171 Habitual Sleep Duration and Chronic Pain in the US Population Over A 10-Year Period: Implications for Sleep Health Disparities

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A69-A70
Author(s):  
Chloe Craig ◽  
Kathryn Kennedy ◽  
Sadia Ghani ◽  
Michael Perlis ◽  
Azizi Seixas ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Neck Pain ◽  
Sleep Duration ◽  
Joint Pain ◽  
Face Pain ◽  
Wide Range ◽  
The Us ◽  
Race Ethnicity ◽  
Pain Experiences

Abstract Introduction Chronic pain is linked with sleep disturbances, which worsen pain experiences. The nature of the bi-directional relationship between sleep and chronic pain has not been explored at the population level, especially among racial/ethnic minorities, a group disproportionately burdened by chronic pain. To address this gap, we investigated the relationship between sleep and chronic pain experiences in the US population and conducted race-stratified analyses. Methods Data from the CDC National Health Interview Survey (NHIS) was used, from 2007-2016. Sleep duration was categorized as <=4hrs, 5-6hrs, 7-8hrs, 9hrs, or 10+hrs. N=298,698 provided data for analysis. Chronic pain outcomes included arthritis, joint pain, neck pain, back pain, jaw/face pain, and migraines/headaches. Covariates included age, sex, body mass index, and employment status. Race/ethnicity was included as a covariate and interaction term, categorized as Non-Hispanic White, Black/African-American, Mexican-American, Other Hispanic/Latino, Asian/Pacific-Islander, Indian/Subcontinent, American Indian/Alaskan Native, and Multiracial/Other. Weighted logistic regression analyses examined sleep as predictor and pain as outcome, adjusted for covariates. Post-hoc analyses examined sleep-by-race/ethnicity interactions. Results Prevalence in the population was 24.7%, 40.0%, 4.8%, 15.7%, 29.5%, and 15.0% for arthritis and joint, jaw/face, neck, back, and migraine/headache pain. In adjusted analyses compared to 7-8hrs, arthritis was more likely among <=4hrs (OR=2.6,p<0.0005), 5-6hrs (OR=1.5,p<0.0005), 9hrs (OR=1.1,p=0.002), and 10+hrs (OR=1.2,p<0.0005). Joint pain was also more likely among <=4hrs (OR=2.8,p<0.0005), 5-6hrs (OR=1.6,p<0.0005), 9hrs (OR=1.1,p=0.002), and 10+hrs (OR=1.2,p<0.0005). Jaw/face pain was also more likely among <=4hrs (OR=3.0,p<0.0005), 5-6hrs (OR=1.6,p<0.0005), 9hrs (OR=1.2,p=0.001), and 10+hrs (OR=1.4,p<0.0005). Neck pain was more likely among <=4hrs (OR=3.0,p<0.0005), 5-6hrs (OR=1.6,p<0.0005), and 10+hrs (OR=1.2,p<0.0005). Back pain was also more likely among <=4hrs (OR=3.1,p<0.0005), 5-6hrs (OR=1.7,p<0.0005), and 10+hrs (OR=1.3,p<0.0005). Migraines/headaches were also more likely among <=4hrs (OR=3.6,P<0.0005), 5-6hrs (OR=1.8,P<0.0005), and 10+hrs (OR=1.4,P<0.0005). Significant sleep-by-race/ethnicity interactions were seen for joint (p=0.002), jaw (p<0.0005), and neck (p=0.002) pain, but not back pain (p=0.08), migraines/headaches (p=0.28), or arthritis (p=0.45). Conclusion Habitual short and long sleep are associated with a wide range of chronic pain conditions. Bidirectional relationships should be explored as a public health priority. Race/ethnicity interactions suggest that the sleep/pain experience differs by group (reasons should be explored). Support (if any) R01MD011600, R01DA051321, K24AG055602, R01AG041783

Western Medicine Treatments for Chronic Pain

2017 ◽  
Author(s):  
Judy Foreman
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Neck Pain ◽  
Western Medicine ◽  
Joint Pain ◽  
Low Back ◽  
Chronic Noncancer Pain ◽  
Noncancer Pain

Overall, how effective is Western medicine at treating chronic pain? Not very, which is especially discouraging for people with low back pain, headaches, joint pain, and neck pain—the biggest causes of chronic noncancer pain in America.1 Indeed, more than 28 percent of all...

scholarly journals Comprehensive Review of Epidemiology, Scope, and Impact of Spinal Pain

2009 ◽  
Vol 4;12 (4;7) ◽  
pp. E35-E70
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Neck Pain ◽  
Pain Syndrome ◽  
Spinal Pain ◽  
The United States ◽  
Low Back ◽  
Chronic Pain Syndrome

Persistent pain interfering with daily activities is common. Chronic pain has been defined in many ways. Chronic pain syndrome is a separate entity from chronic pain. Chronic pain is defined as, “pain that persists 6 months after an injury and beyond the usual course of an acute disease or a reasonable time for a comparable injury to heal, that is associated with chronic pathologic processes that cause continuous or intermittent pain for months or years, that may continue in the presence or absence of demonstrable pathologies; may not be amenable to routine pain control methods; and healing may never occur.” In contrast, chronic pain syndrome has been defined as a complex condition with physical, psychological, emotional, and social components. The prevalence of chronic pain in the adult population ranges from 2% to 40%, with a median point prevalence of 15%. Among chronic pain disorders, pain arising from various structures of the spine constitutes the majority of the problems. The lifetime prevalence of spinal pain has been reported as 54% to 80%. Studies of the prevalence of low back pain and neck pain and its impact in general have shown 23% of patients reporting Grade II to IV low back pain (high pain intensity with disability) versus 15% with neck pain. Further, age related prevalence of persistent pain appears to be much more common in the elderly associated with functional limitations and difficulty in performing daily life activities. Chronic persistent low back and neck pain is seen in 25% to 60% of patients, one-year or longer after the initial episode. Spinal pain is associated with significant economic, societal, and health impact. Estimates and patterns of productivity losses and direct health care expenditures among individuals with back and neck pain in the United States continue to escalate. Recent studies have shown significant increases in the prevalence of various pain problems including low back pain. Frequent use of opioids in managing chronic non-cancer pain has been a major issue for health care in the United States placing a significant strain on the economy with the majority of patients receiving opioids for chronic pain necessitating an increased production of opioids, and escalating costs of opioid use, even with normal intake. The additional costs of misuse, abuse, and addiction are enormous. Comorbidities including psychological and physical conditions and numerous other risk factors are common in spinal pain and add significant complexities to the interventionalist’s clinical task. This section of the American Society of Interventional Pain Physicians (ASIPP)/EvidenceBased Medicine (EBM) guidelines evaluates the epidemiology, scope, and impact of spinal pain and its relevance to health care interventions. Key words: Chronic pain, chronic spinal pain, chronic low back pain, chronic neck pain, chronic thoracic pain, prevalence, health care utilization, loss of productivity, interventional techniques, surgery, comorbid factors, socioeconomic effects, health care impact

scholarly journals Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain

2020 ◽  
Author(s):  
Chelsey Solar ◽  
Allison M Halat ◽  
R Ross MacLean ◽  
Haseena Rajeevan ◽  
David A Williams ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Cognitive Behavioral Therapy ◽  
Chronic Low Back Pain ◽  
Clinical Characteristics ◽  
Behavioral Therapy ◽  
Low Back ◽  
Race Ethnicity ◽  
Participant Characteristics

Abstract Internet-based interventions for chronic pain have demonstrated efficacy and may address access barriers to care. Participant characteristics have been shown to affect engagement with these programs; however, limited information is available about the relationship between participant characteristics and engagement with internet-based programs for self-management of chronic pain. The current study examined relationships between demographic and clinical characteristics and engagement with the Pain EASE program, a self-directed, internet-based cognitive behavioral therapy intervention for veterans with chronic low back pain (cLBP). Veterans with cLBP were enrolled in a 10 week trial of the Pain EASE program. Engagement measures included the number of logins, access to coping skill modules, and completed study staff-initiated weekly check-in calls. Regression analyses were conducted to identify significant predictors of engagement from hypothesized predictors (e.g., race/ethnicity, age, depressive symptom severity, and pain interference). Participants (N = 58) were 93% male, 60.3% identified as White, and had a mean age of 54.5 years. Participants logged into the program a median of 3.5 times, accessed a median of 2 skill modules, and attended a median of 6 check-in calls. Quantile regression revealed that, at the 50th percentile, non-White-identified participants accessed fewer modules than White-identified participants (p = .019). Increased age was associated with increased module use (p = .001). No clinical characteristics were significantly associated with engagement measures. White-identified race/ethnicity and increased age were associated with greater engagement with the Pain EASE program. Results highlight the importance of defining and increasing engagement in internet-delivered pain care.

Validation of the recently developed Total Disability Index: a single measure of disability in neck and back pain patients

2020 ◽  
Vol 32 (4) ◽  
pp. 533-541
Author(s):  
Dana L. Cruz ◽  
Ethan W. Ayres ◽  
Matthew A. Spiegel ◽  
Louis M. Day ◽  
Robert A. Hart ◽  
...  
Keyword(s):  
Back Pain ◽  
Neck Pain ◽  
Internal Consistency ◽  
Spinal Deformity ◽  
Intraclass Correlation ◽  
Neck Disability Index ◽  
Single Measure ◽  
Wide Range ◽  
Degree Of Disability ◽  
Neck Disability

OBJECTIVENeck and back pain are highly prevalent conditions that account for major disability. The Neck Disability Index (NDI) and Oswestry Disability Index (ODI) are the two most common functional status measures for neck and back pain. However, no single instrument exists to evaluate patients with concurrent neck and back pain. The recently developed Total Disability Index (TDI) combines overlapping elements from the ODI and NDI with the unique items from each. This study aimed to prospectively validate the TDI in patients with spinal deformity, back pain, and/or neck pain.METHODSThis study is a retrospective review of prospectively collected data from a single center. The 14-item TDI, derived from ODI and NDI domains, was administered to consecutive patients presenting to a spine practice. Patients were assessed using the ODI, NDI, and EQ-5D. Validation of internal consistency, test-retest reproducibility, and validity of reconstructed NDI and ODI scores derived from TDI were assessed.RESULTSA total of 252 patients (mean age 55 years, 56% female) completed initial assessments (back pain, n = 115; neck pain, n = 52; back and neck pain, n = 55; spinal deformity, n = 55; and no pain/deformity, n = 29). Of these patients, 155 completed retests within 14 days. Patients represented a wide range of disability (mean ODI score: 36.3 ± 21.6; NDI score: 30.8 ± 21.8; and TDI score: 34.1 ± 20.0). TDI demonstrated excellent internal consistency (Cronbach’s alpha = 0.922) and test-retest reliability (intraclass correlation coefficient = 0.96). Differences between actual and reconstructed scores were not clinically significant. Subanalyses demonstrated TDI’s ability to quantify the degree of disability due to back or neck pain in patients complaining of pain in both regions.CONCLUSIONSThe TDI is a valid and reliable disability measure in patients with back and/or neck pain and can capture each spine region’s contribution to total disability. The TDI could be a valuable method for total spine assessment in a clinical setting, and its completion is less time consuming than that for both the ODI and NDI.

Spinal problems

2019 ◽  
pp. 557-570
Author(s):  
Manoj Sivan ◽  
Margaret Phillips ◽  
Ian Baguley ◽  
Melissa Nott
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Neck Pain ◽  
Spinal Canal ◽  
Intervertebral Discs ◽  
Trunk Muscles ◽  
Low Back ◽  
Facet Joints ◽  
Nerve Roots ◽  
Different Types

Low back and neck pain are extremely common symptoms in modern societies. The pain may result from abnormalities occurring within the trunk muscles, the vertebrae, the intervertebral discs, the facet joints, and the ligaments and from the spinal canal and the nerve roots themselves. Pain may also be referred from distant sites—such as the abdomen—and in some cases may be functional or psychogenic in nature. Pain can be described as acute or chronic; pain present for more than 3 months is considered as chronic. This chapter describes the assessment and management of different types of back pain.

scholarly journals 0888 Sleep Duration And Diabetes In The Us For 2007–2015: Moderation By Age, Sex, Race/ethnicity, And Body Mass Index

SLEEP ◽  
2018 ◽  
Vol 41 (suppl_1) ◽  
pp. A330-A330
Author(s):  
O Liang ◽  
A Seixas ◽  
W Killgore ◽  
J Gehrels ◽  
P Alfonso-Miller ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleep Duration ◽  
Body Mass ◽  
The Us ◽  
Race Ethnicity

scholarly journals Nutraceutical Alternatives to Pharmaceutical Analgesics in Osteoarthritis

2021 ◽  
Author(s):  
Shane M. Heffernan ◽  
Gillian E. Conway
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Physical Function ◽  
Joint Pain ◽  
Cardiovascular Events ◽  
Health Concern ◽  
Western World ◽  
Gastrointestinal Complications ◽  
The Us ◽  
Analgesic Use

Chronic pain is a considerable health concern worldwide, effecting almost 30% of all European adults. Osteoarthritis (OA), a progressive pro-inflammatory condition, is one of the leading causes of chronic pain (effecting 13% of all those over 50 years, globally) and is the most common cause of joint pain. The prevalence of non-steroidal anti-inflammatory drug (NSAIDs) and analgesic use has been well studied and is abundant throughout the western world, with women being the greatest users and ibuprofen generally being the most reported NSAID. In the US, 65% of all OA patients are prescribed NSAIDs for pain management and form part of the current recommended strategy for OA clinical management. While some NSAIDs and analgesics are effective at improving pain and physical function, they come with significant and harmful side effects such as gastrointestinal complications, renal disturbances and severe cardiovascular events. Given these side-effects, any reduction in NSAID and analgesia use (and the resulting potentially harmful side effects) is of particular importance to OA public health. As such, a number of non-pharmaceutical alternatives (bioactive nutraceuticals) have been developed that may reduce NSAID and analgesia use while maintaining pain reduction and improvements in physical function. This chapter will discuss select nutraceuticals that are not currently in mainstream use but may have the potential to aid in the treatment of OA.

scholarly journals Individually Unique Dynamics of Cortical Connectivity Reflect the Ongoing Intensity of Chronic Pain

2021 ◽  
Author(s):  
Astrid Mayr ◽  
Pauline Jahn ◽  
Bettina Deak ◽  
Anne Stankewitz ◽  
Vasudev Devulapally ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Back Pain ◽  
Personalised Medicine ◽  
Brain Regions ◽  
Cortical Connectivity ◽  
Wide Range ◽  
The Individual ◽  
Pain Patients

Background. Chronic pain diseases are characterised by an ongoing and fluctuating endogenous pain, yet it remains to be elucidated how this is reflected by the dynamics of ongoing functional cortical connections. The present study addresses this disparity by taking the individual perspective of pain patients into account, which is the varying intensity of endogenous pain. Methods. To this end, we investigated the cortical encoding of 20 chronic back pain patients and 20 chronic migraineurs in four repeated fMRI sessions. During the recording, the patients were asked to continuously rate their pain intensity. A brain parcellation approach subdivided the whole brain into 408 regions. A 10 s sliding-window connectivity analysis computed the pair-wise and time-varying connectivity between all brain regions across the entire recording period. Linear mixed effects models were fitted for each pair of brain regions to explore the relationship between cortical connectivity and the observed trajectory of the patients' fluctuating endogenous pain. Results. Two pain processing entities were taken into account: pain intensity (high, middle, low pain) and the direction of pain intensity changes (rising vs. falling pain). Overall, we found that periods of high and increasing pain were predominantly related to low cortical connectivity. For chronic back pain this applies to the pain intensity-related connectivity for limbic and cingulate areas, and for the precuneus. The change of pain intensity was subserved by connections in left parietal opercular regions, right insular regions, as well as large parts of the parietal, cingular and motor cortices. The change of pain intensity direction in chronic migraine was reflected by decreasing connectivity between the anterior insular cortex and orbitofrontal areas, as well as between the PCC and frontal and ACC regions. Conclusions. Interestingly, the group results were not mirrored by the individual patterns of pain-related connectivity, which is suggested to deny the idea of a common neuronal core problem for chronic pain diseases. In a similar vein, our findings are supported by the experience of clinicians, who encounter patients with a unique composition of characteristics: personality traits, various combinations of symptoms, and a wide range of individual responses to treatment. The diversity of the individual cortical signatures of chronic pain encoding results adds to the understanding of chronic pain as a complex and multifaceted disease. The present findings support recent developments for more personalised medicine.

scholarly journals 0226 Sleep Duration and Symptoms Associated with Race/Ethnicity in Elite Collegiate Athletes

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A87-A88
Author(s):  
T Ramsey ◽  
A Athey ◽  
A Auerbach ◽  
R Turner ◽  
N Williams ◽  
...  
Keyword(s):  
General Population ◽  
Sleep Duration ◽  
American Indians ◽  
Collegiate Athletes ◽  
Early Morning ◽  
Depression Score ◽  
Sleep Paralysis ◽  
Falling Asleep ◽  
Wide Range ◽  
Race Ethnicity

Abstract Introduction Previous studies have documented sleep disparities in the general population. Given the increased interest in sleep among athletes, and the degree to which demographics and schedules among athletes differ from the general population, this analysis aims to examine the relationship between race/ethnicity and sleep duration and symptoms among elite college athletes. Methods Data were obtained from N=189 Division-1 collegiate athletes across a wide range of sports played. Race/ethnicity was self-reported and categorized as Non-Hispanic White, Black/African-American, Hispanic/Latino, Asian, and American Indian/Alaskan Native. Outcomes of interest included self-reported typical sleep duration (in hours), CESD depression score, and frequency of sleep symptoms, assessed using items from the Sleep Disorders Symptom Check List (difficulty falling asleep, difficulty staying asleep, early morning awakenings, tiredness, sleepiness, loud snoring, choking/gasping, fragmentation, hypnogogic/pompic hallucinations, sleep paralysis, and nightmares). Sleep duration and depression were evaluated with linear regression, and symptoms were evaluated as ordinal. Covariates included age and sex. Results Compared to Non-Hispanic Whites, Blacks/African-Americans reported less sleep (B=-0.80, p<0.0005), more depression (B=2.85, p=0.046), more difficulty maintaining sleep (oOR=2.12, p=0.034), early morning awakenings (oOR=3.15, p=0.001), and sleepiness (oOR=2.11, p=0.048); Hispanic/Latinos reported more hypnogogic/pompic hallucinations (oOR=2.90, p=0.007), sleep paralysis (oOR=2.72, p=0.026), and nightmares (oOR=2.22, p=0.035); Asians reported more depression (B=4.46, p=0.028), sleepiness (oOR=5.06, p=0.003), loud snoring (oOR=4.71, p=0.018), and sleep paralysis (oOR=3.57, p=0.031); and American Indians/Alaskan Natives reported less sleep (B=-1.00, p=0.018). Conclusion Racial/ethnic differences in sleep duration and sleep symptoms were seen among athletes. Future studies will be needed to replicate and further explain these findings. Support The REST study was funded by an NCAA Innovations grant. Dr. Grandner is supported by R01MD011600

Chronic Pain Experiences Survey

2005 ◽  
Author(s):  
Marisa Nguyen ◽  
Carlos Ugarte ◽  
Ivonne Fuller ◽  
Gregory Haas ◽  
Russell K. Portenoy
Keyword(s):  
Chronic Pain ◽  
Pain Experiences
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