Journal of Pain最新文献

{"title":"Pain prevalence rates and the mediating role of negative affect in adults referred to personality disorder treatment: A cross-sectional study","authors":"Fillip Ferreira Eikeseth ,&nbsp;Geir Pedersen ,&nbsp;Benjamin Hummelen ,&nbsp;Stefan Sütterlin ,&nbsp;Audun Stubhaug ,&nbsp;Elfrida Hartveit Kvarstein ,&nbsp;Gunnvald Kvarstein","doi":"10.1016/j.jpain.2024.104724","DOIUrl":"10.1016/j.jpain.2024.104724","url":null,"abstract":"<div><div>Personality disorders (PDs) are prevalent among individuals with chronic pain, but less is known about the prevalence of pain in the PD population. This study therefore sought to explore the prevalence of current or everyday pain among individuals referred to outpatient PD treatment, and further explore the mediating role of negative affect in the relationship between PD severity and current pain. Data was retrieved from the Norwegian Network for PDs’ quality register which included 4361 participants. Pain was operationalized using the EQ-5D-3L “pain or discomfort” item and four SCL-90-R pain-related items (“pain bothersomeness”). Rates of self-reported pain were explored both pre and post treatment to determine the persistency of the pain-related symptoms. The role of negative affect in the relationship between PD severity and pain was investigated by linear regression analysis. A substantial burden of pain-related symptoms was demonstrated, as 71 % and 80 % reported moderate to extreme pain or discomfort and pain bothersomeness, respectively. Muscle soreness was the most common pain (59 %) followed by headache (48 %), low back pain (46 %), and heart or chest pain (34 %). Moderate to extreme pain or discomfort was persistent for 77 % of the participants who provided end of treatment data (mean treatment duration was 82 weeks). Negative affect mediated the relationship between PD severity and pain. To our knowledge, this is the first large-scale study on everyday pain in patients with PDs. The findings reveal that moderate to extreme pain is prevalent among persons with PDs and that this co-occurrence is driven by negative affect.</div></div><div><h3>Perspective</h3><div>Pain is a prevalent and potentially underrecognized symptom in personality disorders and persists until treatment termination for a large group of patients. This co-occurrence may be driven by a susceptibility to negative affect that is enhanced by personality disorder features.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104724"},"PeriodicalIF":4.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploratory data-driven approach to classify subgroups of patients with temporomandibular disorders based on pain mechanisms","authors":"Giacomo Asquini ,&nbsp;Valter Devecchi ,&nbsp;Domenico Viscuso ,&nbsp;Rosaria Bucci ,&nbsp;Ambra Michelotti ,&nbsp;Bernard X.W. Liew ,&nbsp;Deborah Falla","doi":"10.1016/j.jpain.2024.104721","DOIUrl":"10.1016/j.jpain.2024.104721","url":null,"abstract":"<div><div>Temporomandibular disorders (TMDs) are a common musculoskeletal condition, presenting treatment challenges due to their non-specific nature. Categorizing patients with TMDs into clusters based on neurobiological pain mechanisms could provide a promising approach to facilitate targeted treatments. This observational study (1) used a network analysis (NA) to explore the complexity of TMDs by investigating relationships among biopsychosocial variables, and (2) validated potential TMD subgroups based on mechanism-specific pain categories. One hundred and two patients with TMD were included. Biopsychosocial variables covered: general health, psychosocial features, TMD pain, and TMD characteristics. A NA evaluated the associations between variables and determined the role of each feature within the network. Hierarchical clustering was used to identify TMD subgroups. The NA revealed significant correlations primarily within the same feature domains, indicating a strong interplay between symptoms and psychological factors. Cluster analysis identified two subgroups driven by nociceptive and nociplastic pain mechanisms; the nociplastic group exhibited higher levels of anxiety, depression, pain catastrophization, central sensitization, pain duration, and more pain locations, along with poorer sleep quality, quality of life, and health status. In contrast, the nociceptive group exhibited restricted maximal mouth opening (MMO), heightened pain during TMJ palpation and mouth opening, and a greater positive response to manual therapy. Across all features, psychological factors, pain locations, and MMO primarily contributed to the separation of subgroups. By adopting a data-driven approach, these results support the significant role of considering the neurobiological basis of pain to improve patient classification. This knowledge may facilitate clinical reasoning and personalized treatments.</div></div><div><h3>Perspective</h3><div>This study used a network analysis to explore the complex biopsychosocial interactions present in people with TMDs, identifying important variables such as the Central Sensitization Inventory and pain-free maximal mouth opening. The findings distinguish potential nociceptive and nociplastic pain subgroups, offering important insights for targeted therapeutic strategies.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104721"},"PeriodicalIF":4.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention and nocebo hyperalgesia: Testing a novel virtual reality attention bias modification paradigm","authors":"Tessa Rooney ,&nbsp;Louise Sharpe ,&nbsp;Jemma Todd ,&nbsp;Geert Crombez ,&nbsp;Dimitri van Ryckeghem ,&nbsp;Ben Colagiuri","doi":"10.1016/j.jpain.2024.104705","DOIUrl":"10.1016/j.jpain.2024.104705","url":null,"abstract":"<div><div>Nocebo effects in pain (nocebo hyperalgesia) have received significant attention recently, with negative expectancies and anxiety proposed to be explanatory factors. While both expectancy and anxiety can bias attention, attention has been rarely explored as a potential mechanism involved in nocebo hyperalgesia. The present study aimed to explore whether attention bias modification (ABM) using an immersive, ecologically valid VR paradigm successfully induced attention biases (AB) and subsequently influenced nocebo hyperalgesia. One-hundred and two healthy participants were randomised in a 2 (AB training: towards vs. away from pain) x 2 (nocebo condition: nocebo vs. control) design. Pain-related AB was successfully changed by the VR paradigm as measured by reaction time and gaze, with moderate to large effects. Participants then completed either a nocebo instruction and conditioning procedure (nocebo paradigm) or a matched control procedure. The primary outcome was self-reported pain intensity. Secondary outcomes were attention bias and self-reports of expectancy, anticipatory anxiety, and state anxiety. The nocebo paradigm induced significantly greater pain expectancy, anticipatory anxiety and pain intensity during the test phase for the nocebo group compared to control. Pain expectancy also fully mediated the effect of the nocebo group on nocebo hyperalgesia and anticipatory anxiety in separate models. ABM did not, however, affect nocebo hyperalgesia or pain expectancy, casting doubt on the potential for ABM to inoculate against nocebo hyperalgesia. Unexpected effects of ABM were observed for state anxiety and anticipatory anxiety, whereby training away from pain exacerbated each, which necessitates further exploration.</div></div><div><h3>Perspective</h3><div>This article tests the efficacy of a novel attention bias modification paradigm, designed in virtual reality, for inducing pain-related biases, and whether these biases exacerbate or inoculate against nocebo hyperalgesia. While pain-related biases were successfully induced, there was no relationship with the strength of induced nocebo hyperalgesia.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104705"},"PeriodicalIF":4.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROGRESS: A patient-centered engagement infrastructure and multi-level approach to enrich diversity, equity, and inclusion in a national randomized online behavioral pain treatment study.","authors":"Jessica Clifton, Emma Adair, Matthias Cheung, Calia Torres, Wendy Andrews, Brittany Dorsonne, Arayam Y Hailu, Elizabeth Heggan, Jackie Miefert, Gabrielle Riazi, Troy C Dildine, Shelly Spears, Regina Greer-Smith, Ting Pun, Neely Williams, Luzmercy Perez, Heather P King, Maisa S Ziadni, Sean Mackey, Beth D Darnall","doi":"10.1016/j.jpain.2024.104718","DOIUrl":"10.1016/j.jpain.2024.104718","url":null,"abstract":"<p><p>Twenty percent of individuals experience chronic pain worldwide posing significant challenges to those living with it. Pain research is crucial for developing and characterizing effective strategies to reduce the burden of chronic pain. Traditional research approaches often yield homogeneous study samples that poorly generalize and have unknown applicability across diverse patient populations. The Pain Relief with Online Groups that Empower Skills-based Symptom Reduction (PROGRESS) study aims to address disparities in pain research engagement and patient outcomes through the intentional inclusion of people with varied backgrounds and experiences of pain, and through a multilevel design informed by diverse stakeholder recommendations. The composition of three advisory boards (Patient Engagement and Diversity Board, Local Patient Advisory Board, and the National Patient Advisory Panel) prioritized diversity in patient/expert advisor background, geographic location, race, and ethnicity. Our engagement approach aligns with the Foundational Expectations for Partnerships in Research by Patient-Centered Outcomes Research Institute (PCORI), which emphasizes diverse representation, early and ongoing engagement, dedicated funds for advisor compensation, collaborative decision making, meaningful participation, and continuous assessment. The first 24 months of study advisor engagement has yielded multiple recruitment strategies resulting in a study population enriched with a breadth of identities within PROGRESS (e.g., inclusive patient-facing materials). Lessons learned underscore the importance of investing time in building patient and stakeholder relationships, trust, and embracing diverse viewpoints amongst the study team. PROGRESS demonstrates the potential of diverse patient-centered engagement to support evidence-based outcomes and practices that are more inclusive, equitable, and representative of the broader population. PERSPECTIVE: The PROGRESS study demonstrates how diverse patient engagement and inclusive advisory boards enhance research outcomes. By aligning with PCORI standards and employing innovative recruitment strategies, it highlights the vital role of stakeholder relationships and diverse perspectives. Key lessons learned emphasize adaptive strategies and continuous feedback for advancing equitable pain research.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"104718"},"PeriodicalIF":4.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of chronic low back pain on implicit motor imagery assessed by a new laterality judgment task","authors":"Lucette Toussaint ,&nbsp;Maxime Billot ,&nbsp;Rémi Cabirol ,&nbsp;Philippe Rigoard ,&nbsp;Paul Teillet ,&nbsp;Romain David ,&nbsp;Romain Tisserand","doi":"10.1016/j.jpain.2024.104719","DOIUrl":"10.1016/j.jpain.2024.104719","url":null,"abstract":"<div><div>It is clear that implicit motor imagery (IMI) is impaired by chronic pain in peripheral regions (hand, feet), but unclear in axial regions (neck, shoulder, back). Previous IMI tasks displayed small-amplitude movements of axial regions, which limits person-centered IMI processes mobilization. This study aimed to assess the impact of chronic low back pain (CLBP) on IMI processes with a new task displaying large-amplitude whole-body movements mobilizing the lumbar spine. Twenty patients with CLBP and twenty age-matched controls performed a laterality judgment task on four distinct whole-body movements (trunk flexion, trunk rotation, capoeira, kickboxing). Participants viewed images from four different body viewpoints (back, left, right and front), randomly presented. Mixed ANOVAs were used to compare judgment accuracy and response times between groups and conditions. In participants with CLBP, response times were longer than in controls. The response times of participants with CLBP were also associated with DN4 scores, a self-reported questionnaire assessing neuropathic pain. We validated the use of a person-centered IMI because, for all participants, the accuracy decreased and the response times increased for images presented in the front viewpoint, i.e. when a 180° turn in IMI was required, compared to other viewpoints. The laterality judgment task proposed here confirmed that CLBP impacts IMI processes, and that the nature of pain (neuropathic or mechanical) needs to be considered because it seems to modulate IMI processes.</div></div><div><h3>Perspectives</h3><div>A laterality judgment task with large-amplitude lumbar movements is key to show that CLBP alters processing speed of sensorimotor information originating from the painful region. This task could become an objective tool, transferable in clinical settings, for assessing the impact and the progression of CLBP on motor control processes.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104719"},"PeriodicalIF":4.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of abstract animations and a graphical body image for assessing pain outcomes among adults with sickle cell disease","authors":"Julia A. O’Brien PhD, RN ,&nbsp;Charles R. Jonassaint PhD, MHS ,&nbsp;Ektha Parchuri MPH ,&nbsp;Christina M. Lalama MS ,&nbsp;Sherif M. Badawy MD, MS ,&nbsp;Megan E. Hamm PhD ,&nbsp;Jennifer N. Stinson RN-EC, PhD, CPNP ,&nbsp;Chitra Lalloo BHSc, PhD ,&nbsp;C. Patrick Carroll MD ,&nbsp;Santosh L. Saraf MD ,&nbsp;Victor R. Gordeuk MD ,&nbsp;Robert M. Cronin MD, MS ,&nbsp;Nirmish Shah MD ,&nbsp;Sophie M. Lanzkron MD, MHS ,&nbsp;Darla Liles MD ,&nbsp;Cassandra Trimnell BA ,&nbsp;Lakiea Bailey PhD ,&nbsp;Raymona Lawrence DPH ,&nbsp;Leshana Saint Jean PhD ,&nbsp;Michael DeBaun MD, MPH ,&nbsp;Kaleab Z. Abebe PhD","doi":"10.1016/j.jpain.2024.104720","DOIUrl":"10.1016/j.jpain.2024.104720","url":null,"abstract":"<div><div>Painimation, a novel digital pain assessment tool, allows patients to communicate their pain quality, intensity, and location using abstract animations (painimations) and a paintable body image. This study determined the construct validity of painimations and body image measures by testing correlations with validated pain outcomes in adults with sickle cell disease (SCD). Analyses used baseline data from a multisite randomized trial of 359 adults with SCD and chronic pain. Participants completed questionnaires on demographics, pain severity, frequency and interference, catastrophizing, opioid use, mood and quality of life, plus the Painimation app. Participants were categorized by selected painimations, and were split into groups based on the proportion of painted body image. Potential confounding was evaluated by age, gender, race, education, disability, site, depression, and anxiety. The 'shooting' painimation was strongly associated with daily pain intensity, pain interference, frequency, and severity. 'Electrifying' was associated with daily pain and opioid misuse, while greater body area in pain correlated with worse outcomes across all pain measures. Both painimations and body image measures correlated with validated pain outcomes, quality of life and mental health measures. This demonstrates animations and body image data can assess SCD pain severity, potentially with more accuracy than a 0–10 scale. Future research will explore whether Painimation can differentiate biological and psychosocial pain components.</div></div><div><h3>Perspective</h3><div>This article presents the preliminary construct validity of Painimation in SCD by examining the associations of “painimations” and body area image data with daily e-diary and traditional self-report pain outcomes.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104720"},"PeriodicalIF":4.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From breast cancer diagnosis to survivorship: Analyzing perioperative biopsychosocial phenotypes and their relationship to pain on long term","authors":"De Groote Amber ,&nbsp;Dams Lore ,&nbsp;Van der Gucht Elien ,&nbsp;Schepers Jan ,&nbsp;Mertens Michel ,&nbsp;De Groef An ,&nbsp;Meeus Mira Ph.D.","doi":"10.1016/j.jpain.2024.104709","DOIUrl":"10.1016/j.jpain.2024.104709","url":null,"abstract":"<div><div>Persistent breast cancer treatment-related pain affects up to 40% of patients, decreasing their quality of life (QoL). While current research typically utilizes correlation and regression analysis to identify biopsychosocial phenotypes contributing to this pain, this study employs cluster analysis to identify qualitatively different phenotypes based on somatosensory and psychosocial characteristics both before and one week post-breast cancer surgery. Further, it investigates how these phenotypes are related to pain intensity one year post-surgery and examines the evolution of phenotype membership from pre- to post-surgery. Somatosensory and psychosocial functioning was evaluated pre- and post-surgery in 184 women undergoing unilateral breast cancer surgery. Eight different quantitative sensory testing (QST) methods including mechanical detection and pain thresholds, pressure pain thresholds, thermal detection and pain thresholds, and conditioned pain modulation were performed at the surgical area (trunk, arm, major pectoral muscle) and a distant location (quadriceps muscle). Psychosocial functioning was assessed using the Central Sensitization Inventory, Pain Catastrophizing Scale, Depression Anxiety Stress Scale-21, and the McGill Quality of Life Questionnaire. Pain intensity was evaluated one year post-breast cancer surgery using the Visual Analogue Scale. Latent class analysis identified five distinct phenotypes before and post-surgery, characterized by differences in mechanical and pain thresholds alongside psychosocial factors. Moreover, higher psychosocial distress and lower QoL correlated with elevated pain intensity one year post-surgery. These findings underscore the importance of addressing breast cancer patients' mental health perioperatively. Therefore, future research should explore whether psychological interventions perioperatively can reduce long-term pain intensity.</div></div><div><h3>Perspective</h3><div>This secondary analysis, utilizing cluster analysis, reveals five distinct phenotype based on somatosensory and psychosocial characteristics both before and post-breast cancer surgery. Higher psychosocial distress and lower quality of life correlated with elevated pain intensity one year post-surgery, emphasizing the need to address patients' mental health perioperatively.</div></div><div><h3>Trial registration</h3><div>clinicaltrials.gov (NCT03351075).</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104709"},"PeriodicalIF":4.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of neighborhood disadvantage and adverse childhood experiences on conditioned pain modulation in adults with chronic low back pain","authors":"Pavithra A. Thomas M.A. ,&nbsp;Paige Van Ditta B.S. ,&nbsp;Samantha Q. Stocking B.S. ,&nbsp;Caroline Webb B.S. ,&nbsp;Samantha M. Meints Ph.D. ,&nbsp;Michael A. Owens Ph.D. ,&nbsp;Tammie Quinn B.S. ,&nbsp;Edwin N. Aroke Ph.D., CRNA ,&nbsp;Matthew C. Morris Ph.D. ,&nbsp;Robert E. Sorge Ph.D. ,&nbsp;Burel R. Goodin Ph.D. ,&nbsp;Demario S. Overstreet Ph.D.","doi":"10.1016/j.jpain.2024.104706","DOIUrl":"10.1016/j.jpain.2024.104706","url":null,"abstract":"<div><div>Chronic low back pain (cLBP) remains a major health crisis worldwide. Current conceptualizations of cLBP utilize the biopsychosocial model, yet research on social factors remains limited. Adverse childhood experiences (ACEs) are a risk factor for a variety of chronic health problems, including cLBP. However, the extent to which socioeconomic context might influence associations between ACEs and cLBP remains unclear. Socioeconomic factors such as healthcare access and living conditions, which cluster at the neighborhood level, may affect how ACEs relate to cLBP in adulthood. This study examined (1) the relationship between ACEs and conditioned pain modulation (CPM), and (2) the moderating effect of area-level deprivation index (ADI) in a sample of community-dwelling adults with cLBP. 183 adults with cLBP (53% female, 62.8% non-Hispanic Black) reported on ACEs, ADI, sociodemographics, and completed experimental testing of conditioned pain modulation (CPM). Greater ACEs were associated with a less efficient CPM response for individuals residing in low neighborhood deprivation (p &lt; 0.01). ACEs were not significantly associated with CPM for those residing in average (p = 0.31) or high deprivation (p = 0.15). Our findings suggest that a history of ACEs is associated with diminished ability to inhibit pain, especially among individuals living in less deprived neighborhoods. The association between ACEs and CPM was weakest for the portion of our sample residing in neighborhoods with the most deprivation. People from disadvantaged backgrounds may experience numerous psychosocial stressors that hinder CPM, making it difficult to assess the specific impact of ACEs on CPM.</div></div><div><h3>Trial registration</h3><div>This study utilized baseline data collected as part of a parent trial titled “Examining Racial and SocioEconomic Disparities in Chronic Low Back Pain” (ERASED - ClinicalTrials.gov ID: NCT03338192).</div></div><div><h3>Perspective</h3><div>This study demonstrates that early life adversity is associated with abnormal endogenous pain modulation, particularly for participants who live in neighborhoods characterized by less deprivation.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104706"},"PeriodicalIF":4.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between smoking, chronic pain, and prescription opioid use: 2013-2021","authors":"William Encinosa PhD ,&nbsp;Didem Bernard PhD ,&nbsp;R. Burciaga Valdez PhD, MHSA","doi":"10.1016/j.jpain.2024.104707","DOIUrl":"10.1016/j.jpain.2024.104707","url":null,"abstract":"<div><div>It is known that smoking is associated with greater chronic pain. However, little is known about the magnitude of this relationship and its association with prescription opioid use. We examine the association between smoking status and three sets of outcomes: (1) starting and discontinuing opioids, (2) intensity of opioid use, and (3) opioid use and pain outcomes after quitting smoking. We use multinomial logit on adults in the nationally representative 2013–2021 Medical Expenditure Panel Survey linked to the National Health Interview Survey (N = 36,796). Smoking adults made up 16% of the population but used 30% of all opioid prescriptions and 40% of all annual Morphine Milligram Equivalents (MMEs). The 1% of the population that smoked and had severe work limitations due to pain used 20% of all MMEs. Smoking adults were 24% more likely than never-smoking adults to have chronic pain. Among those with pain, smoking adults had 46% higher relative risk of starting opioids compared to never-smoking adults (p &lt; .01), and smoking adults had 6.6 times higher relative risk of continuing opioids the next year compared to never-smoking adults (p &lt; .01). Those smoking and using opioids had 95% higher odds of using a prescribed dosage of 50 MME or more than never-smoking adults. A year after quitting smoking, opioid use declined by 20% and pain declined by 7% compared to those continuing to smoke, with no difference from never-smoking adults after 12 years. Integrating smoking cessation into pain management programs could be highly beneficial to adults with chronic pain.</div></div><div><h3>Perspective</h3><div>Rarely are smoking cessation and pain management programs integrated together. We show that such integration would be highly beneficial by estimating a strong association between smoking cessation and reduced chronic pain, work limitations, and prescription opioid use.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104707"},"PeriodicalIF":4.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition from acute to chronic low back pain in a community-based cohort","authors":"Colleen A. Burke PT, DPT ,&nbsp;Rebecca Fillipo PT, DPT ,&nbsp;Steven Z. George PT, PhD, FAPTA ,&nbsp;Flavia P. Kapos DDS, PhD ,&nbsp;Andrzej S. Kosinski PhD ,&nbsp;Emily Ford BLS ,&nbsp;Stephanie T. Danyluk MS ,&nbsp;Carla A. Kingsbury BA ,&nbsp;Kelley Seebeck BA ,&nbsp;Christopher E. Lewis AS ,&nbsp;Cecilia Plez BA ,&nbsp;Michael C. Brown PhD ,&nbsp;Adam P. Goode DPT, PhD","doi":"10.1016/j.jpain.2024.104704","DOIUrl":"10.1016/j.jpain.2024.104704","url":null,"abstract":"<div><div>The transition from acute to chronic low back pain (LBP) in community settings is not well understood. The purpose of this study was to assess the feasibility of recruitment and estimate the transition and continuation of chronic LBP. We also explored characteristics associated with this transition to chronic LBP. We enrolled n = 131 participants, of which n = 118 (90 %) completed 3-month outcomes and n = 111 (85 %) completed 6-month outcomes. Acute LBP was defined by a duration of &lt; 4 weeks and a 30-day LBP-free period before the current acute episode. Chronic LBP was defined as pain most or every day over the past 3 months. The transition from acute to chronic LBP at 3 months was 32.2 % (38/118), and at 6 months, 80.6 % (25/31) of participants who transitioned at 3 months continued to have chronic LBP at 6 months. Participants with more frequent acute LBP and at an intensity of 30/100 were more likely to transition to chronic LBP (Risk Ratio (RR)= 3.13, 95 % Confidence Interval (CI) 1.84, 5.30) and continue to have chronic LBP at 6-months (RR=3.10, 95 % CI 1.48, 6.08). Higher risk on the STarT Back Screening Tool was associated with the transition to chronic LBP at 3 months (RR=1.73, 95 % CI 1.28, 2.35) and continuation of chronic LBP at 6 months (RR=1.26, 95 % CI 1.10, 1.45). The recruitment of acute LBP was feasible in a community setting. Acute LBP is a common condition in the community and frequently transitions to chronic LBP, suggesting the potential for substantial burden in the community.</div></div><div><h3>Perspective</h3><div>This article presents the feasibility of conducting a community-based study to describe the transition, continuation, and psychosocial predictors of acute to chronic low back pain. These findings could help identify community participants at high risk of incident and continued chronic low back pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104704"},"PeriodicalIF":4.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}