scholarly journals The Spatial Extent of Pain Is Associated with Pain Intensity, Catastrophizing and Some Measures of Central Sensitization in People with Frozen Shoulder

2021 ◽  
Vol 11 (1) ◽  
pp. 154
Author(s):  
Mercè Balasch-Bernat ◽  
Lirios Dueñas ◽  
Marta Aguilar-Rodríguez ◽  
Deborah Falla ◽  
Alessandro Schneebeli ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Central Sensitization ◽  
Clinical Symptoms ◽  
Pain Catastrophizing ◽  
Frozen Shoulder ◽  
Spatial Extent ◽  
Pain Sensitization ◽  
Psychological Features ◽  
Painful Area ◽  
Pain Extent

The aim of this cross-sectional study was to explore the spatial extent of pain and its association with clinical symptoms, psychological features, and pain sensitization in people with frozen shoulder (FS). Forty-eight individuals with FS completed pain drawings (PDs) and reported their clinical symptoms including pain intensity (Visual Analogue Scale) and shoulder disability (Shoulder Pain and Disability Index). Moreover, pain sensitization measurements (pressure pain thresholds, temporal summation, conditioned pain modulation, and Central Sensitization Inventory (CSI)) were assessed. Psychological features were assessed by Pain Catastrophizing Scale (PCS) and Pain Vigilance and Awareness Questionnaire. Pain frequency maps were generated, Margolis rating scale was used for pain location, and Spearman correlation coefficients were computed. The mean (SD) pain extent was 12.5% (6.7%) and the most common painful area was the anterolateral shoulder region (100%). Women presented a more widespread pain distribution compared with men. Significant positive associations were obtained between pain extent and current pain intensity (rs = 0.421, p < 0.01), PCS (rs = 0.307, p < 0.05) and CSI (rs = 0.358, p < 0.05). The anterolateral region of the shoulder was the most common painful area in people with FS. Women with FS presented more extended areas of pain; and a more widespread distribution of pain was correlated with higher levels of pain, pain catastrophizing and pain sensitization.

scholarly journals Pain-related beliefs are associated with arm function in persons with frozen shoulder

2020 ◽  
Vol 12 (6) ◽  
pp. 432-440
Author(s):  
L De Baets ◽  
T Matheve ◽  
J Traxler ◽  
JWS Vlaeyen ◽  
A Timmermans
Keyword(s):  
Pain Intensity ◽  
Self Efficacy ◽  
Glenohumeral Joint ◽  
Pain Catastrophizing ◽  
Frozen Shoulder ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Negative Effect ◽  
Explained Variance ◽  
Arm Function

Background Frozen shoulder is a painful glenohumeral joint condition. Pain-related beliefs are recognized drivers of function in musculoskeletal conditions. This cross-sectional study investigates associations between pain-related beliefs and arm function in frozen shoulder. Methods Pain intensity, arm function (Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), pain-related fear (Tampa Scale for Kinesiophobia (TSK-11)) and pain self-efficacy (Pain Self-Efficacy Questionnaire (PSEQ)) were administered in 85 persons with frozen shoulder. Correlation analyses assessed associations between pain-related beliefs and arm function. Regression analysis calculated the explained variance in arm function by pain-related beliefs. Results Pain-related fear, pain catastrophizing and pain self-efficacy were significantly associated with arm function (r = 0.51; r = 0.45 and r = −0.69, all p < .0001, respectively). Thirty-one percent of variance in arm function was explained by control variables, with pain intensity being the only significant one. After adding TSK-11, PCS and PSEQ scores to the model, 26% extra variance in arm function was explained, with significant contributions of pain intensity, pain-related fear and pain self-efficacy (R2 = 0.57). Conclusions Attention should be paid towards the negative effect of pain-related fear on outcomes in frozen shoulder and towards building one’s pain self-efficacy given its protective value in pain management.

scholarly journals Relationship Between Pain Intensity, Pain Catastrophizing, Self-efficacy in Patients With a Frozen Shoulder

2021 ◽  
Author(s):  
Junya Hirata ◽  
Minori Tomiyama ◽  
Yasuhiro Koike ◽  
Manabu Yoshimura ◽  
Keiko Inoue
Keyword(s):  
Pain Intensity ◽  
Self Efficacy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Frozen Shoulder ◽  
Estimation Method ◽  
P Value ◽  
Hypothesis Model ◽  
The Relationship

Abstract Background: The evaluation of pain catastrophizing and self-efficacy is useful for predicting pain and is also associated with shoulder pain. The purposes of our study were to examine the relationship between pain catastrophizing, self-efficacy, and pain intensity in patients with a frozen shoulder.Methods: Ninety-three patients who were diagnosed with frozen shoulder were included in this study. Pain intensity (Numerical Rating Scale: NRS), pain catastrophizing (Pain Catastrophizing Scale: PCS), and self-efficacy (Pain Self-Efficacy Questionnaire: PSEQ) were measured at the first examination, and the relationship was examined using Bayesian estimation method. We developed a hypothesis model in which self-efficacy affects pain catastrophizing and pain catastrophizing affects pain intensity.Results: The path coefficients from the PSEQ score to the PCS score and from the PCS score to the NRS score were significant. The convergence of the hypothesized model was confirmed and validated (posterior prediction p-value 0.35). Conclusion: Our results suggest that self-efficacy affects pain catastrophizing, and pain catastrophizing affects pain intensity.

scholarly journals A Central Nervous System Focused Treatment Program for People with Frozen Shoulder: A Feasibility Study.

2020 ◽  
Author(s):  
Silvia Mena-del Horno ◽  
Lirios Dueñas Moscardó ◽  
Enrique Lluch ◽  
Adriaan Louw ◽  
Alejandro Luque-Suárez ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Pain ◽  
Treatment Program ◽  
Washout Period ◽  
Pain Catastrophizing ◽  
Frozen Shoulder ◽  
Fear Avoidance ◽  
Shoulder Flexion ◽  
Pain Sensitization

Abstract Background: Frozen shoulder (FS) is a highly disabling pathology of poorly understood etiology, which is characterized by the presence of intense pain and progressive loss of range of motion (ROM). The aim of this study was to evaluate the feasibility and clinical impact of a CNS-focused treatment program for people with frozen shoulder (FS).Methods: 10 subjects with primary FS received a 10 weeks CNS-focused intervention including sensory discrimination training and graded motor imagery techniques delivered as clinic sessions (60 minutes) and home therapy (30 minutes five times per week). Measurements were taken at baseline, after a 2-weeks washout period, after treatment and at three months follow-up. The Shoulder Pain and Disability Index (SPADI) was the primary outcome. Secondary measures were: feasibility-related outcomes, self-reported shoulder pain, active and passive range of motion, two-point discrimination threshold (TPDT), left/right judgement task (LRJT), fear-avoidance (Tampa Scale for Kinesiophobia), pain catastrophization (Pain Catastrophizing Scale) and pain sensitization (Central Sensitization Inventory).Results: 70% of participants completed the treatment. No significant changes were found after washout period except for TPDT (p=0.02) and SPADI (p=0.025). Improvements in self-reported shoulder pain (p=0.028) and active shoulder flexion (p=0.016) were shown after treatment (p=0.028) and follow-up (p=0.001) and in SPADI at follow-up (p=0.008). No significant changes were observed in TPDT, LRJT, fear-avoidance, pain catastrophization and pain sensitization. Conclusions: a CNS-focused treatment program might be a suitable approach to improve pain and disability in FS but further research is needed to draw firm conclusions.Trial registration: Clinical Trials. NCT03320200. Registered 25 October 25 2017, https://clinicaltrials.gov/ct2/show/NCT03320200?term=NCT03320200&draw=2&rank=1

scholarly journals Relationship between pain intensity, pain catastrophizing, and self-efficacy in patients with frozen shoulder: a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Junya Hirata ◽  
Minori Tomiyama ◽  
Yasuhiro Koike ◽  
Manabu Yoshimura ◽  
Keiko Inoue
Keyword(s):  
Pain Intensity ◽  
Self Efficacy ◽  
Psychological Factors ◽  
Rating Scale ◽  
Pain Catastrophizing ◽  
Explanatory Power ◽  
Frozen Shoulder ◽  
Estimation Method ◽  
Information Criterion ◽  
The Impact

Abstract Background Pain catastrophizing and self-efficacy are useful for predicting pain; these are associated with pain intensity and facilitate evaluation of psychological factors. However, it remains unclear whether the effects are direct or indirect in patients with frozen shoulder; the impact on each variable has also not been clarified. Thus, this study aimed to examine the structural relationship between pain catastrophizing, self-efficacy, and pain intensity in patients with frozen shoulder. Methods Participants who were diagnosed with frozen shoulder between January 2016 and March 2017 were recruited from a single orthopedic clinic. Patients aged 18 years or older, who had been symptomatic for < 1 year and reported localized pain in one shoulder, experienced night pain, and had restricted active and passive shoulder motions were included. Pain intensity (Numerical Rating Scale (NRS)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), and self-efficacy (Pain Self-Efficacy Questionnaire (PSEQ)) were measured at the first examination, and the relationship was examined using the Bayesian estimation method. The model was modified repeatedly based on the posterior prediction p value, deviance information criterion (DIC), and Bayesian information criterion (BIC); the model with the highest explanatory power was adopted as the final model. Results Ninety-three patients diagnosed with frozen shoulder were included in this study. On path analysis, the model in which pain intensity affected psychological factors had the most explanation. The convergence index potential scale reduction was below 1.1, and the convergence of the estimate was confirmed. The posterior prediction p value was 0.25, DIC = 1328.705, and BIC = 1356.872; the validity of the fit of the model was confirmed. The path coefficients from the NRS to the PSEQ, from the NRS to the PCS, and from the PSEQ to the PCS scores were − 0.232 (95% confidence interval (CI), − 0.406 to − 0.033), 0.259 (95% CI, 0.083–0.419), and − 0.504 (95% CI, − 0.646 to − 0.334), respectively; these values were statistically significant (p < 0.05). Conclusion Our results show that pain intensity increases the risk of chronic pain including pain catastrophizing and self-efficacy and that pain catastrophizing increases by decreasing self-efficacy in patients with frozen shoulder.

Addition of Slowly Repeated Evoked Pain Responses to Clinical Symptoms Enhances Fibromyalgia Diagnostic Accuracy

Pain Medicine ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. 3479-3487 ◽  
Author(s):  
Pablo de la Coba ◽  
Stephen Bruehl ◽  
Gustavo A. Reyes del Paso
Keyword(s):  
Rheumatoid Arthritis ◽  
Diagnostic Accuracy ◽  
Clinical Features ◽  
Clinical Symptoms ◽  
Pain Catastrophizing ◽  
Negative Mood ◽  
Pain Syndrome ◽  
Healthy Individuals ◽  
Clinical Pain ◽  
Pain Sensitization

Abstract Objective Fibromyalgia is a chronic pain syndrome characterized by central sensitization. A novel protocol based on slowly repeated evoked pain (SREP) appears to be a useful marker of pain sensitization in fibromyalgia patients. Whether SREP enhances diagnostic accuracy beyond key clinical symptoms that characterize fibromyalgia has not been examined. Methods Fifty fibromyalgia patients, 30 rheumatoid arthritis patients, and 50 healthy individuals were evaluated to assess clinical pain, as well as fatigue, insomnia, pain catastrophizing, and negative mood. The SREP protocol consisted of a series of nine low-intensity painful pressure stimuli of five seconds’ duration with 30-second interstimulus intervals. SREP sensitization was indexed by increases in pain intensity ratings across stimuli. Results SREP sensitization was observed in fibromyalgia but not in rheumatoid arthritis or healthy individuals. As expected, fibromyalgia patients exhibited a more negative psychosocial profile than did rheumatoid arthritis patients and healthy individuals. SREP was positively associated with clinical pain, fatigue, insomnia, and catastrophizing, but not with negative mood. SREP discriminated fibromyalgia cases from rheumatoid arthritis and healthy individuals even when current clinical pain was included in the analysis. Combining fatigue, insomnia, and SREP led to near perfect diagnostic accuracy (99%) in differentiating fibromyalgia from healthy individuals and 86.3% accuracy in discriminating fibromyalgia from rheumatoid arthritis. Conclusions These results provide further evidence of SREP as a marker of pain sensitization in fibromyalgia and suggest that it captures aspects of fibromyalgia not fully captured by clinical features. Combining SREP with assessment of clinical features could potentially improve fibromyalgia diagnosis.

Symptoms of central sensitization in patients with inflammatory bowel diseases: a case-control study examining the role of musculoskeletal pain and psychological factors

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Carrie Falling ◽  
Simon Stebbings ◽  
G David Baxter ◽  
Corey A Siegel ◽  
Richard B Gearry ◽  
...  
Keyword(s):  
Perceived Stress ◽  
Inflammatory Bowel Diseases ◽  
Central Sensitization ◽  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Group Differences ◽  
Healthy Controls ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Psychological Features

AbstractObjectivesMusculoskeletal (MSK) pain is a common complaint in patients with inflammatory bowel diseases (IBD). MSK pain in IBD has previously demonstrated association with symptoms of central sensitization; however it is uncertain whether these symptoms are influenced simply by the presence of MSK pain and/or IBD. Primary aim of this study was to investigate whether symptoms of central sensitization differed across three groups: IBD patients with and without MSK pain and healthy controls. Secondary aim was to investigate between-group differences for measures of somatosensory functioning.MethodsCross-sectional study was performed on adults with IBD. Assessments included: central sensitization inventory (CSI), pressure pain threshold, temporal summation, conditioned pain modulation, perceived stress, affect style, anxiety, depression, and pain catastrophizing. One-way analyses of variance and covariance were used to investigate between-group differences for measures of central sensitization and potential confounding by psychological factors.ResultsStudy participants (n=66) were age/gender matched across three study groups. Between-group differences were solely demonstrated for CSI scores [F(2,63)=19.835, p<0.001, r=0.62], with IBD patients with MSK pain demonstrating the highest CSI scores and healthy controls the lowest. After controlling for individual psychological features, post hoc comparisons indicated that CSI scores were significantly different between-groups (p≤0.025) after controlling for most psychological variables, with the exception of perceived stress (p=0.063) and pain catastrophizing (p=0.593).ConclusionsIBD patients as a whole demonstrated significantly greater symptoms of central sensitization compared to healthy controls. However, IBD patients with persistent MSK pain demonstrated the greatest symptoms of central sensitization compared to patients without MSK pain and healthy controls. Between-group differences for CSI in IBD patients with MSK were not confounded by psychological features.ImplicationsStudy results indicate that persistent MSK pain in IBD represents patients with greater central sensitization symptomology. This increased symptomology is suggestive of underlying mechanisms related to central sensitization, highlighting patient potentially at risk for worse pain experiences.

scholarly journals Menstrual Pain Intensity, Coping, and Disability: The Role of Pain Catastrophizing

Pain Medicine ◽  
2003 ◽  
Vol 4 (4) ◽  
pp. 352-361 ◽  
Author(s):  
Trudi M. Walsh ◽  
Leeanne LeBlanc ◽  
Patrick J. McGrath
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Menstrual Pain

Pain Catastrophizing Is Independently Associated with Quality of Life in Patients with Severe Hip Osteoarthritis

Pain Medicine ◽  
2018 ◽  
Vol 20 (11) ◽  
pp. 2220-2227 ◽  
Author(s):  
Kazuhiro Hayashi ◽  
Takkan Morishima ◽  
Tatsunori Ikemoto ◽  
Hirofumi Miyagawa ◽  
Takuya Okamoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Gait Speed ◽  
Pain Catastrophizing ◽  
Hip Osteoarthritis ◽  
Cross Sectional ◽  
Japanese Orthopedic Association ◽  
Affected Side ◽  
Tertiary Center

AbstractObjective. Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. Design. Cross-sectional study conducted between June 2017 and February 2018. Setting. Tertiary center. Subjects. Seventy consecutively enrolled patients with severe hip osteoarthritis who had experienced pain for six or more months that limited daily function, and who were scheduled for primary unilateral total hip arthroplasty. Methods. QOL was measured using the EuroQOL-5 Dimensions questionnaire, the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire, and a dissatisfaction visual analog scale. Covariates included pain intensity, pain catastrophizing, range of hip motion, and gait speed. The variables were subjected to multivariate analysis with each QOL scale. Results. The median age was 68 years, and the median Pain Catastrophizing Scale score was 26. In multiple regression analysis, pain catastrophizing, pain intensity in both hips, pain intensity on the affected side, hip flexion on the affected side, and gait speed were independently correlated with QOL. Conclusions. Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.

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