scholarly journals The nature and prevalence of chronic pain in homeless persons: an observational study

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 164 ◽  
Author(s):  
Rebecca Fisher ◽  
Judith Ewing ◽  
Alice Garrett ◽  
E Katherine Harrison ◽  
Kimberly KT Lwin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Short Form ◽  
Homeless People ◽  
Brief Pain Inventory ◽  
Homeless Persons ◽  
Lower Limbs ◽  
Mcgill Pain Questionnaire ◽  
Wide Range

Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs.Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters.Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs.Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people’s lives.

Long-term Outcomes of Deep Brain Stimulation for Neuropathic Pain

Neurosurgery ◽  
2012 ◽  
Vol 72 (2) ◽  
pp. 221-231 ◽  
Author(s):  
Sandra G.J. Boccard ◽  
Erlick A.C. Pereira ◽  
Liz Moir ◽  
Tipu Z. Aziz ◽  
Alexander L. Green
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Short Form ◽  
Case Series ◽  
Mcgill Pain Questionnaire ◽  
Euroqol 5D ◽  
Deep Brain

Abstract BACKGROUND: Deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy has reported variable outcomes and has gained United Kingdom but not USA regulatory approval. OBJECTIVE: To prospectively assess long-term efficacy of DBS for chronic neuropathic pain in a single-center case series. METHODS: Patient reported outcome measures were collated before and after surgery, using a visual analog score, short-form 36-question quality-of-life survey, McGill pain questionnaire, and EuroQol-5D questionnaires (EQ-5D and health state). RESULTS: One hundred ninety-seven patients were referred over 12 years, of whom 85 received DBS for various etiologies: 9 amputees, 7 brachial plexus injuries, 31 after stroke, 13 with spinal pathology, 15 with head and face pain, and 10 miscellaneous. Mean age at surgery was 52 years, and mean follow-up was 19.6 months. Contralateral DBS targeted the periventricular gray area (n = 33), the ventral posterior nuclei of the thalamus (n = 15), or both targets (n = 37). Almost 70% (69.4%) of patients retained implants 6 months after surgery. Thirty-nine of 59 (66%) of those implanted gained benefit and efficacy varied by etiology, improving outcomes in 89% after amputation and 70% after stroke. In this cohort, >30% improvements sustained in visual analog score, McGill pain questionnaire, short-form 36-question quality-of-life survey, and EuroQol-5D questionnaire were observed in 15 patients with >42 months of follow-up, with several outcome measures improving from those assessed at 1 year. CONCLUSION: DBS for pain has long-term efficacy for select etiologies. Clinical trials retaining patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.

Lidocaine infusions in chronic pain management: A prospective case series analysis

2021 ◽  
pp. 204946372110541
Author(s):  
Elizabeth Vacher ◽  
Monika Kosela ◽  
Charlie Song-Smith ◽  
Fausto Morell-Ducos ◽  
Alan Fayaz
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Short Form ◽  
Case Series ◽  
Brief Pain Inventory ◽  
Intravenous Lidocaine ◽  
Patient Cohort ◽  
Pain Outcomes ◽  
The Impact

Chronic pain conditions are prevalent and cause a significant burden of disease. Intravenous lidocaine infusions have been reported to have an analgesic effect in patients with chronic neuropathic pain, but there is limited data supporting the efficacy of lidocaine across other chronic pain phenotypes. Our study aimed to evaluate the efficacy of a single infusion of intravenous lidocaine for pain relief and the impact on quality of life. We evaluated data from 74 patients with chronic pain who were treated with intravenous lidocaine at a specialist pain centre. Participants completed a questionnaire consisting of the Brief Pain Inventory (BPI) Short Form and additional EQ-5D quality of life metrics, before treatment and at follow-up. Data comparing pain severity did not demonstrate a statistically significant change after treatment when averaged across the entire patient cohort (6.15–5.88, p = .106), irrespective of gender or pain phenotype. Scores for pain interference showed statistically significant reductions following treatment (7.05–6.41, p = .023), which may have been driven through improvements in sleep (7.41–6.35, p = .001); however, these reductions are not clinically significant. The patient cohort was stratified into responders and non-responders based on >30% improvement in response to an overall impression of pain reduction question following treatment. In the ‘responder’ cohort, pain intensity scores showed a statistically significant reduction post-infusion (6.18–5.49, p = .0135), but no change was apparent for non-responders (6.07–6.09, p = .920). There were no differences between responders and non-responders for pain sub-types in our study. This study found no difference in pain outcomes in a cohort of patients with chronic pain, a mean of 63 days following a single lidocaine infusion. However, a specific subgroup of responders may show slight improvements in some pain outcomes that may warrant further exploration.

Neuropathic pain in neuromyelitis optica affects activities of daily living and quality of life

2014 ◽  
Vol 20 (12) ◽  
pp. 1658-1661 ◽  
Author(s):  
Sizheng Zhao ◽  
Kerry Mutch ◽  
Liene Elsone ◽  
Turo Nurmikko ◽  
Anu Jacob
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Activities Of Daily Living ◽  
Neuromyelitis Optica ◽  
Daily Living ◽  
Short Form ◽  
Transverse Myelitis ◽  
Brief Pain Inventory ◽  
Cross Sectional

Though pain in neuromyelitis optica (NMO) has been described in two recent reports, the proportion with true neuropathic pain (NP), its features, impact on activities of daily living (ADL) and quality of life has not been well characterised. A cross-sectional study of 50 NMO patients with transverse myelitis was performed using Douleur Neuropathique 4, Brief Pain Inventory, Extended Disability Status Scale and Short Form 36. NP was identified in 62% of patients. Pain was constant in 68% affecting most ADL. Pain was associated with significant reduction of the SF36 Mental Composite Score. The high prevalence of NP and associated disability necessitates an in-depth enquiry in patients with NMO.

Severity of chronic pain and its relationship to quality of life in multiple sclerosis

2005 ◽  
Vol 11 (3) ◽  
pp. 322-327 ◽  
Author(s):  
Lorraine V Kalia ◽  
Paul W OConnor
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Chronic Pain ◽  
Short Form ◽  
Depression Scale ◽  
Pain Severity ◽  
Anxiety And Depression ◽  
Mcgill Pain Questionnaire ◽  
Neurogenic Pain

Introduction: This study used reliable and validated instruments to compare pain severity in multiple sclerosis (MS) to that in other chronic painful conditions, and to examine relationships between chronic pain in MS and health-related quality of life (HRQOL). Methods: Ninety-nine MS patients completed a self-administered survey comprised of the Medical Outcomes 36-Item Short-Form Health Survey, the Short-Form McGill Pain Questionnaire, and the Hospital Anxiety and Depression Scale. Results: Pain severity was not different between MS patients with pain and rheumatoid arthritis (P=0.77) or osteoarthritis (P=0.98) patients. Chronic pain in MS was less often neurogenic than non-neurogenic, although severity of neurogenic pain was greater than that of non-neurogenic pain (P=0.048). Chronic pain in MS was found to have no significant relationship to age, disease duration or disease course. Instead, we found that pain was correlated with aspects of HRQOL, particularly mental health (r=0.44, P<0.0001) versus physical functioning (r=0.19, P>0.05). Chronic pain was significantly related to anxiety and depression for females but not for males with MS. Conclusions: Chronic pain in MS is as severe as pain in arthritic conditions and is associated with reduced HRQOL. Thus, pain can be a significant symptom for MS patients and the need for treatment may be underestimated.

scholarly journals Patient Satisfaction with Spanish Pain Centers: Observational Study with More than 3,000 Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Juan Antonio García García ◽  
Patricia Hernández-Puiggròs ◽  
Javier Tesedo Nieto ◽  
María Pilar Acín Lázaro ◽  
Alfredo Carrera González ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Pain Control ◽  
Short Form ◽  
Waiting Times ◽  
Brief Pain Inventory ◽  
Management Approach

Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p<0.001, and health status (VAS) from 40.6 to 61.9, p<0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement.

Duloxetine Added to Tramadol in Chronic Pain Syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S500-S501
Author(s):  
M. Domijan ◽  
Z. Lončar ◽  
S. Udovičić
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Disturbances ◽  
Short Form ◽  
Pain Syndrome ◽  
Mcgill Pain Questionnaire ◽  
Chronic Pain Syndrome ◽  
Reduction Of Pain ◽  
Competing Interest

IntroductionAbout 15–20% of the population suffering from the chronic pain. Over time, chronic pain can result in different emotional problems, social isolation, sleep disturbances, which reduce the quality of life. Chronic pain syndrome (CPS) indicates persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behavious and self-limitation in activities of daily living. Duloxetine is a potent antidepressant approved by the Food and Drug Administration for the chronic musculoskeletal disorder, diabetic neuropathic pain, fibromyalgia, generallized anxiety disorder and major depressive disorder.ObjectiveTo determine the effect of duloxetine on the reduction of pain and psychosocial suffering.AimsThe goal of the treatment should be to effectively reduce pain while improving function and reducing psychosocial suffering.MethodsThirty-six adult, nondepressed patients, already on tramadol therapy were included. Patients with VAS (visual analogue scale) ≥ 4were treated with duloxetine for 13 weeks. We measured pain intensity with the McGill Pain Questionnaire-Short Form (MPQ-SF) and compared VAS before starting the treatment with duloxetine and weekly for 13 weeks.ResultsPain response was defined as a 30%decrease in the MPQ-SF. A total of 62.5% of the sample met these criteria for response. Among them, 13.8% of patients were discontinued because of adverse effects. Duloxetine significantly improved functioning and the quality of life in patients with CPS.ConclusionsBecause of it is analgesic properties, duloxetine in the lower antidepressant doses (60 mg taken ones daily) combined with tramadol (another analgesic agent) can be useful in CPS for patients who do not respond satisfactory to monotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Analgesic Effect of Bumetanide on Neuropathic Pain in Patients with Spinal Cord Injury

2021 ◽  
Author(s):  
Farinaz Nasirinezhad ◽  
◽  
Leila Zarepour ◽  
Mahmoudreza Hadjighassem ◽  
Zeinab Gharaylou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Analgesic Effect ◽  
Short Form ◽  
Mcgill Pain Questionnaire ◽  
Pain Questionnaire ◽  
Cord Injury

Objectives: The current study evaluated the analgesic effects of bumetanide as an adjunctive treatment in the management of neuropathic pain following spinal cord injury. The peripheral expression of Na-K-Cl-cotransporter-1 1 and K-Cl-cotransporter-2 (KCC2)2 genes in polymorphonuclear lymphocytes (PMLs) assessed as a possible biomarker indicating central mechanisms underlying the observed response. Methods: Through an open-label, single arm, pilot trial of bumetanide (2mg/day), as add-on treatment conducted in 14 SCI patients for 19 weeks. This study consisted of 3 phases: pre-treatment (1month), titration (3 weeks), and active treatment (4 months). Ultimately, 9 patients completed the study. The primary outcome variables were the endpoint pain score using the numeric rating scale (NRS), and also the short-form McGill Pain Questionnaire. Secondary endpoints included the Short-Form Health Survey that assesses the quality of life. Blood samples were collected and used for determining the expression of NKCC1 and KCC2 genes in transcription and translation levels. Results: Bumetanide treatment significantly decreased average pain intensity according to the NRS and the short form of the McGill Pain Questionnaire scores. Baseline expression of KCC2 protein was low between groups and increased significantly following treatment (P<0.05). In the current study, pain improvement accompanied by the greater mean change from the baseline (improvement) for the overall quality of life. Conclusions: These data highlighted the analgesic effect of bumetanide on neuropathic pain and indicated the probable role of upregulation of KCC2 protein and involvement of GABAergic disinhibition in producing neuropathic pain.

scholarly journals The effectiveness of Pictorial Representation of Illness and Self Measure (PRISM) for the assessment of the suffering and quality of interpersonal relationships of patients with chronic pain

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mitsunao Tomioka ◽  
Masako Hosoi ◽  
Tomona Okuzawa ◽  
Kozo Anno ◽  
Rie Iwaki ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Medical Care ◽  
Interpersonal Relationships ◽  
Pain Catastrophizing ◽  
Short Form ◽  
Significant Others ◽  
Pictorial Representation ◽  
Mcgill Pain Questionnaire ◽  
Time Of Admission

Abstract Background Pictorial Representation of Illness and Self Measure (PRISM) is a tool that can be used to visualize and evaluate the burden of suffering caused by an illness. The aim of this study was to identify which aspects of the burden of chronic pain patients are associated with Self/illness separation (SIS), an indicator of the magnitude of suffering. We also examined the effectiveness of PRISM for evaluating changes in the relationships between patients and their medical care and significant others due to our inpatient treatment. Methods Seventy-two patients with chronic pain who were outpatients or admitted to the Department of Psychosomatic Medicine completed PRISM, depression and anxiety scales, and three types of pain-related self-assessment questionnaires (Brief Pain Inventory, Short-form McGill Pain Questionnaire, and Pain Catastrophizing Scale). Outpatients were queried at the time of outpatient visits and inpatients at the time of admission. In addition to PRISM disks related to illness, we asked each patient to place disks related to things important to them and their medical care. Of the inpatients, 31 did PRISM at the time of discharge. Among the reported important factors, which significant other was placed at the time of admission and discharge was evaluated. The distances of self/medical care separation (SMcS) and self/significant others separation (SSoS) were measured. Results Of the 21 scales measured, 10 showed a significant correlation with SIS. Factor analysis of these 10 scales extracted three factors, Life interferences, Negative affects, and Pain intensity. The SMcS and SSoS distances were shorter at discharge than at admission. Conclusions PRISM for patients with chronic pain is an integrated evaluation method that reflects three aspects of pain. By adding medical care and significant others to the usual method of placing only illness on the sheet it became possible to assess changes in the quality of interpersonal relationships.

Validity and reliability of the Greek version of the Pain Beliefs and Perceptions Inventory for patients with chronic pain

2021 ◽  
Vol 28 (6) ◽  
pp. 1-16
Author(s):  
Anna Christakou ◽  
Vasiliki Sakellari
Keyword(s):  
Chronic Pain ◽  
Factor Structure ◽  
Concurrent Validity ◽  
Discriminant Validity ◽  
Short Form ◽  
Brief Pain Inventory ◽  
Mcgill Pain Questionnaire ◽  
Pain Beliefs ◽  
Spearman's Rho ◽  
Spearman’S Rho

Background/aims The Pain Beliefs and Perceptions Inventory has been used widely to evaluate pain perceptions and beliefs of patients with chronic pain. This is a cross-cultural adaptation of the instrument into Greek. The purpose of the study was to investigate: the face and content validity; the factor structure; the concurrent validity; the discriminant validity; and the internal consistency and the test–retest reliability of the Pain Beliefs and Perceptions Inventory for people with chronic pain. Methods A total of 174 patients with chronic low back pain, neck pain and/or pain of limbs lasting for at least 6 months and with a physiotherapy referral participated in the study. Exploratory factor analysis by a principal axis factoring with direct oblimin rotation was chosen to examine the factor structure of the Pain Beliefs and Perceptions Inventory. The concurrent validity was assessed using correlations by Spearman's rho correlation coefficient among the Pain Beliefs and Perceptions Inventory and the Short Form-McGill Pain Questionnaire, the Present Pain Index, the visual analogue scale and the Brief Pain Inventory. The discriminant validity was examined by Spearman's rho correlation coefficient among the Pain Beliefs and Perceptions Inventory and Social Desirability Scale. The reliability of the instrument was examined using Cronbach's α internal consistency coefficients and intraclass correlation coefficients. Results Exploratory factor analysis confirmed the four factor structure of the Pain Beliefs and Perceptions Inventory that explained 66.353% of the total variance. Concurrent validity was determined through examination of correlations between the Pain Beliefs and Perceptions Inventory and other validated constructs (eg Short Form-McGill Pain Questionnaire Affective factor with Total Pain Beliefs and Perceptions Inventory Spearman's rho=0.257, P<0.001, Brief Pain Inventory General Activity and Pain Beliefs and Perceptions Inventory Constancy factor Spearman's rho=0.522, P<0.05, Brief Pain Inventory relations with other people and Pain Beliefs and Perceptions Inventory Constancy factor Spearman's rho=0.512, P<0.05). The discriminant validity of the Pain Beliefs and Perceptions Inventory was confirmed by examining correlations between the Pain Beliefs and Perceptions Inventory with the Marlowe–Crowne Social Desirability Scale. The questionnaire was internally consistent (α=0.89–0.96) and its stability was good (intraclass correlation coefficients=0.73–0.82). Conclusions The Greek translation of the Pain Beliefs and Perceptions Inventory is a reliable and valid instrument to evaluate Greek patients with chronic pain.

scholarly journals Chinese Medicinal Formula (MHGWT) for Relieving Diabetic Neuropathic Pain: A Randomized, Double-Blind, Placebo-Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Chia-I Tsai ◽  
Tsai-Chung Li ◽  
Ming-Hong Chang ◽  
Shih-Yi Lin ◽  
I-Te Lee ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Short Form ◽  
Controlled Trial ◽  
Brief Pain Inventory ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Diabetic Neuropathic Pain ◽  
Double Blind ◽  
Significant Difference ◽  
Before And After

Objective. To investigate the effects of modifiedHungqi Guizhi Wuwu Tang(MHGWT), a formula that comprises Chinese medicinal herbs, in relieving neuropathic pain in diabetics.Method. Between March 2008 and April 2009, 112 participants were randomly assigned to either the MHGWT group, whose members received MHGWT (n=56), or the control group, whose members received a placebo (n=56). Diabetic neuropathic pain (DNP) was rated using the 15-item Short-Form Brief Pain Inventory (SF-BPI), the 17-item Short-Form McGill Pain Questionnaire (SF-MPQ), the 13-item Modified Michigan Neuropathy Screening Instrument (MMNSI), and the 36-item “SF-36.” Nerve conduction studies (NCSs) were performed before and after treatment.Results. After 12 weeks of treatment, the SF-MPQ and SF-BPI scores of the MHGWT group were significantly (P<0.05) reduced and a significant difference between the groups was observed (P<0.05). The levels of NCS in the MHGWT group were nonsignificantly (P>0.05) reduced, and no significant difference in NCS level was observed between the groups (P>0.05).Conclusions. MHGWT shows promise in relieving DNP and deserves further investigation.

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