Phenotypic features of patients with complex regional pain syndrome compared with those with neuropathic pain

2019 ◽  
Vol 44 (9) ◽  
pp. 881-885
Author(s):  
Osman H Alam ◽  
Bilal Zaidi ◽  
Jennifer Pierce ◽  
Stephanie E Moser ◽  
Paul E Hilliard ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Complex Regional Pain Syndrome ◽  
Physical Disability ◽  
Pain Syndrome ◽  
Cross Sectional Study ◽  
Pain Severity ◽  
Medium Effect ◽  
Cross Sectional ◽  
Affective Distress ◽  
Pain Symptoms

IntroductionWe hypothesized that patients with complex regional pain syndrome (CRPS) would describe a more negative pain phenotype including higher pain severity, more neuropathic pain descriptors, more centralized pain symptoms, poorer physical function, and more affective distress when compared with patients with neuropathic pain of the extremities not meeting CRPS criteria.Materials and methodsThis was a retrospective cross-sectional study conducted at a tertiary pain center. The sample included 212 patients who met Budapest Criteria for CRPS and 175 patients with neuropathic pain of the extremities who did not meet criteria. All patients completed a packet of questionnaires before their initial visit containing validated outcome measures assessing pain severity, pain interference, physical functioning, depression, anxiety, and catastrophizing.ResultsPatients with CRPS reported higher physical disability (p=0.022) and more neuropathic pain symptoms (p=0.002) than patients not meeting CRPS criteria, but the groups did not otherwise differ significantly. There were no significant differences in pain severity or affective distress, despite power analyses suggesting the ability to detect small to medium effect sizes (d=0.29; w=0.14). Subanalyses of differences in neuropathic pain symptoms revealed that patients with CRPS, compared with patients not meeting CRPS criteria, were more likely to report pain with light touch (p=0.003), sudden pain attacks (p=0.003), pain with cold or heat (p=0.002), sensation of numbness (p=0.042), and pain with slight pressure (p=0.018).DiscussionCounter to our hypothesis, the present study suggests that patients with CRPS do not have a worse clinical phenotype compared with patients not meeting CRPS criteria, with the exception of higher physical disability and more neuropathic pain symptoms. This corresponds to recent evidence that patients with CRPS are similar to other patient populations with chronic pain.

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
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Psychological Factors ◽  
Illness Perceptions ◽  
Pain Syndrome ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Disability ◽  
Regulation Model

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.

scholarly journals Prevalence of Neuropathic Pain and Related Characteristics in Hidradenitis Suppurativa: A Cross-Sectional Study

2020 ◽  
Vol 9 (12) ◽  
pp. 4046
Author(s):  
Simone Garcovich ◽  
Simona Muratori ◽  
Chiara Moltrasio ◽  
Agata Alba Buscemi ◽  
Giulia Giovanardi ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Hidradenitis Suppurativa ◽  
Specific Treatment ◽  
Cross Sectional Study ◽  
Pain Severity ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Reported ◽  
Reported Data

Background: Pain is a core symptom of hidradenitis suppurativa (HS) and is of complex, multifactorial origin. HS patients frequently report typical neuropathic pain qualities, but its prevalence has been poorly described. Methods: In this cross-sectional study, we examine the prevalence of neuropathic pain (NP) component and related pain-characteristics of a hospital-based cohort of patients with symptomatic HS. We administered the pain-DETECT tool (PDQ), a validated screening tool for NP, collecting clinical and patient-reported data on pain, pruritus and pain-management. We obtained 110 complete datasets from symptomatic HS patients (49.1% females; Hurley I (27.3%])–II (45.5%)–III (27.3%)). According to the PDQ tool, 30% of patients were classified with a high probability (>90%) of neuropathic pain (LNP). LNP status was significantly associated with increased pain severity, disease activity, pruritus intensity and use of pain medication. Regression analysis showed a significant impact of the PDQ score on patient-reported outcomes, including pain severity and the dimensions of activity and affective pain interference. HS patients may present a mixed chronic pain phenotype with a neuropathic component, thus requiring additional pain-assessments. A multi-modal approach to pain management, in combination with disease-specific treatment, should be implemented in future interventional studies.

scholarly journals Is There a Neuropathic-Like Component to Endometriosis-Associated Pain? Results From a Large Cohort Questionnaire Study

2021 ◽  
Vol 2 ◽  
Author(s):  
Lydia Coxon ◽  
Katja Wiech ◽  
Katy Vincent
Keyword(s):  
Neuropathic Pain ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Sensory Profile ◽  
Cross Sectional ◽  
Psychological Measures ◽  
Chronic Inflammatory Condition ◽  
History Of ◽  
New Perspective ◽  
Pain Symptoms

Background: Pain is one of the primary symptoms of endometriosis, a chronic inflammatory condition characterised by the presence of endometrial tissue outside the uterus. Endometriosis-associated pain is commonly considered as nociceptive in nature, but its clinical presentation suggests that it might have neuropathic-like properties in a subgroup of patients.Methods: This is a cross sectional study using an online survey. The survey was distributed by patient support websites. The survey was composed of validated questionnaires assessing pain symptoms, psychological measures and questions about number of surgeries.Main Results: We had 1,417 responses which met the inclusion criteria. Using standard painDETECT cut-off scores, we found that pain was classified as neuropathic in 40% of patients and as mixed neuropathic/nociceptive in a further 35%. In line with observations in other neuropathic conditions, the neuropathic subgroup reported higher pain intensities, greater psychological distress and cognitive impairment. Neuropathic pain was also more likely in those with more surgeries to the abdomen and a longer history of pain. As revealed by a cluster analysis, those with a neuropathic pain component could further be divided into two subgroups based on their sensory profile.Conclusions: The data presented here indicate that endometriosis-associated pain includes a neuropathic-like component in a substantial proportion of women. Although further investigation is required, our finding challenges the current conceptualisation of endometriosis-associated pain as nociceptive and advocates for a new perspective on this type of pain, which is so debilitating to a large number of women.

scholarly journals A Facility-Based Study of Severity of Pain Among Patients with Temporomandibular Myofascial Pain Syndrome

2020 ◽  
Vol 6 (4) ◽  
pp. 402-409
Author(s):  
M Okoh ◽  
N Onyia ◽  
O Azeez ◽  
DS Okoh
Keyword(s):  
Severe Pain ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Cross Sectional Study ◽  
Pain Severity ◽  
Cross Sectional ◽  
Mild Pain ◽  
Female Patients ◽  
And Gender

Background: Myofascial pain syndrome is the most common temporomandibular joint (TMJ) disorder. Objective: To measure pain severity among patients with temporomandibular myofascial pain syndrome using the Visual Analogue Scale (VAS), and to relate pain severity to age and gender. Methods: A cross-sectional study of patients who presented with TMJ pain and were diagnosed with TMJ myofascial pain syndrome was conducted. Data were collected using a structured questionnaire and were statistically analysed. Results: Out of a total of 603 patients, 18 (3.0%) had temporomandibular myofascial pain syndrome. They were aged 22-78 years with female preponderance (11; 61.1%) and a female-to-male ratio of 1.6:1. The majority of the patients had mild pain (7/18; 38.9%). The mean VAS score for the patients in this study was 5.8+2.6. The female patients experienced more severe pain (5/11; 45.4%), compared to males. Conclusion: There was a female preponderance in TMJ myofascial pain syndrome, with a mean VAS pain score of 5.8+2.6. Severe pain was mostly reported by female patients while the male patients often present with mild pain.

scholarly journals Is there a neuropathic-like component to endometriosis-associated pain? Results from a large cohort questionnaire study

2020 ◽  
Author(s):  
Lydia Coxon ◽  
Katja Wiech ◽  
Katy Vincent
Keyword(s):  
Neuropathic Pain ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Sensory Profile ◽  
Cross Sectional ◽  
Psychological Measures ◽  
Chronic Inflammatory Condition ◽  
History Of ◽  
New Perspective ◽  
Pain Symptoms

AbstractBackgroundPain is one of the primary symptoms of endometriosis, a chronic inflammatory condition characterised by the presence of endometrial tissue outside the uterus. Endometriosis-associated pain is commonly considered as nociceptive in nature but its clinical presentation suggests that it might have neuropathic-like properties in a subgroup of patients.MethodsThis is a cross sectional study using an online survey. The survey was distributed by patient support websites. The survey was composed of validated questionnaires assessing pain symptoms, psychological measures and questions about number of surgeries.Main results and the role of chanceWe had 1417 responses which met the inclusion criteria. Using standard painDETECT cut-off scores, we found that pain was classified as neuropathic in 40% of patients and as mixed neuropathic/nociceptive in a further 35%. In line with observations in other neuropathic conditions, the neuropathic subgroup reported higher pain intensities, greater psychological distress and cognitive impairment. Neuropathic pain was also more likely in those with more surgeries to the abdomen and a longer history of pain. As revealed by a cluster analysis, those with a neuropathic pain component could further be divided into two subgroups based on their sensory profile.ConclusionsThe data presented here indicate that endometriosis-associated pain includes a neuropathic-like component in a substantial proportion of women. Although further investigation is required, our finding challenges the current conceptualisation of endometriosis-associated pain as nociceptive and advocates for a new perspective on this type of pain, which is so debilitating to a large number of women.

Central neuropathic pain in multiple sclerosis is associated with impaired innocuous thermal pathways and neuronal hyperexcitability

Pain Medicine ◽  
2021 ◽  
Author(s):  
Michal Rivel ◽  
Anat Achiron ◽  
Mark Dolev ◽  
Yael Stern ◽  
Gaby Zeilig ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neuropathic Pain ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Sensory Testing ◽  
Cross Sectional ◽  
Central Neuropathic Pain ◽  
Body Regions ◽  
Thermal Grill Illusion

Abstract Objective About a third of patients with multiple sclerosis (MS) suffer from chronic and excruciating central neuropathic pain (CNP). The mechanism underlying CNP in MS is not clear, since previous studies are scarce and their results are inconsistent. Our aim was to determine whether CNP in MS is associated with impairment of the spinothalamic-thalamocortical pathways (STTCs) and/or increased excitability of the pain system. Design Cross sectional study Setting General hospital Subjects 47 MS patients with CNP, 42 MS patients without CNP, and 32 healthy controls. Methods Sensory testing included the measurement of temperature, pain, and touch thresholds and the thermal grill illusion (TGI) for evaluating STTCs function, and hyperpathia and allodynia as indicators of hyperexcitability. CNP was characterized using interviews and questionnaires. Results The CNP group had higher cold and warm thresholds (p < 0.01), as well as higher TGI perception thresholds (p < 0.05), especially in painful body regions compared to controls, whereas touch and pain thresholds values were normal. The CNP group also had a significantly greater prevalence of hyperpathia and allodynia. Regression analysis revealed that whereas presence of CNP was associated with a higher cold threshold, CNP intensity, and the number of painful body regions were associated with allodynia and hyperpathia, respectively. Conclusions CNP in MS is characterized by a specific impairment of STTC function; the innocuous thermal pathways, and by pain hyperexcitability. Whereas CNP presence is associated with STTC impairment, its severity and extent are associated with pain hyperexcitability. Interventions that reduce excitability level may therefore mitigate CNP severity.

Mental health, pain symptoms and systemic comorbidities in women with endometriosis: a cross-sectional study

2017 ◽  
Vol 39 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Silvia Vannuccini ◽  
Lucia Lazzeri ◽  
Cinzia Orlandini ◽  
Giuseppe Morgante ◽  
Giuseppe Bifulco ◽  
...  
Keyword(s):  
Mental Health ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Symptoms

scholarly journals The Number of Pain Sites and Other Non-pain Symptoms are Important Clues for Diagnosis: A Cross-sectional Study of Outpatients with Multiple Somatic Complaints

2016 ◽  
Vol 17 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Keiichiro Kita ◽  
Masahiro Nagatsuma ◽  
Akira Wakaguri ◽  
Azusa Sekijima ◽  
Fumiko Watanabe ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Somatic Complaints ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Symptoms

scholarly journals Neuropathic Pain After Total Knee Arthroplasty: A Cross-sectional Study in Female Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 103-108
Author(s):  
Cemile Sevgi Polat ◽  
Didem Sezgin Özcan ◽  
Elif Umay Altaş ◽  
Şule Şahin Onat ◽  
Belma Füsun Köseoğlu
Keyword(s):  
Total Knee Arthroplasty ◽  
Neuropathic Pain ◽  
Knee Arthroplasty ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Patients ◽  
Total Knee
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