The Clinical Journal Of Pain[JOURNAL]
Sun
200 papers
A Qualitative Assessment of Adolescent Symptom Report and Caregiver Concordance Following Outpatient Surgery.
Brown SES, Costa C, Kelly A … +6 more , Oh S, Waitzman G, Dinh D, Clauw D, Waljee JF, Carlozzi NE
Clin J Pain · 2025 Jan · PMID 39668787 · Publisher ↗
OBJECTIVES: Limited data exist regarding recovery from surgery from the adolescent's perspective, or data regarding concordance between adolescent and caregiver symptom reports preventing appreciation of adolescent needs...
OBJECTIVES: Limited data exist regarding recovery from surgery from the adolescent's perspective, or data regarding concordance between adolescent and caregiver symptom reports preventing appreciation of adolescent needs and hindering the provision of appropriate care. METHODS: We conducted semi-structured interviews with adolescents ages 12 to 17 and a parent caregiver 2 weeks following a variety of outpatient elective surgeries about recovery symptoms. We used latent manifest content analysis to analyze interview data. Caregiver-adolescent response concordance was assessed using Cohen κ. RESULTS: Interviews were conducted with 31 adolescent-caregiver pairs (median age: 15 y). Fifty-eight percent of adolescents and 84% of caregivers were female; 71% of adolescents were White. Twenty-three percent of children reported severe pain, some of which was not expected given the surgery. Severe pain was associated with nausea (71%, P=0.002), pain-related sleep disturbance (86%, P=0.007), and severe anxiety (43%, P=0.008). Fatigue was also common (58%), but not associated with severe pain (P=0.484) or sleep disturbance (P=0.577). Thirty-nine percent reported anxiety; 32% experienced anger/frustration. Caregiver-adolescent concordance was only substantial for severe pain (κ=0.71) and anger/frustration (κ=0.67). Caregiver reports also often included psychological symptoms not reported by their children, with qualitative evidence supporting caregiver accuracy. DISCUSSION: Adolescents may experience significant physical symptoms, such as pain and fatigue, even after minor surgeries. Fatigue symptoms may be unrelated to pain or sleep. Caregiver report of adolescent psychological symptoms may be necessary to gain a complete understanding of those symptoms in this population.
Pediatric Neural Changes to Physical and Emotional Pain After Intensive Interdisciplinary Pain Treatment: A Pilot Study.
Lepping RJ, Hoffart CM, Bruce AS … +4 more , Taylor JM, Mardis NJ, Lim SL, Wallace DP
Clin J Pain · 2024 Nov · PMID 39514716 · Publisher ↗
OBJECTIVE: Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth. METH...
OBJECTIVE: Brain areas activated during pain can contribute to enhancing or reducing the pain experience, showing a potential connection between chronic pain and the neural response to pain in adolescents and youth. METHODS: This study examined changes in brain activation associated with experiencing physical pain and observing physical and emotional pain in others by using functional magnetic resonance imaging (fMRI) before and after intensive interdisciplinary pain treatment (IIPT). Eighteen youths (age 14 to 18) with widespread chronic pain completed fMRI testing before and after IIPT to assess changes in brain activation in response to physical and emotional pain. RESULTS: Broadly, brain activation changes were observed in frontal, somatosensory, and limbic regions. These changes may suggest improvements in descending pain modulation via thalamus and caudate, and the different pattern of brain activation after treatment suggests potentially better discrimination between physical and emotional pain. Brain activation changes were also correlated with improvements in clinical outcomes of catastrophizing (reduced activation in right caudate, right mid-cingulate, and postcentral gyrus) and pain-related disability (increased activation in precentral gyrus, left hippocampus, right middle occipital cortex, and left superior frontal gyrus). DISCUSSION: These changes could indicate that reduced brain protective responses to pain were associated with treatment-related improvements. This pilot study highlights the need for larger trials designed to better understand the brain mechanisms involved in pediatric widespread pain treatment.
Assessing the Analgesic Efficacy of Bilateral External Oblique Intercostal Plus Rectus Sheath Block in Laparoscopic Cholecystectomy: Methodology is Important.
Sun L, Feng Y
Clin J Pain · 2024 Dec · PMID 39513297 · Publisher ↗
Abstract loading — click title to view on PubMed.
The Impact of a Brief Educational Seminar on Pediatric Pain-focused Cognitive-Behavioral Therapy for School Providers.
Siebert E, Pierce SJ, Ely SL … +1 more , Cunningham NR
Clin J Pain · 2024 Dec · PMID 39513296 · Full text
OBJECTIVES: Pediatric chronic pain is common and can be detrimental to children's social, emotional, and school functioning. Nonpharmacological approaches to chronic pain, like cognitive- behavioral therapy (CBT), can be...
OBJECTIVES: Pediatric chronic pain is common and can be detrimental to children's social, emotional, and school functioning. Nonpharmacological approaches to chronic pain, like cognitive- behavioral therapy (CBT), can be effective. Schools could provide children with chronic pain access to these interventions. However, school professionals (ie, nurses and mental health providers) are seldom trained in CBT, creating a barrier to accessing such help. A seminar was created to introduce CBT strategies for chronic pediatric pain to school professionals. Feasibility, acceptability, and self-reported knowledge gained from the seminar were examined. MATERIALS AND METHODS: Two introductory seminars (~2.5 h each) were held separately for the Michigan Association of School Nurses and the health department of Northwest Michigan (n = 71 total). The seminar provided an understanding of pain and pain-focused CBT strategies (eg, activity pacing, positive self-statements, and psychoeducation). Fifty-two school nurses, 16 mental health professionals, and 3 participants (unidentified title) rated program acceptability and self-reported knowledge of CBT before and after training (1 = strongly disagree, 5 = strongly agree). RESULTS: Of the respondents, 89.6% agreed the training was helpful, and 87.5% were interested in additional training. For all questions relating to knowledge of CBT, a mixed-model interaction showed a meaningful, increase of at least 1 point (on a 5-point Likert Scale), F(2, 69.83) = 3.93, P = 0.024. CONCLUSION: This study underscores the feasibility and acceptability of training school health providers in CBT for pediatric chronic pain. This project also established key partnerships in Michigan to expand future work in this realm with more comprehensive training and assessment of outcomes.
Comparison of Ultrasound-guided Single-injection Erector Spinae Plane Block, Retrolaminar Block, and Paravertebral Block for Postoperative Analgesia in Single-incision Video-assisted Thoracoscopic Surgery: A 3-arm, Double-blind, Randomized Controlled Noninferiority Trial.
Zhu Y, Yang Y, Zhang Q … +9 more , Li X, Xue W, Liu Y, Zhao Y, Xu W, Yan P, Li S, Fang Y, Huang J
Clin J Pain · 2025 Jan · PMID 39477915 · Publisher ↗
OBJECTIVE: Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB)...
OBJECTIVE: Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS). METHODS: Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures. RESULTS: The AUC for NRS was 107.8±10.53 in the ESPB group, 104.8±8.05 in the RLB group, and 103.6±10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2±3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2±2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events. DISCUSSION: ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety.
Ultrasound-Guided Double-Point Versus Single-Point Serratus Anterior Plane Block for Modified Radical Mastectomy: A Randomized Controlled Trial.
Xu J, Ling D, Xu Q … +5 more , Sun P, Wei S, Gao L, Lou F, Zhang J
Clin J Pain · 2025 Jan · PMID 39475834 · Publisher ↗
OBJECTIVES: The double-point serratus anterior plane block (SAPB) covers more area, including the axilla, than the single-point approach, potentially offering better pain relief after modified radical mastectomy (MRM). T...
OBJECTIVES: The double-point serratus anterior plane block (SAPB) covers more area, including the axilla, than the single-point approach, potentially offering better pain relief after modified radical mastectomy (MRM). The objective of this study were to evaluate the clinical outcomes of these 2 procedures for patients treated with MRMs. METHODS: Sixty women were randomly assigned to double- or single-point groups. Double-point received SAPB at the third and fifth ribs, single-point at the fifth rib. The primary outcome includes pain numeric rating scale (NRS) at rest and movement 24 hours postsurgery. The secondary outcomes are axilla comfort NRS, recovery quality, and adverse events. RESULTS: At 24 hours postsurgery, the double-point group compared with the single-point group showed movement pain NRS of 3 (2 to 3) versus 3 (3 to 4) ( P =0.011) and rest pain NRS of 1 (1 to 1) versus 2 (1 to 3) ( P =0.037). The difference between them did not exceed the minimum clindically important difference (MCID). The axillary comfort NRS in the double-point group was lower than the single-point group at 6 and 12 hours postsurgery, at 1 (1 to 2) versus 2 (2 to 4) ( P =0.001) and 1 (1 to 2) versus 2 (2 to 4) ( P =0.01), respectively, but there were no statistically significant differences at 24 and 48 hours postsurgery. At 48 hours postsurgery, pain scores and opioid use were similar in both groups. Recovery scores, rescue analgesia timing, adverse events, and hospital stay length were similar in both groups. DISCUSSION: Double-point SAPB offers wider anesthetic spread but shows no significant clinical advantage in pain or axillary comfort over single-point SAPB after MRM.
Can Offset Analgesia Magnitude Provide Additional Information About Endogenous Pain Modulation in People With Knee Osteoarthritis?: An Experimental Study.
Johansson E, Puts S, Rice D … +7 more , Beckwée D, Leemans L, Bilterys T, Schiphof D, Bautmans I, Coppieters I, Nijs J
Clin J Pain · 2025 Jan · PMID 39475823 · Publisher ↗
OBJECTIVES: To investigate the relationship between offset analgesia magnitude and the responsiveness to conditioned pain modulation (CPM), temporal summation of (second) pain (TSP), and clinical pain severity in people...
OBJECTIVES: To investigate the relationship between offset analgesia magnitude and the responsiveness to conditioned pain modulation (CPM), temporal summation of (second) pain (TSP), and clinical pain severity in people with knee osteoarthritis (KOA). METHODS: Electrical stimuli were applied to 88 participants with KOA to measure offset analgesia at the volar forearm of the dominant hand, and CPM and TSP at the most symptomatic knee and ipsilateral volar wrist. Clinical pain severity was assessed using the pain subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS PAIN ). Linear mixed-effects models evaluated pain modulatory effects across all tests, and Spearman partial correlations assessed associations between offset analgesia, CPM, TSP, and KOOS PAIN while accounting for covariates of interest. Participants unable to validly finish all psychophysical tests were excluded from effect and correlation analyses but were evaluated for predictors of nonvalid completion using bivariate Stochastic Search Variable Selection. RESULTS: Significant pain modulation was observed across all psychophysical tests ( P <0.05), and no meaningful predictors of nonvalid test completion were found. Offset analgesia magnitude did not significantly correlate with CPM, TSP, or KOOS PAIN ( P ≥0.05), with a maximum partial correlation coefficient of ρ =0.21. DISCUSSION: Offset analgesia was not associated with CPM, TSP, or KOOS PAIN in people with KOA. Despite the lack of case-control studies comparing offset analgesia between people with KOA and healthy controls, these findings suggest that offset analgesia may provide information about endogenous pain modulation beyond CPM and TSP, though its clinical translation remains uncertain.
Alcohol, Tobacco, and Marijuana Use Among Individuals Receiving Prescription Opioids for Pain Management.
Miller-Matero LR, Pappas C, Altairi S … +10 more , Sehgal M, Chrusciel T, Salas J, Secrest S, Wilson L, Carpenter RW, Sullivan MD, Ahmedani BK, Lustman PJ, Scherrer JF
Clin J Pain · 2025 Jan · PMID 39470110 · Full text
OBJECTIVE: Substance use among individuals receiving prescription opioids for pain may be associated with poorer functioning. The purpose of this study was to examine whether the use of substances (ie, alcohol, marijuana...
OBJECTIVE: Substance use among individuals receiving prescription opioids for pain may be associated with poorer functioning. The purpose of this study was to examine whether the use of substances (ie, alcohol, marijuana, or tobacco) among individuals prescribed opioids for pain management was associated with pain, psychiatric disorders, and opioid misuse. METHODS: Patients with non-cancer pain and a new opioid prescription were recruited from 2 health systems. Participants (N = 827) completed measures regarding pain severity, pain interference, psychiatric symptoms, and substance use. RESULTS: Substance use was common with 58.0%, 26.2%, and 28.9% reporting alcohol, tobacco, and marijuana use, respectively. The use of tobacco or marijuana was associated with poorer functioning. Those with tobacco use had greater pain severity, interference, number of pain sites, and concern for opioid misuse, and were more likely to have probable depression, anxiety, and posttraumatic stress disorders. Participants reporting marijuana use were more likely to have higher concerns for opioid misuse scores and probable depression, anxiety, and posttraumatic stress disorders. Use of alcohol was associated with lower pain severity and interference and fewer number of pain sites. CONCLUSION: Substance use is common among individuals receiving prescription opioids. Some types of substance use may be related to poorer opioid, pain, and psychiatric functioning. Clinicians prescribing opioids for pain management should assess for substance use, including tobacco, and be aware of the association with poorer functioning. Interventions could target pain, psychiatric symptoms, and substance use simultaneously to optimize outcomes for individuals with pain and substance use.
Percutaneous Electrical Stimulation Improves Chronic Knee Pain and Function: A Systematic Review and Meta-analyses.
Heredia Ciuró A, Martín Núñez J, Calvache Mateo A … +4 more , López López L, Cebriá I Iranzo MDA, Cabrera Martos I, Valenza MC
Clin J Pain · 2025 Jan · PMID 39412168 · Publisher ↗
OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the effectiveness of percutaneous electrical stimulation in the modulation of pain and its implication in the function of patients with a pa...
OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the effectiveness of percutaneous electrical stimulation in the modulation of pain and its implication in the function of patients with a painful knee condition. MATERIALS AND METHODS: A search was conducted from database inception to September 2023 across PubMed, Web of Science, and Scopus databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies. Study quality was assessed using the physiotherapy evidence database Scale and the risk of bias was evaluated with the Cochrane Assessment tool. RESULTS: Eight studies were included. A significant statistical effect was found ( P < 0.001) for reducing pain and improving function after treatment. In addition, a significant statistical effects were identified for reducing pain ( P = 0.009) and improving function ( P < 0.001) after follow-up. The risk of bias was low. CONCLUSION: This review showed a positive effect of applying the percutaneous electrical stimulation for reducing pain and improving function in adults with a painful knee.
Assessing the Evidence for Erector Spinae Plane Block in Spine Surgery.
Chen IW, Yu TS, Hung KC
Clin J Pain · 2024 Dec · PMID 39392094 · Publisher ↗
Abstract loading — click title to view on PubMed.
The Relationship of Pain Intensity, Perceived Injustice, and Pain Catastrophizing to Heart Rate Variability In Naturally Occurring Acute Pain.
Steere KB, Langford DJ, Collins SM … +1 more , Litwin B
Clin J Pain · 2024 Dec · PMID 39319634 · Publisher ↗
OBJECTIVES: Behavioral factors of pain catastrophizing and perceived injustice are associated with pain intensity in chronic pain. Diminished heart rate variability (HRV) is also strongly associated with chronic pain. Th...
OBJECTIVES: Behavioral factors of pain catastrophizing and perceived injustice are associated with pain intensity in chronic pain. Diminished heart rate variability (HRV) is also strongly associated with chronic pain. These factors have been less explored earlier in the pain experience and it is unclear whether they play a role in the transition from acute to chronic pain. The aim of this study was to determine the relationship between pain catastrophizing, perceived injustice, pain intensity, and HRV in naturally occurring acute pain. MATERIALS AND METHODS: Ninety-seven patients were recruited from local outpatient physical therapy clinics. Seated HRV was captured on 94 patients via Polar chest strap while patients were taking a survey via iPad. In addition to sociodemographic data, the survey included the Pain Catastrophizing Scale (PCS), Injustice Experience Questionnaire (IEQ), and Numeric Pain Rating Scale (NPRS). The natural log of high-frequency power (lnHFP) HRV was used in the statistical analysis. RESULTS: Multiple linear regression modeling revealed that lower pain catastrophizing, higher perceived injustice, and lower pain intensity were associated with lower HRV, and accounted for 11.4% of the variance in HRV. DISCUSSION: While greater chronic pain intensity is associated with lower HRV, the relationship is reversed in the setting of acute pain. These findings highlight the need to better understand the unique factors that contribute to lower HRV in the acute phase.
Relative Perioperative Analgesic Efficacy of Superficial Versus Deep Approach of Serratus Anterior Plane Block for Anterior Chest Wall Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Singh NP, Makkar JK, Dhawan I … +3 more , Singh N, Singh PM, Siddiqui N
Clin J Pain · 2024 Dec · PMID 39314131 · Publisher ↗
OBJECTIVES: Both superficial and deep serratus anterior plane (SAP) blocks are effective for anterior chest wall surgeries, but there is little clarity on which is more effective. Hence, we conducted a systematic review...
OBJECTIVES: Both superficial and deep serratus anterior plane (SAP) blocks are effective for anterior chest wall surgeries, but there is little clarity on which is more effective. Hence, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the comparative efficacy of the 2 approaches for SAP block after anterior chest wall surgery. MATERIALS AND METHODS: A systematic literature search was performed using PubMed, Embase, Scopus, and Cochrane Central Registers of Controlled Trials for eligible RCTs from inception until August 2023. The primary outcome was opioid consumption during the first 24 hours of the postoperative period. The secondary outcomes included pain scores at various intervals, intraoperative opioid consumption, time to first analgesic request, block-related complications, opioid-related side effects, and patient satisfaction scores. Statistical analysis of the pooled data was performed using Review Manager Version 5.3. RESULTS: We identified 7 RCTs published between 2020 and 2022, enrolling 371 patients (186 in the superficial SAP block and 187 in the deep SAP block). Moderate certainty of evidence suggests that both the approaches (deep and superficial) of SAP block were comparable for 24-hour oral morphine equivalent consumption with a mean difference (MD) of 3.78 mg (95% CI: -1.70 to 9.29; P = 0.18; I2 = 87%). The results of other secondary outcomes were comparable, including resting pain scores with an MD of 0.08 (95% CI: -0.27 to 0.43; P = 0.67; I2 = 87%) for early pain and MD of 0.63 (95% CI: -1.28 to 0.01; P = 0.05; I2 = 95%) for late pain scores, time to first analgesic request with MD of -0.41 hour (95% CI: -1.40 to 0.59; P = 0.42; I2 = 90%), and incidence of postoperative nausea and vomiting (odds ratio: 1.45 (95% CI: 0.72 to 2.90; P = 0.30; I2 = 0%). CONCLUSION: Current evidence does not support the preference for one approach of SAP block over the other for postoperative pain. Based on the available data, we recommend further future trials to determine any differences between these interventions.
Transcranial Direct Current Stimulation Reduces Pressure Pain Sensitivity in Patients With Noncancer Chronic Pain.
Zolezzi DM, Kold S, Brock C … +7 more , Jensen ABH, Jensen ST, Larsen IM, Olesen SS, Mørch CD, Drewes AM, Graven-Nielsen T
Clin J Pain · 2024 Nov · PMID 39310962 · Publisher ↗
OBJECTIVES: Noncancer chronic pain is a clinical challenge because pharmacological treatment often fails to relieve pain. Transcranial direct current stimulation (tDCS) is a treatment that could have the potential for pa...
OBJECTIVES: Noncancer chronic pain is a clinical challenge because pharmacological treatment often fails to relieve pain. Transcranial direct current stimulation (tDCS) is a treatment that could have the potential for pain relief and improvement in quality of life. However, there is a lack of clinical trials evaluating the effects of tDCS on the pain system. The aim of the present study was to evaluate the effect of 5 days of anodal tDCS treatment on the pain system in patients with chronic noncancer pain using quantitative sensory testing and quality of life questionnaires: (1) Brief Pain Inventory-short form, (2) European Organization for Research and Treatment of Life Questionnaire-C30, and (3) Hospital Anxiety Depression Scale. METHODS: Eleven patients with noncancer chronic pain (51 ± 13.6 y old, 5M) participated in the study. Anodal tDCS was applied for 5 consecutive days, followed by sham stimulation after a washout period of at least 2 weeks. Pressure pain thresholds and pain tolerance thresholds (PTT) were assessed in different body regions on days 1 and 5. RESULTS: Anodal tDCS appeared to maintain PTT at C5 (clavicle) on day 5, but sham stimulation decreased PTT ( P = 0.007). In addition, anodal tDCS increased PTT compared with sham at day 5 at Th10 ventral dermatomes ( P = 0.014). Both anodal and sham tDCS decreased the Brief Pain Inventory-short form total and interference scores, and the European Organization for Research and Treatment of Life Questionnaire-C30 fatigue score, but no interaction effect was observed. CONCLUSION: This study adds to the evidence in the literature that tDCS may be a potential therapeutic tool for the management of noncancer chronic pain.
Comparison of Intercostal Nerve Block and Serratus Anterior Plane Block for Perioperative Pain Management and Impact on Chronic Pain in Thoracoscopic Surgery: A Randomized Controlled Trial.
Jin J, Sun H, Zhang X … +5 more , Wu X, Pan X, Lv D, He Y, Cao X
Clin J Pain · 2024 Dec · PMID 39310947 · Full text
OBJECTIVES: The intent of this study was to compare the analgesic efficacy of intercostal nerve block (ICNB) under direct thoracoscopic visualization and serratus anterior plane block (SAPB) with ultrasound guidance duri...
OBJECTIVES: The intent of this study was to compare the analgesic efficacy of intercostal nerve block (ICNB) under direct thoracoscopic visualization and serratus anterior plane block (SAPB) with ultrasound guidance during thoracoscopic surgery's perioperative period. Furthermore, it examined their impact on chronic pain and identifies potential risk factors associated with its development. MATERIALS AND METHODS: In this prospective randomized controlled study, 74 thoracoscopic surgery patients were randomly assigned to ICNB or SAPB groups. Attending surgeons administered ICNB, while anesthesiologists performed SAPB, both using 20 mL of 0.5% ropivacaine. Primary outcomes included Visual Analog Scale (VAS) scores for resting and coughing pain at 6, 12, 24, and 48 hours postoperatively, perioperative opioid and NSAID consumption, and chronic pain incidence at 3 months postoperatively. Secondary outcomes aimed to identify independent risk factors for chronic pain. RESULTS: The primary results reveal that the SAPB group exhibited significantly lower VAS scores than the ICNB group for postoperative coughing at 24 hours ( P <0.001, 95% CI=0.5, 1) and for resting pain at 48 hours ( P =0.001, 95% CI=0.2, 1). Conversely, the ICNB group demonstrated a reduced VAS score for resting pain at 6 hours compared with the SAPB group ( P =0.014, 95% CI=-0.5, 0.5). SAPB group required significantly less intraoperative sulfentanil ( P <0.001, 95% CI=2.5, 5), remifentanil ( P =0.005, 95% CI=-0.4, -0.1), and flurbiprofen ester ( P =0.003, 95% CI=0, 50) than ICNB group. Chronic pain incidence was similar ( P =0.572, 95% CI=0.412, 1.279), with mild pain in both ICNB and SAPB groups. Secondary findings indicate that resting VAS score at 12 hours (OR=7.59, P =0.048, 95% CI=1.02, 56.46), chest tube duration (OR=3.35, P =0.029, 95% CI=1.13, 9.97), and surgical duration (OR=1.02, P =0.049, 95% CI=1.00, 1.03) were significant predictors of chronic pain occurrence. DISCUSSION: ICNB and SAPB demonstrated comparable analgesic effects, with similar rates of chronic pain occurrence. Chronic pain independent risk factors included resting VAS score at 12 hours, chest tube duration, and surgical duration.
The Increase in Early Menarche is Associated With the Increase in Chronic Back Pain in Female Adolescents: The Health Behavior in School-aged Children Study 2002-2014.
Roman-Juan J, Jensen MP, Miró J
Clin J Pain · 2024 Nov · PMID 39285799 · Publisher ↗
OBJECTIVE: Research has shown that there has been an increase in the prevalence of chronic back pain (CBP) in adolescents, especially in female adolescents. The purpose of the current study was to test the hypothesis tha...
OBJECTIVE: Research has shown that there has been an increase in the prevalence of chronic back pain (CBP) in adolescents, especially in female adolescents. The purpose of the current study was to test the hypothesis that the observed increase in the prevalence of early menarche in female adolescents is contributing to the increase in the prevalence of CBP over time in this population. METHODS: Cross-sectional data from 251,390 female adolescents from 27 countries/regions were drawn from the Health Behaviour in School-aged Children questionnaire-based surveys conducted in 2002, 2006, 2010, and 2014. The Karlson-Holm-Breen method was used to examine the explanatory role of the increase in the prevalence of early menarche on the increase in the prevalence of CBP while controlling for socioeconomic status, physical activity, body mass index, and psychological symptoms. RESULTS: The increase in the prevalence of early menarche between 2002 and 2014 was associated with the increase in the prevalence of CBP ( P < 0.001). The percent of CBP prevalence increase accounted for by the increase in early menarche was 2.2%. CONCLUSIONS: The increase in the prevalence of CBP in female adolescents observed over the last decade may be explained, in part, by the decrease in the age of menarche. This finding, coupled with research showing a decline in early menarche worldwide, highlights the need to delve deeper into the underlying mechanisms of the association between early menarche and pain-particularly CBP-in female adolescents.
Effects of Clinic-based and Telerehabilitation-based Motor Control Exercises in Individuals with Chronic Low-back Pain: A Randomized Controlled Trial With 3-Month Follow-up.
Fanuscu A, Öz M, Özel Asliyüce Y … +2 more , Turhan E, Ülger Ö
Clin J Pain · 2024 Dec · PMID 39285790 · Publisher ↗
OBJECTIVE: To evaluate the effectiveness of clinic-based and telerehabilitation-based motor control exercises in individuals with chronic low-back pain 3 months posttreatment. METHODS: Forty-two participants were randomi...
OBJECTIVE: To evaluate the effectiveness of clinic-based and telerehabilitation-based motor control exercises in individuals with chronic low-back pain 3 months posttreatment. METHODS: Forty-two participants were randomized to either clinic-based or telerehabilitation-based groups, performing exercises 3 times weekly for 8 weeks. Assessments were conducted pre-intervention, postintervention and 1 and 3 month follow-ups. The primary outcome was pain intensity (Visual Analog Scale) for low-back pain. RESULTS: Both exercise approaches were found to be similarly effective in improving pain disability, quality of life (except for emotional response, energy level, sleep, and social isolation), and pain catastrophizing at both follow-up time points. The Visual Analog Scale showed statistically significant reductions in pain from baseline at all time points in both groups ( P <0.001), with effect sizes ranging from moderate to strong. Nottingham Health Profile showed significant improvements in physical activity, pain, and total score, with effect sizes ranging from moderate to strong. No statistically significant changes in spatiotemporal gait parameters were observed in either group. According to the postintervention intention-to-treat analysis, lumbar flexion range of motion showed statistically significant improvements in both groups with small effect sizes ( P <0.05). DISCUSSION: Telerehabilitation-based motor control exercises proved as effective as clinic-based methods in treating chronic low-back pain, offering a viable alternative tailored to individual needs and circumstances.
Is Social Support Associated With Clinical Outcomes in Adults With Nonspecific Chronic Low Back Pain? A Systematic Review.
Bisconti M, Esposto M, Tamborrino A … +3 more , Brindisino F, Giovannico G, Salvioli S
Clin J Pain · 2024 Oct · PMID 39268726 · Publisher ↗
OBJECTIVES: Nonspecific chronic low back pain (NSCLBP) is associated with psychological and social factors such as social support. However, little research has focused on the latter. This article aimed to review the lite...
OBJECTIVES: Nonspecific chronic low back pain (NSCLBP) is associated with psychological and social factors such as social support. However, little research has focused on the latter. This article aimed to review the literature on the association between social support and clinical outcomes of patients with NSCLBP, particularly regarding differences in sex, gender, and types of social support. METHODS: MEDLINE, EMBASE, Web of Science, PsycINFO, and CENTRAL were searched until April 19, 2024, without restrictions of time or language. Eligible articles were observational studies reporting measures of association between social support and clinical outcomes among adults with NSCLBP. Risk of bias was assessed using the QUIPS tool, and findings were analyzed qualitatively. This systematic review was registered on PROSPERO (CRD42022363210). RESULTS: Of the 3528 identified studies, 11 were included in the review (1290 patients), showing a moderate to high risk of bias. Of the 5 studies showing a significant finding for pain, 4 reported a negative correlation (r=-0.18, -0.32, -0.35, -0.36) and 1 did not report any association index. Of the 6 studies showing a significant finding for disability, 2 reported a negative correlation (r=-0.29, -0.42), 2 reported a positive association (r=0.322; β=0.29), and 2 did not report any association index. No data was available for the investigated subgroups or secondary clinical outcomes. DISCUSSION: Small associations were found between social support and clinical outcomes of individuals with NSCLBP. Further research is needed to establish its clinical relevance according to types of social support, sex, and gender.
Narrative Accounts of Youth and Their Mothers With Chronic Headache: Application of a Socio-narratology Framework to Pain Narratives.
Lund T, Neville A, Jordan A … +3 more , Carter B, Sumpton J, Noel M
Clin J Pain · 2024 Oct · PMID 39268725 · Publisher ↗
OBJECTIVES: This study was the first to apply a socio-narratology framework to the narratives about child pain as told by youth with chronic pain and their parents, all of whom experience chronic headaches. BACKGROUND: S...
OBJECTIVES: This study was the first to apply a socio-narratology framework to the narratives about child pain as told by youth with chronic pain and their parents, all of whom experience chronic headaches. BACKGROUND: Storytelling is a powerful social transaction that occurs within systems (eg, families, clinical encounters) and is both shaped by, and can shape, the pain experience. Narrative can be harnessed as a clinical tool to aid in the ability to listen, understand, and improve clinical encounters. METHODS: Twenty-six youth (aged 11 to 18 y) and their mothers, both with chronic headaches, recruited from a tertiary level pediatric pain clinic separately completed in-depth interviews about children's pain journey narratives. Data were analyzed using narrative analysis, which incorporated elements of socio-narratology to compare similarities and differences between and within dyads' narratives. RESULTS: Five narrative types were generated: (1) The trauma origin story-parents, but not youth, positing traumatic events as the causal link to children's pain; (2) mistreated by the medical system-neglect, harm, and broken promises resulting in learned hopelessness or relying on the family system; (3) the invalidated-invalidation of pain permeated youth's lives, with mothers as empathic buffers; (4) washed away by the pain-challenges perceived as insurmountable and letting the pain take over; and (5) taking power back from pain-youth's ability to live life and accomplish goals despite the pain. CONCLUSION: Findings support the clinical utility of narrative in pediatric pain, including both parents' and youths' narrative accounts to improve clinical encounters and cocreate more youth-centred, empowering narratives.
Comparing Pain Outcomes and Treatment Adherence Between In-Person and Virtual Interdisciplinary Pain Rehabilitation Programs at the San Francisco VA Health Care System.
Murphy E, Toor T, Palyo S … +4 more , Librodo S, Schopmeyer K, Simmons AN, Strigo IA
Clin J Pain · 2024 Nov · PMID 39263907 · Full text
OBJECTIVE: This study compared clinical pain outcomes between patients in a pain treatment program that was conducted in-person, compared with a virtual program. METHODS: In-person (N=127) and virtual (N=101) pain treatm...
OBJECTIVE: This study compared clinical pain outcomes between patients in a pain treatment program that was conducted in-person, compared with a virtual program. METHODS: In-person (N=127) and virtual (N=101) pain treatment programs were compared based on patient-reported, practitioner-collected, and medical record data. The patients were measured at baseline and post-treatment (week 12 for In-Person and week 8 for Virtual patients). We employed the last observation carried forward (LOCF) to handle missing data. RESULTS: Both the In-Person and Virtual groups were similar in regard to all baseline outcomes, except the In-person group having significantly more co-morbidities at baseline, with particularly more cases of mental, behavioral, or neurodevelopmental diseases. Both groups demonstrated significant improvements in the pain-related measurements of pain interference and pain catastrophizing thoughts, but neither group displayed a change in average pain across treatment. Further, both groups improved significantly on emotional well-being scores, but not on physical functioning scores. No significant differences existed between groups on outcomes, except for pain catastrophizing, which was higher in the Virtual group at both time points. The Virtual group had lower rates of dropouts compared with In-Person, while the In-Person group had a larger proportion reach a clinically meaningful change in pain-related outcomes, defined as a >30% improvement. DISCUSSION: While some changes were unique to the In-Person program, overall, patients in the Virtual program achieved similar treatment outcomes, suggesting that it can successfully treat Veterans seeking pain management, with less need for in-person facilities for both patients and clinicians.
Comparison of Cognitive Functions Between Individuals With Chronic Low Back Pain With High and Low Pain Catastrophizing and Pain-free Controls: A Cross-sectional Study.
Bakhshi Feleh F, Mofateh R, Orakifar N … +1 more , Lohrasbi S
Clin J Pain · 2024 Nov · PMID 39263903 · Publisher ↗
OBJECTIVES: Researchers suggested that the interruptive effects of chronic pain on cognitive functions may be modulated by the level of pain catastrophizing (PC). However, in individuals with chronic low back pain (CLBP)...
OBJECTIVES: Researchers suggested that the interruptive effects of chronic pain on cognitive functions may be modulated by the level of pain catastrophizing (PC). However, in individuals with chronic low back pain (CLBP), domains of cognitive function that may be affected by the level of PC remain largely unclear. Therefore, this study aimed to compare cognitive functions between individuals with CLBP with high and low PC and pain-free controls. MATERIALS AND METHODS: This cross-sectional study examined cognitive functions of 42 individuals with CLBP and 21 pain-free controls. The PC scale was used to stratify participants with CLBP into high and low PC. Participants performed 5 cognitive tests from the Cambridge Neuropsychological Test Automated Battery, namely 5-choice reaction time, rapid visual processing, spatial working memory, attention switching task, and stop signal task. RESULTS: The statistical analyses revealed that compared with individuals with CLBP with low PC and pain-free controls, individuals with high PC demonstrated greater values of the between errors ( P =0.01), reaction latency ( P <0.001), and stop signal reaction time variables ( P =0.004, 0.003, respectively) but lower values of probability of hit ( P =0.02, 0.01, respectively), A' ( P =0.01, <0.001, respectively), and percent correct trials variables ( P =0.002, <0.001, respectively). DISCUSSION: The results of the current study showed deficits in sustained attention, working memory, cognitive flexibility, and inhibitory control in individuals with CLBP with high PC. From a clinical perspective, therapeutic interventions targeting PC should be considered to decrease catastrophic thinking about pain in individuals with CLBP. Additional research is warranted to explore cognitive functioning as an outcome of these interventions in individuals with CLBP.
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