Are Illness Perceptions Associated with Pain and Disability in Complex Regional Pain Syndrome? A Cross-Sectional Study

Pain Medicine ◽  
2020 ◽  
Author(s):  
Dana R Antunovich ◽  
Juliette C Horne ◽  
Natalie L Tuck ◽  
Debbie J Bean

Abstract Objective Complex regional pain syndrome (CRPS) is a complex and often poorly understood condition, and people with CRPS will have diverse beliefs about their symptoms. According to the self-regulation model, these beliefs (termed “illness perceptions”) influence health behaviors and outcomes. Previous studies have found that psychological factors influence CRPS outcomes, but few studies have investigated CRPS patients’ illness perceptions specifically. The present study examined whether illness perceptions were related to pain intensity and other relevant outcomes in people with CRPS. Methods In this cross-sectional study, 53 patients with CRPS (type 1 and type 2) completed questionnaires assessing illness perceptions, pain, disability, and psychological factors. Multiple regression analyses were used to determine whether illness perceptions were associated with pain intensity, disability, depression, and kinesiophobia, after controlling for possible covariates (including clinical and demographic factors, pain catastrophizing, and negative affect). Results Negative illness perceptions were associated with greater pain, disability, and kinesiophobia, but not depression. Specifically, attributing more symptoms to CRPS (more negative illness identity perceptions) was associated with greater pain intensity, and reporting a poorer understanding of CRPS (lower illness coherence scores) was associated with greater disability and kinesiophobia. Conclusions Patients with CRPS with more negative illness perceptions (particularly perceptions indicating a poor understanding of their condition) also experience greater pain, disability, and kinesiophobia. Future research could investigate whether altering CRPS patients’ illness perceptions influences clinical outcomes.

2020 ◽  
Vol 9 (10) ◽  
pp. 3252
Author(s):  
Javier Martinez-Calderon ◽  
Mar Flores-Cortes ◽  
Susana Clavero-Cano ◽  
Jose Miguel Morales-Asencio ◽  
Mark P. Jensen ◽  
...  

This study aimed to test the cross-sectional mediating and moderating role that positive psychological factors play in the association between pain intensity and pain interference in individuals with chronic musculoskeletal pain. A descriptive cross-sectional study using mediation analyses was conducted, including 186 individuals with chronic musculoskeletal pain. We conducted cross-sectional mediation and moderation analyses to determine whether the positive psychological factors mediated or moderated the association between pain intensity and pain interference. Pain acceptance, pain self-efficacy, and optimism were all significantly and weakly related to pain interference when controlling for pain intensity. Pain self-efficacy and pain acceptance partially mediated the association between pain intensity and pain interference. On the other hand, the multiple mediation model did not show significant effects. The three positive psychological factors were not found to significantly moderate the association between pain intensity and pain interference. The findings suggest that in chronic musculoskeletal pain patients, the treatments may focus on [i] what they are capable of doing to manage the pain (i.e., pain self-efficacy) and [ii] being better able to accept the pain as pain waxes and wanes might be also particularly helpful. However, these results must be tested in longitudinal studies before drawing any causal conclusion.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Hayato Shigetoh ◽  
Yoichi Tanaka ◽  
Masayuki Koga ◽  
Michihiro Osumi ◽  
Shu Morioka

Background. Central sensitization (CS) and psychological factors are associated with pain intensity; however, the mediating role of CS on the relation between psychological factors and pain intensity remains unclear. Objectives. We performed mediation analysis to investigate how CS mediates relation between psychological factors and pain intensity. Methods. Twenty patients with musculoskeletal pain were included in this cross-sectional study. Central sensitization inventory (CSI), one pain intensity-related outcome measure (Short-Form McGill Pain Questionnaire 2 (SFMPQ2)), and three psychological outcome measures (Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale-4 (PCS), and Tampa Scale for Kinesiophobia-11 (TSK)) of all participants were assessed. The mediation analysis with a bootstrap sampling procedure was used to assess the indirect effects. The level of significance was set at 5%. Results. Mediation analysis showed that the HADS-anxiety, HADS-depression, and PCS had significant indirect effects on the pain ratings of CSI. Additionally, the direct effect was significant only for PCS. Conclusions. The relationship among anxiety symptoms, depression symptoms, and pain intensity was completely mediated by CS. Furthermore, the relationship between catastrophic thinking and pain intensity was partially mediated by CS. Our findings suggest that CS mediates relation between psychological factors and pain intensity, and CS-focused intervention may be important.


2017 ◽  
Vol 6 (01) ◽  
pp. 18
Author(s):  
Indri Wijayanti ◽  
I Nyoman Murdana ◽  
Tirza Z. Tamin

Background: Calcified tendeinitis is a disease characterized by calcification of multifocal cells mediated byliving tissue. Calcified tendeinitis may occur due to the collection of calcium in the pouch of supraspinatustendon or may spread between rotator cuff muscle fibers and bursa. This deposit may or may not cause pain ofdiscomfort. The study aim is to determine the correlation of calcium deposit size to the pain intensity in patientswith calcified tendinotis.Methods: A cross-sectional study, on subjects, were diagnosed with calcified tendinitis rotator cuff bymusculoskeletal ultrasonography examination.Results: The twenty subjects, aged 50-70 years old, No significant correlations were found between calciumdeposit size with the pain intensity using VAS, r=0.238, p=0.32.Conclusion. The size of the calcium deposit has not correlated with the pain intensity in rotator cuff calcifiedtendinitis patients. But further research is needed whether the location and form of calcium deposits affect thepain intensity in calcified tendinitis rotator cuff patients.Keywords: calcified tendinitis; calcium deposit size; pain intensity.


2019 ◽  
Vol 7 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Marchel S. Vetrile ◽  
Aleksandr A. Kuleshov ◽  
Nikolai A. Eskin ◽  
Mikhail B. Tsykunov ◽  
Alexey I. Kokorev ◽  
...  

Aim. We defined the prevalence of back pain in children and adolescents aged 917 years with spinal deformities. Material and methods. The cross-sectional study included 230 students with different spinal deformities aged 917 years. The prevalence of back pain, intensity, location, and situations in which it occurred were assessed via questionnaire. Results. Among 230 respondents, 186 (80.9%) admitted that they had experienced back pain (mainly in the lumbar spine) at various frequencies within the year preceding the study. Mild pain was prevalent (71% of respondents). Girls experienced back pain significantly more frequently than boys. Conclusions. Back pain in children and adolescents requires clinical and instrumental examination, including X-ray. Back pain is a frequent phenomenon in children with different spinal deformities. Тhe incidence of pain in children and adolescents with spinal deformities in our study is statistically higher than that of healthy individuals of the same age group.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031483 ◽  
Author(s):  
Socheat Cheng ◽  
Tahreem Ghazal Siddiqui ◽  
Michael Gossop ◽  
Espen Saxhaug Kristoffersen ◽  
Christofer Lundqvist

ObjectivesTimely recognition of medication misuse and dependence is crucial to avoid both adverse drug events and increasing health expenditure. Yet the detection of these disorders in older people remains challenging due to the paucity of evidence on characteristics of patients at risk. This study investigates sociodemographic, pharmacological and clinical characteristics and factors associated with prolonged medication use, misuse and dependence in hospitalised older patients, focusing on three commonly prescribed central nervous system depressants (CNSDs): opioid analgesics, benzodiazepines and z-hypnotics.DesignA prospective, cross-sectional study complying with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.SettingSomatic departments of the Akershus University Hospital, Norway.Participants246 patients aged 65–90 were included.Outcome measuresProlonged use was defined as using CNSDs for ≥4 weeks. Misuse and dependence were assessed with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria for substance abuse and dependence. We used descriptive statistics to report patients’ characteristics and logistic regression to demonstrate factors associated with prolonged use, and misuse or dependence.ResultsForty per cent of participants reported using CNSDs for ≥4 weeks. The odds of prolonged use were higher for patients aged 75–84 (OR=2.32, 95% CI 1.16 to 4.65) and ≥85 (OR=3.33, 95% CI 1.25 to 8.87) vs <75 years, for pain intensity (OR=1.02, 95% CI 1.01 to 1.04), and polypharmacy versus no polypharmacy (OR=5.16, 95% CI 2.13 to 12.55). The odds were lower for patients who completed secondary education (OR=0.33, 95% CI 0.13 to 0.83) compared with those with only basic education. Factors associated with misuse or dependence were pain intensity (OR=1.02, 95% CI 1.01 to 1.04) and concurrent use of ≥2 CNSDs (OR=3.99, 95% CI 1.34 to 11.88).ConclusionCNSD overuse is prevalent among hospitalised older patients, despite clear guidelines and recommendations. Our findings underline a need for stronger focus on responsible prescribing, timely detection and prevention of this issue, with special attention towards older patients, those with enhanced pain, polypharmacy and/or concurrent use of several CNSDs.Trial registration numberNCT03162081.


The Knee ◽  
2019 ◽  
Vol 26 (1) ◽  
pp. 165-173 ◽  
Author(s):  
Eleuterio A. Sánchez-Romero ◽  
Daniel Pecos-Martín ◽  
Cesar Calvo-Lobo ◽  
David García-Jiménez ◽  
Victoria Ochoa-Sáez ◽  
...  

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