scholarly journals The Role of Sleep in the Transition from Acute to Chronic Musculoskeletal Pain in Youth—A Narrative Review

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 241
Author(s):  
Alessandro Andreucci ◽  
Cornelius B. Groenewald ◽  
Michael Skovdal Rathleff ◽  
Tonya M. Palermo
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Negative Impact ◽  
Pain Catastrophizing ◽  
Pediatric Population ◽  
Small Subgroup ◽  
Sleep Deficiency ◽  
New Treatment ◽  
And Coping ◽  
Social Components

Musculoskeletal pain is common in the general pediatric population and is a challenge to youth, their parents, and society. The majority of children experiencing musculoskeletal pain will recover; however, a small subgroup of youth develops chronic pain. There is limited understanding of the factors that affect the transition from acute to chronic pain in youth. This review introduces sleep deficiency in the acute to chronic pain transition, exploring the potential mediational or mechanistic role and pathways of sleep in this process, including the interaction with sensory, psychological, and social components of pain and highlighting new avenues for treatment. Biological mechanisms include the increased production of inflammatory mediators and the effect on the hypothalamus-pituitary-adrenal (HPA) axis and on the dopaminergic signaling. Psychological and social components include the effect of sleep on the emotional-affective and behavioral components of pain, the negative impact on daily and social activities and coping strategies and on the reward system, increased pain catastrophizing, fear of pain, pain-related anxiety, hypervigilance, and social isolation. Future longitudinal studies are needed to elucidate these mechanistic pathways of the effect of sleep on the transition from acute to chronic pain, which may lead to the development of new treatment targets to prevent this transition.

Pain and Psychological Outcomes Among Iraq and Afghanistan Veterans with Chronic Pain and PTSD: ESCAPE Trial Longitudinal Results

Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1369-1376
Author(s):  
Matthew J Bair ◽  
Samantha D Outcalt ◽  
Dennis Ang ◽  
Jingwei Wu ◽  
Zhangsheng Yu
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Pain Catastrophizing ◽  
Psychological Outcomes ◽  
Stepped Care ◽  
Chronic Musculoskeletal Pain ◽  
Pain Severity ◽  
Analysis Of Covariance ◽  
Escape Trial ◽  
Care Intervention

Abstract Objective To compare pain and psychological outcomes in veterans with chronic musculoskeletal pain and comorbid post-traumatic stress disorder (PTSD) or pain alone and to determine if veterans with comorbidity respond differently to a stepped-care intervention than those with pain alone. Design Secondary analysis of data from the Evaluation of Stepped Care for Chronic Pain (ESCAPE) trial. Setting Six Veterans Health Affairs clinics. Subjects Iraq and Afghanistan veterans (N = 222) with chronic musculoskeletal pain. Methods Longitudinal analysis of veterans with chronic musculoskeletal pain and PTSD or pain alone and available baseline and nine-month trial data. Participants randomized to either usual care or a stepped-care intervention were analyzed. The pain–PTSD comorbidity group screened positive for PTSD and had a PTSD Checklist–Civilian score ≥41 at baseline. Results T tests demonstrated statistically significant differences and worse outcomes on pain severity, pain cognitions, and psychological outcomes in veterans with comorbid pain and PTSD compared with those with pain alone. Analysis of covariance (ANCOVA) modeling change scores from baseline to nine months indicated no statistically significant differences, controlling for PTSD, on pain severity, pain centrality, or pain self-efficacy. Significant differences emerged for pain catastrophizing (t = 3.10, P < 0.01), depression (t = 3.39, P < 0.001), and anxiety (t = 3.80, P < 0.001). The interaction between PTSD and the stepped-care intervention was not significant. Conclusions Veterans with the pain–PTSD comorbidity demonstrated worse pain and psychological outcomes than those with chronic pain alone. These findings indicate a more intense chronic pain experience for veterans when PTSD co-occurs with pain. PTSD did not lead to a differential response to a stepped-care intervention.

scholarly journals Translation and validation of the Norwegian version of the Injustice Experience Questionnaire

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tone Marte Ljosaa ◽  
Hanne Svardal Berg ◽  
Henrik Børsting Jacobsen ◽  
Lars-Petter Granan ◽  
Silje Reme
Keyword(s):  
Chronic Pain ◽  
Psychological Distress ◽  
Negative Impact ◽  
Pain Catastrophizing ◽  
Self Report ◽  
Additional Contribution ◽  
Perceived Injustice ◽  
Related Factors ◽  
Good Reliability ◽  
Experience Questionnaire

Abstract Objectives Perceived injustice is a theoretical construct comprising elements of loss, attribution of blame, and sense of unfairness. Patients with chronic pain often report high levels of perceived injustice, which can have negative impact on physiological and psychosocial aspects and treatment outcome. The Injustice Experience Questionnaire (IEQ) is a self-report 12-item questionnaire that shows good reliability and validity in patients with chronic pain. This study aimed to translate, validate, and expand the use of the Norwegian Injustice Experience Questionnaire (IEQ-N) to a chronic pain population. Methods A mixed-method approach was used to translate and validate the IEQ-N. It was forward-back translated, linguistically validated, and culturally adapted. Individual cognitive debriefing interviews (n=7) and a focus group interview (n=9) was used to explore the patients’ experience with- and understanding of the questionnaire. Statistical descriptive, correlational, factor- and regression analyses were used to investigate the IEQ-N validity, reliability, and factorial structure in a large registry sample (n=3,068) of patients with chronic pain. Results Patients with chronic pain found the IEQ-N relevant. Registry analyses supported that the IEQ-N had a one-factor structure. The internal consistency was high (Chronbach’s alpha=0.92). The construct validity was good, with moderate to strong significant univariate correlation (r=0.29–0.71) (p<0.05) between perceived injustice and related constructs of pain catastrophizing, pain severity, disability, psychological distress, and quality of life. Perceived injustice contributed with significant but small unique variance to pain-related factors (i.e., pain intensity, pain-related disability, psychological distress), but the additional contribution beyond pain catastrophizing was small (0.2–6.7%) (p<0.05). Conclusions Patients in the study found the questionnaire relevant for their situation, and easy to understand. This study provides a reliable and valid Norwegian tool to assess perceived injustice in patients with chronic pain. Ethical committee number REK sør-øst, 2016/1942.

Chronic musculoskeletal pain in children and adolescents

2013 ◽  
pp. 1380-1389 ◽  
Author(s):  
Jacqui Clinch
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Chronic Back Pain ◽  
Negative Impact ◽  
Financial Burden ◽  
Adult Life ◽  
Well Being ◽  
Chronic Widespread Pain ◽  
Widespread Pain ◽  
Number Of Children

Paediatricians review a large number of children who have a wide variety of musculoskeletal pains. The most common chronic pain conditions reviewed in paediatric rheumatology settings include diffuse idiopathic musculoskeletal pain (also called juvenile fibromyalgia or chronic widespread pain), chronic pain related to childhood hypermobility, complex regional pain syndromes (CRPS), chronic back pain, and persistent joint pain following previous or controlled inflammation, e.g. juvenile idiopathic arthritis (JIA). The chronic experience of pain often has a large and wholly negative impact on physical and psychological well-being and also a serious negative impact on financial well-being. The annual financial burden of adolescent chronic pain on the United Kingdom economy is conservatively calculated at £3840 million. Children who suffer persistent musculoskeletal pain and associated symptoms have a significant chance of developing chronic widespread pain and continuing to have pain and pain-associated disability in adult life. This chapter reviews the epidemiology of musculoskeletal pain in childhood, current theories of the aetiology of pain, the impact of chronic pain, the clinical features of common pain presentations and their relevance to diagnosis and treatment planning, and rehabilitation interventions aimed at the management of chronic pain.

The relationship between chronic musculoskeletal pain, anxiety and mindfulness: Adjustments to the Fear-Avoidance Model of Chronic Pain

2017 ◽  
Vol 17 (1) ◽  
pp. 156-166 ◽  
Author(s):  
Katherine B. Curtin ◽  
Deborah Norris
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Pain Catastrophizing ◽  
Pain Severity ◽  
Fear Avoidance ◽  
Pain Anxiety ◽  
Fear Avoidance Model ◽  
Chronic Pain Patients ◽  
The Relationship ◽  
Pain Patients

AbstractBackground and purposeThe Fear-Avoidance Model of Chronic Pain proposed by Vlaeyen and Linton states individuals enter a cycle of chronic pain due to predisposing psychological factors, such as negative affectivity, negative appraisal or anxiety sensitivity. They do not, however, address the closely related concept of anxious rumination. Although Vlaeyen and Linton suggest cognitive-behavioral treatment methods for chronic pain patients who exhibit pain-related fear, they do not consider mindfulness treatments. This cross-sectional study investigated the relationship between chronic musculoskeletal pain (CMP), ruminative anxiety and mindfulness to determine if (1) ruminative anxiety is a risk factor for developing chronic pain and (2) mindfulness is a potential treatment for breaking the cycle of chronic pain.MethodsMiddle-aged adults ages 35-50 years (N = 201) with self-reported CMP were recruited online. Participants completed standardized questionnaires assessing elements of chronic pain, anxiety, and mindfulness.ResultsRuminative anxiety was positively correlated with pain catastrophizing, pain-related fear and avoidance, pain interference, and pain severity but negatively correlated with mindfulness. High ruminative anxiety level predicted significantly higher elements of chronic pain and significantly lower level of mindfulness. Mindfulness significantly predicted variance (R2) in chronic pain and anxiety outcomes. Pain severity, ruminative anxiety, pain catastrophizing, pain-related fear and avoidance, and mindfulness significantly predicted 70.0% of the variance in pain interference, with pain severity, ruminative anxiety and mindfulness being unique predictors.ConclusionsThe present study provides insight into the strength and direction of the relationships between ruminative anxiety, mindfulness and chronic pain in a CMP population, demonstrating the unique associations between specific mindfulness factors and chronic pain elements.ImplicationsIt is possible that ruminative anxiety and mindfulness should be added into the Fear-Avoidance Model of Chronic Pain, with ruminative anxiety as a psychological vulnerability and mindfulness as an effective treatment strategy that breaks the cycle of chronic pain. This updated Fear-Avoidance Model should be explored further to determine the specific mechanism of mindfulness on chronic pain and anxiety and which of the five facets of mindfulness are most important to clinical improvements. This could help clinicians develop individualized mindfulness treatment plans for chronic pain patients.

A cross-sectional analysis of the relationships of FAM components and their effects on quality of life in Chinese patients with chronic musculoskeletal pain

2016 ◽  
Vol 33 (S1) ◽  
pp. S207-S208
Author(s):  
W. Wong ◽  
H. Lim ◽  
P. Chen ◽  
S. Wong ◽  
Y. Chow ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Chinese Population ◽  
Pain Catastrophizing ◽  
Chronic Musculoskeletal Pain ◽  
Chinese Patients ◽  
Cross Sectional ◽  
Pain Anxiety

IntroductionA body of evidence has accrued supporting the Fear-Avoidance Model (FAM) of chronic pain which postulated the mediating role of pain-related fear in the relationships between pain catastrophizing and pain anxiety in affecting pain-related outcomes. Yet, relatively little data points to the extent to which the FAM be extended to understand chronic pain in Chinese population and its impact on quality of life (QoL).ObjectiveThis study explored the relationships between FAM components and their effects on QoL in a Chinese sample.MethodsA total of 401 Chinese patients with chronic musculoskeletal pain completed measures of three core FAM components (pain catastrophizing, pain-related fear, and pain anxiety) and QoL. Cross-sectional structural equation modeling (SEM) assessed the goodness of fit of the FAM for two QoL outcomes, Physical (Model 1) and Mental (Model 2). In both models, pain catastrophizing was hypothesized to underpin pain-related fear, thereby influencing pain anxiety and subsequently QoL outcomes.ResultsResults of SEM evidenced adequate data-model fit (CFI30.90) for the two models tested (Model 1: CFI = 0.93; Model 2: CFI = 0.94). Specifically, pain catastrophizing significantly predicted pain-related fear (Model 1: stdb = 0.90; Model 2: stdb = 0.91), which in turn significantly predicted pain anxiety (Model 1: stdb = 0.92; Model 2: stdb = 0.929) and QoL outcomes in a negative direction (Model 1: stdb = −0.391; Model 2: stdb = −0.651) (all P < 0.001) (Table 1, Fig. 1).ConclusionOur data substantiated the existing FAM literature and offered evidence for the cross-cultural validity of the FAM in the Chinese population with chronic pain.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Generalized Joint Hypermobility and Anxiety in Adolescents and Young Adults, the Impact on Physical and Psychosocial Functioning

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 525
Author(s):  
Janneke de Vries ◽  
Jeanine Verbunt ◽  
Janine Stubbe ◽  
Bart Visser ◽  
Stephan Ramaekers ◽  
...  
Keyword(s):  
Young Adults ◽  
Psychosocial Functioning ◽  
Negative Impact ◽  
Pain Catastrophizing ◽  
Joint Hypermobility ◽  
Adolescents And Young Adults ◽  
P Value ◽  
High Performing ◽  
Generalized Joint Hypermobility ◽  
The Impact

The purpose of this study was to study the association between the presence of generalized joint hypermobility (GJH) and anxiety within a non-clinical high performing group of adolescents and young adults. Second, to study the impact of GJH and/or anxiety on physical and psychosocial functioning, 168 adolescents and young adults (mean (SD) age 20 (2.9)) were screened. Joint (hyper)mobility, anxiety, and physical and psychosocial functioning were measured. In 48.8% of all high performing adolescents and young adults, GJH was present, whereas 60% had symptoms of anxiety. Linear models controlled for confounders showed that adolescents and young adults with GJH and anxiety had decreased workload (ß (95%CI) −0.43 (−0.8 to −0.08), p-value 0.02), increased fatigue (ß (95%CI) 12.97 (6.3–19.5), p-value < 0.01), and a higher level of pain catastrophizing (ß (95%CI) 4.5 (0.5–8.6), p-value 0.03). Adolescents and young adults with only anxiety had increased fatigue (ß (95%CI) 11 (4.9–19.5). In adolescents and young adults with GJH alone, no impact on physical and psychosocial functioning was found. Adolescents and young adults with the combination of GJH and anxiety were significantly more impaired, showing decreased physical and psychosocial functioning with decreased workload, increased fatigue, and pain catastrophizing. Presence of GJH alone had no negative impact on physical and psychosocial functioning. This study confirms the association between GJH and anxiety, but especially emphasizes the disabling role of anxiety. Screening for anxiety is relevant in adolescents and young adults with GJH and might influence tailored interventions.

scholarly journals Identification and Characterization of Unique Subgroups of Chronic Pain Individuals with Dispositional Personality Traits

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
S. Mehta ◽  
D. Rice ◽  
A. McIntyre ◽  
H. Getty ◽  
M. Speechley ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Personality Traits ◽  
Clinical Outcomes ◽  
High Risk Group ◽  
Comprehensive Treatment ◽  
Cluster Membership ◽  
Significant Difference ◽  
Secondary Objective ◽  
The Difference ◽  
And Coping

Objective.The current study attempted to identify and characterize distinct CP subgroups based on their level of dispositional personality traits. The secondary objective was to compare the difference among the subgroups in mood, coping, and disability.Methods.Individuals with chronic pain were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted in order to identify distinct subgroups of patients based on their level of personality traits. Differences in clinical outcomes were compared using the multivariate analysis of variance based on cluster membership.Results.In 229 participants, three clusters were formed. No significant difference was seen among the clusters on patient demographic factors including age, sex, relationship status, duration of pain, and pain intensity. Those with high levels of dispositional personality traits had greater levels of mood impairment compared to the other two groups (p<0.05). Significant difference in disability was seen between the subgroups.Conclusions.The study identified a high risk group of CP individuals whose level of personality traits significantly correlated with impaired mood and coping. Use of pharmacological treatment alone may not be successful in improving clinical outcomes among these individuals. Instead, a more comprehensive treatment involving psychological treatments may be important in managing the personality traits that interfere with recovery.

scholarly journals Chronic Pain Has a Negative Impact on Sexuality in Testis Cancer Survivors

2011 ◽  
Vol 33 (5) ◽  
pp. 886-893 ◽  
Author(s):  
G. Puhse ◽  
J. U. Wachsmuth ◽  
S. Kemper ◽  
I. W. Husstedt ◽  
S. Evers ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cancer Survivors ◽  
Negative Impact ◽  
Testis Cancer

“Caring for the Elderly is Very Difficult”: Challenges and Coping Strategies of Caregivers in Urban Poor Accra, Ghana

2020 ◽  
pp. 105477382098230
Author(s):  
Frank Kyei-Arthur ◽  
Samuel Nii Ardey Codjoe
Keyword(s):  
Coping Strategies ◽  
Family Caregiving ◽  
Urban Poor ◽  
Phenomenological Study ◽  
Negative Impact ◽  
Elderly Care ◽  
The Elderly ◽  
Care Recipients ◽  
Negative Impacts ◽  
And Coping

This study is part of a broader phenomenological study on the experiences of family caregivers and their care recipients. There is a general paucity of research on the experiences of primary and secondary caregivers, and the negative impact of elderly care on caregivers in the urban poor settings in Ghana. This study explored primary and secondary caregivers’ challenges and coping strategies in the urban poor context in Accra, Ghana. This study was conducted in Ga Mashie. Thirty-one caregivers were interviewed. A phenomenological analysis was conducted using NVivo 10. Primary and secondary caregivers experienced economic, physical, social, and psychological burdens. Also, caregivers used spirituality and perseverance to cope with their challenges. The findings demonstrate that caregivers’ challenges varied by type of caregiver. Researchers and policymakers should consider the type of caregiver when designing interventions to mitigate the negative impacts of family caregiving on caregivers.

Sign in / Sign up

Export Citation Format

Share Document