Clinical Journal of Pain最新文献

{"title":"Chronic pain in Autism: A Systematic Review.","authors":"Helena Garriga-Cazorla, Josep Roman-Juan, Lorena Martí, Ester Solé, Rafael Martínez-Leal, Jordi Miró","doi":"10.1097/AJP.0000000000001296","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001296","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this systematic review was to synthesize the state-of-the-art in research on chronic pain in autistic individuals, including epidemiology, assessment, and management.</p><p><strong>Methods: </strong>We conducted a search of the following electronic databases: PubMed/MedLine, CINHAL, PsychINFO, PubPsych, Scopus and Web of Science, from inception to 31 July 2024.</p><p><strong>Results: </strong>A total of 5,603 citations were identified, 87 articles were deemed eligible for further assessment, and 26 articles were included in the final review. Of these, 13 provided data about the epidemiology of chronic pain, 10 were related to pain assessment, and three focused on chronic pain treatment. The most commonly studied locations of chronic pain were the abdomen and the head. The assessment tools used were frequently completed by parents or professionals/researchers and only one study used self-reported measures. Only three studies were on the management of chronic pain in autistic individuals, in particular psychological interventions.</p><p><strong>Discussion: </strong>This study provides initial insights into chronic pain in autistic individuals, and shows that they experience conditions such as chronic abdominal pain and migraines as the general population does. It also highlights challenges to the accurate assessment and treatment of chronic pain, and emphasizes the need for heightened clinician awareness, early identification, and personalized management strategies.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Pain Characteristics with Physical Capacity Trajectories Among Older Adults in the United States.","authors":"Sean D Rundell, Natasha Parman, Elizabeth A Phelan, Zachary A Marcum, Bobby Jones, Kushang V Patel","doi":"10.1097/AJP.0000000000001303","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001303","url":null,"abstract":"<p><strong>Objective: </strong>We investigated the associations of pain characteristics with trajectories of physical capacity in older adults and determined if bothersome and activity-limiting pain modified the association between the number of chronic conditions and trajectories of physical capacity.</p><p><strong>Methods: </strong>We performed a cohort study with 6,783 community-dwelling adults ≥65 years old who participated in the National Health and Aging Trends Study from 2011-2016. We assessed baseline pain characteristics and the number of self-reported chronic conditions (0-12) at baseline. Longitudinal physical capacity outcomes were categorized using previously identified performance-based and self-reported trajectory groups from this cohort. Multinomial logistic regression examined associations of pain characteristics with trajectories of physical capacity, adjusting for demographic and health characteristics. We then tested for effect modification using an interaction term in regression models.</p><p><strong>Results: </strong>Participants who reported bothersome pain, activity-limiting pain, greater number of pain sites, and more frequent pain medication use at baseline were significantly more likely to demonstrate either \"consistently very low\" or declining physical capacity trajectories compared to a \"consistently high\" trajectory. The negative impact of chronic disease burden on risk of a declining trajectory for both performance-based and self-reported physical capacity was greater in those with bothersome pain versus those not reporting pain.</p><p><strong>Discussion: </strong>Overall, we found bothersome pain and other pain characteristics were significantly associated with poor and worsening trajectories of physical capacity in older adults. This suggests pain is an important prognostic factor for targeting population-level interventions addressing physical capacity.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attrition from Pediatric Interdisciplinary Chronic Pain Clinics: Utilizing the \"Paediatric Electronic Persistent Pain Outcomes Collaboration (PaedePPOC) Database\".","authors":"Kristen Tiong, Andrew Gorrie, Greta M Palmer, David Sainsbury, Tiina Jaaniste","doi":"10.1097/AJP.0000000000001302","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001302","url":null,"abstract":"<p><strong>Objectives: </strong>Attrition from pediatric chronic pain clinics limits patients from receiving maximum benefit from evidence-based interventions, with likely persistence of chronic pain, functional and psychosocial impairments. We aimed to determine attrition prevalence from interdisciplinary pediatric outpatient chronic pain clinics and identify any associated patient and caregiver factors.</p><p><strong>Methods: </strong>A retrospective analysis was performed of longitudinal data from patients and caregivers attending 10 interdisciplinary pediatric outpatient chronic pain clinics in Australia or New Zealand contributing to the Paediatric electronic Persistent Pain Outcomes Collaboration (PaedePPOC) database. Data was retrieved for patient attrition, patient and caregiver factors at treatment commencement and subsequent documentation of the episode end for treatment completers and non-completers. Statistical associations with patient attrition were assessed using logistic regression analyses.</p><p><strong>Results: </strong>The prevalence of patient attrition was 19.3% in the PaedePPOC cohort (N=1051), occurring steadily over 11 months. Patients ending their treatment prematurely presented with longer pain duration (>12 mos) (χ2(1, n=879)=8.23, P=0.004) than treatment completers. In the regression model, only older patient age (P=0.010) and higher caregiver psychosocial burden (P=0.025) at treatment commencement were associated with attrition. While pain intensity, patient physical and psychosocial functioning scores and caregiver partner status were not.</p><p><strong>Discussion: </strong>One in five patients commencing an interdisciplinary pediatric outpatient chronic pain clinic intervention did not complete it. Identifying patients at pre-intervention screening with longer pain duration, older in age and from families with greater reported caregiver burden and providing tailored supports may minimize attrition, therefore optimizing efficiency of service provision.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Analgesia Effect Evaluation of Perineural Dexamethasone Plus Various Doses of Ropivacaine in Interscalene Brachial Plexus Block: A Randomized Controlled Trial.","authors":"Qianqian Tang, Shihui Gao, Changming Wang, Zenglong Yan, Jing Zhang","doi":"10.1097/AJP.0000000000001301","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001301","url":null,"abstract":"<p><strong>Objectives: </strong>Interscalene brachial plexus block (ISBPB) has gained popularity as a pain-relief method following shoulder arthroscopic surgery, significantly reducing the need for analgesics. This study was designed to evaluate whether the addition of dexamethasone to different effective concentrations of ropivacaine in ultrasound-guided ISBPB affects postoperative analgesic effect in patients undergoing shoulder arthroscopy surgery.</p><p><strong>Materials and methods: </strong>A total of 140 subjects elected for shoulder arthroscopy under ISBPB and general anesthesia, randomized into six equal groups. Group A, B, and C received 10 mL 0.25%, 0.5%, and 0.75% ropivacaine mixed with 1 mL 0.9% saline, respectively. Likewise, Groups A1, B1, and C1 received the same volumes of ropivacaine with 5 mg dexamethasone. The primary goal was to assess the duration of analgesia with ISBPB, with secondary objectives concerning postoperative nausea and vomiting (PONV) and numerical rating scale (NRS) pain scores.</p><p><strong>Results: </strong>Across a range of ropivacaine concentrations, there was no significant difference in the analgesic efficacy between subjects receiving dexamethasone treatment and those who did not. Notably, there was no demonstrable difference in the duration of analgesia among the treatment groups (Group A vs. Group A1: 510.13±262.39 min, 518.21±395.49 min; P=0.054); (Group B vs. Group B1: 672.42±306.63 min, 646.05±348.48 min; P=0.281); (Group C vs. Group C1: 724.42±384.14 min, 680.29±414.30 min; P=0.782). Furthermore, there was no significant difference in the incidence of intraoperative and postoperative complications.</p><p><strong>Conclusion: </strong>The present study indicated that the addition of dexamethasone to ropivacaine did not appear to provide any additional advantages in postoperative analgesic efficacy compared to the use of ropivacaine alone for patients undergoing shoulder arthroscopy surgery with ISBPB.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observer Scales of Facial Pain Expression Can Significantly Predict Acute Postoperative Pain in the Recovery Room.","authors":"Stefan Lautenbacher, Niklas Ceynowa, Makaras Burlakovas, Philip Lang, Miriam Kunz","doi":"10.1097/AJP.0000000000001300","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001300","url":null,"abstract":"<p><strong>Objectives: </strong>Immediately after surgery and general anesthesia patients may experience periods of dizziness, disorientation and sedation, which can hinder valid pain reports. Observational pain assessment, especially focusing on the face, may add to the subjective pain report in the recovery room. With the present study we wanted to put this assumption to test.</p><p><strong>Methods: </strong>63 patients wo had undergone a wide range of surgical procedures under general anesthesia were observed twice: 10 and 40 minutes after arrival in the recovery room. At these two time points, a trained examiner observed the patients' facial expression and filled out the face items of the Brief Pain Scale non intubated (BPS-NI) and of the Pain and Impaired Cognition15 (PAIC-15) scale. After that, a nurse asked the patients to rate their pain on a Numerical Rating Scale (NRS).</p><p><strong>Results: </strong>For both time points, the observer scales significantly predicted NRS ratings, with the BPS-NI being slightly superior (moderate/strong effect sizes) compared to the PAIC-15 (small/moderate effect sizes). On a group level, observational pain assessment showed a decrease in pain across the two time points, whereas NRS ratings remained stable. Despite this disparity, individual changes in pain ratings between the two time points were also significantly predicted by changes in both observer scales (moderate effect sizes).</p><p><strong>Discussion: </strong>In the recovery room, observational pain assessment can serve as a valid predictor of subjective pain. Thus, in cases where the validity of the pain report may be hampered, especially the face item of the BPI-NI may give substituting information about acute post-operative pain.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine versus Magnesium Sulphate in Ultrasound-Guided Bilateral bi-Level Erector Spinae Plane Block in Corrective Scoliosis Surgery: A Randomized Controlled Clinical Trial.","authors":"Amin M Alansary, Mohamed Mourad Ali, Minatallah Ali Elshafie, Marwa A K Elbeialy","doi":"10.1097/AJP.0000000000001299","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001299","url":null,"abstract":"<p><strong>Objectives: </strong>There is a scarcity of research regarding the effects of LAs adjuvant drugs in erector spinae plane block (ESPB), especially in scoliosis surgery. This study aimed to compare dexmedetomidine (DEX) or magnesium sulfate (MgSO₄) as adjuvants for bupivacaine in bilateral bi-level ultrasound-guided ESPB (USG-ESPB) in patients undergoing corrective scoliosis surgery.</p><p><strong>Methods: </strong>In this prospective, randomized study, sixty patients aged 14 to 25 years were randomly assigned to one of three groups (in a 1:1:1 ratio) after induction of general anesthesia. The DEX group [n=20] received USG-ESPB with 20 mL of bupivacaine 0.125% plus 0.25 µg/kg of DEX for each injection, while the MgSO4 group [n=20] received USG-ESPB with 20 mL of bupivacaine 0.125% plus 2 mg/kg MgSO4 for each injection. The control group [n=20] received conventional perioperative analgesia. The primary outcome was time for the first rescue analgesia. Secondary outcomes included total morphine consumption and pain scores in the first 48 postoperative hours. Hemodynamic parameters were assisted.</p><p><strong>Results: </strong>The mean time to the first analgesic request was the longest among patients in the DEX group (P<0.001). In addition, the total morphine consumption and the 48-h time-weighted average pain score during rest and movement were significantly lower among the patients in the DEX group (P<0.001). However, it was associated with a significant decrease in hemodynamic parameters (P<0.001).</p><p><strong>Conclusion: </strong>Both DEX and MgSO₄ provided a satisfactory pain relief profile. However, DEX with bupivacaine provided a longer period of analgesia.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Dexmedetomidine and Midazolam in Sedoanalgesia for Lumbar Facet Radiofrequency Ablation.","authors":"Mustafa Kurçaloğlu, Pınar Uzun Uslu, Firdevs Yilmazlar, Aygun Jabbarli, Bora Uzuner, Fatih Özkan, Fuat Güldoğuş","doi":"10.1097/AJP.0000000000001298","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001298","url":null,"abstract":"<p><strong>Objectives: </strong>Lumbar facet radiofrequency ablation (LFRA) is a painful procedure. Sedation may be applied to improve patient comfort during the procedure however, deep sedation should be avoided to maintain the patient cooperation. The purpose of this study was to compare dexmedetomidine and midazolam in sedoanalgesia for LFRA.</p><p><strong>Methods: </strong>Patients planning to undergo LFRA were included in this cross-sectional, observational study. Following a bolus dose, intravenous infusion of dexmedetomidine was administered in Group D, while intravenous midazolam was given in Group M. Intraoperative vital signs, procedural pain severity (Numerical Rating Scale-NRS), Patient Satisfaction Score (PSS), Operator Satisfaction Score (OSS), and complications were recorded.</p><p><strong>Results: </strong>A total of 96 patients were included in the study. Group D consisted of 47 and Group M of 49 patients. Procedural NRS, PSS, and OSS were significantly in favor of Group D. Mean procedural NRS of Group D was 2.91±2.03, and 4.14±2.17 in Group M ( P =0.005). The rate of unsatisfactory PSS was one (2.1%) in Group D and seven (20%) in Group M ( P =0.03). The rate of unsatisfactory OSS results was two (4.2%) in Group D and sixteen (32.6%) in Group M ( P <0.001). While over-sedation and low oxygen saturation were significantly more frequent in Group M, hypotension was higher in Group D.</p><p><strong>Discussion: </strong>In sedoanalgesia for LFRA, dexmedetomidine is superior to midazolam with lower procedural pain, higher satisfaction scores and improved patient cooperation. The results of this study can be considered for sedoanalgesia in other interventional pain procedures.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Co-existing Motor Proficiency Delay and Chronic Pain in Children Presenting to a Tertiary Pain Service: A Cross-sectional Observational Study.","authors":"Rebecca Fechner, Kris Rogers, Linsay Rogers, Anna Gollan, Mark Alcock, Erin Turbitt, Arianne P Verhagen, Joshua W Pate","doi":"10.1097/AJP.0000000000001297","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001297","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain can profoundly impact children's physical, social and psychological functioning, with negative effects that can persist into adulthood. The prevalence of motor proficiency delay in children with chronic pain is unknown. We aimed to describe the prevalence of motor proficiency delay in a sample of children and estimate potential predictive factors of delayed motor proficiency from routinely collected self-report measures .</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 94 children and adolescents (6-18) with chronic pain who attended a tertiary pain clinic in Australia. We assessed their motor proficiency using the BOT-2 standardised assessment tool. Participants also completed a suite of routine clinical questionnaires and a self-perception questionnaire. We described the prevalence of motor proficiency delay using descriptive statistics and estimated the extent to which routine demographic and clinical data could explain variation in BOT-2 scores using a multivariable linear model to calculate adjusted R².</p><p><strong>Results: </strong>Overall, 83% of participants presented with challenges in at least one motor-proficiency subtest (e.g., coordination), and 41% had delayed total motor proficiency scores. We found that just 9% of the variance in BOT-2 scores could be explained by the covariates in the multivariable prediction model (Adjusted R2=0.09, 95% CI:0.01 to 0.25).</p><p><strong>Discussion: </strong>Most children presenting to a tertiary pain clinic presented with motor proficiency challenges unlikely to be identified through routinely collected self-report measures. Given the BOT-2 can identify norm-referenced developmental targets, the use of these assessments may enhance clinical formulations and guide developmentally sensitive rehabilitation programs.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pain Self-Efficacy on Health Outcomes in High-Impact Chronic Pain: A Longitudinal Study.","authors":"Dokyoung Sophia You, Edward Lannon, Samsuk Kim, Troy C Dildine, Kenneth A Weber, Emma Raney, Sean C Mackey","doi":"10.1097/AJP.0000000000001295","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001295","url":null,"abstract":"<p><strong>Objectives: </strong>High-impact chronic pain (HICP), affecting 36.4% of individuals with chronic pain, significantly limits work, social, and self-care activities. Effective treatments for HICP remain elusive. In addition to pain catastrophizing, growing evidence suggests that pain self-efficacy may be a treatment target for HICP. Our study examines the relative contributions of pain self-efficacy and catastrophizing to health outcomes in patients with HICP.</p><p><strong>Methods: </strong>A total of 259 patients with chronic pain (154 with HICP; 105 without HICP) completed validated measures at baseline and three months later. These included the Chronic Pain Self-Efficacy Scale (CPSS), the Pain Catastrophizing Scale (PCS), and Patient-Reported Outcomes Measurement Information System (PROMIS) domains for physical health (i.e., pain interference, physical function, fatigue, and sleep disturbance) and psychosocial health (i.e., depression, anxiety, anger, and social isolation).</p><p><strong>Results: </strong>Repeated measures MANOVA showed a significant group effect (HICP vs. No-HICP), but no significant time or group by time interaction effect. The HICP group reported significantly lower CPSS scores and higher PCS scores than the No-HICP group, alongside worse physical and psychosocial health outcomes (η²=0.076~0.445). Pain self-efficacy explained a greater proportion of group differences in health outcomes (52.9-71.7%) compared to pain catastrophizing (10.1-43.3%). Especially, self-efficacy in activity engagement accounted for the largest health disparities between the groups.</p><p><strong>Discussion: </strong>Findings highlight pain self-efficacy as a critical treatment target for HICP, with greater predictive utility than pain catastrophizing. Enhancing self-efficacy through tailored interventions may reduce the burden of HICP. Future studies should prioritize self-efficacy-based interventions and explore their scalability and long-term impact.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Psychological Factors Explain the Persistence of Symptoms in Individuals With Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study.","authors":"Dayana Patricia Rosa, Marc-Olivier Dubé, Simon Beaulieu-Bonneau, Alex Scott, Hugo Masse-Alarie, Jean-Sébastien Roy","doi":"10.1097/AJP.0000000000001280","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001280","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether psychosocial factors, such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with rotator cuff-related shoulder pain (RCRSP) following an education program.</p><p><strong>Methods: </strong>One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included 2 meetings with a physiotherapist. After 12 and 24 weeks, participants filled out pain and disability questionnaires and, based on their scores, were classified as having persistent shoulder pain or as recovered.</p><p><strong>Results: </strong>A univariable modified Poisson regression showed that higher perceived stress (RR adjusted : 1.02; 95% CI: 1.01-1.04), catastrophizing (RR adjusted : 1.01; 95% CI: 1.01-1.02), symptoms of depression (RR adjusted : 1.03; 95% CI: 1.01-1.06) and anxiety (RR adjusted : 1.03; 95% CI: 1.01-1.06), along with lower resilience (RR adjusted : 0.90; 95% CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. In addition, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RR adjusted : 0.98; 95% CI: 0.97-0.99) and 24 weeks (RR adjusted : 0.99; 95% CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RR adjusted : 0.98; 95% CI: 0.97-0.99).</p><p><strong>Discussion: </strong>This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":"41 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}