484856 PMCID: PMC11283970 DOI: 10.1016/j.jpain.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/08/2024] [Accepted: 03/03/2024] [Indexed: 05/12/2024]
Abstract
Exercise and diet are beneficial for pain, yet many patients do not receive such recommendations from providers. This may be due to biases related to gender, race, and weight. We recruited medical students (N = 90) to view videos of women with chronic back pain performing a functional task; patients varied by weight (overweight/obese) and race (Black/White). For each woman patient, providers rated their likelihood of recommending exercises or dietary changes. Ratings significantly differed across recommendations (F(2.75, 244.72) = 6.19, P < .01) in that providers were more likely to recommend flexibility exercises than aerobic exercises and dietary changes and were more likely to recommend strength exercises than dietary changes. Results also indicated that women with obesity were more likely to receive aerobic (F(1,89) = 17.20, P < .01), strength (F(1,89) = 6.08, P = .02), and dietary recommendations (F(1,89) = 37.56, P < .01) than were women with overweight. Additionally, White women were more likely to receive a recommendation for flexibility exercises (F(1,89) = 4.92, P = .03) than Black women. Collectively, these findings suggest that providers' exercise and dietary recommendations for women with chronic pain are influenced by the weight status and racial identity of the patient. Future studies are needed to identify the reasons underlying these systematic differences, including the stereotypes and attitudes that may be driving these effects. PERSPECTIVE: This article presents results on how patient weight and race impact providers' exercise and diet recommendations for women with chronic back pain. Provider recommendations for these modalities may be systematically biased in a way that impedes care and impacts patient functioning.
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Affiliation(s)
- Lauren E. Mehok
- Behavioral Health Care Line, New Mexico Veterans Affairs Healthcare System, Albuquerque, NM
| | - Kaitlyn T. Walsh
- Department of Psychology, Indiana University Indianapolis (IUI), Indianapolis, IN
| | - Megan M. Miller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tracy M. Anastas
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Adam T. Hirsh
- Department of Psychology, Indiana University Indianapolis (IUI), Indianapolis, IN
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Ward SJ, Coates AM, Carter S, Baldock KL, Berryman C, Stanton TR, Yandell C, Buckley JD, Tan SY, Rogers GB, Hill AM. Effects of weight loss through dietary intervention on pain characteristics, functional mobility, and inflammation in adults with elevated adiposity. Front Nutr 2024; 11:1274356. [PMID: 38840696 PMCID: PMC11150618 DOI: 10.3389/fnut.2024.1274356] [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: 08/08/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Background The relationship between adiposity and pain is complex. Excess weight increases the risk for chronic musculoskeletal pain (CMP), driven by increased biomechanical load and low-grade systemic inflammation. Pain limits physical function, impacting energy balance contributing to weight gain. The primary aims of this study were to profile pain characteristics in participants with overweight or obesity and determine if weight loss through dietary-induced energy restriction, and presence of CMP, or magnitude of weight loss, was associated with changes in adiposity, pain, functional mobility, and inflammation. Methods This was a secondary analysis of data from adults (25-65 years) with overweight or obesity (BMI 27.5-34.9 kg/m2) enrolled in a 3-month, 30% energy-restricted dietary intervention to induce weight loss (January 2019-March 2021). Anthropometric measures (weight, waist circumference and fat mass), pain prevalence, pain severity (McGill Pain Questionnaire, MPQ), pain intensity (Visual Analog Scale, VAS), functional mobility (timed up and go, TUG) and inflammation (high sensitivity C-Reactive Protein, hsCRP) were assessed at baseline and 3-months. Results One hundred and ten participants completed the intervention and had weight and pain assessed at both baseline and 3-months. Participants lost 7.0 ± 0.3 kg, representing 7.9% ± 3.7% of body mass. At 3-months, functional mobility improved (TUG -0.2 ± 0.1 s, 95% CI -0.3, -0.1), but there was no change in hsCRP. Compared to baseline, fewer participants reported CMP at 3-months (n = 56, 51% to n = 27, 25%, p < 0.001) and presence of multisite pain decreased from 22.7% to 10.9% (p < 0.001). Improvements in anthropometric measures and functional mobility did not differ between those presenting with or without CMP at baseline. Improvements in pain were not related to the magnitude of weight loss. Conclusion Weight loss was effective in reducing pain prevalence and improving functional mobility, emphasizing the importance of considering weight-loss as a key component of pain management. Clinical trial registration identifier, ACTRN12618001861246.
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Affiliation(s)
- Susan J. Ward
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Alison M. Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Sharayah Carter
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Katherine L. Baldock
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Carolyn Berryman
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
- Innovation, IMPlementation and Clinical Translation (IIMPACT), University of South Australia, Adelaide, SA, Australia
| | - Tasha R. Stanton
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
- Innovation, IMPlementation and Clinical Translation (IIMPACT), University of South Australia, Adelaide, SA, Australia
- Persistent Pain Research Group, Hopwood Centre for Neurobiology, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Catherine Yandell
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jonathan D. Buckley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Sze-Yen Tan
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, VIC, Australia
| | - Geraint B. Rogers
- Microbiome and Host Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Alison M. Hill
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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Aroke EN, Srinivasasainagendra V, Kottae P, Quinn TL, Wiggins AM, Hobson J, Kinnie K, Stoudmire T, Tiwari HK, Goodin BR. The Pace of Biological Aging Predicts Nonspecific Chronic Low Back Pain Severity. THE JOURNAL OF PAIN 2024; 25:974-983. [PMID: 37907115 PMCID: PMC10960701 DOI: 10.1016/j.jpain.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/15/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023]
Abstract
This study aimed to determine if and how the pace of biological aging was associated with nonspecific chronic low back pain (cLBP) and compare what measure of epigenetic age acceleration most strongly predicts cLBP outcomes. We used the Dunedin Pace of Aging from the Epigenome (DunedinPACE), Horvath's, Hannum's, and PhenoAge clocks to determine the pace of biological aging in 69 cLBP, and 49 pain-free controls (PFCs) adults, ages 18 to 85 years. On average, participants with cLBP had higher DunedinPACE (P < .001) but lower Horvath (P = .04) and Hannum (P = .02) accelerated epigenetic age than PFCs. There was no significant difference in PhenoAge acceleration between the cLBP and PFC groups (P = .97). DunedinPACE had the largest effect size (Cohen's d = .78) on group differences. In univariate regressions, a unit increase in DunedinPACE score was associated with 265.98 times higher odds of cLBP than the PFC group (P < .001). After controlling for sex, race, and body mass index (BMI), the odds ratio of cLBP to PFC group was 149.62 (P < .001). Furthermore, among participants with cLBP, DunedinPACE scores positively correlated with pain severity (rs = .385, P = .001) and interference (rs = .338, P = .005). Epigenetic age acceleration from Horvath, Hannum, and PhenoAge clocks were not significant predictors of cLBP. The odds of a faster pace of biological aging are higher among adults with cLBP, and this was associated with greater pain severity and disability. Future interventions to slow the pace of biological aging may improve cLBP outcomes. PERSPECTIVE: Accelerated epigenetic aging is common among adults with nonspecific cLBP. Higher DunedinPACE scores positively correlate with pain severity and interference, and better predict cLBP than other DNA methylation clocks. Interventions to slow the pace of biological aging may be viable targets for improving pain outcomes.
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Affiliation(s)
- Edwin N. Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vinodh Srinivasasainagendra
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pooja Kottae
- Department of Computer Science, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tammie L. Quinn
- Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Asia M. Wiggins
- Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joanna Hobson
- Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kiari Kinnie
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tonya Stoudmire
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hemant K. Tiwari
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R. Goodin
- Department of Anesthesiology, School of Medicine, Washington University, St Louis, USA
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Rezaei M, Tajary Z, Esmaeily Z, Eyvazkhani A, Daei S, Dara MM, Rezaei M, Djazayeri A, Motlagh AD. Association between the empirical dietary inflammatory index and musculoskeletal pain in community-dwelling older adults: a cross-sectional study. Osong Public Health Res Perspect 2023; 14:51-58. [PMID: 36944345 DOI: 10.24171/j.phrp.2022.0194] [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: 07/08/2022] [Accepted: 01/12/2023] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES Inflammation has been proposed to be one of the main causes of musculoskeletal pain. Diet is a lifestyle factor that plays an important role in managing inflammation; thus, we assessed the inflammatory potential of diets using the empirical dietary inflammatory index (EDII) to investigate the relationship between diet and musculoskeletal pain. METHODS This cross-sectional study included 212 elderly individuals who were selected from health centers in Tehran, Iran. Dietary intake was evaluated using a valid and reliable 147-item food frequency questionnaire. To measure the intensity of pain, a visual analogue scale was used. Multiple linear regression was applied to assess the association between the EDII and musculoskeletal pain. RESULTS In total, 62.7% and 37.3% of participants had mild and severe pain, respectively. The EDII values were 0.97±0.72 and 1.10±0.66, respectively, in those with mild and severe pain. A higher EDII score was associated with more intense musculoskeletal pain after adjusting for age and sex (β=0.20; 95% confidence interval [CI], 0.06-0.26; p<0.001), but not after adjustment for other confounders (β=-0.13; 95% CI, -1.54 to 0.60; p=0.39). CONCLUSIONS Our findings indicated that higher dietary inflammation might not be associated with musculoskeletal pain in older adults. However, further investigations are required to confirm these findings.
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Affiliation(s)
- Mahshid Rezaei
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Tajary
- Department of Community Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeily
- Department of Community Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Eyvazkhani
- Department of Community Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Daei
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Marjan Mansouri Dara
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohaddeseh Rezaei
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Abolghassem Djazayeri
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Department of Community Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Dorosty Motlagh
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Department of Community Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Chronic Pain in Musculoskeletal Diseases: Do You Know Your Enemy? J Clin Med 2022; 11:jcm11092609. [PMID: 35566735 PMCID: PMC9101840 DOI: 10.3390/jcm11092609] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 02/06/2023] Open
Abstract
Musculoskeletal pain is a condition that characterises several diseases and represents a constantly growing issue with enormous socio-economic burdens, highlighting the importance of developing treatment algorithms appropriate to the patient’s needs and effective management strategies. Indeed, the algic condition must be assessed and treated independently of the underlying pathological process since it has an extremely negative impact on the emotional and psychic aspects of the individual, leading to isolation and depression. A full understanding of the pathophysiological mechanisms involved in nociceptive stimulation and central sensitization is an important step in improving approaches to musculoskeletal pain. In this context, the bidirectional relationship between immune cells and neurons involved in nociception could represent a key point in the understanding of these mechanisms. Therefore, we provide an updated overview of the magnitude of the musculoskeletal pain problem, in terms of prevalence and costs, and summarise the role of the most important molecular players involved in the development and maintenance of pain. Finally, based on the pathophysiological mechanisms, we propose a model, called the “musculoskeletal pain cycle”, which could be a useful tool to counteract resignation to the algic condition and provide a starting point for developing a treatment algorithm for the patient with musculoskeletal pain.
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Torlak MS, Gonulalan G, Tufekci O, Nazli MS, Atici E. The effect of therapeutic exercise and vegan diet on pain and quality of life in young female patients with chronic non-specific neck pain. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-021-00061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract
Background and purpose
In recent years, dietary practices have begun to be used in painful conditions. This study aimed to investigate the effect of a vegan diet and therapeutic exercise in patients with chronic non-specific neck pain.
Materials and methods
A total of 45 young female patients with chronic non-specific neck pain, aged 18–25 years, participated in the study. Body mass index and body fat percentage were measured with bioelectrical impedance analysis. Pain severity was assessed using the Visual Analogue Scale, quality of life with the short form-36 scale, kinesiophobia with the Tampa scale of kinesiophobia and neck disability with the Neck Disability Index.
Results
The pain severity reduced in the diet group and exercise group after treatment (p = 0.001). After treatment, Neck Disability Index score decreased in the diet group and exercise group (p = 0.001). Tampa scale of kinesiophobia score decreased in the diet group and exercise group (p = 0.001). The eight domains of the short form-36 scale score increased in the diet group and exercise group (p < 0.05). No difference was found in the body mass index and fat percentage in all groups before and after treatment (p˃ 0.05).
Conclusion
A vegan diet and therapeutic exercise are beneficial to patients with chronic non-specific neck pain in terms of pain severity and quality of life.
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Venkatesh HN, Ravish H, Wilma Delphine Silvia CR, Srinivas H. Molecular Signature of the Immune Response to Yoga Therapy in Stress-related Chronic Disease Conditions: An Insight. Int J Yoga 2020; 13:9-17. [PMID: 32030016 PMCID: PMC6937878 DOI: 10.4103/ijoy.ijoy_82_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The world Health Organization defines health as complete well-being in terms of physical, mental and social, and not merely the absence of disease. To attain this, individual should adapt and self-mange the social, physical and emotional challenges of life. Exposure to chronic stress due to urbanization, work stress, nuclear family, pollution, unhealthy food habits, lifestyle, accidental death in the family, and natural calamities are the triggering factors, leading to hormonal imbalance and inflammation in the tissue. The relationship between stress and illness is complex; all chronic illnesses such as cardiovascular disease and asthma have their root in chronic stress attributed by inflammation. In recent times, yoga therapy has emerged as an important complementary alternative medicine for many human diseases. Yoga therapy has a positive impact on mind and body; it acts by incorporating appropriate breathing techniques and mindfulness to attain conscious direction of our awareness of the present moment by meditation, which helps achieve harmony between the body and mind. Studies have also demonstrated the important regulatory effects of yoga therapy on brain structure and functions. Despite these advances, the cellular and molecular mechanisms by which yoga therapy renders its beneficial effects are inadequately known. A growing body of evidence suggests that yoga therapy has immunomodulatory effects. However, the precise mechanistic basis has not been addressed empirically. In this review, we have attempted to highlight the effect of yoga therapy on immune system functioning with an aim to identify important immunological signatures that index the effect of yoga therapy. Toward this, we have summarized the available scientific evidence showing positive impacts of yoga therapy. Finally, we have emphasized the efficacy of yoga in improving physical and mental well-being. Yoga has been a part of Indian culture and tradition for long; now, the time has come to scientifically validate this and implement this as an alternative treatment method for stress-related chronic disease.
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Affiliation(s)
- H N Venkatesh
- Department of Human Genetics, NIMHANS, Bangalore, India
| | - H Ravish
- Department of Neurochemistry, NIMHANS, Bangalore, India
| | - C R Wilma Delphine Silvia
- Department of Biochemistry, Bowring and Lady Curzon Medical College and Research Institute, Bangalore, India
| | - H Srinivas
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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Robson EK, Kamper SJ, Davidson S, Viana da Silva P, Williams A, Hodder RK, Lee H, Hall A, Gleadhill C, Williams CM. Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial. BMJ Open 2019; 9:e029290. [PMID: 31481555 PMCID: PMC6731930 DOI: 10.1136/bmjopen-2019-029290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Low back pain is one of the most common and burdensome chronic conditions worldwide. Lifestyle factors, such as excess weight, physical inactivity, poor diet and smoking, are linked to low back pain chronicity and disability. There are few high-quality randomised controlled trials that investigate the effects of targeting lifestyle risk factors in people with chronic low back pain. METHODS AND ANALYSIS The aim of this study is to determine the effectiveness of a Healthy Lifestyle Program (HeLP) for low back pain targeting weight, physical activity, diet and smoking to reduce disability in patients with chronic low back pain compared with usual care. This is a randomised controlled trial, with participants stratified by body mass index, allocated 1:1 to the HeLP intervention or usual physiotherapy care. HeLP involves three main components: (1) clinical consultations with a physiotherapist and dietitian; (2) educational resources; and (3) telephone-based health coaching support for lifestyle risk factors. The primary outcome is disability (Roland Morris Disability Questionnaire) at 26 weeks. Secondary outcomes include pain intensity, weight, quality of life and smoking status. Data will be collected at baseline, and at weeks 6, 12, 26 and 52. Patients with chronic low back pain who have at least one health risk factor (are overweight or obese, are smokers and have inadequate physical activity or fruit and vegetable consumption) will be recruited from primary or secondary care, or the community. Primary outcome data will be analysed by intention to treat using linear mixed-effects regression models. We will conduct three supplementary analyses: causal mediation analysis, complier average causal effects analysis and economic analysis. ETHICS AND DISSEMINATION This study was approved by the Hunter New England Research Ethics Committee (Approval No 17/02/15/4.05), and the University of Newcastle Human Research Ethics Committee (Ref No H-2017-0222). Outcomes of this trial and supplementary analyses will be disseminated through publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12617001288314.
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Affiliation(s)
- Emma K Robson
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
| | - Steven J Kamper
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Simon Davidson
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
| | - Priscilla Viana da Silva
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
| | - Amanda Williams
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Hopin Lee
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
- Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK
| | - Alix Hall
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
| | - Connor Gleadhill
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
| | - Christopher M Williams
- School of Medicine and Public Health, Hunter Medical Research Institute, The University of Newcastle, Callaghan, Newcastle, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
- Centre for Pain, Health and Lifestyle, Sydney, New South Wales, Australia
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Psychosocial Issues and Lifestyle Changes for the Renal Patient. Nurs Clin North Am 2018; 53:589-600. [PMID: 30388984 DOI: 10.1016/j.cnur.2018.07.008] [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: 11/21/2022]
Abstract
This article provides an overview of the psychosocial issues faced by those with renal disease. The article discusses the physiologic connection between anxiety, depression, and pain-symptoms commonly seen in renal disease and other chronic illnesses. The application of integrative medicine or nonallopathic medicine and its role in the management of anxiety, depression, and pain are presented. Also presented is evidence surrounding several frequently used nonallopathic modalities appropriate for incorporation into a comprehensive management regimen for renal patients to reduce symptom burden. The article concludes with a discussion on the role of palliative care in treatment decisions for renal patients.
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Towery P, Guffey JS, Doerflein C, Stroup K, Saucedo S, Taylor J. Chronic musculoskeletal pain and function improve with a plant-based diet. Complement Ther Med 2018; 40:64-69. [PMID: 30219471 DOI: 10.1016/j.ctim.2018.08.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic musculoskeletal pain, often debilitating, affects all genders, ethnicities, and age groups. Research suggests consumption of a plant-based diet may improve the status of persons with chronic pain. A diet rich in fruits, vegetables and whole grains has been shown to reduce chronic pain and disability associated with musculoskeletal conditions. OBJECTIVE The purpose of this study was to examine the value of a plant-based diet in the management of chronic musculoskeletal pain and functional limitations. METHOD Fourteen subjects participated in the eight-week study. Baseline evaluation included anthropometric measurements and completion of two self-reported outcome measures: Numeric Pain Rating Scale (NPRS) and the Short Form Health Survey (SF-36). A registered dietitian nutritionist provided a sample menu cycle and education on a plant-based diet. Subjects utilized a phone app to log food intake and receive support from the dietitian. Post data collection included a repeat of the baseline measures and the Patient Global Impression of Change Scale. The sample was small. Twenty subjects began, 14 completed. No comparison group was used. Results should be considered with caution. RESULTS The diet intervention resulted in decreased pain and improvement in quality of life. Diet adherence by ten of fourteen subjects was 89% based on completion of food intake records and adherence to allowed foods. CONCLUSION Consumption of a plant-based diet produced positive improvements in chronic pain and function. Interprofessional collaboration between physical therapists and registered dietitian nutritionists, along with other healthcare practitioners, can encourage and promote diet interventions that positively affect chronic pain.
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Affiliation(s)
- Pam Towery
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States.
| | - J Stephen Guffey
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Cody Doerflein
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Kyle Stroup
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Sara Saucedo
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
| | - Jennifer Taylor
- College of Nursing and Health Professions, Arkansas State University, State University, P.O. Box 910, AR 72467, United States
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