Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

{"title":"Genetic and epigenetic mechanisms influencing acute to chronic postsurgical pain transitions in pediatrics: Preclinical to clinical evidence.","authors":"Adam J Dourson, Adam Willits, Namrata G R Raut, Leena Kader, Erin Young, Michael P Jankowski, Vidya Chidambaran","doi":"10.1080/24740527.2021.2021799","DOIUrl":"10.1080/24740527.2021.2021799","url":null,"abstract":"<p><strong>Background: </strong>Chronic postsurgical pain (CPSP) in children remains an important problem with no effective preventive or therapeutic strategies. Recently, genomic underpinnings explaining additional interindividual risk beyond psychological factors have been proposed.</p><p><strong>Aims: </strong>We present a comprehensive review of current preclinical and clinical evidence for genetic and epigenetic mechanisms relevant to pediatric CPSP.</p><p><strong>Methods: </strong>Narrative review.</p><p><strong>Results: </strong>Animal models are relevant to translational research for unraveling genomic mechanisms. For example, <i>Cacng2, p2rx7</i>, and <i>bdnf</i> mutant mice show altered mechanical hypersensitivity to injury, and variants of the same genes have been associated with CPSP susceptibility in humans; similarly, differential DNA methylation (<i>H1SP</i>) and miRNAs (miR-96/7a) have shown translational implications. Animal studies also suggest that crosstalk between neurons and immune cells may be involved in nociceptive priming observed in neonates. In children, differential DNA methylation in regulatory genomic regions enriching GABAergic, dopaminergic, and immune pathways, as well as polygenic risk scores for enhanced prediction of CPSP, have been described. Genome-wide studies in pediatric CPSP are scarce, but pathways identified by adult gene association studies point to potential common mechanisms.</p><p><strong>Conclusions: </strong>Bench-to-bedside genomics research in pediatric CPSP is currently limited. Reverse translational approaches, use of other -omics, and inclusion of pediatric/CPSP endophenotypes in large-scale biobanks may be potential solutions. Time of developmental vulnerability and longitudinal genomic changes after surgery warrant further investigation. Emergence of promising precision pain management strategies based on gene editing and epigenetic programing emphasize need for further research in pediatric CPSP-related genomics.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"85-107"},"PeriodicalIF":2.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41920992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing pediatric chronic postsurgical pain: Time for increased rigor.","authors":"Christine B Sieberg, Keerthana Deepti Karunakaran, Barry Kussman, David Borsook","doi":"10.1080/24740527.2021.2019576","DOIUrl":"10.1080/24740527.2021.2019576","url":null,"abstract":"<p><p>Chronic postsurgical pain (CPSP) results from a cascade of events in the peripheral and central nervous systems following surgery. Several clinical predictors, including the prior pain state, premorbid psychological state (e.g., anxiety, catastrophizing), intraoperative surgical load (establishment of peripheral and central sensitization), and acute postoperative pain management, may contribute to the patient's risk of developing CPSP. However, research on the neurobiological and biobehavioral mechanisms contributing to pediatric CPSP and effective preemptive/treatment strategies are still lacking. Here we evaluate the perisurgical process by identifying key problems and propose potential solutions for the pre-, intra-, and postoperative pain states to both prevent and manage the transition of acute to chronic pain. We propose an eight-step process involving preemptive and preventative analgesia, behavioral interventions, and the use of biomarkers (brain-based, inflammatory, or genetic) to facilitate timely evaluation and treatment of premorbid psychological factors, ongoing surgical pain, and postoperative pain to provide an overall improved outcome. By achieving this, we can begin to establish personalized precision medicine for children and adolescents presenting to surgery and subsequent treatment selection.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"73-84"},"PeriodicalIF":2.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9067470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43609657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending the Biopsychosocial Conceptualisation of Chronic Post Surgical Pain in Children and Adolescents: The Family Systems Perspective.","authors":"Toby Newton-John","doi":"10.1080/24740527.2022.2038032","DOIUrl":"10.1080/24740527.2022.2038032","url":null,"abstract":"<p><p>A substantial number of children and adolescents undergoing surgical procedures, as many as 40% in some estimates, will go on to develop chronic postsurgical pain (CPSP). Because of the significant negative impact of CPSP on social and emotional milestones, as well as the child's quality of life, it is important to identify modifiable factors that are associated with the onset and maintenance of the condition. Research has demonstrated that parent factors can play a role in pediatric chronic pain; however, there has been little examination of parent and family influences on the transition to CPSP. Family systems theories, which consider the influence of the family unit overall on the behavior of individuals members, have been applied to the eating disorders literature for decades. This narrative review proposes a novel application of family systems theory to pediatric CPSP and, in particular, highlights the role that parental dyadic factors may play in the development and maintenance of persistent pain following surgery in children and adolescents.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"143-152"},"PeriodicalIF":2.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9067468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44965284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the transition from acute to chronic postsurgical pain in youth: A narrative review of epidemiologic, perioperative, and psychosocial factors","authors":"Brittany N Rosenbloom, J. Katz","doi":"10.1080/24740527.2022.2059754","DOIUrl":"https://doi.org/10.1080/24740527.2022.2059754","url":null,"abstract":"ABSTRACT A growing number of studies have identified high rates of pediatric chronic postsurgical pain (CPSP) after major surgery. Pediatric CPSP is associated with pain-related distress and comorbid mental health outcomes, such as anxiety and depression. From a biopsychosocial perspective, youth factors, such as genetics, epigenetics, sex, presurgical pain, sleep, anxiety, and pain catastrophizing, as well as parent factors, such as cognitive appraisals of their child’s pain expression and pain catastrophizing, converge and lead to chronic pain disability. A comprehensive and testable psychosocial model of the transition from acute to chronic pediatric postsurgical pain has not been developed. This narrative review begins by evaluating the epidemiology and trajectories of pediatric CPSP and moves on to examine the more influential psychosocial models that have been proposed to understand the development of pediatric CPSP. Much of the literature to date has been conducted on adolescents undergoing spinal fusion. To conceptualize the transition from acute to chronic pain in youth, a combined diathesis-stress and interpersonal fear avoidance model is presented. Novel areas of future research include the potential influence that siblings and peers have on a youth’s development of CPSP as well as the influence of gender.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"166 - 174"},"PeriodicalIF":2.4,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46080020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A memory-reframing intervention to reduce pain in youth undergoing major surgery: Pilot randomized controlled trial of feasibility and acceptability","authors":"M. Pavlova, Tatiana Lund, Jenny Sun, J. Katz, M. Brindle, Melanie Noel","doi":"10.1080/24740527.2022.2058919","DOIUrl":"https://doi.org/10.1080/24740527.2022.2058919","url":null,"abstract":"ABSTRACT Background Three to 22% of youth undergoing surgery develop chronic postsurgical pain (CPSP). Negative biases in pain memories (i.e., recalling higher levels of pain as compared to initial reports) are a risk factor for CPSP development. Children’s memories for pain are modifiable. Existing memory-reframing interventions reduced negatively biased memories associated with procedural pain and pain after minor surgery. However, not one study has tested the feasibility and acceptability of the memory-reframing intervention in youth undergoing major surgery. Aims The current pilot randomized clinical trial (RCT; NCT03110367; clinicaltrials.gov) examined the feasibility and acceptability of, as well as adherence to, a memory reframing intervention. Methods Youth undergoing a major surgery reported their baseline and postsurgery pain levels. Four weeks postsurgery, youth and one of their parents were randomized to receive control or memory-reframing instructions. Following the instructions, parents and youth reminisced about the surgery either as they normally would (control) or using the memory-reframing strategies (intervention). Six weeks postsurgery, youth completed a pain memory interview; parents reported intervention acceptability. Four months postsurgery, youth reported their pain. Results Seventeen youth (76% girls, Mage = 14.1 years) completed the study. The intervention was feasible and acceptable. Parents, but not youth, adhered to the intervention principles. The effect sizes of the intervention on youth pain memories (ηp 2 = 0.22) and pain outcomes (ηp 2 = 0.23) were used to inform a larger RCT sample size. Conclusions Memory reframing is a promising avenue in pediatric pain research. Larger RCTs are needed to determine intervention efficacy to improve pain outcomes.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"152 - 165"},"PeriodicalIF":2.4,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44477127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap: Identifying diverse stakeholder needs and barriers to accessing evidence and resources for children’s pain","authors":"Nicole E. MacKenzie, C. Chambers, Jennifer A. Parker, Erin Aubrey, I. Jordan, D. Richards, Justina Marianayagam, Samina Ali, F. Campbell, G. Finley, Emily Gruenwoldt, B. Stevens, J. Stinson, K. Birnie","doi":"10.1080/24740527.2022.2045192","DOIUrl":"https://doi.org/10.1080/24740527.2022.2045192","url":null,"abstract":"\u0000 Stakeholder engagement in knowledge mobilization (KMb) activities can bridge the knowledge to action gap within children’s pain but may be influenced by how well stakeholder needs and barriers to evidence-based resources are addressed. The needs of different Canadian stakeholder groups related to children’s pain have not been examined, limiting the degree to which KMb efforts can be tailored to each group.\u0000 The study aim was to identify shared and unique needs, barriers, and accessibility of evidence for children’s pain across three stakeholder groups: knowledge users (i.e., health professionals, administrators, policymakers, educators), researchers (including trainees), and patients, caregivers, and family members.\u0000 This study comprised an online needs assessment survey. Analyses included descriptive statistics, one-way analyses of variances, and chi-square tests to examine differences between stakeholder groups. Open-ended responses were analyzed using conventional content analysis.\u0000 A total of 711 stakeholders completed the survey. Educational materials were the most utilized evidence-based resources among all stakeholders. Researchers and patients/caregivers/family members found resources significantly less accessible than knowledge users (P = 0.008). Knowledge of evidence was the primary barrier across all stakeholder groups (69.2%, n = 492); however, each group reported a need for stakeholder-specific resources. Finally, stakeholders desired opportunities to engage in the KMb process through partnerships and an increased awareness of children’s pain.\u0000 Though stakeholders experience common barriers to evidence-based resources for children’s pain, their needs to address these barriers are diverse. Evidence-based resources should be tailored for stakeholders’ contexts, with diverse audiences in mind.\u0000","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"48 - 64"},"PeriodicalIF":2.4,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45153539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and clinical characteristics of free-text writers in chronic pain patient intake questionnaires.","authors":"Rachel Roy, Jordana L Sommer, Ryan Amadeo, Kristin Reynolds, Kayla Kilborn, Brigitte Sabourin, Renée El-Gabalawy","doi":"10.1080/24740527.2021.2016031","DOIUrl":"10.1080/24740527.2021.2016031","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a prevalent and burdensome problem within the Canadian health care system, where the gold standard treatment occurs at multidisciplinary pain facilities. Patient intake questionnaires (PIQs) are standard practice for obtaining health information, with many patients including free-text (e.g., writing in margins of questionnaires) on their PIQs.</p><p><strong>Aims: </strong>This study aims to quantitatively examine whether and how patients who include free-text on PIQs differ from those who do not.</p><p><strong>Methods: </strong>We retrospectively analyzed 367 PIQs at a Canadian pain facility in Winnipeg, Canada. Patients were categorized into free-text (i.e., any text response not required in responding to questions) or no free-text groups. Groups were compared on sociodemographics, pain, health care utilization, and depressive symptoms with independent samples <i>t</i>-tests and chi-square analyses.</p><p><strong>Results: </strong>Patients with free-text compared to those without had more sources of pain (6.66 vs. 4.63), longer duration of pain (123.2 months vs. 68.1 months), and a greater proportion of past pain conditions (66.3% vs. 55.2%). Additionally, they had tried more treatments for their pain, had seen more specialists, had tried more past medications, were currently on more medications, and had undergone more tests. No differences were identified for depressive symptoms across groups.</p><p><strong>Conclusions: </strong>This study is the first to examine patient and health-related correlates of free-text on PIQs at a Canadian pain facility. Results indicate that there are significant differences between groups on pain and health care utilization. Thus, patients using free-text may require additional supports and targeted interventions to improve patient-physician communication and patient outcomes.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"24-32"},"PeriodicalIF":2.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8865255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42268226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the current state of pediatric surgical pain care across Canada and assessing readiness for change","authors":"K. Birnie, J. Stinson, L. Isaac, J. Tyrrell, F. Campbell, I. Jordan, Justina Marianayagam, D. Richards, Brittany N Rosenbloom, F. Clement, P. Hubley","doi":"10.1080/24740527.2022.2038031","DOIUrl":"https://doi.org/10.1080/24740527.2022.2038031","url":null,"abstract":"ABSTRACT Background Preventing pediatric chronic postsurgical pain is a patient, parent/caregiver, health care professional, and policymaker priority. Poorly managed presurgical and acute postsurgical pain are established risk factors for pediatric chronic postsurgical pain. Effective perioperative pain management is essential to prevent the transition from acute to chronic pain after surgery. Aims The aim of this study was to identify current pediatric surgical pain management practices and assess health system readiness for change at health care institutions conducting pediatric surgery in Canada. Methods An online survey was completed by 85 multidisciplinary health care professionals (nurses, surgeons, anesthesiologists, allied health) from 20 health institutions in Canada regarding institutional pre- and postsurgical pediatric pain care, specialty pain services, and Organizational Readiness for Implementing Change (ORIC). Results Of all specialty pain services, acute and chronic/complex pain services were most common, primarily with physician and nursing involvement. Alignment to recommended practices for pediatric pre- and postsurgical pain care varied (38.1%–79.8% reported “yes, for every child”), with tertiary/quaternary children’s hospitals reporting less alignment than other institutions (community/regional or rehabilitation hospitals, community treatment centers). No significant differences were reported between health care institutions serving pediatric populations only versus those also serving adults. Health care professional experience/practice was the most reported strength in pediatric surgical pain care, with inconsistent standard of care the most common gap. Participants “somewhat agreed” that their institutions were committed and capable of change in pediatric surgical pain care. Conclusions There is a continued need to improve pediatric pain care during the perioperative period at Canadian health care institutions to effectively prevent the development of pediatric postsurgical pain.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"108 - 120"},"PeriodicalIF":2.4,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46196351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada.","authors":"Nathan Augeard, Geoff Bostick, Jordan Miller, David Walton, Yannick Tousignant-Laflamme, Anne Hudon, André Bussières, Lynn Cooper, Nicol McNiven, Aliki Thomas, Lesley Singer, Scott M Fishman, Marie H Bement, Julia M Hush, Kathleen A Sluka, Judy Watt-Watson, Lisa C Carlesso, Sinead Dufour, Roland Fletcher, Katherine Harman, Judith Hunter, Suzy Ngomo, Neil Pearson, Kadija Perreault, Barbara Shay, Peter Stilwell, Susan Tupper, Timothy H Wideman","doi":"10.1080/24740527.2021.2004103","DOIUrl":"10.1080/24740527.2021.2004103","url":null,"abstract":"<p><strong>Background: </strong>National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada.</p><p><strong>Aims: </strong>This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context.</p><p><strong>Methods: </strong>A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators.</p><p><strong>Results: </strong>Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being \"very satisfied\" with the process.</p><p><strong>Conclusions: </strong>This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/e5/UCJP_6_2004103.PMC8757473.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10318111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pain and disability in organizations: It's time to pay attention to work and workers.","authors":"Duygu Gulseren","doi":"10.1080/24740527.2021.2010023","DOIUrl":"https://doi.org/10.1080/24740527.2021.2010023","url":null,"abstract":"The Canadian pain community knows that one in every five adults in Canada suffers from pain. What is less well known is that many of those adults stay in the workforce despite their pain. According to the Canadian Survey on Disabilities, more than half of working-age adults (i.e., between the ages 15 and 64 years) in pain are employed. Depending on the requirements of their jobs, these individuals continue to go to work, sit or stand on their feet during long shifts, work in awkward positions and in noisy environments, or lift heavy objects. Many also have comorbidities associated with pain such as anxiety or depression, which can make it harder for them to deal with difficult customers, travel for work, or stay focused on a task. In this editorial, I will (1) present a brief overview of the current state of the chronic pain and work literature, (2) make a case for why we need more pain-related research focused on the workplace and on employees with chronic pain who opt to continue working, and (3) invite pain researchers to collaborate with management scholars to better understand, prevent, and design interventions for chronic pain in the workplace. Chronic pain is a prevalent problem in Canadian workplaces. The prevalence of pain in the workplace is expected to be even more common in the future because work conditions are changing. Factors such as an aging workforce, increasingly demanding jobs, longer work hours, and working more than one job are expected to cause an increase in chronic pain cases. Despite the prevalence of pain in the workplace, very little research has examined the experiences of employees with pain. Although initial attempts have been made on this topic, significant and worrisome gaps exist in the literature. Except for general pain management interventions tested in workplace settings, most studies at the intersection of work and pain focus on absenteeism or on facilitating a return to work. Though these topics are important for our field, they assume, erroneously, that employees who have pain leave work and employees who return to work have no pain or pain that is effectively controlled; unfortunately, this is not the case for many. Employees who are working despite their pain are generally overlooked. We need more research on this topic because the majority of the people with chronic pain are still in the workforce. They struggle with unique challenges at the intersection of the organizational life and their health conditions. Understanding what conditions at work help or hinder their pain and functioning could lead to the development of more effective interventions and policies. Most individuals spend about one-third of their lives at work. Nonetheless, the influence of work is not limited to work hours and should not be underestimated. Work is a place where a person can earn their living, make social connections, and even find a sense of identity and purpose. Due to its wide sphere of influence in a person’s life, work","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"45-47"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}