Behavioural activation and inhibition systems in relation to pain intensity and duration in a sample of people experiencing chronic musculoskeletal pain

Objective: The COVID-19 pandemic has many features that can potentially trigger and increase chronic pain. The aim of this study was to examine the effects of the pandemic on pain, physical activity and anxiety in individuals with chronic musculoskeletal pain, in both periods of isolation and controlled social life. Methods: Seventy one individuals with chronic musculoskeletal pain were included in the study. Three different periods (pre-pandemic, isolation and controlled social life) were evaluated and analyzed. Pain intensity (Visual Analogue Scale (VAS)), coronavirus anxiety (Coronavirus Anxiety Scale Short Form (CAS-SF)), and physical activity level (International Physical Activity Questionnaire Short Form (IPAQ-SF)) were evaluated. Results: The VAS resting score was significantly higher during the isolation compared to the pre-pandemic period (p = 0.002). The VAS activity score was significantly higher in the isolation period compared to both pre-pandemic (p <0.001) and controlled social life periods (p <0.001). The lowest IPAQ-SF score (p <0.001) and the longest sitting time (p <0.001) were in the isolation period. The CAS-SF scores were significantly higher in the isolation period compared to the controlled social life period (p <0.001). Conclusion: While the measures taken during the isolation period had negative impacts on the severity of pain, physical activity and anxiety levels in individuals with chronic musculoskeletal pain, gradual deconfinement in the controlled social life period led to a decrease in pain intensity and anxiety and an increase in physical activity.

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Pain-Related Fear, Pain Intensity and Function in Individuals With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Journal of Pain ◽

10.1016/j.jpain.2019.04.009 ◽

2019 ◽

Vol 20 (12) ◽

pp. 1394-1415 ◽

Cited By ~ 12

Author(s):

Javier Martinez-Calderon ◽

Mar Flores-Cortes ◽

Jose Miguel Morales-Asencio ◽

Alejandro Luque-Suarez

Keyword(s):

Systematic Review ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Meta Analysis ◽

Chronic Musculoskeletal Pain ◽

And Function

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Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care

Pain ◽

10.1016/j.pain.2004.07.001 ◽

2004 ◽

Vol 111 (3) ◽

pp. 245-252 ◽

Cited By ~ 235

Author(s):

Eva Denison ◽

P. Åsenlöf ◽

P. Lindberg

Keyword(s):

Health Care ◽

Primary Health Care ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Self Efficacy ◽

Chronic Musculoskeletal Pain ◽

Fear Avoidance ◽

Primary Health ◽

Pain Patients

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Entraining alpha activity using visual stimulation in patients with chronic musculoskeletal pain. A feasibility study

10.1101/2020.04.27.063339 ◽

2020 ◽

Cited By ~ 1

Author(s):

Laura J. Arendsen ◽

James Henshaw ◽

Christopher A. Brown ◽

Manoj Sivan ◽

Jason R. Taylor ◽

...

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Feasibility Study ◽

Rating Scale ◽

Visual Stimulation ◽

Numerical Rating Scale ◽

Alpha Activity ◽

Chronic Musculoskeletal Pain ◽

Alpha Power

AbstractEntraining alpha activity with rhythmic visual, auditory, and electrical stimulation can reduce experimentally induced pain. However, evidence for alpha entrainment and pain reduction in patients with chronic pain is limited. This feasibility study investigated whether visual alpha stimulation can increase alpha power in patients with chronic musculoskeletal pain and secondarily, if chronic pain was reduced following stimulation. In a within-subject design, 22 patients underwent 4-minute periods of stimulation at 10 Hz (alpha), 7 Hz (high-theta, control), and 1 Hz (control) in a pseudo-randomized order. Patients underwent stimulation both sitting and standing and verbally rated their pain before and after each stimulation block on a 0-10 numerical rating scale. Global alpha power was significantly higher during 10 Hz compared to 1 Hz stimulation when patients were standing (t = −6.08, p <.001). On a more regional level, a significant increase of alpha power was found in the right-middle and left-posterior region when patients were sitting. With respect to our secondary aim, no significant reduction of pain intensity and unpleasantness was found. However, only the alpha stimulation resulted in a minimal clinically important difference in at least 50% of participants for pain intensity (50%) and unpleasantness ratings (65%) in the sitting condition. This study provides initial evidence for the potential of visual stimulation as a means to enhance alpha activity in patients with chronic musculoskeletal pain. The brief period of stimulation was insufficient to reduce chronic pain. This study is the first to provide evidence that a brief period of visual stimulation at alpha frequency can significantly increase alpha power in patients with chronic musculoskeletal pain. Further study is warranted to investigate optimal dose and individual stimulation parameters to achieve pain relief in these patients.

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Effect of Individually Tailored Biopsychosocial Workplace Interventions on Chronic Musculoskeletal Pain and Stress Among Laboratory Technicians: Randomized Controlled Trial

January 2018 - Pain Physician ◽

10.36076/ppj.2015/18/459 ◽

2015 ◽

Vol 5;18 (5;9) ◽

pp. 459-471 ◽

Cited By ~ 4

Author(s):

Kenneth Jay

Keyword(s):

Pain Intensity ◽

Musculoskeletal Pain ◽

Outcome Measure ◽

Chronic Musculoskeletal Pain ◽

Secondary Outcome ◽

Body Region ◽

Response Analysis ◽

Secondary Outcome Measure ◽

Randomized Controlled

Background: Chronic musculoskeletal pain is prevalent among laboratory technicians and work-related stress may aggravate the problem. Objectives: This study investigated the effect of a multifaceted worksite intervention on pain and stress among laboratory technicians with chronic musculoskeletal pain using individually tailored physical and cognitive elements. Study Design: This trial uses a single-blind randomized controlled design with allocation concealment in a 2-armed parallel group format among laboratory technicians. The trial “Implementation of physical exercise at the Workplace (IRMA09) – Laboratory technicians“ was registered at ClinicalTrials.gov prior to participant enrolment. Setting: The study was conducted at the head division of a large private pharmaceutical company’s research and development department in Denmark. The study duration was March 2014 (baseline) to July 2014 (follow-up). Methods: Participants (n = 112) were allocated to receive either physical, cognitive, and mindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at the worksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to the pain affected area, 2) motor control training, 3) mindfulness, and 4) cognitive and behavioral therapy/education. Participants of the REF group were encouraged to follow ongoing company health initiatives. The predefined primary outcome measure was pain intensity (VAS scale 0 – 10) in average of the regions: neck, shoulder, lower and upper back, elbow, and hand at 10 week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceived stress questionnaire. In addition, an explorative dose-response analysis was performed on the adherence to PCMT with pain and stress, respectively, as outcome measures. Results: A significant (P < 0.0001) treatment by time interaction in pain intensity was observed with a between-group difference at follow-up of -1.0 (95%CI: -1.4 to -0.6). No significant effect on stress was observed (treatment by time P = 0.16). Exploratory analyses for each body region separately showed significant pain reductions of the neck, shoulders, upper back and lower back, as well as a tendency for hand pain. Within the PCMT group, general linear models adjusted for age, baseline pain, and stress levels showed significant associations for the change in pain with the number of physical-cognitive training sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulness sessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with the change in stress as outcome. Limitations: Limitations of behavioral interventions include the inability to blind participants to which intervention they receive. Self-reported outcomes are a limitation as they may be influenced by placebo effects and outcome expectations

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Pain Neuroscience Education Plus Usual Care Is More Effective than Usual Care Alone to Improve Self-Efficacy Beliefs in People with Chronic Musculoskeletal Pain: A Non-Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm9072195 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2195 ◽

Cited By ~ 3

Author(s):

Antonio Rondon-Ramos ◽

Javier Martinez-Calderon ◽

Juan Luis Diaz-Cerrillo ◽

Francisco Rivas-Ruiz ◽

Gina Rocio Ariza-Hurtado ◽

...

Keyword(s):

Chronic Pain ◽

Usual Care ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Outcome Measures ◽

Self Efficacy ◽

Efficacy Beliefs ◽

Chronic Musculoskeletal Pain ◽

Pain Interference ◽

Neuroscience Education

Self-efficacy beliefs are associated with less physical impairment and pain intensity in people with chronic pain. Interventions that build self-efficacy beliefs may foster behavioral changes among this population. A non-randomized trial has been carried out to evaluate the effectiveness of pain neuroscience education (PNE) plus usual care in modifying self-efficacy beliefs, pain intensity, pain interference and analgesics consumption in people with chronic musculoskeletal pain. Participants were allocated to an experimental (PNE plus usual care, n = 49) and a control (usual care alone, n = 51) group. The primary outcome was self-efficacy beliefs (Chronic Pain Self-Efficacy Scale), and the secondary outcomes were pain intensity, pain interference (Graded Chronic Pain Scale) and analgesics consumption. The participant’s pain knowledge (revised Neurophysiology of Pain Questionnaire) after PNE intervention was also assessed to analyze its influence on every outcome measure. All the outcome measures were assessed at the baseline and at four-week and four-month follow-ups. PNE plus usual care was more effective than usual care alone to increase self-efficacy beliefs and decrease pain intensity and pain interference at all follow-up points. No differences between groups were found in terms of analgesics consumption. Knowledge of pain neurophysiology did not modify the effects of PNE plus usual care in any of the outcome measures. These results should be taken with caution because of the non-randomized nature of this design, the limited follow-ups and the uncertainty of the presence of clinical changes in self-efficacy for participants. Larger, methodological sound trials are needed.

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Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098673 ◽

2018 ◽

Vol 53 (9) ◽

pp. 554-559 ◽

Cited By ~ 34

Author(s):

Alejandro Luque-Suarez ◽

Javier Martinez-Calderon ◽

Deborah Falla

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Chronic Musculoskeletal Pain ◽

Pain Severity ◽

Cross Sectional ◽

Pain Disability

Objective(1) To explore the level of association between kinesiophobia and pain, disability and quality of life in people with chronic musculoskeletal pain (CMP) detected via cross-sectional analysis and (2) to analyse the prognostic value of kinesiophobia on pain, disability and quality of life in this population detected via longitudinal analyses.DesignA systematic review of the literature including an appraisal of the risk of bias using the adapted Newcastle Ottawa Scale. A synthesis of the evidence was carried out.Data sourcesAn electronic search of PubMed, AMED, CINAHL, PsycINFO, PubPsych and grey literature was undertaken from inception to July 2017.Eligibility criteria for selecting studiesObservational studies exploring the role of kinesiophobia (measured with the Tampa Scale for Kinesiophobia) on pain, disability and quality of life in people with CMP.ResultsSixty-three articles (mostly cross-sectional) (total sample=10 726) were included. We found strong evidence for an association between a greater degree of kinesiophobia and greater levels of pain intensity and disability and moderate evidence between a greater degree of kinesiophobia and higher levels of pain severity and low quality of life. A greater degree of kinesiophobia predicts the progression of disability overtime, with moderate evidence. A greater degree of kinesiophobia also predicts greater levels of pain severity and low levels of quality of life at 6 months, but with limited evidence. Kinesiophobia does not predict changes in pain intensity.Summary/conclusionsThe results of this review encourage clinicians to consider kinesiophobia in their preliminary assessment. More longitudinal studies are needed, as most of the included studies were cross-sectional in nature.Trial registration numberCRD42016042641.

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