scholarly journals The spectrum of pediatric amplified musculoskeletal pain syndrome

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
David D. Sherry ◽  
Maitry Sonagra ◽  
Sabrina Gmuca
Keyword(s):  
Musculoskeletal Pain ◽  
Pediatric Rheumatology ◽  
Functional Disability ◽  
Wide Spectrum ◽  
Pediatric Population ◽  
Pain Syndrome ◽  
Pain Clinic ◽  
Cross Sectional ◽  
Body Regions ◽  
Constant Pain

Abstract Background Children presenting with musculoskeletal pain to pediatric rheumatology clinics are very heterogeneous and on a continuum from those with localized pain to total body pain. Many report intermittent, rather than constant, pain. We examined clinical and psychological characteristics of these children at presentation and specifically those who fulfilled the criteria for fibromyalgia. Methods We performed a retrospective, cross-sectional cohort study of children under ≤18 years old presenting to the pediatric rheumatology pain clinic between January 2015 and July 2019 and enrolled in a patient registry. We included children diagnosed with amplified pain, excluding those fulfilling criteria for complex regional pain syndrome. Abstracted data included clinical characteristics, pain symptoms, functional disability inventory (FDI), widespread pain index, and symptom severity scale. Results We analyzed 636 subjects, predominantly non-Hispanic Caucasian females. Using median split method, 54% had diffuse pain (≥ 5 body regions involved), but, of these, only 58% met criteria for fibromyalgia. Subjects with diffuse pain, compared to those with localized pain had a longer duration of pain (24 vs 12 months, p < 0.01), reported greater pain intensity (6/10 vs 5/10, p < 0.001), greater mental health burden, and poorer function (FDI 25 vs 19, p < 0.0001). Subjects with limited pain more often reported a history of trigger event (34% vs 24%, p < 0.01) but not autonomic changes (14% vs 14%, p = 0.94). The presence of adverse childhood experiences did not differ among those with limited versus diffuse pain except for parental divorce (16% vs 23%, p = 0.03). Intermittent pain was reported in 117 children (18%) and, compared to subjects with constant pain, they reported less pain (0/10 vs 6/10) and were more functional (FDI 13 vs 25) (both p < 0.0001). Conclusions There exists a wide spectrum of pain manifestations among children with amplified pain including limited or diffuse and constant or intermittent pain. Most children who presented to our clinic did not fulfill criteria for fibromyalgia but nonetheless had significant symptoms and disability. Studies focusing on fibromyalgia may miss the full extent of childhood amplified pain. Additionally, research limited to those meeting the fibromyalgia criteria likely underestimate the significant impact of amplified pain among the pediatric population.

Musculoskeletal Pain and Impact on Performance in Orchestra Musicians and Actors

2004 ◽  
Vol 19 (2) ◽  
pp. 55-61
Author(s):  
K Engquist ◽  
P Ørbaek ◽  
K Jakobsson
Keyword(s):  
Musculoskeletal Pain ◽  
Odds Ratio ◽  
Reference Group ◽  
Study Groups ◽  
Physical Work ◽  
Prevalence Odds Ratio ◽  
Cross Sectional ◽  
Body Regions ◽  
Increased Risk ◽  
The Impact

We studied the prevalence of musculoskeletal pain and its impact on performance in orchestra musicians and in a reference group of actors, who share the mental stress in a performance situation, but without having the physical work load from an instrument. Swedish musicians (n = 103) from symphony and chamber orchestras and actors (n = 106) participated in a cross-sectional questionnaire study. Musculoskeletal pain was assessed by a further developed Standardized Nordic Questionnaire. The impact of pain on performance (pain affecting playing capacity, decreased playing time, and change of technique) and trouble-related sick leave also was assessed. Pain intensity was assessed by visual analogue scales. Musculoskeletal pain in the neck and shoulders was the most frequently reported problem, with similar prevalence among musicians and actors, around 25% for present pain and 20% for chronic pain (1-year prevalence). Around 10% of the musicians and 5% of the actors reported pain in the hands. Oral pain was reported by 12% of the musicians and 18% of the actors. The number of affected body regions and the intensity of pain were similar in the study groups. The musicians had an increased risk for pain affecting playing capacity. For the neck, the prevalence odds ratio (POR) was 3.0 (95%CI 1.2-7.2; adjusted for age and gender). String instrumentalists had higher risk estimates than nonstring instrumentalists. A gender difference was not observed. Pain in the oral region affecting playing capacity was less common in musicians, with a prevalence odds ratio of 0.4 (95%CI 0.1-0.8). Even though the prevalence of musculoskeletal pain was similar in the two groups of performing artists, the consequences for the work situation were more serious among musicians.

Prolonged, widespread, disabling musculoskeletal pain of adolescents among referrals to the Pediatric Rheumatology Outpatient Clinic from the Päijät-Häme Hospital District in southern Finland

2018 ◽  
Vol 18 (4) ◽  
pp. 621-628
Author(s):  
Heini Pohjankoski ◽  
Maiju Hietanen ◽  
Leena Leppänen ◽  
Heli Vilen ◽  
Hannu Kautiainen ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Outpatient Clinic ◽  
Pediatric Rheumatology ◽  
Functional Disability ◽  
Screening Tool ◽  
Screening Tools ◽  
Rapid Screening ◽  
Hospital District ◽  
Pain Patients ◽  
Rheumatology Outpatient

Abstract Background and aims Musculoskeletal pain among adolescents is a problem for the patients and their families and has economic consequences for society. The aim of this study is to determine the incidence of prolonged disabling musculoskeletal pain of adolescents among referrals to a pediatric rheumatology outpatient clinic and describe the patient material. The second aim is to find proper screening tools which identifies patients with a risk of pain chronification and to test whether our patients fit the Pediatric Pain Screening Tool (PPST) stratification according to Simons et al. Methods We selected adolescent patients with disabling, prolonged, musculoskeletal pain and calculated the incidence. Furthermore, after the patient collection, we adjusted our pain patients to PPST. Results The incidence of prolonged musculoskeletal pain patients at our clinic was 42/100,000 patient years (pyrs) (age 13–18; 95% CI: 29–60) during years 2010–2015. A nine-item screening tool by Simons et al. proves to be valid for our patient group and helps to identify those patients who need early, prompt treatment. The functional risk stratification by Simons et al. correlates with our patients’ functional disability. Conclusions and implications In order to prevent disability and to target intervention, it is necessary to have proper and rapid screening tools to find the appropriate patients in time.

Burnout and its Association with Musculoskeletal Pain among Primary Care Providers

2017 ◽  
Vol 61 (1) ◽  
pp. 1010-1014 ◽  
Author(s):  
Xuanxuan Zhang ◽  
Mark C. Schall ◽  
Richard Sesek ◽  
Sean Gallagher ◽  
Jesse Michel
Keyword(s):  
Primary Care ◽  
Musculoskeletal Pain ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Body Regions ◽  
Increased Risk ◽  
The Right

Burnout is a growing concern among primary care providers (PCPs). The condition may lead to diminished quality of patient care as well as reduced quality of life. Although self-reported musculoskeletal pain is common among healthcare providers, the relationship between burnout and musculoskeletal pain among PCPs has been studied very little. We describe a cross-sectional pilot survey conducted among 38 PCPs (MDs, DOs, PAs, and NPs) in the Midwestern United States. Self-reported feelings of burnout and musculoskeletal pain in different body regions were analyzed using regression models. Results suggested that increasing number of hours worked per day, severity of pain in the neck / shoulder area, and severity of pain in the right wrist were associated with an increased risk of burnout. On the contrary, burnout decreased with increasing age. The findings suggest that additional research is needed to understand the risk factors for burnout among PCPs, particularly during the early stages of their career.

scholarly journals Classification of Chronic Pain at a Multidisciplinary Pain Rehabilitation Clinic

1998 ◽  
Vol 3 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Jan Lidbeck ◽  
Gertie IM Hautkamp ◽  
Ritva A Ceder ◽  
Urban LO Näslund
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Pain Clinic ◽  
Psychological Pain ◽  
Pain Syndromes ◽  
Epidemiological Surveys ◽  
Clinical Diagnoses ◽  
Chronic Pain Syndromes

OBJECTIVE: To make a detailed diagnostic analysis of patients with chronic pain syndromes, including classification according to the International Association for the Study of Pain (IASP).DESIGN: Descriptive study of consecutive referrals during a two-year period.SETTING: A multidisciplinary out-patient pain clinic focused on occupational rehabilitation.SUBJECTS: A total of 309 chronic pain patients.METHODS: After a standardized multimodal physical and psychological examination, the chronic pain syndrome of each patient was assigned one or more clinical diagnoses; assigned to an etiological pain category (nociceptive pain, non-nociceptive including idiopathic pain, and psychological pain); and coded diagnostically according to IASP taxonomy.RESULTS: In all, 397 clinical diagnoses were made (ie, a mean of 1.3 diagnoses per patient). A large majority (87%) received a diagnosis of myalgia. Myofascial pain (trigger point syndrome) was diagnosed in two-thirds of the patients and was the most frequent clinical pain syndrome. A total of 51.8% of the pain syndromes were categorized as nociceptive, 43.0% as idiopathic and less than 1% as pain of psychological origin. Classification using the IASP system yielded a very high proportion of nociceptive, musculoskeletal pain syndromes of high intensity, with widespread pain and/or pain located in the neck/shoulder/arm region, and of dysfunctional etiology.CONCLUSIONS: Musculoskeletal pain was very common in this series, and myofascial pain syndromes were the most frequent specific pain disorders. However, myofascial pain had generally gone unrecognized by the referring physician. In contrast to findings of other studies, the incidence of low back pain and of primary psychological pain was low. Comparison of the results with those of Swedish epidemiological surveys showed the frequencies of the diagnoses in this series to be representative of chronic pain syndromes in the Swedish general population.

scholarly journals Disordered eating among adolescents with chronic pain: the experience of a pediatric rheumatology subspecialty pain clinic

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Pianucci ◽  
Maitry Sonagra ◽  
Brooke A. Greenberg ◽  
Diana R. Priestley ◽  
Sabrina Gmuca
Keyword(s):  
Chronic Pain ◽  
Logistic Regression ◽  
Disordered Eating ◽  
Pediatric Rheumatology ◽  
Functional Disability ◽  
Patient Characteristics ◽  
Regression Modeling ◽  
Pain Clinic ◽  
Logistic Regression Modeling ◽  
Appropriate Treatment

Abstract Background Disordered eating and chronic pain often co-occur in adolescents, but the relationship between these conditions is not well understood. We aimed to determine the prevalence of and to identify the clinical characteristics associated with the presence of disordered eating among adolescents with chronic musculoskeletal pain (CMP) presenting to a pediatric rheumatology subspecialty pain clinic. Methods This was a retrospective cohort study of pediatric patients presenting to a pediatric rheumatology subspecialty pain clinic for an initial consultation from March 2018 to March 2019. We complemented data from an existing patient registry with secondary chart review for patients identified with disordered eating. We compared patient characteristics based on the presence or absence of disordered eating among adolescents with CMP. Logistic regression modeling was used to determine factors associated with disordered eating. Results Of the 228 patients who were seen for an initial consultation in the pain clinic in 1 year, 51 (22.4%) had disordered eating. Only eight (15.7%) of the 51 patients identified with disordered eating had a previously documented formal eating disorder diagnosis. Through multivariate logistic regression modeling, we found that disordered eating was associated with older age, higher functional disability, presence of abdominal pain, presence of gastrointestinal comorbidities, and presence of anxiety (all p < 0.05). Conclusions Adolescents with chronic pain, especially those who experience gastrointestinal issues, anxiety, and greater functional disability, should be evaluated for disordered eating by the treating clinician in order to ensure timely and appropriate treatment.

scholarly journals Tengsl streituvaldandi þátta í starfsumhverfi, svefns og stoðkerfisverkja hjá millistjórnendum í opinberri þjónustu

2016 ◽  
Vol 12 (2) ◽  
pp. 467 ◽  
Author(s):  
Sigríður Halldórsdóttir ◽  
Hafdís Skúladóttir ◽  
Hjördís Sigursteinsdóttir ◽  
Þórey Agnarsdóttir
Keyword(s):  
Marital Status ◽  
Work Environment ◽  
Musculoskeletal Pain ◽  
Middle Managers ◽  
Cross Sectional ◽  
Insufficient Sleep ◽  
Nursing Unit ◽  
Body Regions ◽  
Lower Back ◽  
Neck Area

Middle managers have demanding roles and often experience themselves between a rock and a hard place, and their jobs are characterized by heavy workload and stress. They have not received adequate attention in management science, in particular within healthcare. We know, for example, little about how stressful factors in the work environment are related to musculoskeletal pain and sleep. The purpose of this study was to examine this relationship. This is a descriptive cross-sectional study in which data was collected by a questionnaire which was sent electronically to 137 nursing managers through the Outcome-survey system. The response rate was 80.9%. Descriptive statistics and inferential statistics were used for statistical analysis. The results showed a clear link between stressful factors in the work environment and insufficient sleep, after controlling for the effects of age, marital status and the number of staff in the nursing unit. Stressful factors in the work environment and sleep affected the intensity of pain in the neck and shoulder area, and sleep correlated with the intensity of pain in the lower back. Taking sleep into account, more stress meant more pain in the neck and shoulder area. Taking into account stressful factors, insufficient sleep meant more pain in all three body regions. Together, stressful factors in the work environment and insufficient sleep explained 17% of the total variation in the intensity of pain in the neck area, 21% in the shoulder area, and 14% in the lower back, taking into account age, marital status and the number of staff in the nursing unit. There was a statistically significant interaction between stressful factors in the work environment and sleep regarding the intensity of musculoskeletal pain in the neck area. The results of this study will hopefully lead to better consideration of stressful factors in the work environment, sleep and musculoskeletal pain of middle managers.

scholarly journals Association between depression, anxiety, and insomnia with musculoskeletal pain source: a multi-center study

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Elham Zarean ◽  
Asma Azadeh ◽  
Habib Pirali ◽  
Behzad Doroushi ◽  
Atieh Edrisi ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Severe Depression ◽  
Pain Syndrome ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
Anxiety Depression ◽  
Insomnia Severity

Abstract Background Musculoskeletal pain syndrome (MPS) is one of the modern diseases. Musculoskeletal pain (MP) may develop at any age and impact physical and mental health. This study aimed to evaluate the association between anxiety, depression, and insomnia with musculoskeletal pain source. This cross-sectional study was conducted on 450 patients with musculoskeletal pain. Goldberg depression (GB), Beck Anxiety Inventory (BAI), and Morin Insomnia Severity Index (ISI) questionnaires were used to collect data. Participants have divided into two groups: individuals with unknown musculoskeletal pain sources and individuals with known musculoskeletal pain sources. Anxiety, depression, and insomnia scores were compared between the two groups. For statistical analysis of data mean (SD), frequency (%), Chi-square, Mann-Whitney test, and Logistic regression models were used. All analysis was performed using SPSS 26. Results In this study, 39.4% of the participants were in severe depression, 31.1% in severe anxiety, 34.7% in the no clinically significant, and 32.9% in the sub-threshold insomnia group. There was a significant difference between the severity of anxiety and insomnia in the two groups with the known and unknown pain sources (p < 0.05). However, the score of depression (OR = 1.00, 95% CI 0.99–1.01), anxiety (OR = 1.00, 95% CI 0.99–1.02), and insomnia (OR = 1.01, 95% CI 0.98–1.03) was not related to the pain source. Conclusion There was a statistically significant relationship between anxiety and insomnia severity with musculoskeletal pain source. According to the high prevalence of depression, anxiety, and depression in both groups with known and unknown musculoskeletal pain sources, the cooperation of orthopedists, rheumatologists, and physical therapists with psychiatrist can be useful in improving the condition of patients.

scholarly journals Assessment and Management of Chronic Musculoskeletal Pain Syndrome in Children: A Review

2017 ◽  
Vol 40 (3) ◽  
pp. 166-173
Author(s):  
Shahana Akhter Rahman ◽  
Mujammel Haque ◽  
Mohammed Mahbubul Islam
Keyword(s):  
Chronic Pain ◽  
Child Health ◽  
Complex Regional Pain Syndrome ◽  
Musculoskeletal Pain ◽  
Pediatric Rheumatology ◽  
Early Recognition ◽  
Pain Syndrome ◽  
Skeletal Growth ◽  
Chronic Musculoskeletal Pain ◽  
Societal Costs

Musculoskeletal pain is a frequent complaint of children, is the most common presenting problem of children referred to pediatric rheumatology clinics. Chronic musculoskeletal (MSK) pain in children is responsible for substantial personal impacts and societal costs, but it has not been intensively or systematically researched. The majority of musculoskeletal pain complaints in children are benign in nature and attributable to trauma, overuse, and normal variations in skeletal growth. There is a subset of children in whom chronic pain complaints develop that persist in the absence of physical and laboratory abnormalities including growing Pain, juvenile fibromyalgia, complex regional pain syndrome. During recent years studies of the epidemiology, etiology and rehabilitation of pain and pain-associated disability in children have revealed a large prevalence of clinically relevant pain, and have emphasized the need for early recognition and intervention.Bangladesh J Child Health 2016; VOL 40 (3) :166-173

scholarly journals SELF-REPORTED MUSCULOSKELETAL ACUTE AND OVERUSE INJURIES AMONG LATVIAN INFANTRY SOLDIERS

2020 ◽  
Vol 6 ◽  
pp. 354
Author(s):  
Darja Nesterovica ◽  
Normunds Vaivads ◽  
Ainars Stepens
Keyword(s):  
Pain Syndrome ◽  
Cross Sectional Study ◽  
Musculoskeletal Injuries ◽  
Injury Incidence ◽  
Cross Sectional ◽  
Leg Injuries ◽  
Body Regions ◽  
Joint Dislocations ◽  
Study Results ◽  
One Year

Musculoskeletal injury is the leading cause of disability among different military populations that results in socioeconomic burden and negatively affects military readiness. Study aim was to describe self-reported musculoskeletal injuries among Latvian infantry soldiers during one-year period. Survey-based cross-sectional study was carried out. Data was assessed using survey about injuries that occurred in one-year period during annual medical check-up. Musculoskeletal injuries were classified according to body regions as it is in Barell injury matrix and by injury type – acute or overuse. Study results showed in one-year injury incidence rate was 867.8 cases per 1000 person-years (95% CI 824.8 – 913.0) with total 197 musculoskeletal injuries reported among active duty infantry soldiers. Typical acute injuries were superficial contusion injuries (n=24), fractures (n=21), joint dislocations (n=21) and sprains (n=29). Typical overuse diagnoses were lower back pain (n=42), patellofemoral pain syndrome (n=11), medial tibial stress syndrome (n=9), plantar fasciitis (n=8). Present study showed high incidence of overuse back injuries and overuse and acute lower leg injuries. Mostly of reported injuries could be classified as preventable and should be reduced through injury reduction programmes. 

Are Auricular Maps Reliable for Chronic Musculoskeletal Pain Disorders?: A Double-Blind Evaluation

2007 ◽  
Vol 25 (3) ◽  
pp. 72-79 ◽  
Author(s):  
Elisabeth Andersson ◽  
Ann L Persson ◽  
Christer PO Carlsson
Keyword(s):  
Musculoskeletal Pain ◽  
Chronic Musculoskeletal Pain ◽  
Pain Clinic ◽  
Auricular Acupuncture ◽  
External Ear ◽  
Tender Points ◽  
Point Scale ◽  
Double Blind ◽  
Body Regions ◽  
Chronic Pain Clinic

Aim To examine the proposed somatotopic relation between the regions in which patients report musculoskeletal pain and tender points located on the external ears according to a map based on commonly used auricular acupuncture maps. Methods Twenty-five patients (16 women) from a chronic pain clinic were included. Patients were asked, before examination of the external ears, if they had past or present musculoskeletal pain in any of 11 body regions. An ear map, collapsed into 11 zones representing the musculoskeletal system, was used. The ear examiner was blinded to the patients’ pain conditions, medical history and ongoing treatment. Patients communicated with the examiner only to express if tenderness was present in the external ear on palpation using a spring-loaded pressure stylus commonly used for auricular acupuncture. The degree of tenderness was registered on a 5-point scale and dichotomised (no tenderness or tenderness). Agreements between the patients’ painful body regions and tenderness in the external ear zones were presented as percentage, kappa values, sensitivity and specificity. Results The 25 patients reported 116 past or present musculoskeletal pain regions and had 110 tender ear zones. No statistically significant agreements were found between the painful body regions and the corresponding tender ear zones. Conclusions Our results did not show agreements between patients’ reported musculoskeletal pain regions and tender zones in the external ears assessed according to commonly used maps in auricular acupuncture using a pressure stylus. However, very tender points occur on the external ear in a population with chronic musculoskeletal pain.

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