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

{"title":"Attending work with chronic pain is associated with higher levels of psychosocial stress.","authors":"Greig Adams,&nbsp;Tim V Salomons","doi":"10.1080/24740527.2021.1889925","DOIUrl":"https://doi.org/10.1080/24740527.2021.1889925","url":null,"abstract":"<p><p><b>Background and Aims</b>: Much is known about the impact of pain in terms of medical costs and missed work. Less is known about its associations when individuals are present for work. This study examines \"presenteeism\" by analyzing the psychosocial costs of pain in the workplace, using the 2015 European Working Conditions Survey (EWCS). <b>Methods</b>: We conducted cross-sectional analysis of 2384 individuals with chronic pain and 2263 individuals without pain (matched by age and sex) using data from the 2015 EWCS. We compared groups in terms of the following psychosocial factors: supervisor support, job responsibility, team cohesion, discrimination, threats/abuse, job competency, job reward, sexual harassment, stress, and job security. The groups were also compared in terms of days lost due to illness. <b>Results</b>: People with pain were 64% less likely to view their job as rewarding (odds ratio [OR] = 0.61; 95% confidence interval [CI], 0.57-0.65), 47% more likely to be subjected to threats/abuse in the workplace (OR = 0.68; 95% CI, 0.63-0.73), 30% more likely to report poor supervisor support (OR = 0.77; 95% CI, 0.73-0.82), and 28% more likely to perceive discrimination in the workplace (OR = 0.78; 95% CI, 0.71-0.85). People with pain missed approximately nine more days of work per year than respondents without pain. <b>Conclusions</b>: Chronic pain was associated with lower vocational fulfillment and feelings of being ostracized in the workplace. These findings suggest that the presence of pain in the workplace goes well beyond lost productivity due to absenteeism.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"107-116"},"PeriodicalIF":2.4,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1889925","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39041197","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":"Exploring physiotherapy practice within hospital-based interprofessional chronic pain clinics in Ontario.","authors":"Linnea Thacker,&nbsp;Robert M Walsh,&nbsp;Gabriella Shinyoung Song,&nbsp;Hammad A Khan,&nbsp;Prem Parmar,&nbsp;Kaitlin T Vance,&nbsp;Gillian Grant,&nbsp;Giulia Mesaroli,&nbsp;Judith Hunter,&nbsp;Kyle Vader","doi":"10.1080/24740527.2021.1905508","DOIUrl":"https://doi.org/10.1080/24740527.2021.1905508","url":null,"abstract":"<p><p><b>Background</b>: Chronic pain affects one in five persons and is a leading contributor to years lived with disability and high health care costs. In 2016, the government of Ontario increased public funding for pediatric and adult hospital-based interprofessional chronic pain clinics (HICPCs) in Ontario, Canada, expanding the role of physiotherapy in chronic pain management in the province. This role has yet to be described in the literature. <b>Aim</b>: The aim of this study was to explore physiotherapy practice within HICPCs in Ontario. <b>Methods</b>: We conducted an interpretive description qualitative study based on semistructured interviews with physiotherapists employed in pediatric and adult HICPCs in Ontario. Interviews were audio recorded, transcribed verbatim, and reviewed for accuracy. We analyzed interview data using thematic analysis. <b>Results</b>: Ten physiotherapists who practiced in pediatric and adult HICPCs (<i>n</i> = 4 pediatric; <i>n</i> = 6 adult) in Ontario were interviewed between February and April 2020. We constructed five themes related to physiotherapy practice in this setting. Themes included (1) contributing a functional lens to care; (2) empowering through pain education; (3) facilitating participation in physical activity and exercise; (4) supporting engagement in self-management strategies; and (5) implementing a collaborative approach to whole-person care. <b>Conclusions</b>: Our results illuminate how physiotherapy practice within HICPCs in Ontario focuses on providing a collaborative and whole-person approach to care, with an emphasis on supporting patients to increase their functional capacity by promoting engagement in active chronic pain management strategies.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"96-106"},"PeriodicalIF":2.4,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1905508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39041196","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":"Plenary Abstracts","authors":"","doi":"10.1080/24740527.2021.1914206","DOIUrl":"https://doi.org/10.1080/24740527.2021.1914206","url":null,"abstract":"We have an increasingly robust armoury as to how to stratify neuropathic pain patients according to symptoms, sensory testing and more advanced techniques such as neurophysiology, genetics and functional imaging. These are now being applied at scale both in large collaborative research consortia and in some cases within national health services. In parallel to these technological advances harmonised data collection and storage is enabling advanced multi-modal data analysis and correlation with long term health outcomes. The application of these techniques is helping us to: identify conditions which were not previously understood to have a neuropathic component, identify those individuals at highest risk of neuropathic pain and stratify patients living with neuropathic pain in a clinically meaningful way. I will discuss how these approaches are enhancing our understanding of neuropathic pain with the ultimate goal of not only developing novel treatment strategies but also better targeting of existing treatments to those most likely to respond.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"A1 - A2"},"PeriodicalIF":2.4,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1914206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43992021","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":"Symposia Abstracts","authors":"K. Birnie, Nader, Ghasemloub, J. Bradley, Kerrc, Linda, Wilhelmd","doi":"10.1080/24740527.2021.1914213","DOIUrl":"https://doi.org/10.1080/24740527.2021.1914213","url":null,"abstract":"","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"A3 - A33"},"PeriodicalIF":2.4,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1914213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60129738","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":"Clinical Innovation Poster Abstracts","authors":"Krista, Baergd","doi":"10.1080/24740527.2021.1914216","DOIUrl":"https://doi.org/10.1080/24740527.2021.1914216","url":null,"abstract":"University of Saskatchewan, College of Medicine, Saskatoon, Saskatchewan, Canada; University of Saskatchewan, Department of Pediatrics, Saskatoon, Saskatchewan, Canada; University of Saskatchewan, College of Medicine, Clinical Research Support Unit (CRSU), Saskatoon, Saskatchewan, Canada; University of Saskatchewan, Department of Pediatrics, Saskatoon, Saskatchewan, Saskatchewan Health Authority— Saskatoon, Saskatchewan, Canada","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"A34 - A47"},"PeriodicalIF":2.4,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1914216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43731710","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":"Cluster analysis of Canadian Armed Forces veterans living with chronic pain: Life After Service Studies 2016.","authors":"Julian Reyes Velez,&nbsp;James M Thompson,&nbsp;Jill Sweet,&nbsp;Jason W Busse,&nbsp;Linda VanTil","doi":"10.1080/24740527.2021.1898278","DOIUrl":"https://doi.org/10.1080/24740527.2021.1898278","url":null,"abstract":"<p><p><b>Objective</b>: This study explored the heterogeneity of Canadian Armed Forces veterans living with chronic pain to inform service needs planning and research using cluster analysis. <b>Design</b>: We used a national cross-sectional Statistics Canada population survey. <b>Participants</b>: Participants included 2754 Canadian Armed Forces (CAF) Regular Force veterans released from service between 1998 and 2015 and surveyed in 2016. <b>Methods</b>: We used cluster analysis of veterans with chronic pain based on pain severity, mental health, and activity limitation characteristics. We compared clusters for sociodemographic, health, and service utilization characteristics. <b>Results</b>: Of 2754 veterans, 1126 (41%) reported chronic pain. Veterans in cluster I (47%) rarely had severe pain (2%) or severe mental health problems (8%), and none had severe activity limitations. Veterans in cluster II (26%) more often than veterans in cluster I but less often than veterans in cluster III endorsed severe pain (27%) and severe mental health problems (22%) and were most likely to report severe activity limitation (91%). Veterans in cluster III (27%) were most likely to report severe pain (36%) and severe mental health problems (96%), and a majority reported severe activity limitations (72%). There was evidence of considerable heterogeneity among individuals in terms of socioeconomic characteristics, pain characteristics, mental and physical health status, activity limitations, social integration, and service utilization indicators. <b>Conclusions</b>: About half of Canadian veterans living with chronic pain infrequently endorse severe pain or serious mental health issues without severe activity limitations. The other half had more complex characteristics. The heterogeneity of CAF veterans with chronic pain emphasizes the need for support systems that can address variability of needs.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"81-95"},"PeriodicalIF":2.4,"publicationDate":"2021-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1898278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39041195","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":"\"They think you're trying to get the drug\": Qualitative investigation of chronic pain patients' health care experiences during the opioid overdose epidemic in Canada.","authors":"Lise Dassieu,&nbsp;Angela Heino,&nbsp;Élise Develay,&nbsp;Jean-Luc Kaboré,&nbsp;M Gabrielle Pagé,&nbsp;Gregg Moor,&nbsp;Maria Hudspith,&nbsp;Manon Choinière","doi":"10.1080/24740527.2021.1881886","DOIUrl":"10.1080/24740527.2021.1881886","url":null,"abstract":"<p><p><b>Background</b>: The opioid overdose epidemic has led health care providers to increased vigilance for opioid-related risks in the treatment of chronic non-cancer pain (CNCP). Media have conveyed stigmatizing representations of opioid analgesics. <b>Aims:</b> This study aimed to understand how the opioid overdose epidemic has impacted health care experiences among people living with CNCP in two Canadian provinces (British Columbia, Quebec). <b>Methods:</b> This qualitative study proceeded through 22 semi-structured interviews conducted in 2019. Participants were recruited from a cross-sectional survey examining the effects of the opioid overdose epidemic on individuals with CNCP. We collected in-depth narratives that we analyzed using a thematic framework. The sample included 12 women and 10 men aged 20 to 70 years, with 11 from each province. <b>Results:</b> Several participants described increased difficulty in accessing medical services for pain since the onset of the opioid overdose epidemic. They reported that some physicians urged them to taper opioids regardless of their pain severity and functional limitations. Some participants reported facing discrimination and care denials as they were labeled \"drug-seeking,\" especially in hospital. Depending on their educational resources, they were unequally able to counter providers' stigmatizing behaviors. However, participants described empathetic relationships with providers with whom they had a long-term relationship. Some participants drew distinctions between themselves and the stigmatized status of \"addict\" in ways that reinforced stigma toward people who are dependent on opioids. <b>Conclusions:</b> Health policies and provider education programs aimed at reducing opioid-related stigma are needed to counter detrimental consequences of the opioid overdose epidemic for people living with CNCP.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"66-80"},"PeriodicalIF":2.4,"publicationDate":"2021-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1881886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39041194","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":"Transcutaneous electrical nerve stimulation (TENS): towards the development of a clinic-friendly method for the evaluation of excitatory and inhibitory pain mechanisms.","authors":"Monica Sean,&nbsp;Alexia Coulombe-Lévêque,&nbsp;Matthieu Vincenot,&nbsp;Marylie Martel,&nbsp;Louis Gendron,&nbsp;Serge Marchand,&nbsp;Guillaume Léonard","doi":"10.1080/24740527.2020.1862624","DOIUrl":"https://doi.org/10.1080/24740527.2020.1862624","url":null,"abstract":"ABSTRACT Background: Temporal summation and conditioned pain modulation (CPM) can be measured using a thermode and cold pressor test (CPTest). Unfortunately, these complex and expensive tools are ill-suited for routine clinical assessments. Aims: We aimed to compare the temporal summation and CPM obtained with the thermode + CPTest paradigm to those obtained with a novel paradigm using transcutaneous electrical nerve stimulation (TENS). Methods: We assessed temporal summation and CPM in 29 healthy participants, using two paradigms (random order): TENS, and thermode + CPTest. In the TENS paradigm, both the conditioning stimulus (CS) and the test stimulus (TS) were delivered using TENS; in the thermode + CPTest paradigm, the CS consisted of a CPTest and the TS was delivered using a thermode. We compared the average temporal summation and CPM evoked by the two paradigms. Results: Average temporal summation was similar for both modalities (P = 0.90), and the number of participants showing temporal summation was similar in both paradigms (19 with thermode vs. 18 with TENS; P = 1.00). Average CPM response was larger following the thermode + CPTest than following the TENS (P = 0.005), and more participants showed CPM with the thermode + CPTest paradigm compared to the TENS paradigm (24 vs. 14; P = 0.01). Conclusions: Both paradigms were roughly equivalent in the ability to evoke temporal summation (although response to one modality did not predict response to the other), but the TENS paradigm appeared to be less apt to induce a CPM response than the thermode + CPTest paradigm.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"56-65"},"PeriodicalIF":2.4,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1862624","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39041193","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":"Exploring pain phenotypes in workers with chronic low back pain: Application of IMMPACT recommendations.","authors":"Lisa C Carlesso,&nbsp;Yannick Tousignant-Laflamme,&nbsp;William Shaw,&nbsp;Christian Larivière,&nbsp;Manon Choinière","doi":"10.1080/24740527.2020.1870103","DOIUrl":"https://doi.org/10.1080/24740527.2020.1870103","url":null,"abstract":"<p><p><b>Background</b>: Chronic low back pain (CLBP) is a major cause of disability globally. Stratified care has been proposed as a means to improve prognosis and treatment but is generally based on limited aspects of pain, including biopsychosocial drivers. <b>Aims</b>: Following Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations, the present study explored pain phenotypes with a sample of workers with CLBP, a population for which no pain phenotypes have been derived to date. <b>Methods</b>: A cross-sectional design was used with a sample of 154 workers with CLBP attending a rehabilitation clinic, recruited in person and from social media. Latent class analysis was used to identify subgroups of patients with different pain profiles based on ten pain indicators (pain variability, pain intensity, pain quality, somatization, sleep quality, depression, fatigue, pain catastrophizing, neuropathic pain, and central sensitization). <b>Results</b>: The majority of the sample (85%) were recruited through social media. Both the two-class and three-class solutions were found to be satisfactory in distinguishing phenotypes of workers with CLBP. Three variables proved particularly important in distinguishing between the pain phenotypes-pain quality, fatigue, and central sensitization-with higher scores on these indicators associated with pain phenotypes with higher pain burden. Increased chronic pain self-efficacy, work-related support, and perceived work abilities were protective risk factors for being in a higher pain burden class. <b>Conclusions</b>: The present study is the first to explore IMMPACT recommendations for pain phenotyping with workers with CLBP. Future prospective research will be needed to validate the proposed pain phenotypes.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"43-55"},"PeriodicalIF":2.4,"publicationDate":"2021-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1870103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38979699","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":"Latent profile analysis of blood marker phenotypes and their relationships with clinical pain and interference reports in people with acute musculoskeletal trauma.","authors":"Joshua Y Lee,&nbsp;David M Walton","doi":"10.1080/24740527.2020.1870102","DOIUrl":"https://doi.org/10.1080/24740527.2020.1870102","url":null,"abstract":"<p><p><b>Background</b>: The prevalence of inadequate treatments for chronic pain has necessitated the search for biological factors that influence the transition to chronicity. <b>Methods</b>: Antecubital blood was drawn from those who experienced acute, noncatastrophic musculoskeletal trauma. Follow-up occurred at 1, 3, 6, and 12 months with the primary outcome being Brief Pain Inventory (BPI) Functional Interference scores. Eight markers were chosen for latent profile analysis: brain-derived neurotrophic factor (BDNF); transforming growth factor-beta 1 (TGF-β1); C-reactive protein (CRP); tumor necrosis factor-alpha (TNF-α); interleukins (ILs) 1-beta, 6, and 10; and the stress hormone cortisol. <b>Results</b>: Mean age of the 106 participants was 44.6 years and 58.5% were female. The final model indicated a three-class solution that could be adequately described by three of the eight markers: class 1 = low concentration of all markers (33.9% of the sample), class 2 = average concentration of all markers (47.7%), and class 3 = high concentration of BDNF and TGF-β1 (18.3%). BPI Pain Interference scores captured at both inception and 6-month follow-up were compared across the three groups. Mean scores were significantly higher in class 3 for the BPI Interference subscale at inception (27.0 [SD 16.4] vs. 35.8 [SD 17.3], <i>P</i> = 0.05) and at 6-month follow-up (2.2 [SD 4.8] vs. 7.3 [SD 10.7], <i>P</i> = 0.03) compared to those of the other two classes. <b>Conclusions</b>: Although recovered populations are not significantly different in BDNF and TGF-β1 levels, those who experience persisting disability are more likely to have moderate to high levels in serum.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"30-42"},"PeriodicalIF":2.4,"publicationDate":"2021-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1870102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38979698","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}