Clinical Journal of Pain最新文献

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Neuronavigation-guided Percutaneous Rhizotomies to Trigeminal Neuralgia: A Systematic Review. 神经导航引导下的三叉神经痛经皮根治术:系统回顾。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001191
Felix Ho Won Wu, Chi Wai Cheung, Yiu Yan Leung
{"title":"Neuronavigation-guided Percutaneous Rhizotomies to Trigeminal Neuralgia: A Systematic Review.","authors":"Felix Ho Won Wu, Chi Wai Cheung, Yiu Yan Leung","doi":"10.1097/AJP.0000000000001191","DOIUrl":"10.1097/AJP.0000000000001191","url":null,"abstract":"<p><strong>Objective: </strong>Neuronavigation improves intraoperative visualization of the cranial structures, which is valuable in percutaneous surgical treatments for patients with trigeminal neuralgia (TN) who are refractory to pharmacotherapy or reluctant to receive open surgery. The objective of this review was to evaluate the available neuronavigation-guided percutaneous surgical treatment modalities with cannulation of foramen ovale to TN, and their relative benefits and limitations.</p><p><strong>Methods: </strong>This review was conducted based on the PRISMA statement. An initial search was performed on electronic databases, followed by manual and reference searches. Study and patient characteristics, rhizotomy procedure and neuronavigation details, and treatment outcomes (initial pain relief and pain recurrence within 2 y, success rate of forman ovale cannulation, and complications) were evaluated. The risk of bias was assessed with a quality assessment based on the ROBINS-I tools.</p><p><strong>Results: </strong>Ten studies (491 operations, 403 participants) were analyzed. Three percutaneous trigeminal rhizotomy modalities identified were radiofrequency thermocoagulation rhizotomy (RFTR), percutaneous balloon compression, and glycerol rhizotomy. Intraoperative computed tomography and magnetic resonance imaging fusion-based RFTR had the highest initial pain relief rate of 97.0%. The success rate of foramen ovale cannulation ranged from 92.3% to 100% under neuronavigation. Facial hypoesthesia and masticatory muscle weakness were the most reported complications.</p><p><strong>Discussion: </strong>Neuronavigation-guided percutaneous trigeminal rhizotomies showed possible superior pain relief outcomes to that of conventional rhizotomies in TN, with the benefits of radiation reduction and lower complication development rates. The limitations of neuronavigation remain its high cost and limited availability. Higher-quality prospective studies and randomized clinical trials of neuronavigation-guided percutaneous trigeminal rhizotomy were lacking.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"253-266"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405113","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}
引用次数: 0
The Activity Management Inventory for Pain (AMI-P): Initial Development and Validation of a Questionnaire Based on Operant Learning and Energy Conservation Models of Activity Management. 疼痛活动管理量表 (AMI-P):基于活动管理的操作学习和能量守恒模型的问卷初步开发和验证。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001198
Mélanie Racine, Mark P Jensen, Douglas Cane, Dwight E Moulin, Johan W S Vlaeyen, Warren R Nielson
{"title":"The Activity Management Inventory for Pain (AMI-P): Initial Development and Validation of a Questionnaire Based on Operant Learning and Energy Conservation Models of Activity Management.","authors":"Mélanie Racine, Mark P Jensen, Douglas Cane, Dwight E Moulin, Johan W S Vlaeyen, Warren R Nielson","doi":"10.1097/AJP.0000000000001198","DOIUrl":"10.1097/AJP.0000000000001198","url":null,"abstract":"<p><strong>Objectives: </strong>Activity management is an important treatment component in chronic pain programs. However, there are shortcomings in measures of this construct, leading to inconsistencies in research findings. Here, we describe the development of the Activity Management Inventory for Pain (AMI-P).</p><p><strong>Materials and methods: </strong>The AMI-P was developed by a group of international researchers with extensive expertise in both chronic pain and activity management. The initial evaluation of the AMI-P items included 2 studies that were both conducted in Canadian tertiary pain care centers.</p><p><strong>Results: </strong>The resulting 20-item measure has 3 behavior scales (Rest, Alternating Activity, and Planned Activity), and 4 goal scales (Feel Less Pain, Get More Done, Complete the Task, and Save Energy). The behavior scales evidenced marginal to good internal consistency and test-retest reliability, and a moderate positive association with an existing pacing measure. The Rest and Alternating Activity scales were associated with greater pain interference, the Alternating Activity and Planned Activity scales were associated with less satisfaction with social roles, and the Planned Activity scale was associated with fewer depressive symptoms. The Alternating Activity scale increased significantly from pretreatment to posttreatment. All goal scales were positively associated with all behavior scales. The Feel Less Pain goal scale was positively associated with measures of avoidance and pain interference, while the Get More Done goal scale was negatively associated with measures of depressive symptoms and overdoing.</p><p><strong>Discussion: </strong>The findings support the reliability and validity of the AMI-P scales, while also highlighting the complexity and multidimensional aspects of activity management.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"200-211"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521971","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}
引用次数: 0
Comment on Application of Dexmedetomidine in Epidural Labor Analgesia. 关于右美托咪定在硬膜外分娩镇痛中的应用的评论。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001195
I-Wen Chen, Ting-Sian Yu, Kuo-Chuan Hung
{"title":"Comment on Application of Dexmedetomidine in Epidural Labor Analgesia.","authors":"I-Wen Chen, Ting-Sian Yu, Kuo-Chuan Hung","doi":"10.1097/AJP.0000000000001195","DOIUrl":"10.1097/AJP.0000000000001195","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"267-268"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479595","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}
引用次数: 0
Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain Results of a Randomized Controlled Trial: Retraction. 长期多学科项目对慢性腰痛患者残疾和恐惧规避行为的影响》,随机对照试验结果:撤回。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001203
{"title":"Effect of a Long-lasting Multidisciplinary Program on Disability and Fear-Avoidance Behaviors in Patients With Chronic Low Back Pain Results of a Randomized Controlled Trial: Retraction.","authors":"","doi":"10.1097/AJP.0000000000001203","DOIUrl":"10.1097/AJP.0000000000001203","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"199"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934028","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}
引用次数: 0
Changes in Multiple Aspects of Pain Outcomes After Rehabilitation: Analysis of Pain Data in a Randomized Controlled Trial Evaluating the Effects of Adding Sensorimotor Training to Manual Therapy and Exercise for Chronic Neck Pain. 康复后疼痛结果多方面的变化:一项随机对照试验的疼痛数据分析:评估在手法治疗和运动治疗慢性颈痛的基础上增加感知运动训练的效果。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001194
Sureeporn Uthaikhup, Munlika Sremakaew, Julia Treleaven, Gwendolen Jull, Marco Barbero, Deborah Falla, Corrado Cescon
{"title":"Changes in Multiple Aspects of Pain Outcomes After Rehabilitation: Analysis of Pain Data in a Randomized Controlled Trial Evaluating the Effects of Adding Sensorimotor Training to Manual Therapy and Exercise for Chronic Neck Pain.","authors":"Sureeporn Uthaikhup, Munlika Sremakaew, Julia Treleaven, Gwendolen Jull, Marco Barbero, Deborah Falla, Corrado Cescon","doi":"10.1097/AJP.0000000000001194","DOIUrl":"10.1097/AJP.0000000000001194","url":null,"abstract":"<p><strong>Objectives: </strong>To examine changes in pain outcomes to fully evaluate the effect of adding sensorimotor training to manual therapy and exercise in patients with chronic neck pain and sensorimotor deficits. Concordance was examined between pain distribution and pain intensity and patient-reported outcomes.</p><p><strong>Methods: </strong>Participants (n=152) were randomly allocated into 4 intervention groups: One group received local neck treatment (NT) comprising manual therapy and exercise and the other 3 groups received additional sensorimotor training (either joint position sense/oculomotor exercises, balance exercises or both). Treatment was delivered twice a week for 6 weeks. Pain and patient-reported outcomes were measured at baseline, posttreatment, and 3-, 6- and 12-month follow-ups.</p><p><strong>Results: </strong>There were greater changes in pain location, extent, and intensity at 6- and 12-month follow-ups in the sensorimotor training groups compared with the NT group ( P <0.05). A greater number of patients in the sensorimotor training groups gained ≥50% reduction in pain extent and intensity relative to the NT group at 6 and 12 months ( P <0.05). Clinical improvement in pain extent was concordant with pain intensity (adjusted kappa=056 to 0.66, %agreement=78.3 to 82.9, P <0.001) and disability (adjusted kappa=0.47 to 0.58, % agreement=73.7 to 79.0, P <0.01) at 3-, 6- and 12-month follow-ups, but not with function and well-being. The concordance tended to decline with time.</p><p><strong>Discussion: </strong>Multiple aspects of the pain experience improved in the longer term by adding sensorimotor training to NT for patients with neck pain and sensorimotor deficits. The concordance between pain and patient-reported outcomes was not always evident and varied over time, suggesting the need for multidimensional assessments of pain.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"212-220"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652029","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}
引用次数: 0
Initiatives Targeting Health Care Professionals: A Systematic Review of Knowledge Translation Pain Assessment and Management Studies Focusing on Older Adults. 针对医疗保健专业人员的倡议:以老年人为重点的疼痛评估和管理研究的知识转化系统回顾。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001190
Laney Yarycky, Louise I R Castillo, Michelle M Gagnon, Thomas Hadjistavropoulos
{"title":"Initiatives Targeting Health Care Professionals: A Systematic Review of Knowledge Translation Pain Assessment and Management Studies Focusing on Older Adults.","authors":"Laney Yarycky, Louise I R Castillo, Michelle M Gagnon, Thomas Hadjistavropoulos","doi":"10.1097/AJP.0000000000001190","DOIUrl":"10.1097/AJP.0000000000001190","url":null,"abstract":"<p><strong>Objectives: </strong>Pain is often undertreated in older adult populations due to factors, such as insufficient continuing education and health care resources. Initiatives to increase knowledge about pain assessment and management are crucial for the incorporation of research evidence into practice. Knowledge translation (KT) studies on pain management for older adults and relevant knowledge users have been conducted; however, the wide variety of KT program formats and outcomes underscores a need to evaluate and systematically report on the relevant literature.</p><p><strong>Materials and methods: </strong>Using a systematic review methodology, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycInfo, and Web of Science databases were searched from inception to June 2023. Pain-related KT programs targeted towards older adults, their informal caregivers, and health care professionals were examined. Initiatives focusing on health care professionals are the focus of this review. Initiatives focusing on older adults are reported in a companion article.</p><p><strong>Results: </strong>From an initial 21,669 search results, 172 studies met our inclusion criteria. These studies varied widely in focus and delivery format but the majority were associated with significant risk of bias. In this report, we are focusing on 124 studies targeting health care professionals; 48 studies involving initiatives targeting older adults are reported in a companion article. Moreover, most programs were classified as knowledge mobilization studies without an implementation component. Across all studies, knowledge user satisfaction with the initiative and the suitability of the material presented were most commonly assessed. Patient outcomes, however, were underemphasized in the literature.</p><p><strong>Conclusion: </strong>Patient and clinical outcomes must be a focus of future research to fully conceptualize the success of KT programs for older adult individuals. Without implementation plans, disseminated knowledge does not tend to translate effectively into practice.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"230-242"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405112","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}
引用次数: 0
My Catastrophizing and Your Catastrophizing: Dyadic Associations of Pain Catastrophizing and the Physical, Psychological, and Relational Well-being of Persons With Endometriosis and Their Partners. 我的灾难化和你的灾难化:我的灾难化和你的灾难化:子宫内膜异位症患者及其伴侣对疼痛的灾难化与生理、心理和关系福祉的相互关系》(Dyadic Associations of Pain Catastrophizing and the Physical, Psychological and Relational Well-Being of Persons with Endometriosis and their Partners)。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001193
Elisa Stragapede, Jonathan D Huber, Serena Corsini-Munt
{"title":"My Catastrophizing and Your Catastrophizing: Dyadic Associations of Pain Catastrophizing and the Physical, Psychological, and Relational Well-being of Persons With Endometriosis and Their Partners.","authors":"Elisa Stragapede, Jonathan D Huber, Serena Corsini-Munt","doi":"10.1097/AJP.0000000000001193","DOIUrl":"10.1097/AJP.0000000000001193","url":null,"abstract":"<p><strong>Objectives: </strong>Endometriosis, a painful chronic gynecologic condition, contributes to disruptions in multiple areas of life for both those affected and their partner. Pain catastrophizing has been associated with worse pain outcomes and quality of life for women with endometriosis and with more cognitive load for partners. Examining both partners' pain catastrophizing dyadically with our variables of interest will enhance understanding of its associations with the distressing nature of experiencing and responding to pain during sex for couples with endometriosis.</p><p><strong>Methods: </strong>Persons with endometriosis experiencing pain during sex and their partners (n=52 couples; 104 individuals) completed online self-report measures of pain catastrophizing, depressive symptoms, sexual satisfaction, and partner responses to pain. Persons with endometriosis reported on pain during sexual activity. Analyses were guided by the Actor-Partner Interdependence Model.</p><p><strong>Results: </strong>Persons with endometriosis' pain catastrophizing was associated with their higher pain intensity and unpleasantness during sex. When persons with endometriosis reported more pain catastrophizing, they were less sexually satisfied and reported their partners responded more negatively to their pain. When partners reported higher catastrophizing, they were more depressed and responded more negatively to the pain.</p><p><strong>Discussion: </strong>Consistent with the Communal Coping Model of pain catastrophizing, although meant to elicit support from the environment, the often-deleterious cognitive process of magnifying, ruminating, and feeling helpless about one's pain (or one's partner's pain) is associated with poorer outcomes for the individual with pain and their romantic partner. Implications for pain management include the relevance of involving the partner and attending to the pain cognitions of both members of the couple.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"221-229"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479600","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}
引用次数: 0
Initiatives Targeting Patients: A Systematic Review of Knowledge Translation Pain Assessment and Management Studies Focusing on Older Adults. 针对患者的倡议:以老年人为重点的疼痛评估和管理研究的知识转化系统回顾。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-04-01 DOI: 10.1097/AJP.0000000000001192
Laney Yarycky, Louise I R Castillo, Michelle M Gagnon, Thomas Hadjistavropoulos
{"title":"Initiatives Targeting Patients: A Systematic Review of Knowledge Translation Pain Assessment and Management Studies Focusing on Older Adults.","authors":"Laney Yarycky, Louise I R Castillo, Michelle M Gagnon, Thomas Hadjistavropoulos","doi":"10.1097/AJP.0000000000001192","DOIUrl":"10.1097/AJP.0000000000001192","url":null,"abstract":"<p><strong>Objectives: </strong>Older adults frequently experience persistent pain but are often unaware of self-management and other strategies that can help improve their condition. In a related article, we reported on pain assessment and management knowledge translation initiatives related to older adults that were targeting health professionals. In this paper, we report on initiatives targeting older adults.</p><p><strong>Materials and methods: </strong>Using systematic review methodology, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycInfo, and Web of Science databases were searched from inception to June 2023. Pain-related knowledge translation programs targeted towards older adults, their informal caregivers, and health care professionals were examined.</p><p><strong>Results: </strong>From an initial 21,669 search results, 172 studies met our inclusion criteria. Of these studies, 49 targeted older adults. These studies varied widely in focus and delivery format, but the majority were associated with a significant risk of bias. Older adults with musculoskeletal pain were the primary recipients of education. Most programs were classified as knowledge mobilization initiatives. The remainder were considered self-management programs. Knowledge users were satisfied with the suitability of the information presented, and patient outcomes were a primary concern across all studies. Behavioral changes and pain management outcomes, however, were underemphasized in the literature.</p><p><strong>Conclusion: </strong>Knowledge acquisition outcomes are overrepresented in the current literature compared with behavioral outcomes changes. Nonetheless, older adults report benefitting from the guidance provided in self-management programs when applying knowledge to practice. Future research is needed to better understand the facilitators and barriers to pain management changes in this population.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"243-252"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418497","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}
引用次数: 0
In Response to: Determining Postoperative Analgesic Efficacy of Dexamethasone Plus Bupivacaine for Regional Block. 回应确定地塞米松加布比卡因用于区域阻滞的术后镇痛效果。
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-03-01 DOI: 10.1097/AJP.0000000000001186
Amin M Alansary, Mohamed M Aziz, Marwa A K Elbeialy
{"title":"In Response to: Determining Postoperative Analgesic Efficacy of Dexamethasone Plus Bupivacaine for Regional Block.","authors":"Amin M Alansary, Mohamed M Aziz, Marwa A K Elbeialy","doi":"10.1097/AJP.0000000000001186","DOIUrl":"10.1097/AJP.0000000000001186","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"198"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832837","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}
引用次数: 0
Cortisol as a Marker of Pain and Distress After Acute Musculoskeletal Trauma. 皮质醇是急性肌肉骨骼创伤后疼痛和痛苦的标志物
IF 2.6 3区 医学
Clinical Journal of Pain Pub Date : 2024-03-01 DOI: 10.1097/AJP.0000000000001188
Joshua A Jesin, David M Walton
{"title":"Cortisol as a Marker of Pain and Distress After Acute Musculoskeletal Trauma.","authors":"Joshua A Jesin, David M Walton","doi":"10.1097/AJP.0000000000001188","DOIUrl":"10.1097/AJP.0000000000001188","url":null,"abstract":"<p><strong>Objectives: </strong>The best available predictors of chronic pain development broadly encompass baseline metrics of cognition (ie, beliefs/expectations) about the trauma and resulting symptoms. In the context of musculoskeletal trauma, we have previously shown the Traumatic Injuries Distress Scale (TIDS) capable of risk-stratifying cohorts for chronic pain development. Here, we explore whether the physiological marker cortisol shows meaningful associations with cognitions predictive of pain outcomes.</p><p><strong>Methods: </strong>Data for these cross-sectional analyses were drawn from an observational study that recruited 130 participants presenting to the hospital with pain related to a recent noncatastrophic Musculoskeletal trauma. Cortisol was measured from the participant's hair, saliva, and blood. In addition to pain and distress questionnaires, metadata such as age, sex, body mass index (BMI), adverse childhood events, pretrauma stress levels, and pre-existing physical/psychological comorbidities were collected.</p><p><strong>Results: </strong>We found no significant associations between cortisol levels and pain or distress in isolation. When stratified by person-level variables, associations were revealed with distress (TIDS) in young age and low pretrauma stress subgroups (hair cortisol) and low BMI (blood cortisol). Through hierarchical regression analysis, we found the \"cortisol X age\" or \"cortisol X stress\" interaction terms significantly improved TIDS prediction beyond either variable in isolation (Age: ∆ R2 =15.1%; pretrauma stress: ∆ R2 =9.1%).</p><p><strong>Discussion: </strong>Our findings suggest that while linear correlations between pain-related distress and cortisol may be overly simplistic, certain person-level variables such as age, pretrauma stress, and BMI are worthy of consideration for experimental design or confounder characterization in future studies of pain and distress following musculoskeletal injuries especially when \"trait\" (hair) cortisol is the predictor variable.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"157-164"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089289","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}
引用次数: 0
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