Characteristics Of Pain In Patients Research Articles

The association between anxiety and depression symptoms and clinical and pain characteristics in patients with hip and knee osteoarthritis

Objectives. This study aimed to estimate the prevalence of anxiety and depression symptoms and explore the association between these symptoms and clinical and pain characteristics in patients with chronic pain (CP) due to hip and knee osteoarthritis (OA). Methods. In this cross-sectional study, adult patients with CP and knee and/or hip OA were included. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale. Visual analogue scale, Western Ontario and McMaster Universities Arthritis Index (WOMAC) and PainDetect Questionnaire assessed pain characteristics and Health Assessment Questionnaire (HAQ) evaluated functional disability. Correlation coefficients were used to explore the associations between anxiety and depression symptoms and clinical and pain characteristics. Results. A total of 61 patients (age 66.2±9.4 years, 67.2% female) were included. Most patients (70.5%) had clinically significant anxiety and/or depression symptoms. Patients with anxiety and/or depression symptoms had higher pain severity (p=0.032) and disability (p=0.014). Depression symptoms had a moderate positive correlation with WOMAC physical function subscale (r=0.520), WOMAC total (r=0.511) and HAQ (r=0.405). Conclusions. Anxiety and depression symptoms are prevalent in knee or hip OA patients with CP and were associated with higher pain severity and functional disability. These findings support the screening of anxiety and depression symptoms in OA patients, in order to develop more effective multidisciplinary treatments.

ADHD-pain: Characteristics of chronic pain and association with muscular dysregulation in adults with ADHD.

A high incidence of attention-deficit hyperactivity disorder (ADHD) has been reported in chronic pain (ChP) patients. Furthermore, an association between ChP and muscular dysregulation has been reported in adults with ADHD. The present study investigated whether ADHD was more prevalent among psychiatric outpatients with ChP than those without ChP, and if there was an association between ChP, muscular dysregulation and characteristics of pain in patients with ADHD. One-hundred and twenty-one individuals remitted to an outpatient psychiatry unit took part in this naturalistic epidemiological cross-sectional study. They were assessed with a pain self-report form (localization, intensity, and onset) and a test of muscle dysregulation (the Motor Function Neurological Assessment). Prevalence of ADHD among patients with ChP, as well as the qualitative characteristics of ChP within the ADHDgroup are reported. Both ChP and pain intensity correlated with muscular dysregulation through Spearman's rho analysis. Additionally, the relationship between various diagnostic categories (ADHD, affective disorders, anxiety, or personality disorders) and incidence of axial pain was evaluated in logistic regression. ADHD was significantly more prevalent in patients with ChP, than in patients without ChP. In the ADHD group, ChP and pain intensity was associated with muscular dysregulation, particularly with high muscle tone. ChP was more axial and widespread, than for the patients without ADHD, and started at an early age. ADHD diagnosis predicted axial pain, whereas affective-, anxiety-, or personality disorders did not. The study suggests that ChP in ADHD is associated with muscular dysregulation and is qualitatively different from ChP in psychiatric patients without ADHD. These findings may lead to further understanding of potential mechanisms involved in ADHD and ChP, and in turn to new treatment strategies for both disorders.

Pain characterization in patients with Parkinson's disease.

Patients with Parkinson's disease (PD) often report chronic pain, which is one of the most complex non-motor symptoms. Therefore, this study aims to review the literature on the characteristics of pain in patients with PD. A systematic literature review was conducted following MOOSE recommendations. Observational studies reporting pain in patients with PD were included. No time restrictions were applied, but studies in Portuguese, Spanish, and English were considered. The search was performed in PubMed®, LILACS, and SciELO databases. Twenty-six articles of observational studies were identified, reporting an average pain prevalence of 67.36%, emphasizing the significance of this symptom in the PD population. Pain was reported in various body regions, including lower limbs, upper limbs, lumbar spine, cervical spine, and other joints. Pain classification varied, encompassing musculoskeletal pain, PD-related pain, neuropathic pain, and dystonic pain, among others. Pain in patients with PD is a prevalent and multifactorial condition, significantly impacting patients' quality of life. Heterogeneity in data across included studies was observed, highlighting the need for additional research to elucidate the underlying mechanisms of pain in patients with PD and develop effective therapeutic strategies to address this symptom and improve the quality of life for individuals living with the disease.

Prevalence and characteristics of pain in patients with lower-extremity ulcers-A cross-sectional study.

The study aimed to investigate the prevalence and characteristics of pain in different ulcer types and to identify factors associated with pain experience in patients with lower-extremity ulcers. A cross-sectional single-centre study was performed, including 130 newly referred outpatients with lower-extremity ulcers. Pain intensity was measured with a visual analog scale (VAS) and pain characteristics with the short form mcgill pain questionnaire-2 (SF-MPQ-2). The mean pain intensity was 29.5 (SD 31.8) at rest and 35.5 (SD 34.1) during movement (0-100 VAS). 61.5% of the patients experienced pain (VAS > 0) at rest and 70.8% during movement. Moderate to severe pain at rest was seen in 39.2% and in 43.8% of patients during movement. The mean total score on SF-MPQ-2 (range 0-220) was 35.9 (SD 32.6). Most of the patients described pain as intermittent (mean 11.8 SD 13.9). Analgesics were prescribed for 78% of the patients. Ulcer type (i.e., arterial, immunological, pressure and venous) and age were associated with pain severity, and women had a significantly lower well-being score than men. Prevalence of pain in patients with lower-extremity ulcers was high across different ulcer aetiologies. Pain intensity and quality must be assessed to obtain adequate pain management.

Pain Characteristics of Patients With Fibromyalgia: A Comparison Between Gender and Different Emotional States

BACKGROUND: Generalized pain is the core symptom of fibromyalgia (FM). Few studies have described FM’s different pain characteristics under various conditions. OBJECTIVE: To explore the pain characteristics of patients with FM of different gender and emotional states. STUDY DESIGN: A cross-sectional study. SETTING: A medical center in Beijing, People’s Republic of China. METHODS: A total of 197 patients with FM were recruited from an outpatient clinic. Three distinct instruments were used to assess their pain characteristics: the Numeric Rating Scale (NRS-11) to assess pain severity, the Widespread Pain Index (WPI) to assess the number of pain regions, and the Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2) to assess pain qualities. The Zung Self-Rating Anxiety Scale and Zung Self-Rating Depression Scale were used to assess patients’ emotional states. An independent 2-sample t test, chi-squared test, and Mann-Whitney U test were used to analyze gender pain characteristics differences and different emotional states (with/without anxiety, with/without depression). RESULTS: Pain severity on the NRS-11 was 7 (5–8), the number of pain regions determined by WPI was 13 (10–16), and the total score of different pain qualities from the SF-MPQ-2 was 2.36 (1.68–3.73) in all patients with FM. The most frequently reported regions of pain were the right shoulder girdle (89.34%), left shoulder girdle (88.32%), upper back (85.28%), and neck (81.73%). The most frequently reported pain qualities were tiredness/exhaustion (97.46%), aching pain (94.42%), numbness (78.68%), cold/freezing pain (75.63%), and tenderness (75.13%). Women patients reported more severe pain and numbness, less frequent chest pain, and shooting pain than men patients did. Patients with FM and anxiety experienced more frequent and more severe feelings of punishing/cruel thoughts, fearfulness, sickening, and tenderness; more frequent jaw pain and cold-freezing pain; more severe pain caused by light touch and tiredness/exhaustion; less frequent lower leg pain than those without anxiety did. Patients with FM and depression reported more frequent and more severe pain caused by light touch; more frequent tenderness; more severe feelings of tiredness/exhaustion, sickening,fearfulness, and punishing/cruel thoughts; and less frequent and less severe piercing pain than those without depression did. LIMITATIONS: The limitations of this study are its single-center design and lack of objective pain indicators. CONCLUSION: Gender significantly affected pain severity, chest pain, numbness, and shooting pain. Jaw pain, lower leg pain, cold/freezing pain, tenderness, pain caused by light touch, piercing pain, and pain-affective descriptors are closely related to emotional states in FM. A comprehensive understanding of pain characteristics in patients with FM would be helpful for disease education, diagnosis, and treatment. KEY WORDS: Fibromyalgia, men, women, anxiety, depression, pain severity, pain regions, pain quality

Main clinical characteristics of pain in patients with lumbosacral transitional vertebrae

Based on an analysis of modern medical literature, to study the main clinical characteristics of pain in patients with transitional lumbosacral vertebrae. A search was made for articles in the scientific electronic libraries CYBERLENINKA, eLIBRARY, Google Scholar, and the electronic database of biomedical publications PubMed. Sixty-eight scientific publications corresponded to the stated goal. The review of literature shows that the localization of pain in patients with transitional vertebrae corresponds to the zone of pseudarthrosis between the enlarged transverse process of the LV vertebra and the wing of the sacrum. In most patients, the pain is deep, not superficial. Pain intensity ranges from 3.0 to 8.4, reaching an average of 6.0 on the visual analog scale. Pain can radiate to one of the buttocks and the lower limb. The intensity of pain in the leg at the same time, on average, reaches 5.4 points. The pain syndrome can last for months, the course of the disease acquires a sluggish, undulating character with periodic exacerbations. The causes of exacerbations of pain may be excessive loads on the spine, concomitant vertebrogenic diseases and spinal injuries, excess weight, and in women, a history of pregnancy. Pain management can be either conservative or surgical. The scope of conservative treatment consists of using acupuncture and taking non-steroidal anti-inflammatory drugs. The greatest therapeutic effect is achieved with local injection therapy of analgesics and glucocorticoids at the neoarticulation point. The effectiveness of the course of therapeutic blockades reaches a period from several months to a year. The arsenal of surgical techniques includes pseudoartrectomy, radiofrequency denervation, minimally invasive endoscopic surgery, and transpedicular fusion. In most patients, after surgical treatment, complete relief of pain is noted. The review provides information on the predominant localization of pain in patients with transitional vertebrae, its nature, intensity, irradiation, duration, causes of exacerbation, as well as the effectiveness of the methods of conservative and surgical treatment.

Multimodal physiotherapy treatment based on a biobehavioral approach in a patient with chronic low back pain: A case report

<abstract> <p>Low back pain and its chronification are among the most common causes of disabilities worldwide. This is why multiple interventions and treatment approaches have been investigated around this pathology in recent years. Currently, the evidence is increasingly leaning towards treating chronic low back pain with a treatment based on the patient's centered biopsychosocial model. This case report presents the evaluation and treatment of a 43-year-old woman with chronic low back pain using a multimodal physiotherapy based on a biobehavioral approach. In the physiotherapy intervention, the patient's pain characteristics and somatosensory, motor-functional, and affective-cognitive states were first evaluated. Subsequently, a multimodal treatment including therapeutic exercise, pain neuroscience education, and orthopedic manual and physical therapies was applied for a total of 14 sessions over a period of 9 weeks. Finally, a post-intervention evaluation and at the one-month follow-up were carried out, in which it was observed that the treatment had significantly improved the patient's symptomatology and their general state. This case suggests that a multimodal physiotherapy treatment based on a biobehavioral approach is an effective option to improve pain symptoms and somatosensory, motor-functional, and affective-cognitive aspects in the reported patient; therefore, a treatment of these characteristics may be an option for patients with chronic low back pain.</p> </abstract>

Clinical analysis of qualitative and quantitative pain characteristics in patients with acute and chronic vertebrogenic lumbosacral pain syndromes

Diverse approaches exist for diagnosing and treating patients afflicted with acute and chronic low back pain syndromes (LBP), thereby necessitating a comprehensive evaluation of the pain syndrome and a meticulous analysis of the neuropathic component to enhance our scholarly comprehension of the distinct differences in pain progression among these individuals. A total of 125 individuals (56 females and 69 males) diagnosed with vertebral lumbar pain syndromes (LBP), aged between 20 and 68 years (42.8 ± 11.1 years), underwent comprehensive evaluation. Stratification into two distinct groups was based on the duration of the pain syndrome: an acute pain group (pain lasting up to 3 months) and a chronic pain group (pain persisting beyond 3 months). Pain assessment, administered upon hospitalization, involved utilizing of well-established tools such as the Visual Analogue Scale (VAS), DN4 Questionnaire, and McGill Pain Questionnaire. The initial pain intensity, measured by VAS upon admission, was recorded as 7.15 ± 1.17 in the acute pain group and 6.08 ± 0.96 in the chronic pain group. Analysis of responses to the DN4 questionnaire revealed that patients with acute pain syndrome obtained an average score of 2.26 ± 1.01, whereas those in the chronic pain group scored 4.53 ± 1.02. The presence of a neuropathic component was identified in 38 % of patients with acute pain and 56 % of patients with chronic pain. Correlational analyses indicated a weak positive correlation (r = 0.12, p < 0.05) between VAS scores and the assessment of neuropathic pain using the DN4 questionnaire in the acute pain group. However, the chronic pain group observed a moderate positive correlation (r = 0.41, p < 0.001). Patients experiencing chronic LBP expressed their pain sensations in a more emotionally descriptive manner. Notably, the chronic pain group exhibited a statistically significant elevation in the number of selected descriptors according to the Index of Chosen Descriptors (ICD) on the sensory scale, as well as an increased Pain Rank Index (PRI) on both sensory and affective scales, compared to the acute pain group. To summarize, individuals with chronic LBP exhibit a more prevalence of the neuropathic component. Moreover, patients in the chronic pain group demonstrated higher scores indicative of sensory and psychosocial aspects of pain. Key words: acute pain, chronic pain, neuropathic component of pain, verbal descriptors, McGill Pain Questionnaire

Do Chest Pain Characteristics in Patients with Acute Myocardial Infarction Differ between Those with and without Obstructive Coronary Artery Disease?

The universal definition of acute myocardial infarction (MI) requires both evidence of myocardial injury and myocardial ischaemia. In MINOCA (MI with non-obstructive coronary arteries), patients must fulfil this MI criteria, but is their chest pain similar to those who have MI with obstructive CAD (MICAD)? This study compares prospectively collected chest pain features between patients with MINOCA and MICAD. Utilising the Coronary Angiogram Database of South Australia (CADOSA), consecutive MI patients were categorized as MINOCA or MICAD based on angiographic findings. Chest pain data were collected via direct patient interviews by trained staff members. Of 6811 consecutive patients fulfilling a clinical MI diagnosis, 411 (6.0%) were MINOCA, and 5948 MICAD. The MINOCA patients were younger, more often female and had less cardiovascular risk factors than those with MICAD. There were no significant differences in chest pain characteristics between the MINOCA and MICAD cohorts in relation to pain location, quality, associated symptoms, or duration. In conclusion, MINOCA patients have chest pain characteristics that are indistinguishable from MICAD patients, suggesting that their pain is ischaemic in nature. Thus, in the presence of positive myocardial injury markers, ischaemic chest pain fulfils the universal criteria for MI, despite the absence of obstructive coronary artery disease.

PAIN IN DIABETES MELLITUS AND BRONCHOSCOPY PROCEDURES: BREAKTHROUGHS IN MANAGEMENT AND CARE

Overall, these two studies provide valuable insights into efforts to reduce pain burden in patients with diabetes mellitus and patients undergoing bronchoscopic procedures. In the context of diabetes mellitus, understanding the characteristics of pain in patients can help in better management. Meanwhile, the use of music as a non-pharmacological therapy in bronchoscopy procedures shows potential to reduce pain and anxiety in patients. However, further research is needed to gain a deeper understanding, as well as to overcome existing limitations, and provide optimal benefits for patients.

The Relationship Between Postoperative Patient-Reported Psychological Outcomes and Preoperative Pain Characteristics in Patients Who Underwent Periacetabular Osteotomy.

This study sought to investigate the relationship between multiple preoperative characteristics of pain (maximum pain severity location, the presence of pain in certain locations, the highest level of pain, and the number of pain locations) and psychological outcome measures as reported by patients. Fifty-four hips (50 patients) that underwent periacetabular osteotomy to treat acetabular dysplasia between February 2017 and July 2020 were reviewed using the Depression, Anxiety, and Stress Scale-21 (DASS21), Hospital Anxiety and Depression Scale (HADS), and Pain Catastrophizing Scale (PCS), radiographic analysis, and questionnaires concerning pain severity/location. Twenty-six hips had their worst pain in the groin, whereas 28 hips had greater or equal levels of pain at another location. There was no significant difference between these two locations on any of the postoperative psychological outcomes (HADS, P=.53; DASS21, P=.85; PCS, P=.97). Additionally, there was not a significant relationship between pain in any location other than the groin and any postoperative psychological outcomes (P≥.08). Finally, the highest level of preoperative pain and the number of locations of pain demonstrated no significant relationship with postoperative psychological outcomes (maximum severity: HADS, P=.28; DASS21, P=.49; PCS, P=.57; number of pain locations: HADS, P=.47; DASS21, P=.60; PCS, P=.35). Variance in preoperative pain location, severity, and number of pain locations seemingly does not result in any significant effect on postoperative psychological outcomes. Thus, a large range of patients with acetabular dysplasia may experience similar, favorable psychological outcomes from treatment with periacetabular osteotomy notwithstanding the characteristics of preoperative pain. [Orthopedics. 2024;47(1):28-33.].

Clinical characteristics of pain in patients with trigeminal neuralgia: data from a neurosurgical clinic

Among the pain syndromes caused by damage to cranial nerves, trigeminal nerve pathology occupies the main place. Trigeminal neuralgia is an exhausting condition characterized by acute shooting recurrent pain in the face. However, according to modern classification of facial pain types, there is also a distinction made for the second type of neuralgia, in which the mentioned pain alternates with dull, burning pain in the area of trigeminal nerve innervation. Numerous clinical and diagnostic criteria which can influence the results of surgical treatment of trigeminal neuralgia are being actively studied. However, the data varies both in terms of the number of criteria considered and the nature of the study, as well as the research outcomes.Objective ‒ to determine the demographic, clinical, and anatomical characteristics of patients with classical trigeminal neuralgia upon their admission in the neurosurgical ward for microvascular decompression of the trigeminal nerve.Materials and мethods. A retrospective analysis of medical data from 92 patients with trigeminal neuralgia, who were admitted to the Regional Clinical Center of Neurosurgery and Neurology from 2011 to 2023 was performed. The data included: patient's gender and age, type of neuralgia according to K. Burchiel and colleagues' classification (2009), involvement of trigeminal nerve branches, duration of pain prior to hospitalization, medication for conservative therapy and its dosage. Results. Trigeminal neuralgia most commonly affects elderly patients. This may be associated with systemic atherosclerotic vessel damage, leading to increased irritation by a denser vessel wall. Another cause of late disease manifestation may be gradual demyelination in the vicinity of the neurovascular conflict. Women are more likely to be affected than men. Right-sided trigeminal nerve involvement and the involvement of lower and upper jaw branches are more characteristic, with pain more frequently being paroxysmal in nature. In seven out of ten patients, the cause of neurovascular conflict is an artery, with the upper cerebellar artery being the most typical conflict.Conclusions. Demographic and clinical-diagnostic indicators vary among patients with trigeminal neuralgia. There are numerous variables that can influence the long-term effects of conservative and surgical treatment in patients with trigeminal neuralgia. A comprehensive assessment of these factors can identify a group of patients who are likely to have the most successful long-term treatment outcomes for trigeminal neuralgia.

Can Exercise Affect the Pain Characteristics in Patients with Fibromyalgia? A Randomized Controlled Trial.

Exercise is often recommended for fibromyalgia. The aim of this study was to investigate the possible influence and change in the pain characteristics of fibromyalgia patients when breathing exercises were added to their exercise program. A total of 106 patients were included and randomly divided into two groups. Τhe first group of patients followed a program of active exercises up to the limits of pain, lasting 30 min with a repetition of two times a week. Patients of the second group followed the same program with the addition of diaphragmatic breaths when they reached the pain limit. The patients completed three questionnaires: the Fibromyalgia Rapid Screening Tool (FiRST), the Brief Pain Inventory (BPI), and the Pain Quality Assessment Scale (PQAS)-once at the beginning, once again after three weeks of exercise, and again 3 months since the beginning of the program. Independent t-tests for the mean total change scores in pain scales demonstrated that for the second group there was a greater improvement in all pain scales, except for the PQAS Deep Pain subscale (p = 0.38). In conclusion, both groups showed significant improvement in all characteristics of the pain scales; however, the improvement of the second group was significantly higher.

Pain Characteristics in Patients with Inflammatory Bowel Disease: A Monocentric Cross-Sectional Study.

The abdominal pain common in inflammatory bowel disease [IBD] patients is traditionally associated with inflammation but may persist during clinical remission. Central sensitization [CS] has not previously been explored in these patients. This study aimed to determine the epidemiology of pain in IBD patients and to specify pain characteristics with particular attention to CS. This cross-sectional study included 200 patients; 67% had Crohn's disease [CD]. Pain was assessed using the McGill questionnaire, using the Douleur Neuropathique 4 [DN4] questionnaire and by clinical examination. Its impacts on quality of life, depression and anxiety were also assessed. Three-quarters of IBD patients complained of pain, including intermittent pain attacks, 62% reported abdominal pain and 17.5% had CS. The prevalence of pain [83.6% vs 59.1%; p < 0.001] and abdominal pain [68.7% vs 48.5%; p = 0.006] was higher in CD patients than in ulcerative colitis [UC] patients. Multivariate analysis confirmed that age [p = 0.02], sex [female] [p = 0.004] and CD [p = 0.005] were independent risk factors for pain. Pain intensity was greater in the case of CS (6 [5-3] vs 3 [1.5-5], p < 0.003) which significantly impaired quality of life [p < 0.003] compared with pain without CS. The prevalence of pain was high in IBD patients [≈75%] and higher in CD patients. Significant impacts on quality of life were confirmed. More than 25% of patients with abdominal pain described CS as responsible for more severe pain and worsened quality of life. NCT04488146.

The relationship between patient-reported outcomes and preoperative pain characteristics in patients who underwent total hip arthroplasty.

AimsThis study aims to answer the following questions in patients with hip osteoarthritis (OA) who underwent total hip arthroplasty (THA): are patient-reported outcome measures (PROMs) affected by the location of the maximum severity of pain?; are PROMs affected by the presence of non-groin pain?; are PROMs affected by the severity of pain?; and are PROMs affected by the number of pain locations?MethodsWe reviewed 336 hips (305 patients) treated with THA for hip OA from December 2016 to November 2019 using pain location/severity questionnaires, modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), international Hip Outcome Tool (iHOT-12) score, and radiological analysis. Descriptive statistics, analysis of covariance (ANCOVA), and Spearman partial correlation coefficients were used.ResultsThere was a significant difference in iHOT-12 scores between groups experiencing the most severe pain in the groin and the trochanter (p = 0.039). Additionally, more favourable mHHS scores were related to the presence of preoperative pain in trochanter (p = 0.049), lower back (p = 0.056), lateral thigh (p = 0.034), and posterior thigh (p = 0.005). Finally, the maximum severity of preoperative pain and number of pain locations had no significant relationship with PROMs (maximum severity: HHS: p = 0.928, HOS: p = 0.163, iHOT-12 p = 0.233; number of pain locations: HHS: p = 0.211; HOS: p = 0.801; iHOT-12: p = 0.112).ConclusionAlthough there was a significant difference in iHOT-12 scores between patients with the most severe pain in the groin or trochanter, and the presence of pain in the trochanter, lower back, lateral thigh, or posterior thigh was related to higher mHHS scores, the majority of preoperative pain characteristics did not have a significant impact on outcomes. Therefore, a broad array of patients with hip OA might expect similar, favourable outcomes from THA notwithstanding preoperative pain characteristics.Cite this article: Bone Jt Open 2022;3(4):332–339.

Use of the painDETECT to discriminate musculoskeletal pain phenotypes

BackgroundMusculoskeletal pain patients present similar pain characteristics regardless of the clinical diagnosis. PainDETECT questionnaire is useful for screening neuropathic-like symptoms in many musculoskeletal conditions. However, no previous studies compared pain phenotypes of patients with musculoskeletal pain using the painDETECT. Therefore, the current study aimed to compare the pain characteristics of patients with musculoskeletal pain classified according to the painDETECT as nociceptive pain, unclear, and neuropathic-like symptoms.MethodsA cross-sectional study was conducted in 308 participants with musculoskeletal pain. Demographic and clinical characteristics of the participants were examined. Neuropathic-like symptoms, pain intensity, pain area, Central Sensitization-related sign and symptoms, functional limitation, and conditioned pain modulation were assessed in patients with musculoskeletal pain. Independent one-way analysis of variance (ANOVA) was used to test for between-group differences for the outcome measures with continuous variables and Pearson chi-square test verified between-group differences on the efficiency of the conditioned pain modulation.ResultsParticipants had a mean age of 52.21 (±15.01) years old and 220 (71.42%) were females. One hundred seventy-three (56.16%) participants present nociceptive pain, 69 (22.40%) unclear, and 66 (21.42%) neuropathic-like symptoms. A one-way ANOVA showed differences for the pain intensity [F (2,305) = 20.097; p < .001], pain area [F (2,305) = 28.525; p < .001], Central Sensitization-related sign and symptoms [F (2,305) = 54.186; p < .001], and functional limitation [F (2,256) = 8.061; p < .001]. However, conditioned pain modulation was similarly impaired among the three groups (X2 = 0.333, p = 0.847).ConclusionPatients with neuropathic-like symptoms revealed unfavorable pain characteristics compared to their counterparts, including pain intensity, generalized pain, Central Sensitization-related sign and symptoms, and functional limitation.

Is Increased Intracranial Pressure a Factor in Persistent Headache After Coronavirus Disease 2019?

This study aimed to determine pain characteristics in patients with persistent headache after COVID-19 and to investigate the role of increased intracranial pressure (ICP) in the pathogenesis of this headache. This is a case-control study comparing the parameters and measurements indicating increased ICP based on magnetic resonance imaging between COVID-19–diagnosed patients with persistent headache and a control group. Optic nerve sheath diameter (ONSD) and eyeball transverse diameter (ETD) were performed on the left eye of each participant. Seventeen of the patients (53.12%) met the diagnostic criteria for new daily persistent headache. Seven patients (21.87%) had migraine, and eight (25%) had tension headache characteristics. No significant difference was observed between the patient and control groups in terms of the ONSD and ETD values. It is possible that the etiopathogenesis is multifactorial. We consider that future studies that will evaluate ICP measurements in large patient groups can present a different perspective for this subject.

Prevalence and characterization of pain in patients with Charcot-Marie-Tooth disease type 1A.

Charcot-Marie-Tooth disease type 1A (CMT1A) is the most common form of hereditary neuropathy. To investigate the prevalence and characteristics of pain in patients with CMT1A. Nineteen patients with a diagnosis of CMT1A were evaluated between September 2018 and October 2019, and other causes of neuropathy were ruled out. The following tools were used for the pain assessment: neurological assessment, LANSS, DN4, clinical evaluation, VAS, CMTNS2 and SF-36. Statistical analysis was performed using prevalence analysis, t test, chi-square test and Spearman's rho. The prevalence of pain was 84.2% in the sample of this study, with moderate intensity and nociceptive characteristics according to the LANSS scale (75%) and clinical evaluation (50%), but differing from DN4, which found neuropathic pain in the majority of the patients (56.2%). Mixed pain was also observed in 43.7% of the patients, according to clinical criteria. There was a statistically significant correlation between pain intensity and SF-36, thus demonstrating that the lower the pain was, the lower the impairment was, in all domains. Pain is a prevalent and important symptom in CMT1A, with moderate intensity and nociceptive characteristics according to two tools, but neuropathic pain is also present, and there may even be a mixed pattern of pain. The correlation of the pain with SF-36 suggests that pain relief could provide improvements to the quality of life of these individuals.

Pain characteristics in amyotrophic lateral sclerosis patients and its impact on quality of life: a prospective observational study in a northern city of China

Pain in amyotrophic lateral sclerosis (ALS) has a considerable impact on the quality of life of both patients and their caregivers, and thus the identification and evaluation of pain characteristics in ALS should be addressed. However, due to the scarcity of research data, pain in ALS is still frequently underestimated and insufficiently treated. The aim of this study was to investigate the characteristics of pain in patients with ALS using standardized pain questionnaires. Eighty-nine patients diagnosed with ALS were interviewed. Consecutive patients with peripheral neuropathy were used as control subjects and were matched to the ALS subjects by age and sex. Patient data including gender, age, the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score, and the pain severity index (PSI) were collected. The characteristics between ALS and peripheral neuropathy, and between ALS patients with and without pain were compared. In all, 89 patients with ALS and 89 control subjects with peripheral neuropathy were included. There were no significant differences in sex ratio and age between the two groups. There were significantly more patients with pain symptoms in the ALS group (35/89, 39%) than in the peripheral neuropathy group (20/89, 22%). Quality of life was significantly affected in the ALS patients with pain (using ALS patients without pain as control subjects). The results suggested that pain was a significant symptom in patients with ALS and had a considerable impact on quality of life.

Typical Pain Patterns in Unhappy Patients After Total Knee Arthroplasty

BackgroundThe primary aim of this study is to assess characteristics of pain in patients with ongoing pain after total knee arthroplasty (TKA). The secondary aim of this study is to identify specific pain patterns and link these to underlying pathologies. MethodsA prospectively collected cohort of 97 painful primary TKA patients was retrospectively evaluated. All patients followed a standardized diagnostic algorithm, which led to a diagnosis that set the indication for revision surgery. Character, location, dynamics, and radiation of pain were systematically assessed and correlated with the underlying pathologies. ResultsMost frequent pain characters were pricking/lancinating (45.7%), pinching/crushing, and dull/heavy (38.6%); 89.5% of all patients localized their knee pain anteriorly; 48.1% reported pain aggravations by descending stairs. Radiating pain was reported in 14% of the patients. Patella-related problems (56.7%) and instability (52.6%) were the most frequent pathologies. Based on correlations between the characteristics 6 specific pain patterns were identified. The most outstanding ones include the following: pattern 1, instability is associated with jumping/shooting, pricking/lancinating and tugging/wrenching pain, and aggravated by chair raising and starting; pattern 6, pain aggravation by descending stairs is associated with anterior and lateral jumping/shooting, tingling/stinging and sharp/lacerating pain character, and TKA positioning and patella baja. ConclusionThe assessment of painful TKA patients involving specific pain patterns help to further differentiate and define the clinical picture and ultimately the cause of a painful TKA. If the causes of the described complaints are known, a decision for a therapy can be made reliably and sustainably at an early stage before the state of pain becomes chronic.