scholarly journals P36 Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: a qualitative systematic review and thematic synthesis

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Sonia Khanom ◽  
John McBeth ◽  
Michelle Briggs ◽  
Ebru Bakir ◽  
Janet McDonagh
Keyword(s):  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Conflicts Of Interest ◽  
Chronic Musculoskeletal Pain ◽  
Future Research ◽  
Daily Fluctuation ◽  
Pain Experience ◽  
Thematic Synthesis ◽  
Normal Fluctuations ◽  
The Impact

Abstract Background Adolescents with chronic musculoskeletal pain experience pain that fluctuates within and across days. The aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders, (ii) identify the concept of pain flare and how this may differ from daily fluctuation of pain, and (ii) identify knowledge gaps to inform the design of future research. Methods Six electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, OpenGrey and Scopus) and reference lists of relevant articles were searched from inception to June 2018. Articles were eligible for inclusion if they were qualitative studies exploring the experiences of pain in adolescents, aged between 10–19 years, diagnosed with juvenile idiopathic arthritis (JIA) and chronic idiopathic pain syndromes (CIPS). Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research (COREQ) framework, and studies were analysed using thematic synthesis. Results Of the 3,787 records identified, 32 studies were included from 11 countries. 536 young people with JIA or CIPS participated in the studies, of which 509 had a diagnosis of JIA, and 27 with CIPS. Interviews were conducted in 29 studies, with 9 studies also combining interviews with focus groups, observations, questionnaires, researcher journaling, visual depictions and diaries. Although all included studies reported adolescent’s experience of pain, only 19 studies provide insight into the impact of fluctuating pain on an individual’s life and lived experience. 21 studies included data from parents, siblings, health professionals and/or individuals with other chronic illnesses, but efforts were made to only extract data referring to or expressed by adolescents with JIA or CIPS. Ages of patients ranged from 3 to 23 years, but all studies averaged within the adolescent range. Principal findings were synthesised under three themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. These themes can be seen to describe a journey through which the adolescent experiences fluctuating pain and associated symptoms, encounters the challenges to lifestyle that fluctuating pain presents, followed by employing coping strategies to regain a sense of control of their lives and pain. Each stage is experienced differently depending on individual factors such as adolescents’ developmental status, pain condition, and duration of the pain experience. Conclusion Adolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It is not clear whether these symptoms and challenges are experienced as part of normal fluctuations in pain, or whether they reflect symptom exacerbations classified as flares. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their normal fluctuations in pain. Conflicts of Interest The authors declare no conflicts of interest.

scholarly journals Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: A qualitative systematic review and thematic synthesis

2020 ◽  
Author(s):  
Sonia Khanom ◽  
Janet E McDonagh ◽  
Michelle Briggs ◽  
Ebru Bakir ◽  
John McBeth
Keyword(s):  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Grey Literature ◽  
Background Level ◽  
Chronic Musculoskeletal Pain ◽  
Future Research ◽  
Symptom Experience ◽  
Health Service Provision ◽  
Pain Experience ◽  
Thematic Synthesis

Abstract Background Adolescents with chronic musculoskeletal pain experience daily fluctuations in pain. Although not all fluctuations are bothersome, pain flares are a distinct type of symptom fluctuation with greater impact. Since literature on the experience of pain flares is non-existent, the aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders in order to (ii) identify knowledge gaps to inform future research on pain flares. Methods Electronic databases (CINAHL, MEDLINE, EMBASE, PsycINFO), grey literature and reference lists were searched from inception to June 2018 for qualitative studies reporting adolescents’ experiences of pain. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research. Studies were analysed using thematic synthesis.Results Of the 3787 records identified, 32 studies (n= 536) were included. Principal findings were synthesised under three key themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. The first theme (symptom experience) describes adolescent’s perception and interpretation of pain fluctuations. The second theme (disruption and loss) describes the physical, social and emotional constraints faced as a result of changes in pain. The third theme (regaining control) describes coping strategies used to resist and accommodate unpredictable phases of pain. Each theme was experienced differently depending on adolescents’ characteristics such as their developmental status, pain condition, and the duration of the pain experience.Conclusions Adolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It was not clear whether these symptoms and challenges were experienced as part of ‘typical’ fluctuations in pain, or whether they reflect symptom exacerbations classified as ‘flares’. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their typical fluctuations in pain. The review also highlights areas relating to the pain experience, symptom management and health service provision that require further exploration to support more personalised, tailored care for adolescents with chronic musculoskeletal pain.

scholarly journals Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: A qualitative systematic review and thematic synthesis

2020 ◽  
Author(s):  
Sonia Khanom ◽  
Janet E McDonagh ◽  
Michelle Briggs ◽  
Ebru Bakir ◽  
John McBeth
Keyword(s):  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Grey Literature ◽  
Background Level ◽  
Distinct Type ◽  
Chronic Musculoskeletal Pain ◽  
Future Research ◽  
Symptom Experience ◽  
Pain Experience ◽  
Thematic Synthesis

Abstract Objectives Adolescents with chronic musculoskeletal pain experience daily fluctuations in pain. Although not all fluctuations are bothersome, pain flares are a distinct type of symptom fluctuation with greater impact. Since literature on the experience of pain flares is non-existent, the aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders in order to (ii) identify knowledge gaps to inform future research on pain flares. Methods Electronic databases (CINAHL, MEDLINE, EMBASE, PsycINFO), grey literature and reference lists were searched from inception to June 2018 for qualitative studies reporting adolescents’ experiences of pain. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research. Studies were analysed using thematic synthesis. Results Of the 3787 records identified, 32 studies (n= 536) were included. Principal findings were synthesised under three themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. Each theme was experienced differently depending on adolescents’ characteristics such as their developmental status, pain condition, and the duration of the pain experience. Conclusions Adolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It was not clear whether these symptoms and challenges were experienced as part of ‘typical’ fluctuations in pain, or whether they reflect symptom exacerbations classified as ‘flares’. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their typical fluctuations in pain.

scholarly journals Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: a qualitative systematic review and thematic synthesis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sonia Khanom ◽  
Janet E. McDonagh ◽  
Michelle Briggs ◽  
Ebru Bakir ◽  
John McBeth
Keyword(s):  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Grey Literature ◽  
Background Level ◽  
Chronic Musculoskeletal Pain ◽  
Future Research ◽  
Symptom Experience ◽  
Health Service Provision ◽  
Pain Experience ◽  
Thematic Synthesis

Abstract Background Adolescents with chronic musculoskeletal pain experience daily fluctuations in pain. Although not all fluctuations are bothersome, pain flares are a distinct type of symptom fluctuation with greater impact. Since literature on the experience of pain flares is non-existent, the aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders in order to (ii) identify knowledge gaps to inform future research on pain flares. Methods Electronic databases (CINAHL, MEDLINE, EMBASE, PsycINFO), grey literature and reference lists were searched from inception to June 2018 for qualitative studies reporting adolescents’ experiences of pain. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research. Studies were analysed using thematic synthesis. Results Of the 3787 records identified, 32 studies (n = 536) were included. Principal findings were synthesised under three key themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. The first theme (symptom experience) describes adolescent’s perception and interpretation of pain fluctuations. The second theme (disruption and loss) describes the physical, social and emotional constraints faced as a result of changes in pain. The third theme (regaining control) describes coping strategies used to resist and accommodate unpredictable phases of pain. Each theme was experienced differently depending on adolescents’ characteristics such as their developmental status, pain condition, and the duration of the pain experience. Conclusions Adolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It was not clear whether these symptoms and challenges were experienced as part of ‘typical’ fluctuations in pain, or whether they reflect symptom exacerbations classified as ‘flares’. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their typical fluctuations in pain. The review also highlights areas relating to the pain experience, symptom management and health service provision that require further exploration to support more personalised, tailored care for adolescents with chronic musculoskeletal pain.

scholarly journals Cost of Waiting on an Orthopaedic Waiting List: a scoping review

2017 ◽  
Vol 12 (2) ◽  
pp. 42-54 ◽  
Author(s):  
Joanne Morris ◽  
Asterie Twizeyemariya ◽  
Karen Grimmer
Keyword(s):  
Quality Of Life ◽  
Musculoskeletal Disorders ◽  
Health Management ◽  
Data Extraction ◽  
Indirect Costs ◽  
Waiting List ◽  
Future Research ◽  
Patient Journey ◽  
The Impact

Background: Approximately 30% Australians suffer from arthritis and other musculoskeletal disorders. From 2003-2033 there is a predicted 223% increase in expenditure on health management of musculoskeletal disorders. There is evidence of increasing prevalence of orthopaedic complaints, in longer waiting lists for specialist consultations in public hospital outpatient clinics. Little is known about the costs and ramifications of waiting for orthopaedic consultations. Aim: Establish what is known about the direct and indirect costs of being placed on a waiting list for an orthopaedic consultation. Method: Patient and Outcome search strategy of Medline, Embase, Pubmed, NHS Economic evaluation database (NHS-EED) from each database inception date. Handsearching of reference lists of included papers alsooccurred. A realist synthesis framework underpinned the review, using a ubiquitous patient journey to map available literature on the impact of waiting. Hierarchy of evidence was reported using NHMRC criteria andarticles critically appraised using either the PEDRo or CASP criteria (relevant to the design). A purpose-built data extraction instrument was developed. Results: We identified 786 studies, of which 139 were relevant, including a systematic review (Hoogeboom et al) with 15 included articles which were added to the list of eligible papers (and the review itself deleted), leaving 153 included articles; 17 were relevant to the review. Fourteen papers reported on quality of life and four reported on costs, two of these papers reported on both and all were of low to moderate quality. The research was not based on a comprehensive understanding of the stages of waiting, and there were inconclusive outcomes for quality of life and cost. Conclusion: There is scant evidence of the impact on quality of life and costs of waiting for orthopaedic outpatient appointments. Future research should aim for improved methodological quality and use patientfocused quality of life measures, and validated measures of cost. Abbreviations: NHMRC – National Health and Medical Research Council; PROMS – Patient Related Outcome Measures; QoL – Quality of Life; WOMAC – Western Ontario and McMaster Universities Osteoarthritis Index; YLD – Years Lived With Disability

scholarly journals Musculoskeletal pain in professional symphony orchestra musicians

2021 ◽  
Vol 15 (2) ◽  
pp. 1-6
Author(s):  
Antonina Kaczorowska ◽  
Agata Mroczek ◽  
Ewelina Lepsy ◽  
Magdalena Kornek ◽  
Agnieszka Kaczorowska ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Body Mass ◽  
Musculoskeletal System ◽  
Symphony Orchestra ◽  
Body Height ◽  
Future Research ◽  
Professional Musicians ◽  
Positive Correlations

Background: A musician’s many years of professional experience may contribute to the development of pain and musculoskeletal disorders. There are a few studies in Poland on gender differences in musculoskeletal pain among adult professional musicians. Aim of the study: This study aimed to assess and compare pain in Polish women and men who are professional musicians, as well as to analyze the relationships between the intensity and frequency of pain and the time spent playing each week and the experience of playing the instrument in years. Material and methods: Sixty professional musicians were examined (26 men and 34 women). Pain intensity was assessed using the visual analog scale (VAS). Participants reported the frequency of musculoskeletal system ailments, the location of the pain, the number of hours of playing the instrument per week, and the playing experience in years. In addition, body weight and height were measured and body mass index (BMI) was calculated. Results: Most of the participants (94% of women and 69% of men) reported pain in the musculoskeletal system (p=0.010). Women experienced significantly greater pain in the musculoskeletal system assessed using the VAS (p=0.036), and also declared pain significantly more often compared to men (p=0.002). Significant positive correlations were found between frequency of symptoms per week with the number of hours of playing per week (r=0.28), year of playing the instrument (r=0.38), and pain assessment on the VAS (r=0.57). Moreover, negative correlations were found between frequency of symptoms per week with body height (r=–0.45) and body mass (r=–0.36). Conclusions: Musculoskeletal disorders are very common among professional musicians, especially among women. In general, the greater the number of hours playing per week and the longer the history of playing, the greater the pain intensity. Future research should aim to evaluate the prevalence and risk factors of musculoskeletal disorders associated with playing an instrument in different groups of musicians.

CHARACTERISTICS OF WORK RELATED MUSCULOSKELETAL DISORDERS IN COMANDOS

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Nguyen Huu Ben ◽  
Phan Van Manh ◽  
Bui Duy Hoan ◽  
Vu Quang Phong ◽  
Nguyen Van Khoi ◽  
...  
Keyword(s):  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Descriptive Study ◽  
Chronic Musculoskeletal Pain ◽  
Cross Sectional ◽  
Work Related ◽  
Lower Back ◽  
Work Related Musculoskeletal Disorders ◽  
Low Rate

Objective: To describe the characteristics of work related musculoskeletal disorders in commandos. Subjects and methods: A cross-sectional descriptive study on 1,500 servicemen of the comando forces participating in the investigation of musculoskeletal disorders. Results: The prevalence of chronic musculoskeletal pain (in 12 months) was 60% of which the pain was mainly found in the nape, shoulder and lower back. Chronic musculoskeletal pain having to leave work only had a low rate (17,73%), most in the lower back with 9.40%. The nape and lower back had the highest rate of acute musculoskeletal pain, 21.40% and 21.27%, respectively. The Comandos soldiers worked mainly in standing and sitting positions. High REBA scores associated with musculoskeletal pain in the neck, elbows, wrists or hands, upper and lower back, thighs, and knees. Conclusion: The rate of musculoskeletal disorders in the commandos was 60%, of which the nape, shoulder, and lower back are the areas with the highest rate of musculoskeletal pain. Standing and sitting are the two main working positions of commandos. High REBA scores are associated with musculoskeletal pain in commandos.

MUSCULOSKELETAL COMPLAINTS AMONG HIGH SCHOOL TEACHERS

2013 ◽  
Vol 16 (02) ◽  
pp. 1350010 ◽  
Author(s):  
Ghorbanali Mohammadi
Keyword(s):  
High School ◽  
Musculoskeletal Disorders ◽  
High School Teachers ◽  
Occupational Injury ◽  
Work Productivity ◽  
Indirect Costs ◽  
Future Research ◽  
School Teachers ◽  
Musculoskeletal Problems ◽  
The Impact

Musculoskeletal disorders represent one of the leading causes of occupational injury and disability in the developed and industrially developing countries. The prevalence of musculoskeletal disorders (MSDs) among Iranian high school teachers was determined by using Nordic questionnaires as the diagnostic tool. Data on MSDs were analyzed in 231 high school teachers. The survey was performed four times, twice every year. The MSDs were defined using three definitions, based on the frequency, duration and pain intensity of the symptoms. Symptoms causing work interference in the last 12 months were reported by 35% male and 15% female participants at baseline. Low back symptoms were the most common cause of work impairment (male = 69%, female = 77%), followed by equality pain in the neck. Based on the participants report, during the last 24 months there were totally 35% male and 15% female days of sick leave due to MSDs. The study confirms that the high prevalence of musculoskeletal problems may prevent teachers from doing their jobs, resulting in work absenteeism, may decrease work productivity, and may incur direct and indirect costs. Future research will examine the impact of organizational of work.

Examining the Influence of Care-Recipient Resistance on Family Caregiver Emotional and Physical Well-Being: Average Frequency Versus Daily Fluctuation

2016 ◽  
Vol 37 (2) ◽  
pp. 203-227 ◽  
Author(s):  
Yumi Shirai ◽  
Susan Silverberg Koerner
Keyword(s):  
Physical Health ◽  
Repeated Measures ◽  
Well Being ◽  
Average Frequency ◽  
The United States ◽  
Care Recipient ◽  
Future Research ◽  
Daily Fluctuation ◽  
Health Symptoms ◽  
The Impact

Although existing cross-sectional research suggests that dependent older family members’ resistive behavior (care-recipient [CR] resistance: verbal or nonverbal rejection or resistance toward caregiver [CG] assistance) can be challenging for informal family CGs, we know little about the impact of the occurrence patterns of CR-resistance—average frequency versus daily fluctuation—on CG emotional and physical well-being. To document CGs’ daily experiences with CR-resistance and their emotional and physical well-being, the present study applied short-term repeated measures, collecting data on 8 consecutive days from 63 CGs in Southern Arizona, the United States. Multilevel modeling of the daily data revealed that neither average frequency nor daily fluctuation in CR-resistance alone had a significant impact on CG emotional/physical health. However, the combination of experiencing relatively high frequency and high daily fluctuation in CR-resistance was associated with significant increases in CG physical health symptoms ( b = .34, p < .01). Specifically, on days when a CG faced more CR-resistance than his or her usual amount, significant increases in physical health symptoms existed for CGs with relatively high average frequency of CR-resistance, but not for CGs with relatively low average frequency of CR-resistance. Based on our results, it appears that monitoring and maintaining a reasonable level of CR-resistance are effective strategies to maintain CG resilience to the negative impact of CR-resistance daily fluctuation. The findings are interpreted in light of Stress Theory, and recommendations for future research and practical interventions are offered.

scholarly journals Prevalence, burden of disease, and lost in health state utilities attributable to chronic musculoskeletal disorders and pain in Chile

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pedro Zitko ◽  
Norberto Bilbeny ◽  
Carlos Balmaceda ◽  
Tomas Abbott ◽  
Cesar Carcamo ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Chronic Low Back Pain ◽  
Population Level ◽  
Chronic Musculoskeletal Pain ◽  
Health State ◽  
Low Back ◽  
Health State Utilities

Abstract Background Musculoskeletal disorders are a leading cause of disability adjusted life years (DALY) in the world. We aim to describe the prevalence and to compare the DALYs and loss of health state utilities (LHSU) attributable to common musculoskeletal disorders in Chile. Methods We used data from the Chilean National Health Survey carried out in 2016–2017. Six musculoskeletal disorders were detected through the COPCOPRD questionnaire: chronic musculoskeletal pain, chronic low back pain, chronic shoulder pain, osteoarthritis of hip and knee, and fibromyalgia. We calculated the DALY for each disorder for 18 sex and age strata, and LHSU following an individual and population level approaches. We also calculated the fraction of LHSU attributable to pain. Results Chronic musculoskeletal pain disorder affects a fifth of the adult population, with a significant difference between sexes. Among specific musculoskeletal disorders highlights chronic low back pain with the highest prevalence. Musculoskeletal disorders are a significant cause of LHSU at the individual level, especially in the case of fibromyalgia. Chronic musculoskeletal pain caused 503,919 [283,940 - 815,132] DALYs in 2017, and roughly two hundred thousand LSHU at population level, which represents 9.7% [8.8–10.6] of the total LSHU occurred in that year. Discrepancy in the burden of musculoskeletal disorders was observed according to DALY or LSHU estimation. The pain and discomfort domain of LHSU accounted for around half of total LHSU in people with musculoskeletal disorders. Conclusion Chronic musculoskeletal pain is a major source of burden and LHSU. Fibromyalgia should deserve more attention in future studies. Using the attributable fraction offers a straightforward and flexible way to explore the burden of musculoskeletal disorders.

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