PAIN CATASTROPHIZING, OPIOID MISUSE, OPIOID USE, AND OPIOID DOSE IN PEOPLE WITH CHRONIC MUSCULOSKELETAL PAIN: A SYSTEMATIC REVIEW

Abstract Objective To compare pain and psychological outcomes in veterans with chronic musculoskeletal pain and comorbid post-traumatic stress disorder (PTSD) or pain alone and to determine if veterans with comorbidity respond differently to a stepped-care intervention than those with pain alone. Design Secondary analysis of data from the Evaluation of Stepped Care for Chronic Pain (ESCAPE) trial. Setting Six Veterans Health Affairs clinics. Subjects Iraq and Afghanistan veterans (N = 222) with chronic musculoskeletal pain. Methods Longitudinal analysis of veterans with chronic musculoskeletal pain and PTSD or pain alone and available baseline and nine-month trial data. Participants randomized to either usual care or a stepped-care intervention were analyzed. The pain–PTSD comorbidity group screened positive for PTSD and had a PTSD Checklist–Civilian score ≥41 at baseline. Results T tests demonstrated statistically significant differences and worse outcomes on pain severity, pain cognitions, and psychological outcomes in veterans with comorbid pain and PTSD compared with those with pain alone. Analysis of covariance (ANCOVA) modeling change scores from baseline to nine months indicated no statistically significant differences, controlling for PTSD, on pain severity, pain centrality, or pain self-efficacy. Significant differences emerged for pain catastrophizing (t = 3.10, P < 0.01), depression (t = 3.39, P < 0.001), and anxiety (t = 3.80, P < 0.001). The interaction between PTSD and the stepped-care intervention was not significant. Conclusions Veterans with the pain–PTSD comorbidity demonstrated worse pain and psychological outcomes than those with chronic pain alone. These findings indicate a more intense chronic pain experience for veterans when PTSD co-occurs with pain. PTSD did not lead to a differential response to a stepped-care intervention.

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Are mindfulness skills associated with reducing kinesiophobia, pain severity, pain catastrophizing and physical disability? Results of Iranian patients with chronic musculoskeletal pain

Health Psychology Report ◽

10.5114/hpr.2019.84747 ◽

2019 ◽

Author(s):

Sajjad Rezaei ◽

Sedigheh Hassanzadeh

Keyword(s):

Musculoskeletal Pain ◽

Physical Disability ◽

Pain Catastrophizing ◽

Chronic Musculoskeletal Pain ◽

Pain Severity ◽

Mindfulness Skills ◽

Iranian Patients

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Sensory discrimination training for adults with chronic musculoskeletal pain: a systematic review

Physiotherapy Theory and Practice ◽

10.1080/09593985.2020.1830455 ◽

2020 ◽

pp. 1-19

Author(s):

Andrew Graham ◽

Cormac G. Ryan ◽

Alasdair MacSween ◽

Jenny Alexanders ◽

Nick Livadas ◽

...

Keyword(s):

Systematic Review ◽

Discrimination Training ◽

Musculoskeletal Pain ◽

Chronic Musculoskeletal Pain ◽

Sensory Discrimination

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Effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain: a protocol of a systematic review

Systematic Reviews ◽

10.1186/s13643-019-1165-7 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Naiane Teixeira Bastos de Oliveira ◽

Irlei dos Santos ◽

Gisela Cristiane Miyamoto ◽

Cristina Maria Nunes Cabral

Keyword(s):

Systematic Review ◽

Older Adults ◽

Aerobic Exercise ◽

Musculoskeletal Pain ◽

Included Study ◽

Chronic Musculoskeletal Pain ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

And Function

Abstract Background Chronic musculoskeletal pain affects the quality of life of older adults by interfering in their ability to perform activities of daily living. Aerobic exercise programs have been used in the treatment of various health conditions, including musculoskeletal disorders. However, there is still little evidence on the effects of aerobic exercise for the treatment of older adults with chronic musculoskeletal pain. Thus, the objective of this study is to assess the effects of aerobic exercise in improving pain and function of older adults with chronic pain as a consequence of different chronic musculoskeletal conditions. Methods The databases to be used in the search are PubMed, EMBASE, CINAHL, PEDro, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials that used aerobic exercise in the treatment of older adults with chronic musculoskeletal pain will be included. Primary outcomes will be pain and function. We will use the PEDro scale to evaluate the methodological quality and statistical description of each included study, and the strength of the recommendations will be summarized using GRADE. Discussion The results of this systematic review will provide a synthesis of the current evidence on the effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. In addition, this information can help health professionals in decision-making about the use of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. Ethics and dissemination This systematic review was recorded prospectively, and the results will be part of a doctoral thesis to be published in a peer-reviewed international journal and possibly presented at international conferences. Systematic review registration PROSPERO, CRD42019118903.

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Enablers and barriers of people with chronic musculoskeletal pain for engaging in telehealth interventions: protocol for a qualitative systematic review and meta-synthesis

Systematic Reviews ◽

10.1186/s13643-020-01390-x ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Lívia G. Fernandes ◽

Hemakumar Devan ◽

Steven J. Kamper ◽

Christopher M. Williams ◽

Bruno T. Saragiotto

Keyword(s):

Systematic Review ◽

Musculoskeletal Pain ◽

Chronic Musculoskeletal Pain ◽

Qualitative Systematic Review

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Central neurobiological effects of physical exercise in individuals with chronic musculoskeletal pain: a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-036151 ◽

2020 ◽

Vol 10 (7) ◽

pp. e036151

Author(s):

Rutger M J de Zoete ◽

Kenneth Chen ◽

Michele Sterling

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

High Risk ◽

Physical Exercise ◽

Clinical Outcomes ◽

Musculoskeletal Pain ◽

Exercise Intervention ◽

Risk Of Bias ◽

Chronic Musculoskeletal Pain ◽

Brain Areas

ObjectivePrimary objectives: to investigate the central neurobiological effects (using MRI) of physical exercise in individuals with chronic pain. Secondary objectives: (1) to investigate the associations between central changes and clinical outcomes and (2) to investigate whether different types and dosages of physical exercise exert different central changes.DesignSystematic review searching four electronic databases up to September 2018: AMED, CINAHL, Embase and MEDLINE. Two reviewers independently assessed the methodological quality of included studies using the Cochrane Collaboration’s Risk of Bias in Non-Randomised Studies-I tool. A standardised extraction table was used for data extraction, which was performed by two reviewers.InterventionsStudies reporting any physical exercise intervention in any chronic musculoskeletal pain condition were included. Eligibility of 4011 records was screened independently by two reviewers, and four studies were included in the review.Primary and secondary outcome measuresPrimary outcome: any brain outcome assessed with any MR technique. Secondary outcomes: any self-reported clinical outcomes, and type and dosage of the exercise intervention.ResultsAll four studies had high risk of bias. There was heterogeneity between the brain areas studied and the types of exercise interventions delivered. All studies reported functional MRI changes in various brain areas following an exercise intervention. Insufficient data were available to conduct a meta-analysis or to answer the secondary aims.ConclusionsOnly a limited number of studies were available and all were at high risk of bias. None of the studies was randomised or included blinded assessment. Exercise may exert effects on brain neurobiology in people with chronic pain. Due to the high risk of bias, future studies should use a randomised study design. Investigation of morphological brain changes could be included.PROSPERO registration numberCRD42018108179.

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