Acceptance: a factor to consider in persistent pain after neck trauma

2019 ◽  
Vol 19 (4) ◽  
pp. 733-741 ◽  
Author(s):  
Sophia Åkerblom ◽  
Johan Larsson ◽  
Eva-Maj Malmström ◽  
Elisabeth Persson ◽  
Hans Westergren
Keyword(s):  
Sex Education ◽  
Psychological Factors ◽  
Enhanced Recovery ◽  
Treatment Strategies ◽  
Persistent Pain ◽  
Pain Severity ◽  
Pain Interference ◽  
Widespread Pain ◽  
Neck Trauma ◽  
Pain Distribution

AbstractBackground and aimsStudies on the interaction between acceptance and pain-related processes after neck trauma are to our knowledge sparse and such treatment strategies are rarely incorporated in management and treatment of posttraumatic neck pain. Thus, the aim of the present study is to investigate how acceptance relates to persistent pain in patients after neck trauma, when controlling for the influence of other psychological factors, trauma characteristics and demographic variables.MethodsConsecutive patients with persistent pain and disability after neck trauma (n = 565) were assessed by a multi-professional team at a specialized pain rehabilitation clinic. Separate regression analyses were conducted with three outcomes: pain distribution, pain interference, and pain severity. Predictors were age, sex, education, time since trauma, type of trauma, anxiety, depression, and acceptance.ResultsAcceptance was the only factor associated with all outcomes, and patients with lower acceptance displayed more widespread pain and greater interference and severity of pain. The results also showed that higher depression was associated with worse pain interference and severity, whilst anxiety only mattered significantly for pain severity and not for pain interference. Female sex was related to more widespread pain and greater pain interference.ConclusionsOverall acceptance stood out as the most important factor for the different outcomes and lower acceptance was associated with more widespread pain distribution and greater pain interference and severity.ImplicationsThe findings of this study add to a growing body of literature confirming that the development of chronicity after neck trauma should be understood as a multidimensional process, best described by a biopsychosocial model. The results also suggest that psychological factors and especially acceptance might be important processes with implications for enhanced recovery after neck trauma.

scholarly journals CHRONIC PAIN CONTRIBUTES TO INJURIOUS FALLS IN COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S622-S622
Author(s):  
Yurun Cai ◽  
Suzanne Leveille ◽  
Ling Shi ◽  
Tongjian You ◽  
Ping Chen
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Community Dwelling ◽  
Pain Severity ◽  
Pain Interference ◽  
Fall Injuries ◽  
Injurious Falls ◽  
Multisite Pain ◽  
Community Dwelling Older Adults ◽  
Pain Distribution

Abstract Fall injuries are a leading cause of death among older adults, and chronic pain has been identified as a fall risk factor. However, the potential impact of chronic pain on injurious falls is unknown. This prospective study examined the relation between chronic pain and injurious falls in a 4-year follow-up of community-dwelling older adults. The MOBILIZE Boston study recruited 765 older adults aged ≥70y living in the Boston area. Pain characteristics, including pain severity, pain interference, and pain location, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Musculoskeletal pain distribution was categorized as “no pain”, “single site pain”, or “multisite pain”. Injurious falls were ascertained in telephone interviews following reports of falls on the monthly fall calendar postcards. The overall rate of injurious falls was 35/100 person-years. Negative binomial models, adjusting for sociodemographics, BMI, chronic conditions, mobility difficulty, analgesic and psychiatric medications, and depression, showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls. Participants in the highest third of pain interference scores had a 53% greater risk of injurious falls compared to those in the lowest pain interference group (adj.IRR=1.53, 95% CI: 1.15, 2.05). Older adults with multisite pain had a 50% higher risk of injurious falls than those without pain (adj.IRR=1.50, 95% CI: 1.16, 1.93). Risk of injurious falls related to pain was stronger among women than men. Research is needed to determine effective strategies to prevent fall injuries among older adults with chronic pain.

Polypharmacy, Opioid Use, and Fibromyalgia

2016 ◽  
Vol 19 (1) ◽  
pp. 97-105 ◽  
Author(s):  
Victoria Menzies ◽  
Leroy R. Thacker ◽  
Sallie D. Mayer ◽  
Anna M. Young ◽  
Shelby Evans ◽  
...  
Keyword(s):  
Symptom Management ◽  
Patient Population ◽  
Adverse Drug Events ◽  
Predictor Variable ◽  
Chronic Widespread Pain ◽  
Pain Severity ◽  
Pain Interference ◽  
Widespread Pain ◽  
Opioid Use ◽  
The Impact

The major therapeutic approach for treating fibromyalgia (FM), a chronic widespread pain syndrome, is pharmacotherapy-centered symptom management. Complexity of treatment often leads to multiple medication prescriptions. While there is no current alternative to the probable need for polypharmacy in this patient population, there remains concern related to potential side effects and adverse drug events. In this secondary analysis of data on medications taken collected from two parent studies, all medications were broken down into the following categories: opioid, nonopioid, antidepressant, anticonvulsant, muscle relaxant, and benzodiazepine. The impact on pain severity and pain interference of these medication categories as well as perceived stress, fatigue, and depression scores was assessed. Baseline pain severity ( p = .0106) and pain interference ( p = .0002) were significantly correlated with opioid use as compared to nonopioid use. A multivariate regression with backward elimination resulted in a model for pain severity with one significant predictor variable, fatigue ( p < .0001); pain interference had three significant predictor variables: opioid use ( p = .04), fatigue ( p < .0001), and depression ( p = .04). While future studies should further address the utility of opioids and examine the role of polypharmacy as part of symptom management strategies for individuals with FM, study findings suggest that, for those who suffer chronic widespread pain as the predominant symptom experience, a challenge equally as perplexing for nurses and nursing research alike as managing the pain lies in addressing the fatigue and depression in this patient population.

scholarly journals State-of-the-art colorectal disease: postoperative ileus

2021 ◽  
Author(s):  
Nils P. Sommer ◽  
Reiner Schneider ◽  
Sven Wehner ◽  
Jörg C. Kalff ◽  
Tim O. Vilz
Keyword(s):  
Postoperative Ileus ◽  
Enhanced Recovery ◽  
Treatment Strategies ◽  
Colorectal Disease ◽  
Opioid Receptor Antagonists ◽  
Hospital Stays ◽  
Definition Of ◽  
Meta Analyses ◽  
Epidural Catheters ◽  
Prolonged Hospital

Abstract Purpose Postoperative Ileus (POI) remains an important complication for patients after abdominal surgery with an incidence of 10–27% representing an everyday issue for abdominal surgeons. It accounts for patients’ discomfort, increased morbidity, prolonged hospital stays, and a high economic burden. This review outlines the current understanding of POI pathophysiology and focuses on preventive treatments that have proven to be effective or at least show promising effects. Methods Pathophysiology and recommendations for POI treatment are summarized on the basis of a selective literature review. Results While a lot of therapies have been researched over the past decades, many of them failed to prove successful in meta-analyses. To date, there is no evidence-based treatment once POI has manifested. In the era of enhanced recovery after surgery or fast track regimes, a few approaches show a beneficial effect in preventing POI: multimodal, opioid-sparing analgesia with placement of epidural catheters or transverse abdominis plane block; μ-opioid-receptor antagonists; and goal-directed fluid therapy and in general the use of minimally invasive surgery. Conclusion The results of different studies are often contradictory, as a concise definition of POI and reliable surrogate endpoints are still absent. These will be needed to advance POI research and provide clinicians with consistent data to improve the treatment strategies.

scholarly journals Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome

2018 ◽  
Vol 31 (2) ◽  
pp. e13509 ◽  
Author(s):  
John M. Hollier ◽  
Miranda A. L. van Tilburg ◽  
Yan Liu ◽  
Danita I. Czyzewski ◽  
Mariella M. Self ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Psychological Factors ◽  
Pain Severity ◽  
Irritable Bowel

scholarly journals OP0349 Remaining pain and widespread pain distribution during the first 12 months after ra diagnosis

2018 ◽  
Author(s):  
Y.C. Lee ◽  
O. Schieir ◽  
M.-F. Valois ◽  
S.J. Bartlett ◽  
G. Boire ◽  
...  
Keyword(s):  
Widespread Pain ◽  
Pain Distribution

scholarly journals Central Sensitization in Neurological, Psychiatric, and Pain Disorders: A Multicenter Case-Controlled Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Keisuke Suzuki ◽  
Yasuo Haruyama ◽  
Gen Kobashi ◽  
Toshimi Sairenchi ◽  
Koji Uchiyama ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Central Sensitization ◽  
Pain Severity ◽  
Pain Interference ◽  
Daily Activities ◽  
Effect Sizes ◽  
Medium Effect ◽  
Controlled Study ◽  
Severity Scores ◽  
The Impact

Background. The role of central sensitization in refractory pain-related diseases has not yet been clarified. Methods. We performed a multicenter case-controlled study including 551 patients with various neurological, psychological, and pain disorders and 5,188 healthy controls to investigate the impact of central sensitization in these patients. Symptoms related to central sensitization syndrome (CSS) were assessed by the Central Sensitization Inventory (CSI) parts A and B. Patients were categorized into 5 groups based on CSI-A scores from subclinical to extreme. The Brief Pain Inventory (BPI), addressing pain severity and pain interference with daily activities, and the Patient Health Questionnaire (PHQ)-9, assessing depressive symptoms, were also administered. Results. CSI-A scores and CSI-B disease numbers were significantly greater in patients than in controls ( p < 0.001 ). Medium effect sizes (r = 0.37) for CSI-A scores and large effect sizes (r = 0.64) for CSI-B disease numbers were found between patients and control groups. Compared with the CSI-A subclinical group, the CSI-A mild, moderate, severe, and extreme groups had significantly higher BPI pain interference and severity scores, PHQ-9 scores, and CSS-related disease numbers based on ANCOVA. Greater CSI-B numbers resulted in higher CSI-A scores ( p < 0.001 ) and a higher odds ratio ( p for trend <0.001). CSS-related symptoms were associated with pain severity, pain interference with daily activities, and depressive symptoms in various pain-related diseases. Conclusions. Our findings suggest that CSS may participate in these conditions as common pathophysiology.

Pharmacologic Management of Foot Pain in the Older Patient

2004 ◽  
Vol 94 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Edward W. Martin
Keyword(s):  
Pain Treatment ◽  
Treatment Strategies ◽  
Persistent Pain ◽  
Foot Pain ◽  
Loss Of Function ◽  
Significant Disability ◽  
Pharmacologic Management ◽  
Inflammatory Drugs ◽  
Topical Medications ◽  
Cyclooxygenase 2 Inhibitors

Foot pain, if not effectively managed, can result in significant disability and loss of function in older patients. This article reviews treatment strategies for acute and persistent pain, emphasizing new pharmacologic approaches. Indications, guidelines, and precautions for acute-pain treatment with acetaminophen, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, and opioids are discussed. Strategies for management of persistent pain using opioids, tricyclic antidepressants, gabapentin, and topical medications are reviewed. Common pain-management and prescribing errors are highlighted. (J Am Podiatr Med Assoc 94(2): 98-103, 2004)

Cancer-related breathlessness

2019 ◽  
pp. 513-518
Keyword(s):  
Airway Obstruction ◽  
Psychological Factors ◽  
Pulmonary Embolus ◽  
Low Dose ◽  
Radiation Pneumonitis ◽  
Treatment Strategies ◽  
Complex Nature ◽  
Relaxation Techniques ◽  
Pharmacological Interventions ◽  
Distressing Symptom

This chapter addresses the link between cancer and breathlessness by first considering dyspnoea caused directly by malignancy (such as airway obstruction), dyspnoea indirectly caused by malignancy (e.g. pulmonary embolus), and dyspnoea caused by treatment (e.g. radiation pneumonitis). Reference is made to the complex nature of breathlessness in this setting, with clear links to physiological and psychological factors. Methodologies for diagnosing and assessing breathlessness are considered, before discussing the management and treatment of this distressing symptom. Treatment strategies are divided into non-pharmacological, such as positioning and relaxation techniques and modifications, and pharmacological interventions such as use of low-dose opiates.

scholarly journals Epidemiology of uveal melanoma in Brazil

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Evandro Lucena ◽  
Daniel Cohen Goldemberg ◽  
Luiz Claudio Santos Thuler ◽  
Andreia Cristina de Melo
Keyword(s):  
Sex Education ◽  
Uveal Melanoma ◽  
Healthcare Access ◽  
Regional Distribution ◽  
Age Distribution ◽  
Treatment Strategies ◽  
Distant Metastases ◽  
Cancer Registries ◽  
Clinical Staging ◽  
Continuous Variables

Abstract Purpose To report the prevalence of uveal melanoma in a Hospital database in Brazil over the period of 16 years (2000 to 2016). Design Descriptive epidemiological study evaluating the Brazilian Hospital Based Cancer Registries. Participants/methods Uveal melanomas were identified based on ICD-O-3 codes C69.3 [choroid], C69.4 [ciliary body and iris], and C69.2 [retina]) derived from the Integrator Registry database. Kolmogorov–Smirnov Test was used for evaluation of normality of data, t-test and Chi square were used for categorical and continuous variables respectively using SPSS Software. Main outcome measures Age, sex, education, regional distribution, clinical staging at the diagnosis, time from diagnosis to treatment (≤ 60 days versus > 60 days) and first-course therapy (surgery, chemotherapy, radiotherapy or a combination of such). Results There were 2166 cases of uveal melanoma representing 5.4% of all cases of melanoma. Histological confirmation of uveal melanoma was available in all cases. Higher prevalence of 1139 cases (52.6%) in women than 1027 cases (47.4%) in men was observed. Age distribution revealed 1411 cases (65.1%) in the group between 41 and 69 years old. A total of 429 (19.8%) patients were classified as initial disease and 334 (15.4%) as advanced (regional or distant metastases). Staging as initial disease was more frequent (113–24.8%) in patients with > 8 school years than in patients with < 8 school years (179–17.6%) reflecting disparities in healthcare access between those two populations. No difference was noticed in terms of diagnosis, staging and treatment after the Brazilian “60 days law” (Federal Law 12.732/12) came into effect in 2013 regulating the maximum period that a patient with cancer has to wait until start the treatment. Conclusion Epidemiological data is critical for planning early treatment strategies and allocating medical resources. This study intended to understand the characteristics of uveal melanoma in Brazil.

Sign in / Sign up

Export Citation Format

Share Document