1
|
Skordis C, Liaskou C, Papagiakoumou E, Sotiropoulos S, Plavoukou T, Karakasidou P, Georgoudis G. Intra-rater and Inter-rater Reliability of the Commander Pressure Algometer in Greek Patients With Chronic Neck Pain. Cureus 2024; 16:e66350. [PMID: 39247009 PMCID: PMC11379426 DOI: 10.7759/cureus.66350] [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] [Accepted: 04/23/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction Non-specific chronic neck pain (NSCNP) is a musculoskeletal disorder that affects 45%-54% of the general population. There is a strong correlation between patient-reported pain and mechanical pain pressure threshold (PPT) measured with an algometer. Purpose This study aims to investigate the intra- and inter-rater reliability of the Commander algometer in Greek NSCNP patients, in an urban primary care setting. Methods Thirty-three patients (22 women and 11 men) suffering from NSCNP (>3 months), the majority (42.4%) between the ages of 50 years and 59 years and overweight, were measured bilaterally both at the neck (mastoid, trapezius head-insertion and mid-portion, C5-C6 facet, insertion of levator scapula) and at the control areas (mid-deltoid and tibialis anterior) using the Commander algometer. Measurements were taken twice over a span of six days, by two raters, in a primary care setting. Intraclass correlation coefficient (ICC) statistics were used as measures of reliability (p = 0.05). Results Intra-rater reliability was "moderate to good" for both raters. ICC values for PPT at the seven bilaterally measured sites varied between 0.67 and 0.86 for the first rater (p ≤ 0.001) and 0.64 and 0.82 for the second rater (p ≤ 0.003). The inter-rater reliability was "moderate to excellent" (ICC = 0.68-0.92) in the first measurement (T1) and "moderate to good" (ICC = 0.68 to 0.89) in the second measurement (T2). Conclusion This study supports the intra- and inter-rater reliability of the Commander algometer in detecting reliably the mechanical PPT, in Greek NSCNP patients, as measured according to the procedures and methodology followed throughout this study.
Collapse
Affiliation(s)
| | - Christina Liaskou
- Physiotherapy Department, University of West Attica (UNIWA), Athens, GRC
| | | | | | - Theodora Plavoukou
- Physiotherapy Department, University of West Attica (UNIWA), Athens, GRC
| | - Palina Karakasidou
- Physiotherapy Department, University of West Attica (UNIWA), Athens, GRC
| | - George Georgoudis
- Physiotherapy Department, University of West Attica (UNIWA), Athens, GRC
| |
Collapse
|
2
|
Medrano-de-la-Fuente R, Hernando-Garijo I, Mingo-Gómez MT, Jiménez-Del-Barrio S, Hernández-Lázaro H, Ceballos-Laita L. Is adding dry needling to a standard care protocol beneficial in patients with chronic neck pain? A randomized placebo-controlled trial. Complement Ther Clin Pract 2024; 55:101842. [PMID: 38364664 DOI: 10.1016/j.ctcp.2024.101842] [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: 11/03/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE To evaluate the short-term effects of adding a dry needling therapy to a standard care protocol based on education, exercise and electrotherapy, compared to a sham procedure and to a standard care protocol in isolation in patients with chronic neck pain. MATERIAL AND METHODS A randomized placebo-controlled trial was performed. The participants in the dry needling group received a standard care protocol based on patient education, therapeutic exercise and electrotherapy, as well as two sessions of dry needling in the upper trapezius, levator scapulae, and/or sternocleidomastoid muscles. The participants in the sham dry needling group received the same standard care protocol and two sessions of sham dry needling. The participants in the control group received the same standard care protocol. The outcomes measured were pain intensity, pressure pain threshold, neck disability, range of movement, activation of deep cervical flexor muscles, kinesiophobia, pain catastrophizing, anxiety, and depression. RESULTS No significant group by time interactions were found for any of the outcome variables except for lower cervical spine range of movement (F = 3.79; p = 0.030). CONCLUSION The addition of two sessions of dry needling in the superficial neck muscles to a standard protocol did not yield superior results compared to either the standard care alone or the standard care plus sham dry needling in patients with chronic neck pain in any outcome except for cervical range of movement.
Collapse
Affiliation(s)
- Ricardo Medrano-de-la-Fuente
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - Ignacio Hernando-Garijo
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - María Teresa Mingo-Gómez
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - Sandra Jiménez-Del-Barrio
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain.
| | - Héctor Hernández-Lázaro
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| | - Luis Ceballos-Laita
- Faculty of Health Sciences, University of Valladolid, C/ Universidad, 42004, Soria, Spain; Clinical Research in Health Sciences Group, University of Valladolid, C/ Universidad, 42004, Soria, Spain
| |
Collapse
|
3
|
Groisman S, da Silva LDS, Sanches TRR, Rocha CSDS, Malysz T, Jotz GP. Assessment of Long-term Effects of Adding Osteopathic Manipulative Treatment to Neck Exercises for Individuals With Non-specific Chronic Neck Pain: A Randomized Trial. J Chiropr Med 2023; 22:265-274. [PMID: 38205221 PMCID: PMC10774622 DOI: 10.1016/j.jcm.2023.10.003] [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: 08/22/2022] [Revised: 07/28/2023] [Accepted: 10/05/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The purpose of this study was to evaluate the long-term effects of adding osteopathic manipulative treatment (OMT) to neck exercises compared to exercises alone for individuals with non-specific chronic neck pain (NCNP). Methods A randomized controlled trial was conducted by assigning 90 individuals with NCNP into the following 2 groups: (1) exercises group (EG, n = 45) or (2) OMT plus exercises group (OMT/EG, n = 45). All participants received 4 weeks of treatment. The clinical outcomes were recorded at baseline and at 3 and 6 months after the treatment. The primary outcomes were pain and function-Numerical Pain Rating Scale (NPRS), Pressure Pain Threshold, and the Neck Disability Index (NDI). The secondary outcomes included range of motion for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. Results In comparison to baseline data, both groups had a reduction of NPRS (P < .05) and NDI (P < .05) after the treatment. However, no statistically significant differences in pain intensity or disability were found when OMT/EG was compared to EG alone at 3 months (P = 0.1 and P = 0.2, respectively) and at 6 months (P = 0.4 and P = 0.9, respectively for pain and disability) and no difference was found between OMT/EG and the EG in the secondary outcomes during the same follow-up period (P > .05). Conclusion Outcomes of pain and functionality for patients in both groups were improved at 6 months. Our findings show that the combination of OMT and neck exercises for 4 weeks did not improve functionality and reduction of pain in patients with NCNP.
Collapse
Affiliation(s)
- Sandro Groisman
- Doctoral Program in Health Sciences; Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre/RS, Brazil
- FEEVALE University, Novo Hamburgo/RS, Brazil
- Brazilian Institute of Osteopathy (IBO), Porto Alegre/RS, Brazil
| | | | | | - Clarice Sperotto dos Santos Rocha
- Brazilian Institute of Osteopathy (IBO), Porto Alegre/RS, Brazil
- School of Physical Education, Physiotheraphy and Dance; Federal University of Rio Grande do Sul (UFRGS), Porto Alegre/RS, Brazil
| | - Tais Malysz
- Doctoral Program in Neuroscience; Federal University of Rio Grande do Sul (UFRGS), Porto Alegre/RS, Brazil
- Department of Morphological Sciences; Federal University of Rio Grande do Sul (UFRGS), Porto Alegre/RS, Brazil
| | - Geraldo Pereira Jotz
- Doctoral Program in Health Sciences; Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre/RS, Brazil
- Department of Morphological Sciences; Federal University of Rio Grande do Sul (UFRGS), Porto Alegre/RS, Brazil
| |
Collapse
|
4
|
Ambalavanar U, Berkers V, Haavik H, Murphy BA. Effect Sizes for Changes in Health and Well-Being Following Treatment With the One-To-Zero Technique in Individuals With Occipito-Atlantal Joint Dysfunction: A Repeated Measures Study. J Chiropr Med 2023; 22:302-312. [PMID: 38205225 PMCID: PMC10774879 DOI: 10.1016/j.jcm.2023.10.004] [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: 06/15/2023] [Revised: 10/07/2023] [Accepted: 10/07/2023] [Indexed: 01/12/2024] Open
Abstract
Objectives The purpose of this study was to determine effect sizes (ES) for changes in self-reported measures of musculoskeletal pain and dysfunction resulting from the one-to-zero method using a repeated measures study design. Methods Twenty participants presenting with articular dysfunction of the occipito-atlantal (C0-C1) complex were treated using the one-to-zero method, a high-velocity low-amplitude thrust administered between the C0-C1 complex before treating other restrictive segments in a cephalocaudal direction. The participants completed online questionnaires using Google Forms that assessed aspects of the biopsychosocial model of pain at baseline and within a week after treatment. The questionnaires included the following: (1) Demographic and Health Behavior Survey; (2) Neck Bournemouth Questionnaire (NBQ) or Neck Disability Index (NDI); (3) Beck Anxiety Index (BAI); (4) Insomnia Severity Index (ISI); and (5) 36-Item Short Form Health Survey (SF-36). Paired t test or Wilcoxon signed ranks test was performed, dependent on normality. Cohen's d values were calculated for each questionnaire score (0.20 indicative of small; ≥0.50 medium; and ≥0.80 large ES). Results The NDI, NBQ, BAI, and ISI had a large ES (all d ≥ 0.80). In the SF-36, 4 subscales had a small to near-medium ES, 1 subscale had a medium to near-large ES, and the remaining 2 had a large ES (d ≥ 0.80). The physical and mental component summary had a large (d = 0.88) and small ES (d = 0.35), respectively. Conclusion The effect sizes suggest the one-to-zero treatment induces change in various aspects of the biopsychosocial model.
Collapse
Affiliation(s)
- Ushani Ambalavanar
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Victoria Berkers
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
| | | |
Collapse
|
5
|
Chen Z, Falla D, Elgueta Cancino E, A Deane J. Can baseline features predict a reduction in pain and disability following neck-specific exercise in people with chronic non-specific neck pain?: A systematic review and meta-analysis protocol. BMJ Open 2023; 13:e074494. [PMID: 37429689 PMCID: PMC10335581 DOI: 10.1136/bmjopen-2023-074494] [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: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Neck-specific exercises (NSEs) are commonly used for the treatment of chronic non-specific neck pain (CNSNP). However, it remains unclear whether baseline features can predict the response to neck-specific exercise (NSE) in people with CNSNP. This systematic review aims to assess whether baseline features such as age, gender, muscle activity, fatigability, endurance and fear of movement can predict pain and disability reduction following a NSE intervention. METHODS AND ANALYSIS This systematic review and meta-analysis will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols guidelines checklist. The Web of Science, PubMed, Scopus, MEDLINE, Embase and CINAHL databases; key journals; and grey literature will be searched up until June 2023, including medical subject heading terms and keywords combinations. Included studies will investigate an association between the baseline features and pain and disability outcomes following NSE in people with CNSNP. Two independent reviewers will oversee the searching, screening, data extraction and assessment of risk of bias. The risk of bias will be assessed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) and Risk-Of-Bias tool for randomised trials 2 (ROB 2). The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). Using standardised forms, details regarding study characteristics, baseline features (predictive factors), intervention, primary outcome and effect size (OR and 95% CI of each predictive factor and p value) will be extracted from included studies. Meta-analyses will be considered, if the studies are sufficiently homogeneous and if three or more studies investigate the same or comparable factors that predict the same response (pain intensity or disability). In the event that less than three studies investigated the same factors, a narrative synthesis will be conducted. ETHICS AND DISSEMINATION Ethical approval will not be required as this review will be based on published studies. The results of this study will be submitted to a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42023408332.
Collapse
Affiliation(s)
- Ziyan Chen
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Edith Elgueta Cancino
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andrés Bello, Santiago, Chile
| | - Janet A Deane
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
6
|
Farrell SF, Edmunds D, Fletcher J, Martine H, Mohamed H, Liimatainen J, Sterling M. Effectiveness of psychological interventions delivered by physiotherapists in the management of neck pain: a systematic review with meta-analysis. Pain Rep 2023; 8:e1076. [PMID: 37731474 PMCID: PMC10508403 DOI: 10.1097/pr9.0000000000001076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/15/2023] [Accepted: 02/25/2023] [Indexed: 09/22/2023] Open
Abstract
Physiotherapists are increasingly using psychological treatments for musculoskeletal conditions. We assessed the effects of physiotherapist-delivered psychological interventions on pain, disability, and quality of life in neck pain. We evaluated quality of intervention reporting. We searched databases for randomized controlled trials (RCTs) comprising individuals with acute or chronic whiplash-associated disorder (WAD) or nontraumatic neck pain (NTNP), comparing physiotherapist-delivered psychological interventions to standard care or no treatment. Data were extracted regarding study characteristics and outcomes. Standardised mean difference (SMD) was calculated by random-effects meta-analysis. We evaluated certainty of evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) and intervention reporting using TIDieR. Fourteen RCTs (18 articles-4 detail additional outcome/follow-up data) were included comprising 2028 patients, examining acute WAD (n = 4), subacute/mixed NTNP (n = 3), chronic WAD (n = 2), and chronic NTNP (n = 5). Treatment effects on pain favoured psychological interventions in chronic NTNP at short-term (SMD -0.40 [95% CI -0.73, -0.07]), medium-term (SMD -0.29 [95% CI -0.57, 0.00]), and long-term (SMD -0.32 [95% CI -0.60, -0.05]) follow-up. For disability, effects favoured psychological interventions in acute WAD at short-term follow-up (SMD -0.39 [95% CI -0.72, -0.07]) and chronic NTNP at short-term (SMD -0.53 [95% CI -0.91, -0.15]), medium-term (SMD -0.49 [95% CI -0.77, -0.21]), and long-term (SMD -0.60 [95% CI -0.94, -0.26]) follow-up. GRADE ratings were typically moderate, and intervention reporting often lacked provision of trial materials and procedural descriptions. Psychological interventions delivered by physiotherapists were more effective than standard physiotherapy for chronic NTNP (small-to-medium effects) and, in the short term, acute WAD.
Collapse
Affiliation(s)
- Scott F. Farrell
- RECOVER Injury Research Centre and NHMRC Centre for Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
| | - Devon Edmunds
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - John Fletcher
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Harry Martine
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Hashem Mohamed
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Jenna Liimatainen
- RECOVER Injury Research Centre and NHMRC Centre for Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre and NHMRC Centre for Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
| |
Collapse
|
7
|
Alghamdi MS, Alghamdi AF, Almalawi AM, Alsulami RA, Hazazi HA, Al Ghashmari AA, Al Dawais AS, Salawati E. The Association Between Neck Pain and Psychological Distress Experienced by King Abdulaziz University Students: A Cross-Sectional Study. Cureus 2023; 15:e35685. [PMID: 37012948 PMCID: PMC10066660 DOI: 10.7759/cureus.35685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Background Musculoskeletal discomfort resulting from soft tissue injuries to muscles, bones, nerves, tendons, joints, or cartilage is referred to as musculoskeletal disorders. Neck pain is a common musculoskeletal condition with a significant socioeconomic impact on patients. Previous literature has linked the onset of neck pain to various factors, including psychological factors that may affect musculoskeletal disorders (MSDs), similarly to physical factors. Psychological conditions, including anxiety and depression, may result in MSDs. Limited studies on the relationship between neck pain and psychological distress have been conducted among undergraduate students in Jeddah. The study aimed to investigate the relationship between neck pain and psychological distress. Additionally, the study examined the risk factors for developing neck pain, depression, and anxiety in King Abdulaziz University (KAU) undergraduate students. Method This cross-sectional study was conducted in November 2022 at KAU in Jeddah, Saudi Arabia, by distributing a google forms survey among undergraduate university students in KAU, excluding graduate students and students who did not agree to participate. We received 509 responses; each respondent gave written consent and participated in the study. Result Neck pain prevalence was 50.7% of all students (95% CI, 46.3-55.1). Significantly higher neck pain scores were observed in women (p<0.001), in students who did little or no exercise, and in those who drank coffee more frequently >3 cups daily. Anxiety (p<0.001) and depression (p<0.001) scores were also positively and significantly correlated with neck pain scores. The results of the association analysis revealed that women had significant scores for anxiety (p<0.001) and depression (p<0.001). Female sex (p<0.001) and increased neck pain score (p<0.001) were independent risk factors for anxiety. Higher neck pain scores were also associated with depression (p<0.001). Conclusion Our study showed that anxiety and depression significantly impact neck pain. Furthermore, the increased score of depression and anxiety indicates worsening neck pain.
Collapse
|
8
|
Ahorukomeye P, Mahajan A, Du JY, Yu CC, Bhandutia AK, Ahn NU. Association Between Hypercholesterolemia and Neck Pain in a Cross-sectional Population-based Study. Spine (Phila Pa 1976) 2023; 48:137-142. [PMID: 36122297 DOI: 10.1097/brs.0000000000004485] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/06/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective cross-sectional analysis. SUMMARY OF BACKGROUND DATA Degenerative changes are a major contributor to chronic neck pain. According to the vascular hypothesis of disk disease, atherosclerosis of the segmental arteries contributes to ischemia of the lumbar disks and resulting degenerative changes. Prior studies have demonstrated an association between atherosclerotic risk factors and lumbar degenerative disease. Similarly, atherosclerosis may contribute to cervical disk degeneration. Cardiovascular disease is associated with the development of atherosclerosis, particularly in small vessels to the cervical spine. Hypercholesterolemia is a major contributor to the morbidity associated with cardiovascular disease. This study aims to examine the relationship between hypercholesterolemia and neck pain. MATERIALS AND METHODS Analysis was focused on the respondents to neck pain items of the standardized questionnaire. Odds ratios were calculated, and logistic regression analyses adjusted for demographic, education, and mental health conditions. RESULTS There were 30,461 participants in the 2018 Medicare Expenditure Panel Survey (MEPS) survey. Of those, 1049 (3.4%) subjects responded to presence of a diagnosis of cervical disorders with neck pain. Mean age of respondents was 62.6±16.1. Overall prevalence of neck pain was 21.1%. Prevalence of neck pain was similar by age, sex, education level, and occupation ( P >0.05 for each). Neck pain was more prevalent in white race and lower total family income ( P <0.05). Current everyday smokers also had higher prevalence of neck pain ( P <0.05). Logistic regression analysis revealed a higher prevalence of neck pain in those with hypercholesterolemia after controlling for relevant covariates (adjusted odds ratio=1.54, 95% CI: 1.08-2.22, P =0.018). CONCLUSIONS Subjects with hypercholesterolemia were 54% more likely to have neck pain after controlling for confounders. This suggests that hypercholesterolemia has a role to play in degeneration of the cervical spine. Therefore, prevention and proper management of high cholesterol may curtail the development and progression of degenerative cervical disk disease and thus, neck pain.
Collapse
Affiliation(s)
- Peter Ahorukomeye
- University Hospitals Cleveland Medical Center, Cleveland, OH
- Case Western Reserve School of Medicine, Cleveland, OH
| | | | - Jerry Y Du
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | | | | | - Nicholas U Ahn
- University Hospitals Cleveland Medical Center, Cleveland, OH
- Case Western Reserve School of Medicine, Cleveland, OH
| |
Collapse
|
9
|
Cabanillas-Barea S, Carrasco-Uribarren A, Medrano-de-la-Fuente R, Jiménez-del-Barrio S, Pardos-Aguilella P, Pérez-Guillén S, Ceballos-Laita L. Clinical and Psychological Variables in Female Patients with Cervical Syndromes: A Cross-Sectional and Correlational Study. Healthcare (Basel) 2022; 10:2398. [PMID: 36553923 PMCID: PMC9777707 DOI: 10.3390/healthcare10122398] [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: 10/18/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Background: The objectives of this study were: (1) to compare the pain intensity, cervical range of motion (ROM), psychological distress and kinesiophobia in patients with cervicogenic dizziness (CGD), tension-type headache (TTH), and mechanical chronic neck pain (MCNP); and (2) to investigate the relationships between pain intensity and cervical ROM and between psychological distress and kinesiophobia. Methods: a cross-sectional and correlational study was designed. In total, 109 patients (32 patients with CGD, 33 with TTH and 44 with MCNP) were included. Pain intensity, cervical ROM, psychological distress and kinesiophobia were assessed. Results: Statistically significant differences were found between the groups in pain intensity, psychological distress and kinesiophobia. The patients with MCNP showed higher pain intensity compared to the other groups (p < 0.001). The patients with CGD showed higher depression and kinesiophobia values compared to the MCNP and TTH groups (p < 0.05). No differences were found for cervical flexion, extension, lateral flexion, or rotation ROM (p > 0.05). The CGD and MCNP groups found a moderate positive correlation between psychological distress and kinesiophobia (p < 0.05). The patients with TTH and MCNP showed a moderate positive correlation between pain intensity, psychological distress and kinesiophobia (p < 0.05). Conclusion: Pain intensity, psychological distress and kinesiophobia should be considered in the three groups. Psychological distress was correlated with kinesiophobia in the CGD and MCNP groups. The MCNP group showed a correlation between pain intensity, psychological distress and kinesiophobia.
Collapse
Affiliation(s)
- Sara Cabanillas-Barea
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| | - Andoni Carrasco-Uribarren
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| | - Ricardo Medrano-de-la-Fuente
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Sandra Jiménez-del-Barrio
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | | | - Silvia Pérez-Guillén
- Faculty of Medicine and Health Sciences, International University of Catalonia, 08195 Sant Cugat del Vallés, Spain
| | | |
Collapse
|
10
|
Bottaro R, Faraci P. The Association Between Upper Disorders and Psychological Well-Being and its Implication in Text Neck Syndrome: A Systematic Review. CLINICAL NEUROPSYCHIATRY 2022; 19:280-287. [PMID: 36340273 PMCID: PMC9597647 DOI: 10.36131/cnfioritieditore20220503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective Non-specific/chronic musculoskeletal disorder in neck, head or low back (that we called Upper Disorders; UD) are widely common health problem in high-income, urban, and industrialized countries, especially for sedentary people who use electronic devices. This systematic review aims to analyse the association between UD and psychological disease. Method The database searches were conducted in 8 different databases, using relevant keywords. According to PRISMA Statements, full-text peer-reviewed articles in English which analysed the association between UD and indicators of psychological disease (i.e., mood disturbance, anxiety, depression, stress, social support, and alexithymia) in non-clinical sample were included. Results Of 8798 abstracts and titles, 10 full-text papers were included. The overall results showed a strong association between UD and mood disturbance, anxiety, depression, stress, alexithymia, and low social support. Thus, high levels of UD were associated with high levels of psychological disease. Conclusions The results supported the assessment of physical and psychological symptoms in a holistic perspective. Their implications in terms of holistic care and text neck syndrome were discussed.
Collapse
Affiliation(s)
- Rossella Bottaro
- Faculty of Human and Social Sciences – University of Enna “Kore”,Corresponding Author Rossella Bottaro Cittadella Universitaria – 94100 Enna, Italy Phone number: +39 0935 536536 E-mail:
| | - Palmira Faraci
- Faculty of Human and Social Sciences – University of Enna “Kore”
| |
Collapse
|
11
|
Investigation of the effectiveness of neck stabilization exercises in patients with chronic neck pain: A randomized, single-blind clinical, controlled study. Turk J Phys Med Rehabil 2022; 68:364-371. [DOI: 10.5606/tftrd.2022.8481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives: This study aims to compare the efficacy of neck stabilization exercises versus a conventional exercise program on pain, range of motion, disability, and depression in patients with chronic neck pain.
Patients and methods: This prospective, single-blind, randomized controlled study included 60 patients with chronic neck pain, 58 (21 males, 37 females; mean age: 36.7±8.5 years; range, 18 to 55 years) of whom completed the study. The patients were randomized into two groups. Patients in one group were given neck stabilization exercises, while the patients in the other group were given conventional neck exercises. Neck pain due to activities of daily living (Visual Analog Scale), neck range of motion in sagittal, transverse, and frontal planes, disability (Neck Disability Index), and depression (Beck Depression Inventory) were evaluated at the beginning, at the end of the treatment, and at the first and third months after the end of treatment.
Results: Significant improvement was achieved in both groups in terms of Visual Analog Scale, Neck Disability Index, neck range of motion in the sagittal, transverse, and frontal planes, and Beck Depression Inventory compared to the beginning of treatment (p<0.05). In the stabilization exercise group, statistically significant improvement was found in the range of motion of the neck in the transverse plane (p<0.05).
Conclusion: Stabilization exercise programs, which show their effect by maintaining segmental stabilization, postural control, and balance between the superficial and deep muscles of the neck region, contribute to reduced pain in daily activities and improved function similar to conventional exercise programs.
Collapse
|
12
|
Surís X, Ortiz-Santamaria V, Pueyo-Sánchez MJ, Mompart-Penina A, Larrosa M, Ricart A. Decreasing prevalence of chronic back pain in Catalonia. Analysis of the Catalan Health Survey. Public Health 2022; 206:38-45. [PMID: 35349966 DOI: 10.1016/j.puhe.2022.02.019] [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: 06/13/2021] [Revised: 02/03/2022] [Accepted: 02/20/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Chronic back pain is one of the main health problems reported by the adult population and its prevalence is influenced by different sociodemographic, work and lifestyle-related factors. The aim of this study was to describe the trend in the lifetime prevalence of chronic back pain in the adult Catalan population between 2011 and 2018 and its associated factors. STUDY DESIGN Cross-sectional study. Secondary analysis of a health survey. METHODS Trend in lifetime prevalence of chronic back pain by age and sex groups was estimated from the Catalan Health Survey. Association of chronic back pain with sex, age, health status, lifestyle factors, comorbidities, socio-economic and work-related variables was analysed. RESULTS A total of 31,823 people were interviewed between 2011 and 2018. The prevalence of chronic back pain decreased from 29.7% to 24.2% between 2011-2014 and 2015-2018 in the total population with higher prevalence and a greater difference in women (35%-28.50%) than in men (24.2%-19.7%). Factors associated with higher prevalence of chronic back pain were female sex, older age, poor health status, smoking, alcohol consumption, insufficient physical activity, overweight or obesity, mental health problems, lower educational level or social class, dissatisfaction at workplace, poor social support and family financial problems. CONCLUSIONS The analysis shows a decreasing prevalence of chronic back pain from 2011 to 2018 in the adult population of Catalonia in all age groups and more significantly in women. An improvement of healthy lifestyle habits, social and occupational determinants, could have reduced the burden of chronic back pain in our community.
Collapse
Affiliation(s)
- Xavier Surís
- Rheumatology Department, Fundació Hospital Asil de Granollers, Barcelona, Spain; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat Del Vallès, Barcelona, Spain; Servei Català de La Salut, Generalitat de Catalunya, Barcelona, Spain; Master Plan of Musculoskeletal Diseases, Departament de Salut, Barcelona, Spain.
| | - Vera Ortiz-Santamaria
- Rheumatology Department, Fundació Hospital Asil de Granollers, Barcelona, Spain; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat Del Vallès, Barcelona, Spain
| | | | - Anna Mompart-Penina
- Direcció General de Planificació en Salut, Departament de Salut, Barcelona, Spain
| | - Marta Larrosa
- Master Plan of Musculoskeletal Diseases, Departament de Salut, Barcelona, Spain
| | - Assumpta Ricart
- Servei Català de La Salut, Generalitat de Catalunya, Barcelona, Spain
| |
Collapse
|
13
|
Hurley RW, Adams MCB, Barad M, Bhaskar A, Bhatia A, Chadwick A, Deer TR, Hah J, Hooten WM, Kissoon NR, Lee DW, Mccormick Z, Moon JY, Narouze S, Provenzano DA, Schneider BJ, van Eerd M, Van Zundert J, Wallace MS, Wilson SM, Zhao Z, Cohen SP. Consensus practice guidelines on interventions for cervical spine (facet) joint pain from a multispecialty international working group. Reg Anesth Pain Med 2022; 47:3-59. [PMID: 34764220 PMCID: PMC8639967 DOI: 10.1136/rapm-2021-103031] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/02/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The past two decades have witnessed a surge in the use of cervical spine joint procedures including joint injections, nerve blocks and radiofrequency ablation to treat chronic neck pain, yet many aspects of the procedures remain controversial. METHODS In August 2020, the American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine approved and charged the Cervical Joint Working Group to develop neck pain guidelines. Eighteen stakeholder societies were identified, and formal request-for-participation and member nomination letters were sent to those organizations. Participating entities selected panel members and an ad hoc steering committee selected preliminary questions, which were then revised by the full committee. Each question was assigned to a module composed of 4-5 members, who worked with the Subcommittee Lead and the Committee Chairs on preliminary versions, which were sent to the full committee after revisions. We used a modified Delphi method whereby the questions were sent to the committee en bloc and comments were returned in a non-blinded fashion to the Chairs, who incorporated the comments and sent out revised versions until consensus was reached. Before commencing, it was agreed that a recommendation would be noted with >50% agreement among committee members, but a consensus recommendation would require ≥75% agreement. RESULTS Twenty questions were selected, with 100% consensus achieved in committee on 17 topics. Among participating organizations, 14 of 15 that voted approved or supported the guidelines en bloc, with 14 questions being approved with no dissensions or abstentions. Specific questions addressed included the value of clinical presentation and imaging in selecting patients for procedures, whether conservative treatment should be used before injections, whether imaging is necessary for blocks, diagnostic and prognostic value of medial branch blocks and intra-articular joint injections, the effects of sedation and injectate volume on validity, whether facet blocks have therapeutic value, what the ideal cut-off value is for designating a block as positive, how many blocks should be performed before radiofrequency ablation, the orientation of electrodes, whether larger lesions translate into higher success rates, whether stimulation should be used before radiofrequency ablation, how best to mitigate complication risks, if different standards should be applied to clinical practice and trials, and the indications for repeating radiofrequency ablation. CONCLUSIONS Cervical medial branch radiofrequency ablation may provide benefit to well-selected individuals, with medial branch blocks being more predictive than intra-articular injections. More stringent selection criteria are likely to improve denervation outcomes, but at the expense of false-negatives (ie, lower overall success rate). Clinical trials should be tailored based on objectives, and selection criteria for some may be more stringent than what is ideal in clinical practice.
Collapse
Affiliation(s)
- Robert W Hurley
- Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Meredith C B Adams
- Anesthesiology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Meredith Barad
- Anesthesiology, Perioperative and Pain Medicine, Stanford Hospital and Clinics, Redwood City, California, USA
| | - Arun Bhaskar
- Anesthesiology, Imperial College Healthcare NHS Trust Haemodialysis Clinic, Hayes Satellite Unit, Hayes, UK
| | - Anuj Bhatia
- Anesthesia and Pain Management, University of Toronto and University Health Network - Toronto Western Hospital, Toronto, Ontario, Canada
| | - Andrea Chadwick
- Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Timothy R Deer
- Spine and Nerve Center of the Virginias, West Virginia University - Health Sciences Campus, Morgantown, West Virginia, USA
| | - Jennifer Hah
- Stanford University School of Medicine, Palo Alto, California, USA
| | | | | | - David Wonhee Lee
- Fullerton Orthopaedic Surgery Medical Group, Fullerton, California, USA
| | - Zachary Mccormick
- Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jee Youn Moon
- Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongno-gu, South Korea
| | - Samer Narouze
- Center for Pain Medicine, Summa Western Reserve Hospital, Cuyahoga Falls, Ohio, USA
| | - David A Provenzano
- Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA
- Pain Diagnostics and Interventional Care, Edgeworth, Pennsylvania, USA
| | - Byron J Schneider
- Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee, USA
| | - Maarten van Eerd
- Anesthesiology, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
| | - Jan Van Zundert
- Anesthesiology, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
| | - Mark S Wallace
- Anesthesiology, UCSD Medical Center - Thornton Hospital, San Diego, California, USA
| | | | - Zirong Zhao
- Neurology, VA Healthcare Center District of Columbia, Washington, District of Columbia, USA
| | - Steven P Cohen
- Anesthesiology, Neurology, Physical Medicine and Rehabilitation and Psychiatry, Pain Medicine Division, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
14
|
Farrell SF, Campos AI, Kho PF, de Zoete RMJ, Sterling M, Rentería ME, Ngo TT, Cuéllar-Partida G. Genetic basis to structural grey matter associations with chronic pain. Brain 2021; 144:3611-3622. [PMID: 34907416 DOI: 10.1093/brain/awab334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 01/26/2023] Open
Abstract
Structural neuroimaging studies of individuals with chronic pain conditions have often observed decreased regional grey matter at a phenotypic level. However, it is not known if this association can be attributed to genetic factors. Here we employed a novel integrative data-driven and hypothesis-testing approach to determine whether there is a genetic basis to grey matter morphology differences in chronic pain. Using publicly available genome-wide association study summary statistics for regional chronic pain conditions (n = 196 963) and structural neuroimaging measures (n = 19 629-34 000), we applied bivariate linkage disequilibrium-score regression and latent causal variable analyses to determine the genetic correlations (rG) and genetic causal proportion (GCP) between these complex traits, respectively. Five a priori brain regions (i.e. prefrontal cortex, cingulate cortex, insula, thalamus and superior temporal gyrus) were selected based on systematic reviews of grey matter morphology studies in chronic pain. Across this evidence-based selection of five brain regions, 10 significant negative genetic correlations (out of 369) were found (false discovery rate < 5%), suggesting a shared genetic basis to both reduced regional grey matter morphology and the presence of chronic pain. Specifically, negative genetic correlations were observed between reduced insula grey matter morphology and chronic pain in the abdomen (mean insula cortical thickness), hips (left insula volume) and neck/shoulders (left and right insula volume). Similarly, a shared genetic basis was found for reduced posterior cingulate cortex volume in chronic pain of the hip (left and right posterior cingulate), neck/shoulder (left posterior cingulate) and chronic pain at any site (left posterior cingulate); and for reduced pars triangularis volume in chronic neck/shoulder (left pars triangularis) and widespread pain (right pars triangularis). Across these negative genetic correlations, a significant genetic causal proportion was only found between mean insula thickness and chronic abdominal pain [rG (standard error, SE) = -0.25 (0.08), P = 1.06 × 10-3; GCP (SE) = -0.69 (0.20), P = 4.96 × 10-4]. This finding suggests that the genes underlying reduced cortical thickness of the insula causally contribute to an increased risk of chronic abdominal pain. Altogether, these results provide independent corroborating evidence for observational reports of decreased grey matter of particular brain regions in chronic pain. Further, we show for the first time that this association is mediated (in part) by genetic factors. These novel findings warrant further investigation into the neurogenetic pathways that underlie the development and prolongation of chronic pain conditions.
Collapse
Affiliation(s)
- Scott F Farrell
- RECOVER Injury Research Centre, The University of Queensland, Herston, QLD, Australia.,NHMRC Centre for Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Herston, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Adrián I Campos
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia.,Genetic Epidemiology Laboratory, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Pik-Fang Kho
- Molecular Cancer Epidemiology Laboratory, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.,School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rutger M J de Zoete
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, The University of Queensland, Herston, QLD, Australia.,NHMRC Centre for Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Herston, QLD, Australia
| | - Miguel E Rentería
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia.,Genetic Epidemiology Laboratory, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Trung Thanh Ngo
- Diamantina Institute, The University of Queensland and Translational Research Institute, Woolloongabba, QLD, Australia
| | - Gabriel Cuéllar-Partida
- Diamantina Institute, The University of Queensland and Translational Research Institute, Woolloongabba, QLD, Australia
| |
Collapse
|
15
|
Nazarchuk IA. Constitutional psychic human qualities influence on the emotional and psychic state at the patients with neurological spine disorders. 18 2021. [DOI: 10.26565/2312-5675-2021-18-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective - to study the emotional and psychic state at the patients with neurological cervical spine disorders (NCSD) and determine of the constitutional psychic human qualities influence at the it.
Methods and subjects. 87 patients (18-44 years old), who suffered from subacute and chronic NCSD, were examined by clinical-anamnestic, clinical-functional (vertebral neurological), clinical-neurological methods. Emotional and psychic state was examined by Spielberger-Hanin test and Hamilton Depression Rating Scale. Psychic functions of human constitution were studied by temperament type determining with using Eysenck’s EPQ questionnaire.
Results and discussion. The course of subacute and chronic cervicalgia, cervicocranialgia, cervicobrachialgia (neck and shoulder pain) was characterized depression symptoms at the melancholic temperament type (at 76% patients, р< 0,05). At the choleric temperament type depression symptoms was present meeted very often too (at 68% patients). At the sanguine temperament type depression symptoms was very rarely (at 29% patients). The peculiarities from reactive and personality anxiety were found too. It were at the melancholic and choleric patient highter significantly, than at the sanguine patients (p <0,05, p <0,01, p < 0,001). Temperament influence on the depression symptoms and anxiety confirmed by reliable correlations.
Conclusions. The emotional and psychic state at the patients with NCSD characterize as anxiety on the background of neurological symptoms of cervicalgia, cervicocranialgia, cervicobrachialgia (neck and shoulder pain). It this symptoms add with decreased performance, mood and sleep disturbances and all these complaints in the aggregate are summed up as depressive disorders, mainly of mild severity. Constitutional psychic human qualities, which included in temperament, influence on the it formation. The models of influence different temperament types on the emotional and psychic states at the patients with NCSD were represented. It points pathogenic significance of melancholic and choleric temperament types and sanogenetic qualities of sanguine type. Constitutional psychic human qualities and emotional and psychic state should be considere at the diagnostic and treatment patients with NCSD. Significance of the human constitution, emotional and psychic state for NCSD confirm by study results. It is background for following studies.
Collapse
Affiliation(s)
- Iryna A. Nazarchuk
- V.N. Karazin Kharkiv National University, Kharkiv, Ukraine; State institution "Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
| |
Collapse
|
16
|
Hurley RW, Adams MCB, Barad M, Bhaskar A, Bhatia A, Chadwick A, Deer TR, Hah J, Hooten WM, Kissoon NR, Lee DW, Mccormick Z, Moon JY, Narouze S, Provenzano DA, Schneider BJ, van Eerd M, Van Zundert J, Wallace MS, Wilson SM, Zhao Z, Cohen SP. Consensus practice guidelines on interventions for cervical spine (facet) joint pain from a multispecialty international working group. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2443-2524. [PMID: 34788462 PMCID: PMC8633772 DOI: 10.1093/pm/pnab281] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The past two decades have witnessed a surge in the use of cervical spine joint procedures including joint injections, nerve blocks and radiofrequency ablation to treat chronic neck pain, yet many aspects of the procedures remain controversial. METHODS In August 2020, the American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine approved and charged the Cervical Joint Working Group to develop neck pain guidelines. Eighteen stakeholder societies were identified, and formal request-for-participation and member nomination letters were sent to those organizations. Participating entities selected panel members and an ad hoc steering committee selected preliminary questions, which were then revised by the full committee. Each question was assigned to a module composed of 4-5 members, who worked with the Subcommittee Lead and the Committee Chairs on preliminary versions, which were sent to the full committee after revisions. We used a modified Delphi method whereby the questions were sent to the committee en bloc and comments were returned in a non-blinded fashion to the Chairs, who incorporated the comments and sent out revised versions until consensus was reached. Before commencing, it was agreed that a recommendation would be noted with >50% agreement among committee members, but a consensus recommendation would require ≥75% agreement. RESULTS Twenty questions were selected, with 100% consensus achieved in committee on 17 topics. Among participating organizations, 14 of 15 that voted approved or supported the guidelines en bloc, with 14 questions being approved with no dissensions or abstentions. Specific questions addressed included the value of clinical presentation and imaging in selecting patients for procedures, whether conservative treatment should be used before injections, whether imaging is necessary for blocks, diagnostic and prognostic value of medial branch blocks and intra-articular joint injections, the effects of sedation and injectate volume on validity, whether facet blocks have therapeutic value, what the ideal cut-off value is for designating a block as positive, how many blocks should be performed before radiofrequency ablation, the orientation of electrodes, whether larger lesions translate into higher success rates, whether stimulation should be used before radiofrequency ablation, how best to mitigate complication risks, if different standards should be applied to clinical practice and trials, and the indications for repeating radiofrequency ablation. CONCLUSIONS Cervical medial branch radiofrequency ablation may provide benefit to well-selected individuals, with medial branch blocks being more predictive than intra-articular injections. More stringent selection criteria are likely to improve denervation outcomes, but at the expense of false-negatives (ie, lower overall success rate). Clinical trials should be tailored based on objectives, and selection criteria for some may be more stringent than what is ideal in clinical practice.
Collapse
Affiliation(s)
- Robert W Hurley
- Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Meredith C B Adams
- Anesthesiology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Meredith Barad
- Anesthesiology, Perioperative and Pain Medicine, Stanford Hospital and Clinics, Redwood City, California, USA
| | - Arun Bhaskar
- Anesthesiology, Imperial College Healthcare NHS Trust Haemodialysis Clinic, Hayes Satellite Unit, Hayes, UK
| | - Anuj Bhatia
- Anesthesia and Pain Management, University of Toronto and University Health Network - Toronto Western Hospital, Toronto, Ontario, Canada
| | - Andrea Chadwick
- Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Timothy R Deer
- Spine and Nerve Center of the Virginias, West Virginia University - Health Sciences Campus, Morgantown, West Virginia, USA
| | - Jennifer Hah
- Anesthesiology, Stanford University School of Medicine, Palo Alto, California, USA
| | | | | | - David Wonhee Lee
- Fullerton Orthopaedic Surgery Medical Group, Fullerton, California, USA
| | - Zachary Mccormick
- Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jee Youn Moon
- Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongno-gu, South Korea
| | - Samer Narouze
- Center for Pain Medicine, Summa Western Reserve Hospital, Cuyahoga Falls, Ohio, USA
| | - David A Provenzano
- Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA
- Pain Diagnostics and Interventional Care, Edgeworth, Pennsylvania, USA
| | - Byron J Schneider
- Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee, USA
| | - Maarten van Eerd
- Anesthesiology, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
| | - Jan Van Zundert
- Anesthesiology, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
| | - Mark S Wallace
- Anesthesiology, UCSD Medical Center - Thornton Hospital, San Diego, California, USA
| | | | - Zirong Zhao
- Neurology, VA Healthcare Center District of Columbia, Washington, District of Columbia, USA
| | - Steven P Cohen
- Anesthesia, WRNMMC, Bethesda, Maryland, USA
- Physical Medicine and Rehabilitation, WRNMMC, Bethesda, Maryland, USA
- Anesthesiology, Neurology, Physical Medicine and Rehabilitation and Psychiatry, Pain Medicine Division, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
17
|
Stephen S, Brandt C, Olivier B. Neck Pain and Disability: Are They Related to Dysfunctional Breathing and Stress? Physiother Can 2021. [DOI: 10.3138/ptc-2020-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: People with neck pain are likely to have negative respiratory findings. The purpose of this study was to investigate the relationship between neck pain and dysfunctional breathing and to examine their relationship to stress. Method: This cross-sectional study included 49 participants with neck pain and 49 age- and sex-matched controls. We measured neck pain using the numeric rating scale (NRS); neck disability using the Neck Disability Index (NDI); dysfunctional breathing using the Nijmegen Questionnaire (NQ), Self-Evaluation of Breathing Questionnaire (SEBQ), breath hold time, and respiratory rate (RR); and stress using the Perceived Stress Scale (PSS). Results:Participants with neck pain scored higher on the NQ ( p < 0.001) and the SEBQ ( p < 0.001) than controls. NQ and SEBQ scores correlated moderately with NDI scores ( r > 0.50; 95% CI: 0.25, 0.68 and 0.33, 0.73, respectively) and PSS scores ( r > 0.50; 95% CI: 0.29, 0.78 and 0.31, 0.73, respectively). SEBQ scores showed a fair correlation with NRS scores and RR a fair correlation with NDI scores. Conclusions: Participants with neck pain had more dysfunctional breathing symptoms than participants without neck pain, and dysfunctional breathing was correlated with increased neck disability and increased stress. The NQ and SEBQ can be useful in assessing dysfunctional breathing in patients with neck pain.
Collapse
Affiliation(s)
- Sarah Stephen
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Corlia Brandt
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Benita Olivier
- Wits Sport and Health (WiSH) Research Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
18
|
Stenneberg MS, Scholten-Peeters GGM, den Uil CS, Wildeman ME, van Trijffel E, de Bie RA. Clinical characteristics differ between patients with non-traumatic neck pain, patients with whiplash-associated disorders, and pain-free individuals. Physiother Theory Pract 2021; 38:2592-2602. [PMID: 34465257 DOI: 10.1080/09593985.2021.1962464] [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: 10/20/2022]
Abstract
BackgroundEvidence is lacking to what extent patients with Whiplash-Associated Disorders (WAD), those with non-traumatic neck pain (NTNP), and pain-free individuals differ regarding type and severity of impairments, disability, and psychological factors.Objective To compare clinical characteristics between patients with WAD, with NTNP, and pain-free individuals in primary care physiotherapy. Additionally, differences between patient groups for both acute and chronic symptoms were assessed.MethodA cross-sectional study was conducted including 168 patients with WAD, 336 matched patients with NTNP, and 336 pain-free individuals. Differences and prevalence rates were calculated for pain intensity, pain distribution, cervical range of motion, neck flexor muscle endurance, self-reported disability, and psychological factors.Results Patients with WAD had higher pain intensity (median 6/10 vs. 5/10 p<.01), had a wider distribution of their neck pain (p=.02), more restricted cervical flexion-extension (-11.9°) and rotation (-12.4°), less muscle endurance (-5.5 seconds), and more disability (+14.0%), compared to patients with NTNP. More patients with WAD reported low back pain (+9.5%) and headache (+12.2%) as musculoskeletal comorbidities. Regarding anxiety, depression, and stress, most patients (>83%) scored in the normal range. No significant differences between the patient groups were observed (p>.16). Both patient groups scored significantly worse than pain-free individuals on all characteristics. Patients with WAD and NTNP experienced different types of activity limitations and participation restrictions.ConclusionWAD is a more severe condition than NTNP and should be considered a separate subgroup. A different approach in clinical practice and research is required for WAD and NTNP.
Collapse
Affiliation(s)
- Martijn S Stenneberg
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Vrije Universiteit Brussel, Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Experimental Anatomy Research Department (EXAN), Laarbeeklaan, Brussel, Belgium
| | - Gwendolyne G M Scholten-Peeters
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat, Amsterdam, The Netherlands
| | - Carlien S den Uil
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
| | | | - Emiel van Trijffel
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands.,Vrije Universiteit Brussel, Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Experimental Anatomy Research Department (EXAN), Laarbeeklaan, Brussel, Belgium.,Ziekenhuisgroep Twente, ZGT Academy, Almelo, Netherlands
| | - Rob A de Bie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Maastricht University, Department of Epidemiology, Maastricht, Netherlands
| |
Collapse
|
19
|
Association between psychosocial factors and mental health symptoms to cervical spine pain with or without radiculopathy on health outcomes: systematic review protocol. Pain Rep 2021; 6:e870. [PMID: 33981923 PMCID: PMC8108582 DOI: 10.1097/pr9.0000000000000870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/25/2022] Open
Abstract
Systematic review protocol assessing associations between psychosocial factors and/or mental health symptoms and health outcomes in adults with cervical spine pain with or without radiculopathy. Introduction: Cervical spine pain with or without radiculopathy (CSp ± R) has significant negative impacts to a person's quality of life. Psychosocial factors and/or mental health symptoms are associated with spinal pain with or without radiculopathy and negatively impact health outcomes. This area of research is not yet established for CSp ± R. Our objective is to conduct a systematic review assessing the association between psychosocial factors and/or mental health symptoms and health outcomes in adults with CSp ± R. Methods: A systematic electronic search of 3 online databases will retrieve studies in which adults (older than 18 years) with CSp ± R, assessing how psychosocial factors or mental health symptoms impact outcomes related to disability, pain, and/or healthcare utilisation. Data extracted will include study design, CSp ± R definition, psychosocial and/or mental health symptoms, and health outcomes. Reporting study quality through the Newcastle–Ottawa Quality Scale Assessment and certainty through Grading of Recommendations, Assessment, Development and Evaluations will be completed. Studies will be assessed from a clinical perspective, methodology design, and statistical testing to determine whether studies can be pooled for meta-analysis. If there is significant clinical heterogeneity, narrative description will be undertaken. Perspective: This will be a comprehensive synthesis review to enhance understanding of the association of psychosocial factors and/or mental health symptoms and CSp ± R on health outcomes. The findings will support the formulation of prognosis, collaborative management decisions, and guide healthcare resources to improve outcomes for this patient group. The review will identify gaps in research, thereby informing future experimental and observational study design.
Collapse
|
20
|
Kim JI, Han CH, Jeon JH, Kim JY, Kwon O, Jung SY, Lee JH, Yang C, Kim E, Kim YI. Effectiveness and Safety of Polydioxanone Thread Embedding Acupuncture Compared to Physical Therapy in the Treatment of Patients with Non-Specific Chronic Neck Pain: An Assessor-Blinded, Randomized, Controlled, Clinical Trial. J Pain Res 2021; 14:201-211. [PMID: 33536781 PMCID: PMC7850897 DOI: 10.2147/jpr.s276941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/24/2020] [Indexed: 01/04/2023] Open
Abstract
Background Thread embedding acupuncture (TEA) has recently been used as a conservative treatment method for non-specific chronic neck pain (CNP). The objective of this study was to evaluate the effectiveness and safety of TEA compared to physical therapy (PT) for treating patients with CNP. Methods A total of 128 patients diagnosed with CNP were randomly assigned to a TEA group and a PT group at a 1:1 ratio. The TEA group received four sessions of TEA, while the PT group received eight sessions of PT over 4 weeks. Outcomes were assessed using Neck Pain and Disability Scale (NPDS), clinically important difference (CID), cervical spinal angle, Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Patient Global Impression of Change (PGIC), and EuroQol Five-Dimension (EQ-5D) at baseline and 5, 9, and 13 weeks. Results The TEA group showed significant improvement in NPDS compared to the PT group at 5, 9, and 13 weeks. Proportions of patients with decreased NPDS scores of more than 11.5 points (minimal CID) were significantly higher in the TEA group at 5, 9, and 13 weeks. There were significant differences between the two groups at 5, 9, and 13 weeks for BDI-II, and at 5 and 9 weeks for BAI. For EQ-5D, the TEA group showed significant improvement at 5, 9, and 13 weeks. There was no significant difference in cervical spinal angle between the two groups. For PGIC, better improvement was observed at 9 and 13 weeks in the TEA group. Adverse events associated with interventions were mostly temporary and mild. Conclusion For patients with CNP, TEA treatment was found to be more effective than PT treatment for improving their pain and dysfunction, quality of life, and psychological distress. Despite some post-treatment discomfort, TEA treatment can be considered as a useful treatment method for patients with CNP. Trial Registration This trial has been registered 5 April 2019 in Clinical Research Information Service of South Korea (CRIS- KCT0003720).
Collapse
Affiliation(s)
- Jae Ik Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Chang-Hyun Han
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.,Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ju Hyun Jeon
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Jin Youp Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - So-Young Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.,Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Changsop Yang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Eunseok Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Young Il Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| |
Collapse
|
21
|
Pinheiro Barcessat AR, Nolli Bittencourt M, Góes Gonçalves R, Goncalves de Oliveira Cruz AV, Coelho Pereira JA, Bechelli FA, Rinaldi A. REAC Neuromodulation Treatments in Depression, Anxiety and Stress. A Comparative Retrospective Study. Psychol Res Behav Manag 2020; 13:1247-1256. [PMID: 33376420 PMCID: PMC7762445 DOI: 10.2147/prbm.s287143] [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] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/05/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction The purpose of this retrospective study was to compare the effects of two different modalities of administration of the neuro psycho physical optimization (NPPO) neuromodulation treatment, applied with radio electric asymmetric conveyer (REAC) biotechnology devices. Both the modalities are aimed at improving the strategies to deal with and optimize the allostatic response to environmental stressors and exposome. This allows to reduce the dysfunctional adaptive behavior patterns, which underlie many neuropsychological symptoms and pathologies, and to improve the symptoms of depression, anxiety and stress. Materials and Methods From a population of subjects experiencing at least two of the three symptoms depression, anxiety and stress, the selection of pre and post-treatment Depression, Anxiety, Stress 21 items scale (DASS 21) data was made proceeding with a reverse chronological recruitment mechanism, until reaching 150 subjects for each of the 2 groups. The first group was treated with the neuro psycho physical optimization treatment (NPPO), which is the punctiform modality of administration on the auricle pavilion, and the second group was treated with the neuro psycho physical optimization treatment, which is the area modality of administration applied by the planar probe on the cervicobrachial area (NPPO-CB). Results The Wilcoxon signs test confirmed the differences in scores in pre and post-treatment DASS-21. The comparison between the two groups data and the comparison across groups data showed that NPPO and NPPO-CB have the same efficacy in reducing the symptoms of depression, anxiety and stress, after a single treatment cycle. Statistical significance was set at p <0.05. Discussion This is the first efficacy descriptive comparison between the two different modalities of administration of the NPPO treatment, as different options for the same clinical indication.
Collapse
Affiliation(s)
| | | | - Rebeca Góes Gonçalves
- Health and Biological Sciences Department, Federal University of Amapá, Macapá, Brazil
| | | | | | - Fabio Augusto Bechelli
- International Scientific Society of Neuro Psycho Physical Optimization with REAC Technology, Brazilian Branch, São Paulo, Brazil
| | - Arianna Rinaldi
- Research Department, Rinaldi Fontani Foundation, Florence, Italy.,Department of Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
| |
Collapse
|
22
|
Predictors of Outcomes After Single-level Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy: A Multivariate Analysis. Clin Spine Surg 2020; 33:E525-E532. [PMID: 32349058 DOI: 10.1097/bsd.0000000000000997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
STUDY DESIGN This was a retrospective study that was carried out using prospectively collected registry data. OBJECTIVE The objective of this study was to identify preoperative predictors of outcomes after anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA Proper patient selection is paramount to achieving good surgical results. Identifying predictors of outcomes may aid surgical decision-making and facilitate counseling of patients to manage expectations. METHODS Prospectively collected registry data of 104 patients who underwent single-level ACDF for cervical spondylotic myelopathy were reviewed. Outcomes assessed at 2 years were the presence of residual neck pain/arm pain (AP), and attainment of a minimal clinically important difference (MCID) for Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) score, and Physical Component Score (PCS) of SF-36, as well as patient satisfaction, fulfilment of expectations, willingness to undergo same surgery again, return to work (RTW), and return to function (RTF). Receiver operating characteristic curves and multivariate stepwise logistical regression were performed to identify independent predictors of each outcome using 22 covariates including demographics, comorbidities, and preoperative disease state. RESULTS Lower preoperative NDI was predictive of the absence of residual neck pain/AP at 2 years. Higher preoperative JOA score was predictive of MCID attainment for PCS, satisfaction, expectation fulfilment, willingness to undergo the same surgery for same condition, and RTF. Poorer preoperative scores of NDI, JOA, and PCS were predictors of attaining MCID of the respective scores. Older patients were less likely to attain MCID for JOA. Higher preoperative AP was a risk factor for unsuccessful RTW. CONCLUSIONS In general, the preoperative JOA score was the best predictor of outcomes after ACDF. A preoperative JOA cutoff value of 9.25-10.25 predicted satisfaction, expectation fulfilment, willingness to undergo same surgery, and RTF with at least 70% sensitivity and 50% specificity. These findings may aid surgeons in identifying patients at risk of a poor outcome and guide preoperative counseling to establish realistic expectations of the surgical outcome. LEVEL OF EVIDENCE Level III-Non-randomized controlled cohort/follow-up study.
Collapse
|
23
|
Derakhshanrad N, Yekaninejad MS, Mehrdad R, Saberi H. Neck pain associated with smartphone overuse: cross-sectional report of a cohort study among office workers. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 30:461-467. [PMID: 33108531 DOI: 10.1007/s00586-020-06640-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/17/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the current study was to investigate the extent of smartphone use, possible correlation with neck pain and/or psychological impairment in office workers. METHOD A convenience sample of 1,602 office workers who were using smartphone for prolonged periods (≥ 4 years) participated in a cross-sectional report of a cohort study, assessing demographic, abnormal symptoms of pain in the neck, physical activity, and psychological behavior characteristics. Participants were assessed using a short version of the Smartphone Addiction Scale (SAS-SV), Depression, Anxiety and Stress Scales (DASS-42) questionnaire, as well as International Physical Activity Questionnaire-Short Form (IPAQ-SF). Multiple logistic regression model was conducted to evaluate the adjusted effect of smartphone overuse on nuchal symptoms. RESULTS The prevalence of neck pain among the office workers was 30.1%. Significantly more female (33.3% vs. 24.5%) and younger (42.2 vs. 43.2 years) employees reported to have neck pain. Overall in 326 (20.3%, 95% CI: 18.4%-22.4%) of studied subjects had, SAS score ≥ 31 and ≥ 33 for male and females, respectively, and so smartphone overuse (SO) was diagnosed. The results of multiple logistic regression model revealed that those with SO were approximately 6 times more likely to have neck pain (95% CI: 4.44-8.09, P < 0.001). CONCLUSIONS Smartphone overuse in office workers significantly increases the chance of neck pain by 6 times. Hence SO has been associated with, not only somatic complaints, but also psychological distress such as anxiety, stress, and depression. This may necessitate adherence to neck-school, when smartphone use is associated with neck pain.
Collapse
Affiliation(s)
- Nazi Derakhshanrad
- Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, 1449614535, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research On Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooshang Saberi
- Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, 1449614535, Tehran, Iran.
| |
Collapse
|
24
|
Jiménez-Trujillo I, López-de-Andrés A, Del Barrio JL, Hernández-Barrera V, Valero-de-Bernabé M, Jiménez-García R. Gender Differences in the Prevalence and Characteristics of Pain in Spain: Report from a Population-Based Study. PAIN MEDICINE 2020; 20:2349-2359. [PMID: 30789640 DOI: 10.1093/pm/pnz004] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess the prevalence and characteristics of chronic neck pain, chronic low back pain, and migraine or frequent headaches among Spanish adults in 2014 according to gender, to identify predictors for each of these types of pains, and to compare the prevalence with those found in 2009. DESIGN Cross-sectional study. SETTING Spain. METHODS We used data collected from the 2014 European Health Interview Survey (N = 22,842). Sociodemographic features, self-rated health status, lifestyle habits, comorbid conditions, pain characteristics, and self-reported use of medications were analyzed. RESULTS The prevalence of all types of pain was significantly higher among women than men. For chronic neck pain, the figures were 25.68% vs 12.54%, for chronic low back pain, 27.03% vs 18.83%, and for migraine or frequent headaches, 15.93% vs 6.74%, in women and men, respectively. Predictors of these types of pain included female gender, advanced age, poor self-rated health, psychological distress, comorbidities, and obesity. The prevalence of neck pain and low back pain increased from 2009 to 2014 for both sexes, and the prevalence of migraine or frequent headaches remained stable over time. CONCLUSIONS The prevalence and intensity of all the forms of chronic pain were higher among women. Women experiencing pain used prescribed medications for pain, anxiety, and/or depression and sleeping pills more than men. The prevalence of chronic neck and low back has increased in the last five years in Spain, and the prevalence of migraine or frequent headaches has remained stable.
Collapse
Affiliation(s)
- Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - José Luis Del Barrio
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Marisa Valero-de-Bernabé
- Preventive Medicine and Public Health Department, Medicine Faculty, Universidad Complutense de Madrid, Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| |
Collapse
|
25
|
Farrell SF, Zoete RMJ, Cabot PJ, Sterling M. Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis. Eur J Pain 2020; 24:1666-1686. [DOI: 10.1002/ejp.1630] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/28/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Scott F. Farrell
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Gold Coast Queensland Australia
| | - Rutger M. J. Zoete
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
- School of Allied Health Science and Practice The University of Adelaide Adelaide South Australia Australia
| | - Peter J. Cabot
- School of Pharmacy The University of Queensland Brisbane Queensland Australia
| | - Michele Sterling
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
| |
Collapse
|
26
|
Mental Disorders, Musculoskeletal Disorders and Income-Driven Patterns: Evidence from the Global Burden of Disease Study 2017. J Clin Med 2020; 9:jcm9072189. [PMID: 32664414 PMCID: PMC7408666 DOI: 10.3390/jcm9072189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background: The aim of the present study was to use the extensive Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) database from 1990–2017 to evaluate the levels and temporal correlation trends between disability adjusted life years (DALYs) attributed to musculoskeletal (MSK) disorders, all mental disorders collectively and by mental disorder sub-category. Methods: We utilized results of the GBD 2017 to describe the correlation patterns between DALYs due to MSK disorders, mental disorders and other diseases among 195 countries. Mixed model analysis was also applied. Results: A consistent relation was reported between age-adjusted DALYs attributed to MSK and mental disorders (in total) among the 195 countries, in both sexes, for 1990 to 2017 (1990 Rho = 0.487; 2017 Rho = 0.439 p < 0.05). Distinct regional and gender correlation patterns between age-adjusted DALYs due to MSK and mental disorders were reported. No correlation was reported between DALYs due to MSK and all mental disorders collectively, among Low- or Middle-income countries. However, in High-income countries (HICs), the correlation was strong and consistent between 1990 and 2017 (1990 Rho = 0.735; 2017 Rho = 0.727, p < 0.05). Conclusions: The reported correlation patterns call for targeted preventive strategies and intervention policies for mental and MSK disorders internationally. Special attention is needed among HICs.
Collapse
|
27
|
Nadal-Nicolás Y, Rubio-Arias JÁ, Martínez-Olcina M, Reche-García C, Hernández-García M, Martínez-Rodríguez A. Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4611. [PMID: 32604939 PMCID: PMC7345776 DOI: 10.3390/ijerph17124611] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022]
Abstract
Fibromyalgia is a condition characterised by chronic widespread muscle pain and fatigue, sleep disturbances, cognitive disorders, and mood disturbance. The purpose of this study was to determine the effectiveness of a manual therapy technique performed with moderate digital pressure in women with fibromyalgia (n = 24). In this randomised, controlled trial, the participants were randomly assigned to the experimental group or placebo group. The experimental group was assisted with manual therapy sessions based on connective tissue massage, whereas the placebo group was "treated" with ultrasound sessions performed without conductive gel and with the machine turned off as the placebo. Fatigue severity scale (FSS), visual analogical scale (VAS), Pittsburgh sleep quality index (PSQI), and profile of mood states (POMS-29) were completed before and after the intervention. In the experimental group (manual therapy), significant results were obtained on a VAS scale, referring to the neck pain in patients with fibromyalgia (p < 0.001). Correlations showed a relationship between fatigue and sleep variables (R = 0.411; p = 0.046) and pain variables with the POMS anger-hostility subscale (R = 0.436; p = 0.033). Although the size of the sample could be a limitation, the study concluded that the application of manual therapy in fibromyalgia patients performed with moderate pressure for 15 min on the posterior cervical musculature decreased the perception of pain, muscle fatigue, and the state of tension-anxiety.
Collapse
Affiliation(s)
| | - Jacobo Ángel Rubio-Arias
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Science, Polytechnic University of Madrid, 28040 Madrid, Spain;
| | - María Martínez-Olcina
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | | | - María Hernández-García
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | - Alejandro Martínez-Rodríguez
- Faculty of Sciences, Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, 03690 Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| |
Collapse
|
28
|
Shi S, Zhou Z, Ni HJ, Wang CF, He ZM, Yang YH, Du JH, Wu JS, He SS. Does anxiety influence the prognosis of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation? A preliminary propensity score matching analysis. INTERNATIONAL ORTHOPAEDICS 2020; 44:2357-2363. [PMID: 32529310 DOI: 10.1007/s00264-020-04656-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 06/02/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Previous reports revealed a correlation between psychological problems and spinal surgery. There is a lack of knowledge on the effect of anxiety on the percutaneous transforaminal endoscopic discectomy (PTED) outcome at the two year follow-up. The purpose of this study is to investigate changes in anxiety after PTED among patients with lumbar disc herniation (LDH), to compare the effect of anxiety on the prognosis using propensity score matching analysis, and to identify the related parameters of anxiety. METHODS A total of 145 patients with LDH requiring PTED surgery were included. Twenty-six LDH patients with anxiety were matched with 26 control patients utilizing propensity score matching analysis. The demographic and peri-operative data were collected and analyzed. A correlation analysis was utilized. RESULTS Both groups achieved significant improvements in visual analogue scale (VAS) scores for pain, Japanese Orthopedic Association (JOA) scores for neurological deficit, and 36-item Short-Form Health Survey (SF-36) scores and Oswestry Disability Index (ODI) scores for quality of life. A statistical difference was detected between the pre-operative and the post-operative Zung Self-Rating Anxiety Scale scores in the anxiety cohort. However, the difference between the anxiety group and the control group was statistically significant in the aforementioned parameters. The VAS, JOA, ODI and the SF-36 scores, and the disease duration were associated with pre-operative anxiety. CONCLUSION PTED may provide significant improvements in clinical outcomes and symptoms of anxiety. A negative impact on the patient's prognosis may be caused by the presence of anxiety. Pain severity, neurological deficit, disease duration, and quality of life were associated with anxiety.
Collapse
Affiliation(s)
- Sheng Shi
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China
| | - Zhi Zhou
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China
| | - Hai-Jian Ni
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China
| | - Chuan-Feng Wang
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China
| | - Zhi-Min He
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China.,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China
| | - Yue-Hua Yang
- Department of Orthopedics, The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, 510900, People's Republic of China
| | - Jun-Hua Du
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China
| | - Jun-Song Wu
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China
| | - Shi-Sheng He
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China. .,Spinal Pain Research Institute, Tongji University School of Medicine, Shanghai, 200072, People's Republic of China.
| |
Collapse
|
29
|
Groisman S, Malysz T, de Souza da Silva L, Rocha Ribeiro Sanches T, Camargo Bragante K, Locatelli F, Pontel Vigolo C, Vaccari S, Homercher Rosa Francisco C, Monteiro Steigleder S, Jotz GP. Osteopathic manipulative treatment combined with exercise improves pain and disability in individuals with non-specific chronic neck pain: A pragmatic randomized controlled trial. J Bodyw Mov Ther 2020; 24:189-195. [PMID: 32507144 DOI: 10.1016/j.jbmt.2019.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine effectiveness of osteopathic manipulative treatment combined with stretching and strengthening exercises in the cervical region on pain and disability in individuals with non-specific chronic neck pain. METHODS 90 adults with non-specific chronic neck pain were randomized to either exercises group (EG, n = 45) or osteopathic manipulative treatment associated with exercises group (OMT/EG, n = 45). The primary outcomes were obtained by the use of Numeric Pain-Rating Scale (NPRS), Pressure Pain Threshold (PPT) and Neck Disability Index (NDI). Secondary outcomes included range of motion (ROM) for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire Work/Physical Activity (FABQ-W/PA) and Pain-self efficacy at two different moments: baseline and 4 weeks after the first treatment. Techniques and dosages of OMT were selected pragmatically by a registered osteopath. Generalized Estimating Equations model (GEE), complemented by the Least Significant Difference (LSD) and the intention-to-treat analysis, was used to assess the clinical outcomes. RESULTS Analysis with GEE indicated that OMT/EG reduced pain and disability more than the EG alone after 4 weeks of treatment with statistically significant difference (p < 0,05), as well as cervical active rotation was significantly improved (p = 0.03). There were no between-group differences observed in Pressure Pain Threshold (PPT) measure, Fear-Avoidance Beliefs Questionnaire and Pain-self efficacy. CONCLUSION The association between OMT and exercises reduces pain and improves functional disability more than only exercise for individuals with non-specific chronic neck pain.
Collapse
Affiliation(s)
- Sandro Groisman
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; Instituto Brasileiro de Osteopatia (IBO), Brazil.
| | - Tais Malysz
- Graduate Program in Neuroscience, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Department of Morphological Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | | | - Karoline Camargo Bragante
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | | | | | | | | | | | - Geraldo Pereira Jotz
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; Department of Morphological Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| |
Collapse
|
30
|
Willaert W, Malfliet A, Coppieters I, Lenoir D, De Pauw R, Danneels L, Roussel N, Meeus M, Cagnie B, Nijs J, Kregel J. Does Pain Neuroscience Education and Cognition-Targeted Motor Control Training Improve Cervical Motor Output? Secondary Analysis of a Randomized Clinical Trial. Pain Pract 2020; 20:600-614. [PMID: 32187789 DOI: 10.1111/papr.12884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND In the context of interventions aimed at reducing pain, disability, and maladaptive pain cognitions in chronic neck pain, it is hypothesized that patients who have greater symptom reduction possibly also demonstrate greater improvement in cervical motor output. Therefore, the aim of this study was to examine the effect of pain neuroscience education plus cognition-targeted motor control training on cervical motor output. METHODS Impairments in cervical motor output were measured in 64 subjects with chronic neck pain using standardized tests. Cervical muscle strength, cervical mobility, balance, and cervical neuromuscular control were derived. To assess the differences between groups in response to treatment, a random-intercept linear mixed-models analysis, applying a diagonal covariance matrix, was used. RESULTS A significant treatment × time interaction effect was found for neuromuscular control of the deep cervical flexors, favoring the experimental treatment at 3 months' follow-up (mean group difference: 1.982; 95% confidence interval 0.779, 3.185; large effect size d = 0.82). Significant main effects of time were found for the neuromuscular capacity of scapulothoracic muscles and for cervical mobility. No significant effects were found for balance, cervical muscle strength, or endurance of cervical flexors. CONCLUSION Pain neuroscience education combined with cognition-targeted motor control training is not more effective than biomedically focused education and exercise therapy for improving cervical motor output in people with chronic neck pain. Our findings question the relative importance of factors such as pain, disability, and maladaptive pain cognitions on cervical motor output and the need to address it in treatment.
Collapse
Affiliation(s)
- Ward Willaert
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Anneleen Malfliet
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium.,Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Iris Coppieters
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium
| | - Dorine Lenoir
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Robby De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nathalie Roussel
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jo Nijs
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussel, Belgium
| | - Jeroen Kregel
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| |
Collapse
|
31
|
Meng W, Adams MJ, Reel P, Rajendrakumar A, Huang Y, Deary IJ, Palmer CNA, McIntosh AM, Smith BH. Genetic correlations between pain phenotypes and depression and neuroticism. Eur J Hum Genet 2019; 28:358-366. [PMID: 31659249 PMCID: PMC7028719 DOI: 10.1038/s41431-019-0530-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/23/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022] Open
Abstract
Correlations between pain phenotypes and psychiatric traits such as depression and the personality trait of neuroticism are not fully understood. In this study, we estimated the genetic correlations of eight pain phenotypes (defined by the UK Biobank, n = 151,922–226,683) with depressive symptoms, major depressive disorders and neuroticism using the the cross-trait linkage disequilibrium score regression (LDSC) method integrated in the LD Hub. We also used the LDSC software to calculate the genetic correlations among pain phenotypes. All pain phenotypes, except hip pain and knee pain, had significant and positive genetic correlations with depressive symptoms, major depressive disorders and neuroticism. All pain phenotypes were heritable, with pain all over the body showing the highest heritability (h2 = 0.31, standard error = 0.072). Many pain phenotypes had positive and significant genetic correlations with each other indicating shared genetic mechanisms. Our results suggest that pain, neuroticism and depression share partially overlapping genetic risk factors.
Collapse
Affiliation(s)
- Weihua Meng
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD2 4BF, UK.
| | - Mark J Adams
- Division of Psychiatry, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Parminder Reel
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Aravind Rajendrakumar
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Yu Huang
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Colin N A Palmer
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| | - Andrew M McIntosh
- Division of Psychiatry, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH10 5HF, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Blair H Smith
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD2 4BF, UK
| |
Collapse
|
32
|
Kim EJ, Chotai S, Schneider BJ, Sivaganesan A, McGirt MJ, Devin CJ. Effect of Depression on Patient-Reported Outcomes Following Cervical Epidural Steroid Injection for Degenerative Spine Disease. PAIN MEDICINE 2019; 19:2371-2376. [PMID: 30357417 DOI: 10.1093/pm/pny196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To assess the effect depression has on outcomes after cervical epidural steroid injections (CESIs). Design Retrospective review of a prospectively collected database. Setting Single institution tertiary care center. Subjects Fifty-seven patients with cervical spondylosis and cervical radicular pain who were deemed appropriate surgical candidates but elected to undergo CESI first were included. Methods Twenty-one of 57 (37%) patients with depression (defined as Zung Depression Scale >33) were included. Patient-reported outcomes including Neck Disability Index (NDI), numeric rating scale (NRS) for arm pain (AP), NRS for neck pain (NP), and EuroQol-5D (EQ-5D) were collected at baseline and three-month follow-up. Minimal clinically important differences were then calculated to provide dichotomous outcome measures of success. Results Overall, 24 and 28 patients achieved at least 50% improvement in AP and NP, respectively. In terms of disability, 25/57 (43.9%) patients achieved >13.2-point improvement on the NDI overall. In patients with depression, 4/21 (19.0%) and 5/21 (23.8%) achieved at least 50% improvement on the NRS for AP and NP, respectively, compared with 20/36 (55.5%) and 23/36 (63.8%) in patients without depression. This difference was statistically significant for both pain measures (P < 0.002 AP, P < 0.006 NP). Statistically fewer patients, 5/21 (24%), with depression achieved ≥13.2-point improvement on the NDI compared with 20/36 (55%) nondepressed patients (P < 0.01). There was no difference in outcomes between groups on the EQ-5D. Conclusions Patients with cervical spondylosis and comorbid depression who undergo CESI are less likely to achieve successful outcomes in both pain and function compared with nondepressed patients at three months.
Collapse
Affiliation(s)
- Elliott J Kim
- Departments of Orthopaedic Surgery.,Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Silky Chotai
- Departments of Orthopaedic Surgery.,Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Byron J Schneider
- Departments of Orthopaedic Surgery.,Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ahilan Sivaganesan
- Departments of Orthopaedic Surgery.,Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew J McGirt
- Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina, USA
| | - Clint J Devin
- Departments of Orthopaedic Surgery.,Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
33
|
Kim JI, Kim YI, Kim E, Jeon JH, Kim JY, Kwon O, Jung SY, Han CH. Effectiveness and safety of polydioxanone thread embedding acupuncture compared to physical therapy in the treatment of patients with non-specific chronic neck pain: Study protocol for an assessor-blinded, randomized, controlled, clinical trial. Medicine (Baltimore) 2019; 98:e16768. [PMID: 31393397 PMCID: PMC6709075 DOI: 10.1097/md.0000000000016768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As the number of patients who suffer from non-specific chronic neck pain (CNP) is increasing in the Republic of Korea, conservative treatments for patients with CNP have been spotlighted. Although several studies on thread embedding acupuncture (TEA) treatment have been published for the treatment of such patients, no randomized controlled trial has been reported that investigates the effectiveness and safety of the TEA treatment compared with other conservative treatments for the treatment of patients with CNP. Therefore, the purpose of this trial is to compare the effectiveness and safety of TEA to those of physical therapy (PT) for the treatment of patients with CNP. METHODS/DESIGN This study is planned as a parallel design, randomized, controlled, assessor-blinded, clinical study. One hundred twenty-eight patients diagnosed with CNP will be randomly assigned to either the TEA group or the PT group in a 1:1 ratio. Participants in the TEA group will receive 4 sessions of TEA treatment, while those in the PT group will receive 8 sessions of PT treatment over 4 weeks. An assessment of effectiveness based on the outcomes of the Neck Pain and Disability Scale (NPDS), cervical spinal angle, Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Patient Global Impression of Change (PGIC), EuroQol-Five Dimension 3 level version (EQ-5D-3L), and Pressure Pain Threshold (PPT) will be conducted at baseline, and at 5, 9, and 13 weeks. The primary outcome is the mean change in the NPDS at 9 weeks. Adverse events (AEs) will be recorded at every visit. DISCUSSION The results of this study will be expected to provide useful information for the effectiveness and safety of TEA treatment compared to PT treatment for patients with CNP. TRIAL REGISTRATION Clinical Research Information Service of Republic of Korea (CRIS- KCT0003720), April 5, 2019.
Collapse
Affiliation(s)
- Jae Ik Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon
| | - Young Il Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon
| | - Eunseok Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon
| | - Ju Hyun Jeon
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon
| | - Jin Youp Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - So-Young Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine
| | - Chang-Hyun Han
- Clinical Medicine Division, Korea Institute of Oriental Medicine
- Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| |
Collapse
|
34
|
Poor Baseline Mental Health Does Not Influence Improvement in Patient-reported Outcomes, Satisfaction, and Return to Work Two Years After Single-level Anterior Cervical Discectomy and Fusion. Spine (Phila Pa 1976) 2019; 44:839-847. [PMID: 30540718 DOI: 10.1097/brs.0000000000002960] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective study using prospectively collected registry data. OBJECTIVE The authors examine the influence of preoperative mental health on outcomes after anterior cervical discectomy and fusion (ACDF) and determine the impact of ACDF on postoperative mental health. SUMMARY OF BACKGROUND DATA While studies have reported a negative correlation between preoperative mental health and outcomes following lumbar spine surgery, the influence on outcomes following cervical spine surgery remains relatively understudied. METHODS Prospectively collected registry data of 104 patients who underwent single-level ACDF for cervical spondylotic myelopathy were reviewed. Patients were dichotomized into top and bottom halves based on preoperative SF-36 MCS (Mental Component Summary) using a cutoff of 48. Outcomes assessed were visual analogue scale for neck pain, arm pain, AAOS Neck Pain and Disability, Neurogenic Symptoms, Neck Disability Index, Short-Form 36, Japanese Orthopaedic Association myelopathy score, return to work, return to function, satisfaction and expectation fulfilment up to 2 years postoperatively. RESULTS The preoperative MCS was 37.5 ± 8.1 and 57.4 ± 6.3 in the Low and High MCS groups respectively (P < 0.001). The Low MCS group had poorer preoperative scores (P < 0.05). There was no significant difference in length of stay or comorbidities (P > 0.05). The High MCS group had less neck pain (P = 0.002) and showed a trend towards lower Neck Disability Index (P = 0.062) at 2 years. The Low MCS group demonstrated greater improvement in Japanese Orthopaedic Association (P = 0.007) and similar improvement in other scores (P > 0.05). There was no significant difference in proportion that achieved minimal clinically important difference for each score (P > 0.05). Both groups had similar rates of return to work, return to function, expectation fulfilment, and satisfaction (P > 0.05). Lower preoperative MCS was predictive of greater improvement in MCS (r = -0.477, P < 0.001). CONCLUSION Despite relatively greater pain and disability at 2 years, patients with poor baseline mental health experienced similar improvement in clinical outcomes, return to work, and satisfaction rates. LEVEL OF EVIDENCE 3.
Collapse
|
35
|
Yazdi M, Karimi Zeverdegani S, MollaAghaBabaee AH. Association of derived patterns of musculoskeletal disorders with psychological problems: a latent class analysis. Environ Health Prev Med 2019; 24:34. [PMID: 31092202 PMCID: PMC6521474 DOI: 10.1186/s12199-019-0784-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/11/2019] [Indexed: 01/15/2023] Open
Abstract
Background Musculoskeletal symptoms often occur in more than one anatomical site. The present study aimed to define specific patterns of multisite musculoskeletal disorders and examine how these patterns are related to common psychological problems. Methods Using the data from an interview-based health survey of 358 samples of the industrial manufacturing male employees, we derived major patterns of musculoskeletal complaints using latent class analysis and investigated its association with psychological problems score extracted from depression, anxiety, and stress measured by Depression/Anxiety/Stress Scale (DASS-21). Musculoskeletal disorders were assessed by Nordic Musculoskeletal Questionnaire (NMQ). The statistical analysis was carried out by Mplus 8. Results Complaints in the lower back (42.1%) and neck (30.7%) had the highest prevalence, and in the hip (15.0%) and ankle (12.2%) the lowest. Three major patterns of musculoskeletal disorders were extracted using latent class analysis. Class 1 (12.9%) was characterized by a high rate of complaints in upper musculoskeletal sites, such as the neck, shoulder, and joints; class 2 (38.2%) was identified by a higher rate of complaints in the lower and upper back; and class 3 (48.9%) was marked by low rates of complaints in all musculoskeletal sites. After adjustment for confounding variables and specifying class 3 as the reference, it turned out that there was a statistically significant association between the psychological problems score and the chance of being in class 1 (OR = 2.47, 95% CI 1.66–3.68), but not a significant association with the chance of being in class 2 (OR = 1.51, 95% CI 0.83–2.72). Conclusion Musculoskeletal disorders can be summarized in the latent class-derived patterns in the adult study population and provide additional prognostics. Common psychological problems are significantly associated with the type of musculoskeletal disorder patterns. The findings in this study could be useful for dealing with prevention and treatment programs.
Collapse
Affiliation(s)
- Maryam Yazdi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan Endocrine & Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Karimi Zeverdegani
- Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | |
Collapse
|
36
|
Kim E, Kim HS, Jung SY, Han CH, Kim YI. Efficacy and safety of polydioxanone thread embedded at specific acupoints for non-specific chronic neck pain: a study protocol for a randomized, subject-assessor-blinded, sham-controlled pilot trial. Trials 2018; 19:672. [PMID: 30522504 PMCID: PMC6282385 DOI: 10.1186/s13063-018-3058-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/16/2018] [Indexed: 01/24/2023] Open
Abstract
Background This study aims to evaluate the efficacy and safety of thread-embedding acupuncture (TEA) with polydioxanone thread embedded at various acupoints, compared with sham TEA, for the treatment of non-specific chronic neck pain. Methods/design This study will be an 8-week-long, two-armed, parallel, randomized, subject-assessor-blinded, sham-controlled pilot trial. Fifty eligible patients will be randomly allocated into the real TEA group or the sham TEA group. The real TEA group will receive TEA treatment at 14 fixed acupoints in the neck region. The sham TEA group will receive the same treatment as the real TEA group, but with a sham device with the thread removed. Both groups will receive treatment once a week for a total of four sessions. The primary outcome will be the mean change in the visual analog scale (VAS) from baseline to week 6 (2 weeks post intervention). Clinical relevance (ratio of the number of patients with decreases on the VAS of ≥15 mm or with percentiles ≥ 30% and ≥ 50% relative to baseline to the total number of patients), Neck Disability Index, pressure pain threshold, the Hospital Anxiety and Depression Scale, EuroQol 5-Dimensions questionnaire, Patient Global Impression of Change, blinding test, and adverse events will be used to assess secondary outcomes. Discussion The results of this study will provide valuable data for a large-scale clinical trial to evaluate the clinical effects of polydioxanone TEA in the treatment of patients with non-specific chronic neck pain. Trial registration Clinical Research Information Service (CRIS), Republic of Korea, KCT0002452. Registered on 6 September 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3058-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Eunseok Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea
| | - Hye Su Kim
- Department of Acupuncture and Moxibustion Medicine, Dunsan Korean Medicine Hospital of Daejeon University, 75, Daedeok-daero 176 beon-gil, Seo-gu, Daejeon, 35235, Republic of Korea
| | - So-Young Jung
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672, Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Chang Hyun Han
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672, Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea.
| | - Young-Il Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
| |
Collapse
|
37
|
Kim E, Kim YS, Kim YI, Jeon JH, Yoo HR, Park YC, Jung IC. Effectiveness and Safety of Polydioxanone Thread-Embedding Acupuncture as an Adjunctive Therapy for Patients with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. J Altern Complement Med 2018; 25:417-426. [PMID: 30523703 DOI: 10.1089/acm.2018.0228] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness and safety of treatment with thread-embedding acupuncture (TEA) using polydioxanone in addition to usual care for patients with chronic nonspecific neck pain (CNP) compared with treatment with usual care alone. METHODS A single-center, assessor-blinded, two-armed randomized controlled trial was performed. One hundred and six outpatients with CNP were randomly allocated into the TEA plus usual care (TU) group or the usual care (UC) group in a 1:1 ratio. TEA treatments in the neck region were provided once a week for 4 weeks, and usual care, as needed, was allowed. The primary outcome was the mean Neck Pain and Disability Scale (NPDS) score. Secondary outcomes included clinical relevance measured by using the clinically important difference (CID), pressure pain threshold (PPT), Hospital Anxiety and Depression Scale (HADS), EuroQol-5 Dimension (EQ-5D), and patient global impression of change (PGIC). Participants were assessed at baseline and at weeks 3, 5, and 9. Statistical analyses included analysis of covariance with baseline score as a covariate. RESULTS The TU group showed significant improvement in NPDS scores compared with the UC group (adjusted group difference, week 5: 13.74 [95% confidence interval: 7.57-19.90]; p < 0.0001 and week 9: 17.46 [11.15-23.76]; p < 0.0001). The proportion of patients with a decrease on the NPDS score of ≥11.5 points (minimal CID) was significantly higher in the TU group at weeks 5 and 9 than in the UC group. At weeks 5 and 9, significant differences were observed on the anxiety/depression subscale of HADS, EQ-5D, and PGIC between the two groups, but not the PPTs at three sites. Temporary stiffness was observed after TEA treatment, but no serious adverse events occurred. CONCLUSIONS The results suggest that polydioxanone TEA is a safe and clinically beneficial adjunctive treatment for patients with CNP.
Collapse
Affiliation(s)
- Eunseok Kim
- 1 Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Yong-Suk Kim
- 2 Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital , Seoul, Republic of Korea
| | - Young Il Kim
- 1 Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Ju-Hyun Jeon
- 1 Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Daejeon University , Daejeon, Republic of Korea
| | - Ho-Ryong Yoo
- 3 Department of Neurologic Disorder, Dunsan Korean Medicine Hospital, Daejeon University , Daejeon, Republic of Korea
| | - Yang-Chun Park
- 4 Department of Internal Medicine, and Dunsan Korean Medicine Hospital, Daejeon University , Daejeon, Republic of Korea
| | - In Chul Jung
- 5 Department of Neuropsychiatry, Dunsan Korean Medicine Hospital, Daejeon University , Daejeon, Republic of Korea
| |
Collapse
|
38
|
Melkevik O, Clausen T, Pedersen J, Garde AH, Holtermann A, Rugulies R. Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence. BMC Public Health 2018; 18:981. [PMID: 30081870 PMCID: PMC6090744 DOI: 10.1186/s12889-018-5740-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/21/2018] [Indexed: 11/26/2022] Open
Abstract
Background Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA. Methods A sample of 6572 Danish female health care workers responding to a questionnaire about health and working conditions were followed up in a national register of social transfer payments (DREAM) for 550 days. We estimated the risk for LTSA of four weeks or more, associated with depressive symptoms and number of musculoskeletal pain locations using a Cox proportional hazards model allowing multiple observations per individual. We conducted a test for multiplicative interaction between musculoskeletal pain locations and depressive symptoms, and presented stratified regression models to facilitate the interpretation of the results. Results The severity of depressive symptoms was correlated with the number of pain locations reported (Spearman’s rho = .24, p < 0.001). We found a significant multiplicative interaction between depressive symptoms and musculoskeletal pain in predicting the risk of LTSA. Depressive symptoms and number of musculoskeletal pain locations were associated with increased risk of LTSA for individuals who did not have comorbid symptoms. However, we found no significant associations between the two predictors and LTSA among participants who reported comorbid symptoms. Conclusions The risk of LTSA associated with depressive symptoms and musculoskeletal pain appears to be moderated by the presence of comorbid symptoms. The modified risk for LTSA among workers with comorbid symptoms requires further investigation.
Collapse
Affiliation(s)
| | | | | | - Anne Helene Garde
- NRCWE, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- NRCWE, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Reiner Rugulies
- NRCWE, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
39
|
Walton DM, Elliott JM. A new clinical model for facilitating the development of pattern recognition skills in clinical pain assessment. Musculoskelet Sci Pract 2018; 36:17-24. [PMID: 29669311 DOI: 10.1016/j.msksp.2018.03.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 03/10/2018] [Accepted: 03/17/2018] [Indexed: 11/16/2022]
Abstract
Common, enigmatic musculoskeletal conditions such as whiplash-associated disorder, myofascial pain syndrome, low back pain, headache, fibromyalgia, osteoarthritis, and rotator cuff pathology, account for significant social, economic, and personal burdens on a global scale. Despite their primacy (and shared sequelae) there remains a paucity of available and effective management options for patients with both acute and chronic conditions. Establishing an accurate prognostic or diagnostic profile on a patient-by-patient basis can challenge the insight of both novice and expert clinicians. Questions remain on how and when to choose the right tool(s), at the right time(s), for the right patient(s), for the right problem(s). The aim of this paper is to introduce a new clinical reasoning framework that is simple in presentation but allows interpretation of complex clinical patterns, and is adaptable across patient populations with acute or chronic, traumatic or non-traumatic pain. The concepts of clinical phenotyping (e.g. identifying observable characteristics of an individual resulting from the interaction of his/her genotype and their environment) and triangulation serve as the foundation for this framework. Based on our own clinical and research programs, we present these concepts using two patient cases; a) whiplash-associated disorder (WAD) following a motor vehicle collision and b) mechanical low back pain.
Collapse
Affiliation(s)
- David M Walton
- Faculty of Health Science, Western University Canada, Canada.
| | - James M Elliott
- Faculty of Health Sciences, The University of Sydney, and the Kolling Institute, Royal North Shore Hospital, NSW, Australia.
| |
Collapse
|
40
|
Jimenez-Garcia R, del Barrio JL, Hernandez-Barrera V, de Miguel-Díez J, Jimenez-Trujillo I, Martinez-Huedo MA, Lopez-de-Andres A. Is there an association between diabetes and neck pain and lower back pain? Results of a population-based study. J Pain Res 2018; 11:1005-1015. [PMID: 29872337 PMCID: PMC5973317 DOI: 10.2147/jpr.s158877] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The objective of the study was to study the association between low back pain (LBP), neck pain (NP), and diabetes while controlling for many sociodemographic characteristics, comorbidities, and lifestyle variables. The study also aimed to identify which of these variables is independently associated with LBP and NP among diabetes sufferers. METHODS A case-control study using data taken from the European Health Interview Surveys for Spain was conducted in 2009/2010 (n=22,188) and 2014 (n=22,842). We selected subjects ≥40 years of age. Diabetes status was self-reported. One non-diabetic control was matched by the year of survey, age, and sex for each diabetic case. The presence of LBP and NP was defined as the affirmative answer to both of the questions: "Have you suffered chronic LBP/NP over the last 12 months?" and "Has your physician confirmed the diagnosis?" Independent variables included demographic and socioeconomic characteristics, health status variables, lifestyles, and pain characteristics. RESULTS The prevalence of NP (32.2% vs 26.8%) and LBP (37.1% vs 30.3%) was significantly higher among those suffering from diabetes. Multivariable analysis showed that diabetes was associated with a 1.19 (95% CI 1.04-1.36) and 1.20 (95% CI 1.06-1.35) higher risk of NP and LBP. Among diabetic subjects, being female, concomitant mental or respiratory disorders, being obese, and physically inactive are variables associated with suffering from these pains. Those suffering NP had 8 times higher risk of reporting LBP than those without NP and the same association is found among those suffering from LBP. CONCLUSION The prevalence and intensity of NP and LBP are high among people with diabetes, affecting them significantly more than their age- and sex-matched non-diabetic controls. Specific preventive and educational strategies must be implemented to reduce the incidence, severity, and negative effect on the quality of NP and LBP among diabetic patients.
Collapse
Affiliation(s)
- Rodrigo Jimenez-Garcia
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - José Luis del Barrio
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentín Hernandez-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Javier de Miguel-Díez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Isabel Jimenez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | | | - Ana Lopez-de-Andres
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| |
Collapse
|
41
|
Amin NA, Quek KF, Oxley JA, Noah R, Nordin R. Emotional Distress as a Predictor of Work-Related Musculoskeletal Disorders in Malaysian Nursing Professionals. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9:69-78. [PMID: 29667644 PMCID: PMC6466982 DOI: 10.15171/ijoem.2018.1158] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/26/2017] [Indexed: 12/04/2022]
Abstract
BACKGROUND Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions. OBJECTIVE To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses. METHODS A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis. RESULTS A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold. CONCLUSION There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.
Collapse
Affiliation(s)
- Nur Azma Amin
- Universiti Kuala Lumpur-Institute of Medical Science Technology, Malaysia.
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Malaysia
| | | | - Rahim Noah
- Universiti Kuala Lumpur-Institute of Medical Science Technology, Malaysia
| | - Rusli Nordin
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Malaysia
| |
Collapse
|
42
|
Kaka B, Ogwumike OO, Adeniyi AF, Maharaj SS, Ogunlade SO, Bello B. Effectiveness of neck stabilisation and dynamic exercises on pain intensity, depression and anxiety among patients with non-specific neck pain: a randomised controlled trial. Scand J Pain 2018; 18:321-331. [DOI: 10.1515/sjpain-2017-0146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/24/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Background and aims:
Non-specific neck pain (NsNP) constitutes a burden to the bearers and a management challenge to physiotherapists globally. Effectiveness of neck stabilisation and dynamic exercises in the management of NsNP has been documented, but it is not clear which exercise regimen is more effective in alleviating its associated pain, depression and anxiety. This study was carried out to compare the effectiveness of neck stabilisation and/or dynamic exercises on pain intensity, depression and anxiety among patients with NsNP.
Methods:
Eighty-nine consenting individuals with NsNP participated in this single-blind, randomised controlled trial. They were recruited from the outpatient physiotherapy clinics of the National Orthopaedic Hospital in Dala, Kano State, Nigeria. Participants were randomly assigned into one of three intervention groups: neck stabilisation exercise group (NSEG; n=30), neck dynamic exercise group (NDEG; n=28) and neck stabilisation and dynamic exercise group (NSDEG; n=31). Treatment was administered thrice weekly for 8 consecutive weeks. Variables were assessed at baseline, at the end of the fourth and eighth weeks. Pain intensity was assessed through the use of a visual analogue scale, while depression and anxiety were evaluated using both the Beck Depression Inventory and Beck Anxiety Inventory. The data was analysed using descriptive statistics, multivariate analysis of variance (MANOVA) and post hoc tests with Bonferroni adjustment at the p=0.05 significant level.
Results:
Ages of participants in NSEG (46.8±12.4 years), NDEG (48.6±11.6 years) and NSDEG (45.1±13.4 years) were comparable. The comparison for NSEG, NSDEG and NDEG within groups revealed that there was significant difference in pain intensity, depression and anxiety scores from baseline, in the fourth and eighth weeks of the study – (F=62.40, p=0.001, F=13.91, p=0.001 and F=20.93, p=0.001); (F=11.92, p=0.001, F=8.75, p=0.004 and F=9.70, p=0.001) and (F=36.63, p=0.001, F=11.99, p=0.001 and F=6.59, p=0.001), respectively. A group comparison of the pain intensity, depression and anxiety scores of participants in the NSEG, NSDEG and NDEG at the baseline of the study revealed that there were no significant differences in the pain intensity and depression and anxiety scores among the three groups: p=0.159, 0.58 and 0.179, respectively. At week 4 of the study, however, a significant difference in pain intensity and anxiety scores across the three groups was recorded – p=0.018, p=0.011, respectively, but no significant difference was noted in depression scores (p=0.93). At week 8 of the study, it was determined that there were significant differences in pain intensity and depression scores p=0.001 and p=0.041, but no significant dissimilarities in the anxiety scores. Post hoc revealed that only pain was significant and lay with NSEG.
Conclusions:
The study concluded that the stabilisation, dynamic and stabilisation, plus dynamic exercises were effective in relieving pain and reducing depression and anxiety in patients with NsNP. However, stabilisation showed a more marked effect than the combination exercises of stabilisation plus dynamic exercises, and dynamic exercises in reducing pain intensity in patients with NsNP.
Implications:
It is recommended that stabilisation exercises be chosen over stabilisation plus dynamic exercises, or dynamic exercise, while treating patients with NsNP. However, both are effective.
Collapse
Affiliation(s)
- Bashir Kaka
- Department of Physiotherapy , School of Health Sciences, College of Health Sciences , University of KwaZulu-Natal , Westville, Durban , South Africa , E-mail:
| | - Omoyemi O. Ogwumike
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - Ade. F. Adeniyi
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - Sonill S. Maharaj
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences , University of KwaZulu-Natal , Westville, Durban , South Africa
| | - Samuel O. Ogunlade
- Department of Surgery, Faculty of Clinical Sciences, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - Bashir Bello
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences , Bayero University Kano , Kano , Nigeria
| |
Collapse
|
43
|
Nazari G, Bobos P, Billis E, MacDermid JC. Cervical flexor muscle training reduces pain, anxiety, and depression levels in patients with chronic neck pain by a clinically important amount: A prospective cohort study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018. [PMID: 29536618 DOI: 10.1002/pri.1712] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Neck pain is the fourth leading cause of disability in the United States and exerts an important socio-economic burden around the world. The aims of this study were to determine the effectiveness of deep and superficial flexor muscle training in addition to home-based exercises in reducing chronic neck pain and anxiety/depression levels. METHODS This was a prospective cohort study. Patients between 18 and 65 years old with chronic neck pain were eligible to participate if they had disability levels at least 5 out of 50 on the Neck Disability Index. Patients were divided into three groups: Group A received deep neck flexor and home-based exercises; Group B received superficial muscle and home-based exercises; and Group C received home-based exercises only. The Numeric Pain Rating Scale (NPRS), Neck Disability Index, and Hospital Anxiety and Depression Scale were administered at baseline and 7 weeks later. RESULTS The highest improvements in pain intensity levels were observed in Group A with 4.75 (1.74) NPRS points, and the lowest were in Group C with 1.00 (1.10). The highest reductions in anxiety and depression levels were noted in Group A (2.80) and Group B (1.65), respectively. The highest improvements in pain intensity levels were observed among Groups A versus C with 2.80 (0.52) NPRS. The highest reductions in anxiety and depression levels were noted among Groups A versus C with 1.75 (1.10) points and Groups B versus C with 1.60 (0.90) points, respectively. CONCLUSIONS Deep and superficial flexor muscle training along with home-based exercises is likely to reduce chronic neck pain and anxiety/depression levels by a clinically relevant amount. Future larger scaled randomized controlled trials are warranted to further support these findings.
Collapse
Affiliation(s)
- Goris Nazari
- Physical Therapy, Western University, London, Ontario, Canada
| | - Pavlos Bobos
- Physical Therapy, Western University, London, Ontario, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada
| | - Evdokia Billis
- Department of Physical Therapy, Technological Educational Institute of Western Greece, Patras, Greece
| | - Joy C MacDermid
- Physical Therapy, Western University, London, Ontario, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada
| |
Collapse
|
44
|
Poorman GW, Passias PG, Horn SR, Frangella NJ, Daniels AH, Hamilton DK, Kim H, Sciubba D, Diebo BG, Bortz CA, Segreto FA, Kelly MP, Smith JS, Neuman BJ, Shaffrey CI, LaFage V, LaFage R, Ames CP, Hart R, Mundis GM, Eastlack R. Despite worse baseline status depressed patients achieved outcomes similar to those in nondepressed patients after surgery for cervical deformity. Neurosurg Focus 2017; 43:E10. [DOI: 10.3171/2017.8.focus17486] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEDepression and anxiety have been demonstrated to have negative impacts on outcomes after spine surgery. In patients with cervical deformity (CD), the psychological and physiological burdens of the disease may overlap without clear boundaries. While surgery has a proven record of bringing about significant pain relief and decreased disability, the impact of depression and anxiety on recovery from cervical deformity corrective surgery has not been previously reported on in the literature. The purpose of the present study was to determine the effect of depression and anxiety on patients’ recovery from and improvement after CD surgery.METHODSThe authors conducted a retrospective review of a prospective, multicenter CD database. Patients with a history of clinical depression, in addition to those with current self-reported anxiety or depression, were defined as depressed (D group). The D group was compared with nondepressed patients (ND group) with a similar baseline deformity determined by propensity score matching of the cervical sagittal vertical axis (cSVA). Baseline demographic, comorbidity, clinical, and radiographic data were compared among patients using t-tests. Improvement of symptoms was recorded at 3 months, 6 months, and 1 year postoperatively. All health-related quality of life (HRQOL) scores collected at these follow-up time points were compared using t-tests.RESULTSSixty-six patients were matched for baseline radiographic parameters: 33 with a history of depression and/or current depression, and 33 without. Depressed patients had similar age, sex, race, and radiographic alignment: cSVA, T-1 slope minus C2–7 lordosis, SVA, and T-1 pelvic angle (p > 0.05). Compared with nondepressed individuals, depressed patients had a higher incidence of osteoporosis (21.2% vs 3.2%, p = 0.028), rheumatoid arthritis (18.2% vs 3.2%, p = 0.012), and connective tissue disorders (18.2% vs 3.2%, p = 0.012). At baseline, the D group had greater neck pain (7.9 of 10 vs 6.6 on a Numeric Rating Scale [NRS], p = 0.015), lower mean EQ-5D scores (68.9 vs 74.7, p < 0.001), but similar Neck Disability Index (NDI) scores (57.5 vs 49.9, p = 0.063) and myelopathy scores (13.4 vs 13.9, p = 0.546). Surgeries performed in either group were similar in terms of number of levels fused, osteotomies performed, and correction achieved (baseline to 3-month measurements) (p < 0.05). At 3 months, EQ-5D scores remained lower in the D group (74.0 vs 78.2, p = 0.044), and NDI scores were similar (48.5 vs 39.0, p = 0.053). However, neck pain improved in the D group (NRS score of 5.0 vs 4.3, p = 0.331), and modified Japanese Orthopaedic Association (mJOA) scores remained similar (14.2 vs 15.0, p = 0.211). At 6 months and 1 year, all HRQOL scores were similar between the 2 cohorts. One-year measurements were as follows: NDI 39.7 vs 40.7 (p = 0.878), NRS neck pain score of 4.1 vs 5.0 (p = 0.326), EQ-5D score of 77.1 vs 78.2 (p = 0.646), and mJOA score of 14.0 vs 14.2 (p = 0.835). Anxiety/depression levels reported on the EQ-5D scale were significantly higher in the depressed cohort at baseline, 3 months, and 6 months (all p < 0.05), but were similar between groups at 1 year postoperatively (1.72 vs 1.53, p = 0.416).CONCLUSIONSClinical depression was observed in many of the study patients with CD. After matching for baseline deformity, depression symptomology resulted in worse baseline EQ-5D and pain scores. Despite these baseline differences, both cohorts achieved similar results in all HRQOL assessments 6 months and 1 year postoperatively, demonstrating no clinical impact of depression on recovery up until 1 year after CD surgery. Thus, a history of depression does not appear to have an impact on recovery from CD surgery.
Collapse
Affiliation(s)
- Gregory W. Poorman
- 1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Peter G. Passias
- 1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Samantha R. Horn
- 1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Nicholas J. Frangella
- 1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Alan H. Daniels
- 2Department of Orthopaedic Surgery, Brown University Alpert Medical School, Providence, Rhode Island
| | - D. Kojo Hamilton
- 3Department of Neurologic Surgery, University of Pittsburgh, Pennsylvania
| | - Hanjo Kim
- 4Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | - Daniel Sciubba
- 5Department of Neurologic Surgery, Johns Hopkins Medical Center, Baltimore, Maryland
| | - Bassel G. Diebo
- 6Department of Orthopaedic Surgery, University Hospital of Brooklyn, New York, New York
| | - Cole A. Bortz
- 1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Frank A. Segreto
- 1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Michael P. Kelly
- 7Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri
| | - Justin S. Smith
- 8Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Brian J. Neuman
- 5Department of Neurologic Surgery, Johns Hopkins Medical Center, Baltimore, Maryland
| | - Christopher I. Shaffrey
- 8Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Virginie LaFage
- 4Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | - Renaud LaFage
- 4Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | - Christopher P. Ames
- 9Department of Neurological Surgery, University of California, San Francisco, California
| | - Robert Hart
- 10Swedish Neuroscience Institute, Seattle, Washington; and
| | | | - Robert Eastlack
- 11San Diego Center for Spinal Disorders, La Jolla, California
| |
Collapse
|
45
|
Horn ME, George SZ, Fritz JM. Influence of Initial Provider on Health Care Utilization in Patients Seeking Care for Neck Pain. Mayo Clin Proc Innov Qual Outcomes 2017; 1:226-233. [PMID: 30225421 PMCID: PMC6132197 DOI: 10.1016/j.mayocpiqo.2017.09.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective To examine patients seeking care for neck pain to determine associations between the type of provider initially consulted and 1-year health care utilization. Patients and Methods A retrospective cohort of 1702 patients (69.25% women, average age, 45.32±14.75 years) with a new episode of neck pain who consulted a primary care provider, physical therapist (PT), chiropractor (DC), or specialist from January 1, 2012, to June 30, 2013, was analyzed. Descriptive statistics were calculated for each group, and subsequent 1-year health care utilization of imaging, opioids, surgery, and injections was compared between groups. Results Compared with initial primary care provider consultation, patients consulting with a DC or PT had decreased odds of being prescribed opioids within 1 year from the index visit (DC: adjusted odds ratio [aOR], 0.54; 95% CI, 0.39-0.76; PT: aOR, 0.59; 95% CI, 0.44-0.78). Patients consulting with a DC additionally demonstrated decreased odds of advanced imaging (aOR, 0.43; 95% CI, 0.15-0.76) and injections (aOR, 0.34; 95% CI, 0.19-0.56). Initiating care with a specialist or PT increased the odds of advanced imaging (specialist: aOR, 2.96; 95% CI, 2.01-4.38; PT: aOR, 1.57; 95% CI, 1.01-2.46), but only initiating care with a specialist increased the odds of injections (aOR, 3.21; 95% CI, 2.31-4.47). Conclusion Initially consulting with a nonpharmacological provider may decrease opioid exposure (PT and DC) over the next year and also decrease advanced imaging and injections (DC only). These data provide an initial indication of how following recent practice guidelines may influence health care utilization in patients with a new episode of neck pain.
Collapse
Key Words
- ACP, American College of Physicians
- CDC, Centers for Disease Control and Prevention
- DC, chiropractor
- ICD-9, International Classification of Diseases, Ninth Revision
- IQR, interquartile range
- MRI, magnetic resonance imaging
- PCP, primary care provider
- PT, physical therapist
- UUHP, University of Utah Health Plans
- aOR, adjusted odds ratio
Collapse
Affiliation(s)
- Maggie E Horn
- Department of Orthopaedic Surgery, Physical Therapy Division, Duke University, Durham, NC
| | - Steven Z George
- Duke Clinical Research Institute, Duke University, Durham, NC.,Department of Orthopaedic Surgery, Duke University, Durham, NC
| | - Julie M Fritz
- Department of Physical Therapy, College of Health, University of Utah, Salt Lake City, UT
| |
Collapse
|
46
|
Jabłońska R, Ślusarz R, Królikowska A, Haor B, Antczak A, Szewczyk M. Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease. J Pain Res 2017; 10:89-99. [PMID: 28115868 PMCID: PMC5222600 DOI: 10.2147/jpr.s121328] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease. PATIENTS AND METHODS The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140). RESULTS Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery (p=0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery (p=0.368). CONCLUSION This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.
Collapse
Affiliation(s)
| | | | | | - Beata Haor
- Neurological and Neurosurgical Nursing Department
| | - Anna Antczak
- Neurological and Neurosurgical Nursing Department
| | - Maria Szewczyk
- Department of Surgery Nursing, Faculty of Health Science, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University,Toruń, Bydgoszcz, Poland
| |
Collapse
|
47
|
Alavi SS, Makarem J, Abbasi M, Rahimi A, Mehrdad R. Association between upper extremity musculoskeletal disorders and mental health status in office workers. Work 2016; 55:3-11. [PMID: 27612063 DOI: 10.3233/wor-162382] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied. OBJECTIVE The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status. METHODS In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%). RESULTS Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms. CONCLUSION Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.
Collapse
Affiliation(s)
- Seyedeh Shohreh Alavi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalil Makarem
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahya Abbasi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Rahimi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
48
|
Barbe MF, Xin DL, Hadrévi J, Elliott ME, Barr-Gillespie AE. Sickness behaviors (reduced social interaction and pain behaviors) are linked to inflammatory mechanisms in a rat model of work-related musculoskeletal disorders. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1541931213601225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We sought to determine if sickness behaviors (decreased social interaction and pain) are induced in a rat model of work-related overuse and effectiveness of anti-inflammatory treatments. Rats first trained to learn a high force reaching task (15 min/week day for 6 wks), with subsets treated prophylactically with ibuprofen or anti-TNFalpha. Others performed a high repetition high force (HRHF) task for 6 or 12 weeks (2 hrs/day, 3 days/wk) untreated, or with ibuprofen, anti-TNFalpha or rest treatments beginning task week 5. Untreated HRHF rats had increased IL-1beta, IL-6 and TNFalpha in serum and brain, increased Substance P in spinal cord, decreased social interaction and increased forepaw allodynia. Secondary anti-inflammatory treatments attenuated social interaction and brain changes, but not allodynia or spinal cord changes; rest provided partial attenuation. Prophylactic treatments prevented all changes. Thus, inflammatory mechanisms mediate the development of sickness behaviors induced by work-related overuse, but not maintenance of allodynia.
Collapse
Affiliation(s)
- MF Barbe
- Dept of Anatomy and Cell Biology, Temple Univ School of Medicine, Philadelphia, PA, USA
| | - DL Xin
- Dept of Surgery, Univ of Pennsylvania, Philadelphia
| | - J Hadrévi
- Dept of Public Health & Clinical Medicine, Occupational and Environmental Medicine, Umeå Univ, Umeå, Sweden
| | - ME Elliott
- Dept of Neurosurgery, Thomas Jefferson Univ, Philadelphia
| | | |
Collapse
|
49
|
Elbinoune I, Amine B, Shyen S, Gueddari S, Abouqal R, Hajjaj-Hassouni N. Chronic neck pain and anxiety-depression: prevalence and associated risk factors. Pan Afr Med J 2016; 24:89. [PMID: 27642428 PMCID: PMC5012832 DOI: 10.11604/pamj.2016.24.89.8831] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 03/14/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction Chronic pain in rheumatology often has a psychic impact, which may aggravate the daily life of patients. Chronic neck pain, as an example, is a frequent reason for consultation. The aim of this study is to assess the prevalence of anxiety and depression in patients with neck pain, and identify risk factors associated with their occurrence. Methods It was a cross-sectional study that concerned 80 patients with neck pain lasting for more than 3 months, seen in rheumatology consultations. All patients with symptomatic neck pain or psychological history or receiving psychotropic medication were excluded from the study. For each patient, we determined the sociodemographic characteristics and clinical ones. The anxious and depressed mood was assessed by the Hospital Anxiety and Depression Scale (HAD). Results Of the 80 patients, 67 (83.8%) were women. Average age of our population was 51.8± 11.8 years. Median duration of symptoms was 24 months [12, 48]. Mean VAS pain was 63.9% ± 12.5, mean VAS functional discomfort was 60.9% ± 14.2 and mean VAS disability was 59.8% ± 14.7. 32 patients (40%) were illiterate and 18 (22.5%) had university level. Anxiety was found in 54 (68.4%) and 44 (55.7%) patients were depressed. In univariate analysis, VAS disability was statistically linked to anxiety (OR:1.05; 95%CI: 1.01-1.08; p = 0.02). The cervicobrachial neuralgia (CBN) was significantly associated with depression (OR: 3.33; 95%CI: 1.20-9.23; p = 0.02). Primary education level had a statistically significant relationship with anxiety (OR: 6.00; 95%CI: 1.03-34.84; p = 0.04) and depression (OR: 5.00; 95%CI: 1.09-22.82; p = 0.03). In multivariate analysis, VAS disability and CBN were independently associated with anxiety and depression respectively. Conclusion This study underlines the fact that anxiety and depression are prevalent in chronic neck pain (CNP) patients. Furthermore, disability and CBN which are linked to CNP can predict which patient is at higher risk of psychological distress.
Collapse
Affiliation(s)
- Imane Elbinoune
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Bouchra Amine
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| | - Siham Shyen
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Sanae Gueddari
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco
| | - Najia Hajjaj-Hassouni
- Rheumatology Departement, El Ayachi Hospital, Ibn Sina University hospital, Sale, Morocco; Laboratory of Biostatistics, Clinical and Epidemiological Research (LBRCE), Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Rabat, Morocco; LIPROS-URAC30, Mohammed V Souissi University, Rabat, Morocco
| |
Collapse
|
50
|
Uluğ N, Yakut Y, Alemdaroğlu İ, Yılmaz Ö. Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain. J Phys Ther Sci 2016; 28:665-70. [PMID: 27064399 PMCID: PMC4793030 DOI: 10.1589/jpts.28.665] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 11/19/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to compare patients with low back and neck pain
with respect to kinesiophobia, pain, and quality of life. [Subjects and Methods]
Three-hundred patients with low back (mean age 43.2±11 years) and 300 with neck pain (mean
age 42.8±10.2 years) were included in this study. Pain severity was evaluated by using the
Short-Form McGill Pain Questionnaire, which includes a Visual Analogue Scale, quality of
life by the Nottingham Health Profile, and kinesiophobia by the Tampa Scale for
Kinesiophobia. [Results] Pain severity was similar in both groups, with a Visual Analogue
Scale score of 6.7±2 in the low back pain and 6.8±2 in the neck pain group. Nottingham
Health Profile pain [z=−4.132] and physical activity scores [z=−5.640] in the low back
pain group were significantly higher. Kinesiophobia was also more severe in the low back
pain group, with a mean 42.05±5.91 versus 39.7±6.0 Tampa Scale for Kinesiophobia score
[z=−4.732]. [Conclusion] Patients with low back pain developed more severe kinesiophobia,
regardless of the pain severity, and had greater pain perception and lower physical
activity levels. Kinesiophobia adversely affects the quality of life and requires
effective management of low back pain.
Collapse
Affiliation(s)
- Naime Uluğ
- Department of Physical Medicine and Rehabilitation, Hacettepe University Hospital, Turkey
| | - Yavuz Yakut
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Turkey
| | - İpek Alemdaroğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Turkey
| | - Öznur Yılmaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Turkey
| |
Collapse
|